[Mesenteric abscess due to Chryseobacterium meningosepticum revealing mesenteric Castleman´s disease in an immunocompetent young adult]. / Abcès mésentérique du au Chryseobacterium meningosepticum révélant la maladie de Castleman à localisation mésentérique chez un jeune adulte immunocompetent.

Mesenteric abscess caused by chryseobacterium meningosepticum is an extremely rare clinical entity, most often found in immunodeficient patients. Castleman disease can manifest as a mesenteric abscess. We here report the case of a 23-year-old patient admitted with generalized acute peritonitis evolving over the last 2 weeks. Abdominal ultrasound showed hypoechoic mass in the intestinal loops, without any further details. During laparotomy, pus was found in the large cavity, a mesenteric abscess was detected in the mesentery of the jejunum 35 cm from the angle of Treitz, without loop perforation and mesenteric adenopathy was found in corresponence with the abscess. Pyoculture isolated chryseobacterium meningosepticum. Histological analysis of mesenteric adenopathy biopsies showed structural anomalies, suggesting hyaline vascular type of Castleman disease. Treatment was based on incision and drainage of the abscess, with pyogenic membrane removal and abdominal cavity lavage with physiological saline solution. Chryseobacterium meningosepticum was only susceptible to Ciprofloxacin. The postoperative course was simple and the patient was discharged on postoperative day 10 after surgery. Clinical and paraclinical follow-up at 12 months did not show any other lymphadenopathy or recurrence. The purpose of this study is to show an extremely rare case of mesenteric abscess due to chryseobacterium meningosepticum associated with isolated mesenteric Castleman disease in an immunocompetent patient and management approaches.

A case of infective endocarditis mimicking a large mesenteric abscess.

Infective endocarditis (IE) demonstrates a broad array of clinical presentations and complications. However, IE with prominent abdominal findings is uncommon. We encountered a case of IE caused by Staphylococcus aureus that presented a large mesenteric abscess and was initially diagnosed as an intra-abdominal infection. There are few reports of IE with mesenteric abscess formation. Even if an intra-abdominal abscess is the main symptom, the possibility that it is part of a systemic infection should be considered if the causative organism is atypical or if symptoms are present in multiple organs. Physicians should always be aware of the possibility that IE may mimic other diseases, including intra-abdominal infections.

Mesenteric abscess caused by coinfection with Bacillus Calmette-Guérin and Phialemonium sp. in chronic granulomatous disease.

Opportunistic infections are life-threatening conditions in immunocompromised patients including those with primary immunodeficiency. We describe a case of X-linked chronic granulomatous disease presenting with mesenteric abscess caused by a coinfection with Bacillus Calmette-Guérin (BCG) and Phialemonium sp. The patient received BCG vaccination at 5 months old. He developed left axillary BCG lymphadenitis at 17 months of age, and 3 months later mesenteric abscess occurred. Concomitant use of rifampicin and itraconazole at 17 months of age might have reduced serum itraconazole concentrations and led to superinfection with Phialemonium sp. in our patient, which was susceptible to itraconazole and voriconazole in vitro. The patient was successfully treated with a combination of isoniazid, rifampicin, streptomycin, ciprofloxacin, prednisolone, interferon-γ, and an increased dose of itraconazole, followed by hematopoietic stem cell transplantation. Our results suggest that clinician need to be aware of rifampicin drug interactions, and that precise detection and identification of pathogens are essential to appropriate treatment.

Perforated Meckel's Diverticulum Masquerading as a Mesenteric Abscess Related to Umbilical Piercing: An Unusual Cause of Acute Abdomen.

Perforated Meckel's diverticulum (MD) is a rare cause of acute abdomen in adults. We describe the case of a 32-year-old man presenting with worsening abdominal pain three weeks following the piercing of his umbilicus. Computed tomography of the abdomen and pelvis demonstrated a small mesenteric collection intimately related to the recently placed navel ornamentation, and a preliminary diagnosis of intra-abdominal abscess secondary to an infected umbilical piercing was made. Initial conservative management with antibiotic therapy was unsuccessful. Subsequent open surgical approach demonstrated an inflamed, perforated Meckel's diverticulum with a small, adjacent infected collection separate from, but in close proximity to the belly-button foreign body. The patient was successfully treated with small bowel resection and followed an uneventful postoperative course.

A case of intra-abdominal abscess caused by unconsciously ingestion of fish bone in elderly patient / 고신대학교의과대학학술지

Cases showing complications such as esophageal injury, deep neck infection, and mediastinitis caused by accidental ingestion of fish bone are common. But ingestion of fish bone rarely causes perforation of the gastrointestinal tract or an intra-abdominal abscess. We report herein a case of a 78-year-old man with a periumbilical mesenteric abscess caused by fish bone which was ingested unconsciously. The fish bone was found in the terminal ileum and it was removed by colonoscopy. The patient improved and he was discharged after systemic antibiotic therapy. Occasionally, when patients swallow fish bone without a foreign body sensation, clinicians should suspect perforation caused by fish bone in case of an intra-abdominal abscess of unknown cause.