Mycobacterium senegalense Infection in Kidney Transplant Patient with Diabetes, Memphis, Tennessee, USA.

Fewer than 30 cases of Mycobacterium senegalense infection have been reported. We report a complicated case of M. senegalense infection in Memphis, Tennessee, in the southeastern United States. The patient's comorbidities of past organ transplant and insulin-dependent diabetes required delicate consideration of those health conditions to guide treatment.

Streptococcus pneumoniae-associated pneumonia, meningitis, and endocarditis: a case of Austrian syndrome.

Streptococcus pneumoniae is the leading cause of hospitalization in cases of community-acquired pneumonia and meningitis in adults. It is also an uncommon cause of endocarditis in the antibiotic era. The occurrence of these three entities in one individual is rare, forming a triad termed Austrian syndrome.

Scedosporium apiospermum infection presenting as a pneumothorax and cavitary lung lesions in a patient with acquired immune deficiency syndrome.

The Scedosporium genus consists of filamentous fungi that inhabit soil, sewage, manure, and polluted waters, and contains two medically important species: Scedosporium apiospermum and Scedosporium prolificans. Scedosporiosis is caused by inhalation or traumatic subcutaneous implantation of the organism, and may have varied clinical presentations. A variety of pulmonary manifestations can occur, but to our knowledge, pneumothorax as initial presentation has not been reported. Treatment may be difficult, as the disease occurs more commonly in immunocompromised patients, and the organism may demonstrate resistance to various antifungal agents. We describe successful treatment of extensive pulmonary disease due to S apiospermum in a patient with acquired immune deficiency syndrome (AIDS).

Bordetella bronchiseptica bacteremia in a patient with AIDS.

Bordetella bronchiseptica bacteremia is often associated with various infection in animals. The majority of B bronchiseptica infections reported in humans are cases of pneumonia. Very few cases have been reported in patients with a history of acquired immune deficiency syndrome (AIDS). The patient described herein, who had a history of AIDS, was likely infected with B bronchiseptica as a result of his hemodialysis catheter. The patient was successfully treated with antibiotics without the removal of the catheter.

Cedecea davisae bacteremia in a neutropenic patient with acute myeloid leukemia.

Cedecea are the new members of Enterobacteriacea. Because of their inherent resistance to some antibiotics, the clinical response could be unpredictable making management of Cedecea infection in immunocompromised patients challenging. We report a case of acute myeloid leukemia with central line-related Cedecea bacteremia.

Cryptococcal meningitis after neurosurgery.

Infection caused by Cryptococcus neoformans can affect a variety of patient populations from the immunocompetent host to those who are severely immunocompromised. Although the clinical presentation can vary, there is a predilection for invasion of the central nervous system. Cryptococcal meningitis is the most common neurologic manifestation. The authors describe a case of an immunocompetent patient who presented with cryptococcal meningitis after a neurosurgical procedure.

Mycobacterium gordonae pulmonary infection in an immunocompetent adult.

CONTEXT: Nontuberculous mycobacteria are non-communicable organisms and currently there are over 125 species. Nontuberculous mycobacteria are usually recovered from the environment and can cause disease through respiratory, cutaneous, parenteral and gastrointestinal exposure. CASE REPORT: We describe a case of a young, immunocompetent patient that developed symptomatic Mycobacterium gordonae pulmonary infection. A computed tomography of the chest revealed hilar lymphadenopathy and nodular densities on the left side. Definitive diagnosis was made by a culture of a transbronchial biopsy. Treatment consisted of a short course of rifampin and ethambutol, which resulted in a clinical and radiographic improvement. CONCLUSIONS: Mycobacterium gordonae is capable of causing clinically significant disease in both immunocompetent and immunosuppressed individuals.

Lingual leishmaniasis complicating visceral disease.

Leishmania species are obligate intracellular parasites transmitted by various types of female sand flies. The clinical syndrome that results depends on a number of factors including the Leishmania species and immune response of the host. Here, we report successful treatment of lingual leishmaniasis complicating visceral disease in an immunocompetent patient.