Fatal Case Of Disseminated Infection Research Articles

High-throughput sequencing of Strongyloides stercoralis - a fatal disseminated infection in a dog.

The rhabditid nematode Strongyloides stercoralis is known worldwide as the causative agent of strongyloidiasis in humans. In addition to public health concerns, S. stercoralis also infects dogs, which represent a possible reservoir for potentially zoonotic transmissions. We describe the first confirmed case of fatal disseminated infection in a dog in the Czech Republic. The microscopic and histological results were supported by a complex genotyping approach. Using high-throughput sequencing of the hypervariable region (HVR-IV) of 18S rDNA and Sanger sequencing of the partial cytochrome c oxidase subunit 1 gene (cox1), the potentially zoonotic haplotype/lineage A of S. stercoralis was confirmed, while the solely canine haplotype/lineage B was not found. The development of the disease is mainly associated with immunodeficiency, and in this case, it was triggered by inappropriate treatment, in particular the use of corticosteroids.

Fatal Disseminated Pseudomonas Aeruginosa Infection in a Captive Green Iguana (Iguana iguana)

Abstract Infections with various bacteria, especially gram-negative aerobes, are a well-recognized problem in captive cold-blooded animals with immunocompromised health status, or in those kept under poor conditions. Pseudomonas is one of the most represented genera. Here, we present a case of fatal disseminated infection caused by Pseudomonas aeruginosa in a captive green iguana kept at the “Pionirska dolina” Zoo in Sarajevo, Bosnia and Herzegovina. At necropsy, severe stomatitis, pneumonia, hepatitis and nephritis, accompanied with focally extensive dermatitis were observed. Histopathology revealed multifocal necrosis in various visceral organs. Culture and subsequent MALDI-TOF MS analysis were conducted to identify the isolate as P. aeruginosa. Antimicrobial susceptibility testing revealed a wide susceptibility of the isolate, however applied therapy was instilled too late in the presented case. This case demonstrates the significance of timely and accurate identification, and antimicrobial susceptibility testing of bacterial isolates implicated in the pathology of captive reptiles. The importance of monitoring the adequate environmental conditions (enclosure temperature, humidity and conformation), health status and possible clinical signs of illness are highlighted.

Breakthrough disseminated Saprochaete capitata infection in a child with acute myeloid leukaemia receiving caspofungin therapy

Introduction: We present a fatal case of disseminated infection in a child with leukaemia, caused by Saprochaete capitata, an ascomycetous yeast. Case presentation: The aetiological role of disseminated infection by S. capitata in a child with relapsed acute myeloid leukaemia following bone‐marrow transplantation was established by its repeated isolation from blood, tracheal secretion and urine samples. The identity of S. capitata was confirmed by phenotypic and molecular methods. The isolate showed reduced susceptibility to caspofungin. Conclusion: This report indicates that patients receiving echinocandin prophylaxis are at risk of breakthrough infections caused by S. capitata or other arthroconidial yeast species. To the best of our knowledge, this is the first well‐documented case of S. capitata infection from the Middle East.

Fatal Subacute Myocarditis Associated with Human Bocavirus 2 in a 13-Month-Old Child

Human bocavirus has rarely been incriminated in fatal or life-threatening respiratory infections. We report a case of fatal disseminated infection with subacute lymphocytic myocarditis in a 13-month-old child. The human bocavirus 2 genome was detected by PCR analysis in nasal swab, plasma, urine, ascitic fluid, and mesenteric node, skeletal muscle, and lung tissue specimens.

FatalNocardia farcinicaBacteremia Diagnosed by Matrix-Assisted Laser Desorption-Ionization Time of Flight Mass Spectrometry in a Patient with Myelodysplastic Syndrome Treated with Corticosteroids

Nocardia farcinica is a Gram-positive weakly acid-fast filamentous saprophytic bacterium, an uncommon cause of human infections, acquired usually through the respiratory tract, often life-threatening, and associated with different clinical presentations. Predisposing conditions for N. farcinica infections include hematologic malignancies, treatment with corticosteroids, and any other condition of immunosuppression. Clinical and microbiological diagnoses of N. farcinica infections are troublesome, and the isolation and identification of the etiologic agent are difficult and time-consuming processes. We describe a case of fatal disseminated infection in a patient with myelodysplastic syndrome, treated with corticosteroids, in which N. farcinica has been isolated from blood culture and identified by Matrix-Assisted Laser Desorption-Ionization Time of Flight Mass Spectrometry. The patient died after 18 days of hospitalization in spite of triple antimicrobial therapy. Nocardia farcinica infection should be suspected in patients with history of malignancy, under corticosteroid therapy, suffering from subacute pulmonary infection,and who do not respond to conventional antimicrobial therapy. Matrix-Assisted Laser Desorption-Ionization Time of Flight Mass Spectrometry can be a valuable tool for rapid diagnosis of nocardiosis.

Fatal Disseminated Cryptococcus gattii Infection in New Mexico

We report a case of fatal disseminated infection with Cryptococcus gattii in a patient from New Mexico. The patient had no history of recent travel to known C. gattii-endemic areas. Multilocus sequence typing revealed that the isolate belonged to the major molecular type VGIII. Virulence studies in a mouse pulmonary model of infection demonstrated that the strain was less virulent than other C. gattii strains. This represents the first documented case of C. gattii likely acquired in New Mexico.

Fatal Bacillus cereus Meningoencephalitis in an Adult With Acute Myelogenous Leukemia

Bacillus cereus, a ubiquitous, endospore-forming, aerobic gram-positive bacillus, is primarily associated with toxin-mediated food poisoning. Frequently, isolates of Bacillus species from clinical specimens are discussed as contaminants. We report a rapidly fatal case of disseminated infection due to B cereus in a patient receiving induction chemotherapy for M0 acute leukemia. A short clinical syndrome of nausea and vomiting preceded neurologic symptoms. Autopsy showed extensive meningoencephalitis with subarachnoid hemorrhage and multiple liver abscesses. Areas of necrosis were devoid of any inflammatory response consistent with a severely immunocompromised state. The organism was isolated from immediate premortem and autopsy blood specimens. This case illustrates the possibility and severity of true B cereus infections in immunocompromised patients, the clinicopathologic features of which are as yet not well defined.

Disseminated infection withConidiobolus incongruus

The first fatal case of disseminated infection due to Conidiobolus incongruus is reported. The patient presented with a subcutaneous mass, febrility, weight loss, cough and hemoptysis. Histological examination of skin and subcutaneous tissue, lung, lymph nodes, esophagus, liver and jejunum showed a granulomatous reaction with bright eosinophilic amorphous material and broad hyphae. A fungus cultured from skin and subcutaneous tissue was identified as Conidiobolus incongruus.