Short Clinical Course Research Articles

Leptomeningeal carcinomatosis in BRCA-mutated pancreatic cancer.

239 Background: Pancreatic adenocarcinoma is a rapidly fatal cancer with 5-year overall survival <5%. 5-10% of pancreatic cancers occur in patients with family history of disease, and 5-27% of these familial cancers are BRCA associated, with defects in Homologous Recombination Repair (HRR). In breast and ovarian cancer, BRCA mutations may be associated with increased risk for brain metastasis (BM). BM is rare in pancreatic cancer, but it is suggested HRR deficient pancreatic cancer patients may have an increased risk for BM/LC. Methods: We analyzed 3030 prospectively identified patients with pancreatic cancer and HHR mutation germline sequencing data (BRCA1/2, ATM, PALB2) from the Mayo Clinic Pancreatic Cancer SPORE Registry. We used clinical databases (2000-2018) to assess the presence of BM or leptomeningeal carcinomatosis (LC). Unconditional logistic regression analysis, with Odds Ratio (OR) and 95% Confidence Interval (CI), assessed the association between HRR gene germline mutation carrier status and any BM. Results: Of 3030 total pancreatic cancer patients, 8 were diagnosed with clinically evident BM/LC (0.26%), confirming the very low incidence of this metastasis site (Table). Of these, all had BM, and 4 also had LC present. No patients had LC diagnosed without BM present. 175/3030 (5.8%) patients had a germline HHR gene mutation. Of these, 1 patient was a BRCA2 carrier (0.57% of HRR deficient patients). 7 /2763 (0.25%) patients without germline HRR mutations had BM or LC (p = 0.44, OR 2.26; 95% CI: 0.27, 18.49). Conclusions: To our knowledge, this is the largest review of BRCA-associated pancreatic cancer patients with BM or LC. The incidence of BM is rare at 0.27%, with LC at 0.14%. Limitations include likely underdiagnosis given short clinical course and lack of availability of somatic HRR gene status. Our study suggests HRR germline carrier patients may have an increased risk of BM/LC development compared to non-carriers. Given rarity, larger studies should be explored. [Table: see text]

The improvement in neurocognitive functioning in anorexia nervosa adolescents throughout the integrative model of psychotherapy including cognitive remediation therapy

BackgroundPatients with anorexia nervosa (AN) experience difficulties in neurocognitive functioning in the acute phase of illness which might be related to clinical presentation, but also in the apparently remitted state after weight recovery. Among the most commonly reported persistent deficits is cognitive inflexibility, which can be interpreted as a vulnerability trait or a “neuropsychological scar” reflecting the detrimental effect of prolonged semi-starvation in patients with a long duration of illness. Studies of adolescent samples with a relatively short clinical course may enable avoiding the effect of prolonged illness and help to determine whether neuropsychological deficits are trait or state dependent.The aim of this study is to assess cognitive functioning in adolescents with AN before and after the inpatient treatment programme, including cognitive remediation therapy (CRT).MethodsForty-seven adolescent female inpatients with AN diagnosed according to DSM-5 and fifty healthy female adolescents matched for the education level and age were recruited. The patients underwent a multimodal treatment including a ten-week CRT. The standardized and cross-validated neuropsychological (Trail Making Test – TMT A and B, Color-Word Stroop Task – CWST, Ruff Figural Fluency Test – RFFT) and clinical measurements (Beck Depression Inventory – BDI, Eating Attitude Test – EAT-26, Yale-Brown Obsessive Compulsive Scale – Y-BOCS) were used to assess both clinical (in the acute phase and after partial weight recovery) and control subjects.ResultsInitially, AN patients performed significantly worse compared to the controls, but afterwards, inpatient treatment improvement was noted on all examined measures. In a few subtests (TMT, CWST) performance of AN patients after the programme was still significantly poorer than in HC.ConclusionsCognitive inflexibility in adolescent AN patients, as measured with TMT, CWST, and RFFT tends to improve after therapy. Nevertheless, a few neuropsychological subtests which did not show complete normalization may warrant attention in subsequent studies. Further research including control intervention is needed to conclude whether CRT intervention affects the outcome.

Aggressive natural killer cell leukemia or extranodal NK/T cell lymphoma? a case with nasal involvement

BackgroundAggressive natural killer cell leukemia/lymphoma (ANKL) is a rare and highly aggressive NK cell neoplasm with a short clinical course and poor prognosis and is often misdiagnosed and confused with NK/T cell lymphoma (NKTL), which has a very different prognosis. Here, we present a case with nasal and bone marrow involvement, provide a literature review and make a differential diagnosis.Case presentationA 41-year-old male presented nasal congestion pharyngalgia, palatal perforation, high fever and multiorgan dysfunction. Our diagnosis primarily relied on clinical features, the morphology and immunophenotype of the neoplastic cells and imaging studies. Characteristic large granular lymphocytes with azurophilic granules were visible in the bone marrow smears. In addition, the neoplastic cells expressed a typical immunophenotype, and the T cell receptor γ (TCR-γ) gene rearrangement analysis and presence of Epstein-Barr virus (EBV) were negative. The patient’s symptoms and signs were temporarily relieved after chemotherapy treatment, but after a short time, he underwent a rapid clinical decline and died 8 weeks later after admission due to multiorgan function failure.ConclusionOur case demonstrates that to avoid a misdiagnosis, bone marrow analyses and other examinations should be performed early when a patient initially presents nasal lesions and other systemic symptoms. To the best of our knowledge, this may be the first reported case of ANKL with sternal tenderness.

Axonal TDP-43 aggregates in sporadic amyotrophic lateral sclerosis.

Axonal aggregates of phosphorylated (p-) transactive response DNA-binding protein 43 kDa (TDP-43) in sporadic amyotrophic lateral sclerosis (sALS) were examined in relation to propagation of the protein in the nervous system. Brains and spinal cords of Japanese patients with sALS and control subjects were examined immunohistochemically using formalin-fixed paraffin-embedded specimens with special reference to the topographical distribution, microscopic features, presynaptic aggregates, and correlation between the aggregates in axons and the clinical course. (i) Aggregates of p-TDP-43 were frequently present in axons of the hypoglossal and facial nerve fibres and the spinal anterior horn cells. (ii) Aggregates of p-TDP-43 in the axons showed two characteristic microscopic features - dash-like granuloreticular aggregates (GRAs) and massive aggregates (MAs). (iii) MAs were surrounded by p-neurofilaments, but p-neurofilament immunnoreactivity decreased at the inside of axons with GRAs. (iv) Patients showing MAs and GRAs had a relatively shorter clinical course than patients without the aggregates. (v) Some neurones in the red nucleus in patients were surrounded by synapses containing p- and p-independent (i)-TDP-43, and almost all neurones had lost their nuclear TDP-43 immunoreactivity; 17% of those neurones in the red nucleus also had TDP-43-immunopositive neuronal cytoplasmic inclusions, but no postsynaptic p-TDP-43 deposition was evident. There are two types of axonal p-TDP-43 aggregates, MAs and GRAs, located predominantly in the facial and hypoglossal nuclei and anterior horn cells. These aggregates may influence the function of neurones, and presynaptic aggregates of the protein induce loss of p-i-TDP-43 in the nuclei of postsynaptic neurones.

Infectious canine hepatitis in red foxes (Vulpes vulpes) in wildlife rescue centres in the UK

Outbreaks of infectious canine hepatitis are described in red foxes (Vulpes vulpes) at two wildlife rescue centres in the UK. Disease occurred in two-month-old to four-month-old juvenile foxes, which were...

De Novo Philadelphia Positive Acute Myeloid Leukemia with Extensive Basophilia: A Diagnostic Dilemma.

Basophilia in peripheral blood as well as bone marrow is an unusual finding, seen in certain reactive and neoplastic conditions. Amongst the malignant hematological diseases, it is a diagnostic hall mark of chronic myeloproliferative disorders, particularly, chronic myeloid leukemia. Basophilia may also be seen in cases acute myeloid leukemia, particularly FAB AML M2 and M4. Here we document an interesting case of de novo acute myeloid leukemia which had extensive peripheral blood and bone marrow basophilia. Molecular analysis revealed p190, bcr-abl fusion transcript. A short clinical course, absence of organomegaly and features suggestive of an underlying myeloproliferative disorder, aided in establishing a diagnosis of Philadelphia positive de novo acute myeloid leukemia.

Characterization of surfactant alterations in pigs infected with Actinobacillus pleuropneumoniae

ABSTRACTPurpose/Aim of the study: Surfactant, a surface active complex of phospholipids and proteins located at the inner surface of alveoli and small conducting airways is necessary for breathing. Bacterial respiratory tract infections frequently lead to surfactant alterations and to an increase in surface tension. Pigs, often used in experimental lung research, could suffer from severe pleuropneumonia, a highly contagious disease often characterized by sudden onset, short clinical course, high morbidity, and high mortality. It is caused by the gram-negative bacterium Actinobacillus pleuropneumoniae (A.pp.). This study tests the hypothesis that also in the subacute stage pathomorphological lung alterations are accompanied with increased inactive surfactant components. Clinical lung scores, functional and ultrastructural analysis of porcine surfactant were performed in pigs before infection and in the subacute state of infection. Clinical signs were determined using inter alia different subscores. Surfactant was isolated from the BALF for functional and quantitative ultrastructural studies. Results: In the subacute stage clinical, ultrosonographic and radiographic scores as well as the overall Respiratory Health Score showed significantly higher values than before infection. However, surfactant surprisingly contained more active surfactant subtypes and significantly less inactive subtypes such as unilamellar vesicles. The quantity of multilamellar vesicles with unclear function did not differ. The minimal surface tension of surfactant before and after infection was comparable. Conclusions: Thus, in spite of continued severe lung tissue alterations the surfactant system show signs of recovery. This may be the result of an effective adaption to inflammatory lung disorders caused by swine-specific pathogens.

Clinical course of persistent geotropic direction-changing positional nystagmus with neutral position—Light cupula

Conclusion: A short clinical course and frequent recurrence are common features of persistent geotropic direction-changing positional nystagmus with neutral position (positional nystagmus of light cupula: PNLC) and cupulolithiasis of the lateral semicircular canal. It is suggested that PNLC is caused by light debris attached to the cupula of the lateral semicircular canal. Objectives: PNLC is a sub-type of direction-changing positional nystagmus. It is thought to be caused by anti-gravitational deviation of the cupula of the lateral semicircular canal (light cupula); however, the exact mechanism is yet to be elucidated. To this end, the clinical features of PNLC were studied.Method: Clinical charts of 27 patients (13 men and 14 women) with PNLC were reviewed. Results: The nystagmus had resolved within a week in 70% and within 30 days in 89% of the patients. The recurrence rate was 33%. The subjects did not have a history of alcohol intake, head trauma, or vestibular neuritis.

Clinically Mild Encephalitis with Isolated Transient Reversible Splenial Lesion - Uncommon Clinicoradiological Entity

Clinically mild encephalitis with an isolated transient reversible lesion in the splenium of the corpus callosum (SCC) is a uncommon described clinicoradiological entity that are seen in a number of clinical conditions with varied etiologies. Awareness of these lesions is necessary to be differentiated from other infective or non infective causes. We report a case of postpartum young female presenting with mild encephalitis. The patient had a short clinical course and made a full recovery. Initial magnetic resonance (MR) images showed an isolated lesion in the centre of the SCC, which resolved completely on a repeat MR imaging done two weeks later. This isolated reversible clinicoradiological entity irrespective of multiple differential diagnosis described in the literature carries an excellent prognosis. Its proposed pathophysiology still need to be well understood and full emphasis should be on avoiding unnecessary investigation and therapeutic intervention.

P-019: Short term clinical course in pediatric IBD based on a nationwide, prospective Hungarian pediatric IBD registry (HUPIR)

P-019: Short term clinical course in pediatric IBD based on a nationwide, prospective Hungarian pediatric IBD registry (HUPIR)

Detection and molecular characterization of naturally transmitted sheep associated malignant catarrhal fever in cattle in India.

Malignant catarrhal fever (MCF) is a fatal herpesvirus infection of domestic and wild ruminants, with a short and dramatic clinical course characterized primarily by high fever, severe depression, swollen lymph nodes, salivation, diarrhea, dermatitis, neurological disorders, and ocular lesions often leading to blindness. In the present study, fatal clinical cases of sheep associated malignant catarrhal fever (SA-MCF) were identified in cattle in the state of Karnataka. These cases were initially presented with symptoms of diarrhea, respiratory distress, conjunctivitis, and nasal discharges. Laboratory diagnosis confirmed the detection of ovine herpesvirus-2 (OvHV-2) genome in the peripheral blood samples of two ailing animals. The blood samples collected subsequently from sheep of the neighboring areas also showed presence of OvHV-2 genome indicating a nidus of infection in the region. The positive test results were further confirmed by nucleotide sequencing of the OIE approved portion of tegument gene as well as complete ORF8 region of the OvHV-2 genome. Phylogenetic analysis based on the sequence of the latter region indicated close genetic relationship with other OvHV-2 reported elsewhere in the world.

Ortner's syndrome: A rare cause in an elderly smoker

Hoarseness of voice is a common complaint in the emergency room following benign illness of the upper respiratory tract, most of the time it has a short clinical course and recovers with symptomatic treatment. However hoarseness may follow recurrent laryngeal palsy referred to as Ortner's syndrome (cardio-vocal syndrome) in patients with underlying cardiovascular disorders.1–4 In this paper we present a rare case of Ortner's syndrome in an elderly smoker with chronic obstructive pulmonary disease (COPD) and an aneurysm of descending thoracic aorta. The available literature on this subject has been reviewed and discussed.

Occipital anaplastic oligodendroglioma with multiple organ metastases after a short clinical course: a case report and literature review

BackgroundIt is generally believed that malignant gliomas never metastasize outside the central nervous system (CNS). However, the notion that oligodendrogliomas (OGDs) cells cannot spread outside CNS is being challenged.MethodsWe described in detail the clinical story of one patient with anaplastic OGD, which metastasized to lymph nodes, bone marrowand bones Genetic analyses included detection of 1p and 19q chromosomal arms, methylation status of MGMT promoter, and PTEN exon mutations. A search of worldwide literature was conducted for reports of metastatic OGDs using NCBI-PubMed, with the keywords “extracranial”, “extraneural”, “oligodendroglioma”, “oligodendrogliomas”, “metastatic”, “metastasis”, and “metastases”, in different combinations.ResultsAn open biopsy of the infiltrated bones in our patient revealed that malignant cells had replaced the patient’s marrow. Moreover, the diagnosis of multiple-organ metastases of anaplastic OGD was confirmed based on immunohistochemical staining. Genetic analyses showed that the tumors originated from previously resected brain lesions. None of the lesions had 1p and 19q deletions, but hypermethylation of MGMT promoter, and the G → A transversion at codon 234 of PTEN exon 2 were detected. Literatures review yielded 60 reports of metastatic OGDs from 1951 to the present, which with our patient makes 61 cases. Concerning these 61 patients, there were 110 infiltrated sites correlated closely with primary OGDs. The most frequent metastatic sites were bone and bone marrow (n = 47; 42.7%), lymph nodes (n = 22; 20.0%), liver (n = 7; 6.4%), scalp (n = 6; 5.5%), lung (n = 6; 5.5%), pleura (n = 4; 3.6%), chest wall (n = 3; 2.7%), iliopsoas muscle (n = 2; 1.8%), soft tissue (n = 2; 1.8%), and parotid gland (n = 2; 1.8%).ConclusionsExtracranial metastases in anaplastic OGD are very rare but they do occur; bone and bone marrow may be the most common sites. Detection of certain molecular markers such as deletion of 1p and 19q chromosomal arms, hypermethylation of MGMT promoter, and characteristic PTEN exon mutations may help differentiate subtypes which are more prone to extracranial metastases.Virtual slidesThe virtual slide(s) for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/8749838611478560.

Iron status of channel catfish Ictalurus punctatus affected by channel catfish anemia and response to parenteral iron

Originally reported in 1983, channel catfish anemia (CCA), also 'white lip' or 'no blood,' is a major idiopathic disease affecting commercial production in the Mississippi Delta region of the USA. Affected individuals are characterized by lethargy, anorexia, extreme pallor, and packed cell volumes often below 5%, but a definitive cause for CCA remains elusive. Records from the National Warmwater Aquaculture Center (NWAC) reveal that, on average, CCA accounted for 4.7% of case submissions from 1994 to 2012. Known infectious agents, parasites, and perturbations in commonly measured water quality variables have been largely excluded, and research has focused on potential feed-related etiologies, particularly folic acid deficiency. No natural or anthropogenic contaminants have been found in feeds, and no associations have been made to any particular feed brand or formulation, or to the age or condition of the feed itself. Contrary to reports indicating a short clinical course, NWAC records indicate an insidious condition where certain ponds have contained fish diagnosed with CCA for up to 4 consecutive years and individual outbreaks have persisted for at least 5 mo. Investigation into the iron status of CCA-affected fish revealed values consistent with iron deficiency anemia, including low-packed cell volume (mean ± SE, 5.6 ± 1.0 vs. 24.8 ± 2.4%), serum iron (35.2 ± 3.5 vs. 104.4 ± 18.5 µg dl-1), liver iron (12.2 ± 2.6 vs. 23.3 ± 4.6 µg g-1), and percent transferrin saturation (14.5 ± 2.7 vs. 26.9 ± 3.1%) in anemic and healthy controls, respectively. Administration of parenteral iron produced complete recovery and returned iron indices to within the ranges of normal controls. Despite these findings, factors predisposing a state of hypoferremia remain unknown.

Endogenous Cushing’s syndrome: The Philippine general hospital experience

Background and significance: Endogenous Cushing's syndrome is a rare disease entity approximately 13 cases permillion population. In Asia, and specifically in the Philippines, the exact incidence is unknown. As well, it's clinical presentation among Filipinos is not well described. The local epidemiology of obesity, diabetes and hypertension are different from other countries. These conditions are the usual initial differential diagnosis for Cushing's syndrome. This case collection is thus important for the awareness of clinicians on the clinical presentation and course of individuals with this condition. Methodology: Medical records of patients diagnosed with Endogenous Cushing’s Syndrome (non steroid-induced) withinthe year 2005-2011 were retrieved using the ICD 10 code for Cushing’s Syndrome (E24). Exogenous Cushing’sSyndrome (steroid-induced) were all excluded from the study. All selected medical records were individually reviewed,assessed and carefully recorded. Results: The study included 19 cases (8 pituitary adenoma, 7 adrenal adenoma, 4 ectopic adenoma) of endogenous Cushing’s Syndrome. Female predominance was noted. The most commonly reported clinical symptom and sign were weight gain and moon facies respectively. Short clinical course, hyperpigmentation, ecchymoses, behavioural changes andsevere hypokalemia were observed to be more prominent among cases with ectopic sources. All cases had significantlyelevated midnight serum cortisol level and 24 hour urine cortisol with ectopic sources exhibiting the highest level. There was no observed correlation between the tumour size and level of serum cortisol in all types. Majority underwent tumour resection leading to complete reversal of steroid excess. Conclusion: In our series of 19 cases, adrenal, pituitary and ectopic foci were the main sources of endogenous steroid excess. Ectopic ACTH syndrome manifested differently with other causes providing clues that might help in rapid clinical differentiation. Imaging studies should only be used to confirm tumour location after rigorous biochemical tests. Surgical management remained to be the definitive cure for most of the cases, hence prompt diagnosis and localization is necessary.

Sawfly larval poisoning in cattle: Report on new outbreaks and brief review of the literature

Sawfly larval poisoning (SLP) is an acute hepatotoxicosis documented in livestock in Australia, Denmark and in countries of South America. It is caused by the ingestion of the larval stage of insects of the suborder Symphyta, order Hymenoptera, commonly known as "sawfly". Three species of sawfly are reportedly involved in the toxicosis. The insect involved in Australian SLP is Lophyrotoma interrupta (Pergidae), in Denmark the cause of SLP is the ingestion of the larvae Arge pullata (Argidae), and in South American countries documented outbreaks of SLP were caused by the ingestion of yet another sawfly, Perreyia flavipes (Pergidae). In all geographical areas where it occurred, SLP causes important livestock losses. In cattle, as well as in other affected species, the disease has a short clinical course and in many outbreaks affected cattle can be found dead. When observed, clinical signs include apathy, recumbence, tremors, paddling movements and death in 24-48 hours. Neurological signs such aggressiveness attributable to hepatic encephalopathy are also observed. In cases with a more protracted course icterus and photodermatitis may develop. Gross findings included ascites, petechiae and ecchymosis over serosal surfaces of thoracic and abdominal cavities, and an enlarged liver that displays accentuation of the lobular pattern and edema of the gall bladder wall. Sawfly larval body fragments and heads are consistently found in the fore stomachs and occasionally abomasum of affected cattle. Main microscopic lesions are restricted to the liver and consist of centrolobular (periacinar) to massive hepatocellular necrosis. In most lobules necrotic areas extended up to the portal triads where only a few viable hepatocytes remain. Mild to moderate lymphocyte necrosis is seen in lymphatic tissues. Cases occur in the winter months when the larval stages of the sawfly are developing. D-amino acid-containing peptides have been found to be the toxic principle in each sawfly involved in SLP. The octapeptide lophyrotomin is the major toxin in the in the larvae of Australian and Danish sawflies and is present in small amounts in the larvae of South American sawfly. The heptadecapeptide pergidin is the main toxin in the South American sawfly while small amounts of pergidin have been found in the other two species of toxic sawfly. During the winter of 2011 (July-August) four outbreaks of SLP were diagnosed in the State of Rio Grande do Sul, Brazil. The findings in those outbreaks are reported here and a brief review of the literature regarding SLP around the world is provided.

English

Acute generalized exanthematous pustulosis (AGEP) is a rare reaction pattern with a typical morphology and a short clinical course that in majority of cases is related to medication administration. It is an acute pustular eruption with unique clinical features, a rapid clinical course and a typical histopathology. Herein, we report the case of a patient with acute generalized exanthematous pustulosis for its classical presentation.

Progressive adult primary glioblastoma in the medulla oblongata with an unmethylated MGMT promoter and without an IDH mutation

A 63-year-old woman presented with dizziness followed by gait disturbance and loss of appetite. Magnetic resonance image (MRI) showed that a lesion located in the medulla oblongata, appearing as hyperintense on T2-weighted image and with slight enhancement area, appeared in the ventral aspect of the mass on T1-weighted MR imaging with gadolinium. It was diagnosed as high-grade brain-stem glioma and the patient underwent chemoradiotherapy. However, she died 18 days after treatment, and autopsy was performed. The pathological diagnosis was glioblastoma (GBM) with unmethylated O-6-methylguanine-DNA methyltransferase promoter and wild isocitrate dehydrogenase 1 gene. We report an extremely short clinical course of adult GBM in medulla oblongata with genetic analysis and present a review of the literature.

Atypical neuropathological sCJD‐MM phenotype with abundant white matter Kuru‐type plaques sparing the cerebellar cortex

We describe an atypical neuropatholgical phenotype of sporadic Creutzfeldt-Jakob disease (sCJD) in a 64-year-old man presenting with a 5-month history of rapidly progressive dementia, comprising behavioral disturbances, memory complaints, disorientation and language alterations. MRI showed diffuse atrophy and hyperintensities in parietal, occipital, temporal and frontal cortices and left caudate nucleus on T2-weighted and fluid-attenuated inversion recovery images. No typical EEG alterations were observed. Repeated 14-3-3 assay was positive after a first negative test. Neuropathology showed classical CJD changes with small cortical foci of large confluent vacuoles and relatively well-preserved cerebellar cortex. The most striking feature was the presence of abundant Kuru-type plaques in both cerebral cortex and subcortical white matter. Sparse Kuru-type plaques were also seen in cerebellum, although only in white matter. Immunohistochemistry showed, in addition to unicentric plaques, diffuse synaptic and patchy perivacuolar, as well as plaque-like and periaxonal pathological prion protein deposits (PrP(res) ). Western blot studies demonstrated the co-occurrence of PrP(res) types 1 and 2 in frontal cortex and a relatively weak type 2 signal in cerebellum. PRNP genotyping revealed methionine homozygosity at codon 129 and excluded mutations. This case shows a previously undescribed combination of histopathological features which preclude its classification according to the current phenotypic and molecular sCJD classification. The observation demonstrates that Kuru-type amyloid plaques mainly involving the cerebral white matter may also occur in sCJD cases with short clinical course and the co-existence of PrP(res) types 1 and 2. This case further highlights the complexity of the correlations between histopathological phenotype and PrP(res) isotype in prion diseases.

Chromobacterium violaceum infection: A clinical review of an important but neglected infection

Background Increasing reported cases with Chrombacterium violaceum infection has been noticed in recent decades. It is noteworthy for its difficult-to-treat entity characterized by a high frequency of sepsis, easily distantant metastasis, multidrug-resistance, and frequent relapse, and high mortality rate. Methods The English-language literature was reviewed from 1952 through December 2009 by an electronic view via the PubMed and Medline databases and manual searches. Results One hundred and six patients with Chrombacterium violaceum infection from the literature were studied. The four leading clinical manifestations reviewed in the published literature, in the order of frequency, were fever (100%), sepsis (82%), skin lesions (67.9%), and abdominal pain (31.1%). Localized abscess was found in 52 patients (49%) and liver was the mostly common involved organ. Fifty-six patients (53%) were dead. Almost all of the penicillin, ampicillin, and first and second-generation cephalosporins exhibited totally resistant to Chrombacterium violaceum. The most important risk factors in mortality in 61 patients with Chrombacterium violaceum bacteremia were at a young age ( p = 0.0789), presence of localized abscess ( p = 0.030), shorter clinical course ( p < 0.001), and inappropriate antimicrobial treatment ( p < 0.001). Seven patients (6.6%) experienced of relapse or reinfection, with a median interval of 135 days (range, 4 to 1095 days). Conclusions A high index of suspicion for Chromobacterium violaceum infection is required along with prompt diagnosis, optimal antimicrobial therapy, and adequate therapeutic duration for a successful therapy.