A case report of colonic Ameboma mimicking colon cancer in an immunocompromised patient
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ABSTRACT:
SUBMITTER: Omwansa P
PROVIDER: S-EPMC10510079 | biostudies-literature | 2023 Aug
REPOSITORIES: biostudies-literature
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Project description: Not available
| S-EPMC11249769 | biostudies-literature
Project description:BackgroundInfection with Borrelia burgdorferi sensu lato complex (B. b. sl) spirochetes can cause Lyme borreliosis, manifesting as localized infection (e.g. erythema migrans) or disseminated disease (e.g. Lyme neuroborreliosis). Generally, patients with disseminated Lyme borreliosis will produce an antibody response several weeks post-infection. So far, no case of neuroborreliosis has been described with persistently negative serology one month after infection.Case presentationWe present a patient with a history of Mantle cell lymphoma and treatment with R-CHOP (rituximab, doxorubicine, vincristine, cyclofosfamide, prednisone), with a meningo-encephalitis, who was treated for a suspected lymphoma relapse. However, no malignant cells or other signs of malignancy were found, and microbial tests did not reveal any clues, including Borrelia serology. He did not recall being bitten by ticks, and a Borrelia PCR on CSF was negative. After spontaneous improvement of symptoms, he was discharged without definite diagnosis. Several weeks later, he was readmitted with a relapse of symptoms of meningo-encephalitis. This time however, a Borrelia PCR on CSF was positive, confirmed by two independent laboratories, and the patient received ceftriaxone upon which he partially recovered. Interestingly, during the diagnostic process of this exceptionally difficult case, a variety of different serological assays for Borrelia antibodies remained negative. Only P41 (flagellin) IgG was detected by blot and the Liaison IgG became equivocal 2 months after initial testing.ConclusionsTo the best of our knowledge this is the first case of neuroborreliosis that is seronegative on repeated sera and multiple test modalities. This unique case demonstrates the difficulty to diagnose neuroborreliosis in severely immunocompromised patients. In this case, a delay in diagnosis was caused by broad differential diagnosis, an absent known history of tick bites, negative serology and the low sensitivity of PCR on CSF. Therefore, awareness of the diagnostic limitations to detect Borrelia infection in this specific patient category is warranted.
| S-EPMC6090844 | biostudies-literature
Project description:BackgroundEncephalitis is rarely caused by nontuberculous mycobacteria (NTM), which is generally not considered a highly virulent pathogen. However, NTM encephalitis in immunocompromised hosts occurs with varied clinical presentations, posing a diagnostic challenge in clinical practice. This study aims to describe an atypical case of NTM encephalitis caused by Mycobacterium celatum, which has not previously been reported to infect the central nervous system of immunocompromised hosts, mimicking autoimmune striatal encephalitis (ASE).Case presentationA 35-year-old immunosuppressed woman presented with prolonged fever for 4 months and rapidly progressive cognitive decline for 3 months. Neurological examination showed impaired cognition and parkinsonism. Laboratory testing was unremarkable. Her brain imaging on T2-weighted fluid-attenuated inversion recovery (T2/FLAIR) exhibited lesions involving basal ganglia and subcortical white matter in both hemispheres, mimicking ASE. Cerebrospinal fluid (CSF) analysis revealed mild pleocytosis with normal glucose and protein levels. CSF comprehensive microbiological studies and autoimmune panels were negative. ASE was suspected, and immunotherapies were given. Despite immunotherapies, her condition worsened with seizures, warranting a stereotactic brain biopsy to achieve a definite diagnosis. Her brain tissue pathology result was non-specific. However, we identified M. celatum from her brain tissue. Thus, the final diagnosis was M. celatum encephalitis. Therefore, we discontinued immunotherapies and started anti-NTM treatment, including isoniazid, rifampicin, ethambutol, and levofloxacin. After completing a 16-month treatment course, her clinical condition was stable, afebrile, and seizure-free.ConclusionsWe proposed that NTM invades the central nervous system and also triggers immune dysregulation, developing features resembling ASE. In case of suspicious autoimmune encephalitis with poor response to immunotherapies, a tissue biopsy should be performed to exclude chronic infection.
| S-EPMC11884120 | biostudies-literature
Project description:An aspergilloma is a conglomeration of Aspergillus hyphae, fibrin, mucus, and cellular debris, typically found within a pulmonary cavity or ectatic bronchus. Computerized tomography (CT) scans often depict a cavity containing a solid mass and a notable crescent sign. Though these signs are indicative of aspergilloma, the European Respiratory Society emphasizes the need for a more detailed diagnostic criteria. A patient with a history of hemoptysis was initially diagnosed with an aspergilloma based on CT chest findings, showing a cavitary lesion in the left upper lobe with an intracavitary lobular opacity. Post resection, histological examination contradicted the initial diagnosis, revealing lung cancer instead. This case underscores the importance of tissue diagnosis from the outset or employing a multifaceted diagnostic criteria encompassing radiological findings, serology and microbiology tests. In the absence of an initial tissue diagnosis, rigorous follow-up, including early interval scanning, is crucial.
| S-EPMC10629857 | biostudies-literature
Project description:We report a case of Campylobacter volucris bacteremia in an immunocompromised patient with polycythemia vera and alcoholic liver cirrhosis. To our knowledge, this is the first case report in which this organism has been isolated from a human clinical specimen.
| S-EPMC4432047 | biostudies-literature
Project description:BackgroundFrancisella philomiragia is a very rare opportunistic pathogen of humans which causes protean diseases such as pneumonia and other systemic infections. Subsequent failure of prompt treatment may result in poor prognosis with mortality among infected patients.Case presentationThe present report describes a case of F. philomiragia bacteraemia first reported in Malaysia and Asian in a 60-year-old patient with underlying end-stage renal disease (ESRF) and diabetes mellitus. He presented with Acute Pulmonary Oedema with Non-ST-Elevation Myocardial Infarction (NSTEMI) in our hospital. He was intubated in view of persistent type I respiratory failure and persistent desaturation despite post haemodialysis. Blood investigation indicated the presence of ongoing infection and inflammation. The aerobic blood culture growth of F. philomiragia was identified using the matrix-assisted laser desorption/ionization-time of flight (MALDI-TOF) mass spectrometry (Score value: 2.16) and confirmed by 16S Ribosomal DNA (16S rDNA) sequencing. He was discharged well on day 26 of admission, after completing one week of piperacillin/tazobactam and two weeks of doxycycline.ConclusionClinical suspicion should be raised if patients with known risk factors are presenting with pneumonia or pulmonary nodules especially as these are the most common manifestations of F. philomiragia infection. Early diagnosis via accurate laboratory identification of the organism through MALDI-TOF mass spectrometry and molecular technique such as 16S rDNA sequencing are vital for prompt treatment that results in better outcomes for the afflicted patients.
| S-EPMC8489096 | biostudies-literature
Project description:Cytomegalovirus (CMV) commonly infects immunocompromised individuals, such as cancer patients. We present a case involving a 60-year-old male with Stage 3A lung adenocarcinoma and chronic obstructive pulmonary disease (COPD) diagnosed with CMV tracheobronchitis, initially suspected as cancer progression. Treatment with ganciclovir led to partial improvement in symptoms of shortness of breath and cough, as well as bronchoscopic findings. However, due to ganciclovir-induced neutropenia, the therapy was switched to foscarnet. Distinguishing between cancer progression and infectious tracheobronchitis through physical examination and chest CT scans remains challenging. In lung cancer patients presenting with airway and bronchial narrowing along with ulcerative mucosal lesions, CMV infection should be considered. A bronchoscopic biopsy is crucial for accurate diagnosis and determining the appropriate treatment in these patients.
| S-EPMC11496192 | biostudies-literature
Project description:Human infection caused by bacteria of the Edwardsiella genus is rare and most often presents with gastroenteritis that rarely requires antibiotics. Our case report describes a medically complex patient with chronic steroid use contributing to an immunocompromised state, who presented with fever and abdominal pain. The patient was later found to have Edwardsiella tarda (E. tarda) bacteremia and underwent paracentesis confirming E. tarda bacterial peritonitis requiring a prolonged antibiotic course. This case report aims to illustrate the presentation, diagnosis, and management of an uncommon infection that can have severe complications especially among immunocompromised patients.
| S-EPMC10694257 | biostudies-literature
Project description: Not available
| S-EPMC10634414 | biostudies-literature
Project description:Study Design Case report. Objective Merkel cell carcinoma (MCC), an uncommon cutaneous neuroendocrine malignancy, is a rare cause of spinal metastasis, with only five cases previously reported. We report a rare case of MCC metastatic to the spine in an immunocompromised patient. Methods A 55-year-old male with previously resected MCC, immunocompromised due to cardiac transplant, presented with sharp mid-thoracic back pain radiating around the trunk to the midline. Computed tomography of the thoracic spine showed a dorsal epidural mass from T6 to T8 with compression of the spinal cord. Laminectomy and subtotal tumor resection were performed, and pathology confirmed Merkel cell tumor through immunohistochemistry staining positive for cytokeratin 20 and negative for thyroid transcription factor-1. Results Further treatment with radiation therapy was initiated, and the patient did well for 4 months after surgery, but returned with a lesion in the cervical spine. He then opted for hospice care. Conclusions With an increasing number of immunocompromised patients presenting with back pain, MCC should be considered in the differential diagnosis of spinal metastatic disease.
| S-EPMC3699249 | biostudies-other