Septic Arthritis in an Immunocompetent Adult: A Case Report and Review of Literature.

Septic arthritis is a medical emergency that requires prompt diagnosis to prevent long-term intra-articular complications. is an anaerobic gram-negative rod which has been infrequently reported to cause septic arthritis. We present a 49-year-old female that presented with spontaneous left knee pain and swelling without history of insult to the knee.

Septic Arthritis in a Renal Transplant Patient.

Blastomycosis is a rare endemic fungal infection caused by the dimorphic fungus It is more likely to occur in persons living in areas of the United States and Canada, which border the Ohio and Mississippi River Valleys and the Great Lakes region. Most infections are localized to the lungs, often presenting as acute or chronic pneumonia. Occasionally, patients progress to develop disseminated disease and extrapulmonary infections.

Effectiveness of the vacuum assisted aspiration AngioVac system in the removal of intravascular masses.

Background: Invasive procedures used to manage intravascular masses such as vegetation from endocarditis, deep vein thrombosis, and septic emboli are associated with high rates of complications and mortality, especially in patients with several pre-existing comorbidities. A minimally invasive technique that has become more popular in recent years is the AngioVac procedure. This single-centered, retrospective study focuses on patient presenting comorbidities and indications for the procedure as well as postprocedural outcomes.

Clinical and Financial Impact of Rapid Antimicrobial Susceptibility Testing in Blood Cultures.

The rapid identification of pathogens that cause bloodstream infections plays a vital role in the modern clinical microbiology laboratory. Despite demonstrating a significant reduction in turnaround time and a significant effect on clinical decisions, most methods do not provide complete antimicrobial susceptibility testing (AST) information. We employed rapid identification (ID) and AST using the Accelerate PhenoTest on positive blood cultures containing Gram-negative bacilli.

Fatal Case of Liver and Brain Abscesses Due to Fusobacterium nucleatum.

is an anaerobic gram-negative organism regarded as an oral commensal. We present a case of a 63-year-old male presenting with weakness, encephalopathy and right upper quadrant palpable mass found to have liver abscess with innumerable intracranial abscesses. is a rare cause of concomitant liver and brain abscesses associated with odontogenic infection with potentially fatal outcomes.

Rhabdomyolysis Secondary to COVID-19 Vaccination.

Rhabdomyolysis has been described as a complication of coronavirus disease 2019 (COVID-19) infection, but few cases of rhabdomyolysis associated with COVID-19 vaccination have been reported. We described a case of an 80-year-old male who developed rhabdomyolysis two days after receiving his second dose of the Moderna COVID-19 vaccine. He presented with severe weakness, myalgias, and an initial creatinine kinase (CK) of 6,546 IU/L that improved with intravenous fluids.

A Rare Case of Spontaneous Splenic Rupture Secondary to Tularemia Following a Cat Bite.

Spontaneous splenic rupture is a rare but potentially life-threatening condition. More common infectious causes include infectious mononucleosis, cytomegalovirus (CMV), human immunodeficiency virus (HIV), and malaria. We present a case of a 42-year-old male who was admitted with persistent fevers, myalgia, and a recent ulcerative lesion on the base of his left thumb after a cat bite.

Maggot Wound Therapy Associated with Wohlfahrtiimonas chitiniclastica Blood Infection.

Maggot therapy is the intentional application of live, disinfected fly larvae to wounds for debridement and wound care. Although some studies suggest possible beneficial applications for wound healing, subsequent infection is a potential risk of treatment. We present a case of a 70-year-old male with chronic left temporal wound from squamous cell carcinoma treated with maggot therapy complicated by bacteremia with .

Chronic Infectious Complications of Recreational Urethral Sounding With Retained Foreign Body.

The practice of recreational urethral sounding involves insertion of foreign body in the urethra usually for sexual gratification. We present a case of a 62-year-old male with longstanding recurrent urinary tract infections complicated with Staphylococcus epidermidis bacteremia, discitis, and osteomyelitis at T12-L1 vertebral level associated with left psoas abscess secondary to a retained foreign body inserted into his urethra and urinary bladder. He had extraction of foreign body, cystoscopy, and open cystolithotripsy.

Acquisition of Clostridium difficile Colonization and Infection After Transfer From a Veterans Affairs Hospital to an Affiliated Long-Term Care Facility.

BACKGROUND Clostridium difficile infection (CDI) and asymptomatic carriage of toxigenic C. difficile are common in long-term care facilities (LTCFs). However, whether C.

A Comparison of Molecular Typing Methods Applied to complex: Sequencing, Rep-PCR, and MLST.

Molecular typing using repetitive sequenced-based PCR (rep-PCR) and sequencing were applied to a collection of diverse complex isolates. To determine the most practical method for reference laboratories, we analyzed 71 complex isolates from sporadic and outbreak occurrences originating from 4 geographic areas. While rep-PCR was more discriminating, sequencing provided a broader and a more objective geographical tracking method similar to multilocus sequence typing (MLST).

Utility of a single nasal polymerase chain reaction assay in predicting absence of skin and environmental contamination in hospitalized patients with past methicillin-resistant Staphylococcus aureus.

We evaluated hospitalized patients with a history of methicillin-resistant Staphylococcus aureus (MRSA) for persistent colonization and need for contact precautions. Up to 3 daily cultures of nares, skin, and any present wounds were compared with a single nasal polymerase chain reaction (PCR) assay. Most patients (76.

Appropriateness of empiric therapy in patients with suspected Clostridium difficile infection.

Objective: The objective of this study was to test the hypothesis that many patients with suspected Clostridium difficile infection (CDI) receive inappropriate empiric therapy and/or receive continued therapy despite negative test results.

Methods: We performed a 3 month prospective cohort study at the Cleveland Veteran Affairs Medical Center to assess the appropriateness of empiric CDI therapy for all patients with stool samples submitted for CDI testing. Empiric therapy for CDI was considered appropriate if patients with suspected CDI had findings suggestive of severe or complicated illness.

Beyond the Hawthorne effect: reduction of Clostridium difficile environmental contamination through active intervention to improve cleaning practices.

Education and passive observation resulted in a significant improvement in housekeeper disinfection of nontoxigenic Clostridium difficile spores artificially inoculated onto surfaces in C. difficile infection rooms. A further significant reduction occurred with direct supervision and real-time feedback, suggesting that optimal disinfection is achieved by working closely with housekeepers.

Diagnostic assessment of different environmental cleaning monitoring methods.

In a simultaneous assessment of 250 environmental surfaces after terminal cleaning using aerobic cultures as a gold standard, both fluorescent marker and an adenosine triphosphate bioluminescence assay system demonstrated better diagnosticity compared with subjective visual inspection. These results support the use of these environmental monitoring systems in the health care setting.

Acquisition of spores on gloved hands after contact with the skin of patients with Clostridium difficile infection and with environmental surfaces in their rooms.

In a prospective study of 30 patients with Clostridium difficile infection, we found that acquisition of spores on gloved hands was as likely after contact with commonly touched environmental surfaces (ie, bed rail, bedside table, telephone, call button) as after contact with commonly examined skin sites (ie, chest, abdomen, arm, hand).

Clinical and infection control implications of Clostridium difficile infection with negative enzyme immunoassay for toxin.

In a prospective study of 132 patients with a diagnosis of Clostridium difficile infection (CDI) by polymerase chain reaction, 43 (32%) had enzyme immunoassay (EIA) results negative for toxin. EIA-negative patients with CDI did not differ in clinical presentation from EIA-positive patients and presented a similar risk for transmission of spores.

Clostridium difficile infection in a Department of Veterans Affairs long-term care facility.

In a Veterans Affairs medical center, 39% of healthcare facility-onset, healthcare facility-associated Clostridium difficile infections had their onset in the affiliated long-term care facility (LTCF). Eighty-five percent of LTCF-onset patients had been transferred from the hospital within the past month. Delays in diagnosis and treatment were common for LTCF-onset patients.

Contamination of hands with methicillin-resistant Staphylococcus aureus after contact with environmental surfaces and after contact with the skin of colonized patients.

In a study of 40 methicillin-resistant Staphylococcus aureus (MRSA) carriers, hand contamination was equally likely after contact with commonly examined skin sites and commonly touched environmental surfaces in patient rooms (40% vs 45%). These findings suggest that contaminated surfaces may be an important source of MRSA transmission.

Effectiveness of routine patient bathing to decrease the burden of spores on the skin of patients with Clostridium difficile infection.

For 74 patients with Clostridium difficile infection, the quality and frequency of bathing was often limited because of such factors as the presence of devices, decreased mobility, and pain. Routine bathing practices had limited efficacy in decreasing the burden of spores on skin; however, showers were more effective than bed baths.