Unrecognized Cause of Native Valve Infective Endocarditis Due to Staphylococcus aureus: Laser Hair Removal.

Laser hair removal for esthetic purposes has commonly been performed worldwide. This procedure is considered to be safe and effective, and severe complications such as systemic bacterial infections have seldom been reported. We present a case of native valve infective endocarditis (IE) potentially associated with laser hair removal.

Blood cultures should be collected for acute cholangitis regardless of severity.

Background: Despite the high frequency of bacteremia in acute cholangitis, the indications for blood cultures and the relationship between the incidence of bacteremia and severity of acute cholangitis have not been well established. This study examined the association between the 2018 Tokyo Guidelines (TG18) severity grading for acute cholangitis and incidence of bacteremia to identify the need for blood cultures among patients with acute cholangitis in each severity grade.

Methods: Patients with acute cholangitis who visited our emergency department between 2019 and 2020 were retrospectively investigated.

Clinical prediction rule is more useful than qSOFA and the Sepsis-3 definition of sepsis for screening bacteremia.

Background: Clinical guidelines recommend blood cultures for patients suspected with sepsis and bacteremia. Sepsis-3 task force introduced the new definition of sepsis in 2016; however, the relationship between the Sepsis-3 definition of sepsis and bacteremia remains unclear. This study aimed to investigate how to detect patients who need blood cultures.

Intravenous lobular capillary haemangioma presenting as neck discomfort associated with neck anteflexion.

Lobular capillary haemangioma, also known as pyogenic granuloma, is a benign vascular tumour that usually originates in the skin and mucosal membrane. It sometimes derives from the lumen of a vein and the clinical presentations are various and non-specific. A 72-year-old woman complained of a sensation of pressure in her left neck for 1 month when cooking.

Characteristics of pneumonia with negative chest radiography in cases confirmed by computed tomography.

: Chest radiography is commonly used for diagnosing community-acquired pneumonia (CAP). Computed tomography (CT) is not routinely recommended for initial assessment of CAP patients but is more sensitive and more specific than chest radiography. : To investigate characteristics of pneumonia with negative chest radiography in cases confirmed by CT.

Serum Levels of Fibroblast Growth Factor 23 in People Living with HIV.

Background: Fibroblast growth factor (FGF) 23 is a well-known phosphaturic hormone produced mainly by bone cells to maintain phosphate and mineral homeostasis. Serum FGF23 levels are elevated in patients with chronic kidney disease (CKD), and elevated FGF23 might increase the risk of cardiovascular disease (CVD). Several reports have documented an increased incidence of risk factors for osteopenia, CKD, and CVD in people living with HIV (PLWH).

Efficacies of atovaquone, pentamidine, and trimethoprim/sulfamethoxazole for the prevention of Pneumocystis jirovecii pneumonia in patients with connective tissue diseases.

Background: Pneumocystis jirovecii pneumonia (PCP) is an opportunistic infection in patients on steroid therapy for connective tissue diseases. The standard agent for primary PCP prophylaxis is trimethoprim/sulfamethoxazole (TMP-SMX), although this agent can cause common adverse reactions, including myelosuppression and renal toxicity, that result in cessation. Aerosolized pentamidine and oral atovaquone are alternatives for PCP prophylaxis.

Inhibition of osteoblast differentiation by ritonavir.

Osteoporosis is one of the chronic complications seen in human immunodeficiency virus (HIV)-infected patients, and affects patients at high prevalence. The causes of osteoporosis in HIV-infected patients are multiple, and include chronic HIV infection, living habits such as smoking and alcohol consumption, and antiretroviral drug use. Among antiretroviral drugs, protease inhibitors have been reported to be associated with osteoporosis.

The prevalence of low serum free testosterone and the short-term effect of anti-retroviral therapy in male Japanese treatment-naïve HIV patients.

Objectives: The prevalence of hypogonadism in HIV patients is still a matter of debate. Today, serum free testosterone (fTST) is thought to be more important than serum testosterone in the diagnosis of hypogonadism in patients with HIV. This study aimed to determine the prevalence of low fTST levels and the effects of anti-retroviral therapy (ART) on fTST levels in treatment-naïve male Japanese patients with HIV.

Short Communication: The Clinical Value of Cystatin C as a Marker of Renal Function in HIV Patients Receiving Dolutegravir.

Dolutegravir (DTG) is an integrase strand transfer inhibitor that is used for the treatment of HIV infection. DTG inhibits organic cation transporter 2 on the basolateral side of proximal tubule cells of the kidney and leads to increased serum creatinine levels without true renal function deterioration. In HIV patients who receive DTG, an alternative test to serum creatinine measurement is needed to determine the correct renal function.

Co-Colonization with Neisseria species Is a Risk Factor for Prolonged Colonization with Multidrug-Resistant Acinetobacter baumannii in the Respiratory Tract.

Multidrug-resistant Acinetobacter baumannii (MDRAB) colonization increases the risk of bacterial spread in the hospital setting. The impact of clinical factors, including antibiotic use, on prolongation of MDRAB colonization has not been investigated. Patients with respiratory tract MDRAB detected using culture were enrolled in this study.

Decreased serum bone specific alkaline phosphatase and increased urinary N-terminal telopeptide of type I collagen as prognostic markers for bone mineral density loss in HIV patients on cART.

Objectives: Bone mineral density (BMD) loss is a major chronic complication in HIV patients. We performed a prospective study to determine the time course of BMD changes and to find prognostic factors of BMD loss in HIV patients on combination antiretroviral therapy (cART).

Patients And Methods: Subjects were 54 male Japanese HIV patients who had been on cART ≥1 year with no therapeutic agents for osteoporosis.

Increase of 25-hydroxyvitamin D levels after initiation of combination antiretroviral therapy.

Although vitamin D deficiency in HIV patients reported worldwide, the mechanisms and the effect of combination antiretroviral therapy (cART) on vitamin D levels are unclear. Patients were 50 male Japanese with HIV who visited Teikyo University Hospital, Tokyo, Japan. Patients were divided into those receiving cART (cART-experienced group, n = 30) and those who had not received cART (cART-naïve group, n = 20).

Characteristics of serum endocan levels in infection.

Objectives: Endocan is a newly recognized biomarker of sepsis. However, there have been no studies of the trends in endocan levels during infection and their associations with other clinical factors. The aim of this study was to assess the time course of endocan levels and the associations of endocan with clinical factors during infection by comparison with other biomarkers.

Clinical features of catheter-related candidemia at disease onset.

Introduction: Early detection of catheter-related candidemia is necessary to ensure that patients receive prompt and appropriate treatment. The aim of the present case-control study is to investigate the clinical features of catheter-related candidemia at disease onset, so as to determine the clinical indications for empiric antifungal therapy.

Methods: All 41 cases of catheter-related candidemia from September 2009 to August 2011 at a teaching hospital were included in the present study.

Hyaluronic Acid concentration in pleural fluid: diagnostic aid for tuberculous pleurisy.

Background: A high concentration of hyaluronic acid in pleural fluid is suggestive of malignant mesothelioma. However, a relatively high concentration of hyaluronic acid was also seen in the pleural fluid of patients with benign inflammatory diseases. To show the utility of measuring hyaluronic acid levels in pleural fluid to diagnose tuberculous pleurisy, we compared the clinical features and levels of hyaluronic acid in the pleural fluid of patients with and without tuberculous pleurisy.

Multifocal Cellulitis due to Disseminated Neisseria Gonorrhoeae in a Male Patient.

We report a rare case of disseminated gonococcal infection in a 37-year-old man presenting with multifocal cellulitis. The patient presented with fever and painful swelling of the right foot and left hand, and was admitted to our hospital. CT scanning of the extremities revealed multifocal cellulitis.

Clinical efficacy of peramivir in adult patients with seasonal influenza during the winter of 2012 in Japan.

Background: Peramivir is an intravenously administered neuraminidase inhibitor for influenza. The clinical efficacy of peramivir remains unclear because it is used in a limited number of countries. We compared the clinical efficacy of peramivir with that of oseltamivir in influenza patients during the 2012-2013 season.

Liver Abscess With a Markedly High Level of Carbohydrate Antigen 19-9.

Serological tumor markers are useful for detection of malignancies and evaluation of disease progression. However, some markers are rarely elevated in patients with benign diseases and without malignancies. We herein present a case of a liver abscess with a highly elevated carbohydrate antigen (CA 19-9) level in both the serum and abscess fluid.

Infective endocarditis due to Enterobacter cloacae resistant to third- and fourth-generation cephalosporins.

We report the case of using a long-term combination of meropenem and amikacin to treat infective endocarditis caused by Enterobacter cloacae resistant to third- and fourth-generation cephalosporins. Multi-drug resistant Gram-negative bacilli, such as the E. cloacae in our study, may become possible pathogens of infective endocarditis.