Subcutaneous pythiosis in human treated successfully with antimicrobial treatment, debridement and immunotherapy.

Pythiosis is caused due to a filamentous eukaryotic micro-organism called and the disease occurs commonly in horses and cattle. Subcutaneous pythiosis infection in humans is rare with no clear clinical guidelines for treatment. We present a case of a man in his 20s with non-resolving ulcers noted over lower extremity after exposure to swamp water draining animal remains.

Pulmonary Embolism in a Patient with Rheumatoid Arthritis on Etanercept Therapy.

Pulmonary embolism (PE) represents mechanical obstruction of one or more branches of pulmonary vasculature due to thromboembolism from a deep vein thrombosis. Hormonal contraceptives, hormonal replacement therapy, antipsychotics and fibrates are medications that are associated with increased risk of venous thromboembolism(VTE). Etanercept is a TNF alpha and beta receptor blocker.

Finding of in blood using cell-free DNA technique in a patient with infective endocarditis.

Introduction: The annual incidence of infective endocarditis (IE) is 3-9 cases per 100000 in developed countries and most cases are due to staphylococci and streptococci. IE due to Gram-positive anaerobic cocci (GPAC) is very rare.

Case Report: We present a case of a 38-year-old female with bacteremia and infective endocarditis of the native mitral valve.

A Case Report and Literature Review of New-Onset Myasthenia Gravis After COVID-19 Infection.

Myasthenia gravis (MG) is an autoimmune disorder affecting the neuromuscular junction caused by a B-cell-mediated, T-cell-dependent immunologic attack at the end plate of the postsynaptic membrane. Attack on muscle acetylcholine receptors (AChR) of the postsynaptic membrane due to the AChR, muscle-specific tyrosine kinase, or lipoprotein receptor-related peptide 4 antibodies lead to symptoms of painless, fluctuating weakness of muscle groups and often begins with ocular signs and symptoms. Coronavirus disease 2019 (COVID-19) is an acute respiratory disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), a novel coronavirus closely related to SARS-CoV.

Treatment of Extra-Intestinal Abscess following Acute Appendicitis.

Unlabelled: infection (CDI) commonly presents with diarrhoea, colitis, and in more severe cases, toxic megacolon. Extraintestinal infection (EI CDI) is rarely reported. Intraabdominal abscesses are the most commonly reported EI CDI presentation.

Pembrolizumab for the treatment of Progressive Multifocal Leukoencephalopathy (PML) in a patient with AIDS: A case report and literature review.

Progressive multifocal leukoencephalopathy (PML) is an opportunistic central nervous system (CNS) infection caused by the reactivation of John Cunningham polyomavirus (JCV) from suppression of the host immune system due to conditions such as human immunodeficiency virus causing acquired immunodeficiency syndrome (HIV/AIDS), hematological malignancies, multiple sclerosis, and use of immunosuppressant medications. Pembrolizumab is an immune checkpoint inhibitor targeting programmed cell death protein-1 (PD-1) receptors on lymphocytes. In recent years its use is expanding to treat several malignancies and it is a drug of interest for the treatment of PML.

Listeria Meningitis in a Patient With Plaque Psoriasis on Ustekinumab Therapy.

Listeria monocytogenes is a foodborne infection and is a leading cause of meningitis. The at-risk population includes patients over age 65, neonates, pregnant females, and patients with impaired cell immunity. Ustekinumab is a human monoclonal antibody that binds to and interferes with the proinflammatory cytokines, interleukin-12 (IL-12) and interleukin-23(IL-23).

Case of coexisting and lung infection with metastatic disease of the central nervous system.

Nocardiosis is a rare opportunistic gram-positive bacterial infection. The genus consists of non-motile, aerobic, non-spore-forming, catalase-positive, filamentous-branching bacteria with fragmentation into coccoid or bacillary forms. Opportunistic infections due to are reported in immunocompromised patients.

Bullous Pemphigoid Associated With Pembrolizumab Therapy for Non-Small-Cell Lung Cancer: A Case Report.

Pembrolizumab is an immune checkpoint inhibitor being increasingly used as immunotherapy for a multitude of cancers. With the increasing use of these agents, various immune-related adverse events are being recognized. Lichenoid reaction, pruritus, and eczema are well-established cutaneous side effects of pembrolizumab, but bullous pemphigoid (BP) is a rare side effect of the drug.

Strongyloides Hyper-Infection Syndrome and Ciliocytophthoria Mimicking .

Unlabelled: Ciliocytophthoria is a phenomenon where degenerated cells in infections or malignancy can present as ciliated cells on microscopy and so may be confused with ciliated parasitic infection. We present an interesting case of recurrent shortness of breath, misdiagnosed as chronic obstructive pulmonary disease exacerbations leading to unnecessary exposure to antimicrobials and steroids. The case was diagnosed as hyper-infection syndrome.

More than Valley Fever: Pulmonary Actinomycosis and Coccidioidomycosis Co-infection in a Patient.

Unlabelled: Pulmonary coccidioidomycosis and pulmonary actinomycosis are unheard of as co-pathogens. Infection with these organisms on their own can mimic lung cancer, thus presenting a diagnostic challenge. We present the case of a 75-year-old woman presenting with haemoptysis with a chest CT chest finding of a lung mass suggestive of lung cancer.

Pneumonia Despite Voriconazole Prophylaxis: A Case Report and Literature Review.

Unlabelled: species are a rare cause of fungal pulmonary infections in immunocompromised hosts. and are the two most common species of clinical significance. Both species differ in their susceptibility to antifungal agents.

Deaths due to delayed presentation to the hospital from fear of contracting COVID-19 during lockdown period: a tertiary care center experience.

: Sudden rise in COVID-19 cases in March 2020 due to spread of pandemic led to immediate lockdown order in many states and cities across the USA. Everyone had to stay home to stop the spread of the virus. We investigated all deaths in our hospital during lockdown period and assessed how many presented and died from non-COVID-19-related illness.

meningitis diagnosed using next- generation sequencing of microbial cell-free DNA.

meningitis is frequently caused by exposure to dog or cat bites and occurs more commonly in immunocompromised individuals. CSF analysis is the first step in diagnosis; however, in situations where CSF cultures turn negative, molecular techniques such as 16S rRNA gene amplification followed by polymerase chain reaction (PCR) product sequencing have shown promise. Next generation sequencing of cell free DNA (NGS cfDNA) can assist in identifying the causative agent in a quick and accurate manner.

Fulminant Pancreatitis Due to Disseminated Histoplasmosis: Case Report and Literature Review.

Acute pancreatitis (AP), an inflammatory disease of the pancreas, is clinically classified into mild AP, moderately severe, and severe based on local complications and presence of organ failure. Histoplasmosis, caused by the dimorphic fungus Histoplasma capsulatum, typically presents with pulmonary disease. Extrapulmonary disease/disseminated histoplasmosis can affect the gastrointestinal tract, with only a few reported cases of pancreatitis secondary to the above.

Rapid Diagnosis of Invasive Aspergillosis and Active Hepatitis-B Virus Co-Infection in a HIV-1 Infected Patient Using Cell Free DNA Sequencing.

Multiple simultaneous opportunistic infections in Human Immunodeficiency virus-1/Acquired immunodeficiency syndrome (HIV-1/AIDS) is a known and dreaded occurrence that often leads to poor outcomes. We present a case of disseminated aspergillosis and active Hepatitis-B virus (HBV) infection in such a host, where cell free DNA (cfDNA) next generation sequencing (NGS) of plasma was used to expedite diagnosis. Bronchoscopy was avoided and treatment was started expeditiously.

Disseminated Infection in an Immunocompetent Patient.

Unlabelled: is a genus of aerobic, non-motile and non-spore-forming filamentous branching bacteria with fragmentation into bacillary or coccoid forms. Infections caused by often occur in immunocompromised hosts and are potentially life-threatening. has rarely been reported to cause infection in immunocompetent hosts.

Rare Presentation of Pneumonitis in the Absence of Neurological Symptoms in an AIDS Patient and Use of Next-Generation Sequencing for Diagnosis.

Unlabelled: is a known cause of encephalitis in human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) patients. pneumonitis is a manifestation of extracerebral toxoplasmosis and can be clinically indistinguishable from other opportunistic infections including pneumonia (PJP) and miliary tuberculosis. In this case report, pneumonitis and disseminated toxoplasmosis was diagnosed using next-generation sequencing (NGS) and polymerase chain reaction (PCR) assessment.

Segmental Arterial Mediolysis: An Under-Recognized Cause of Chronic Abdominal Pain.

Unlabelled: Segmental arterial mediolysis (SAM) is a non-inflammatory, non-atherosclerotic vasculopathy mostly involving the abdominal arteries. SAM was recently recognized as a more prevalent aetiology of abdominal pain than initially thought by healthcare providers. It is still a commonly missed diagnosis in patients with recurrent emergency room (ER) visits for abdominal pain.

Isolated Non-Resolving Vulvar Lesion as a Presentation of Disseminated Histoplasmosis in a Woman with HIV.

Unlabelled: Disseminated histoplasmosis is most commonly caused by and is a known opportunistic infection in immunocompromised patients. The clinical presentation of histoplasmosis varies from asymptomatic to a progressive disseminated form. Pulmonary and CNS involvement is common in disseminated histoplasmosis.

Rare case of septic arthritis in an immunocompetent patient.

family comprises two genera: and (previously known as ) commonly colonises the urogenital tract in humans. Although species have well-established pathogenicity in urogenital infections, its involvement in septic arthritis has been limited to prosthetic joint infections and immunocompromised individuals. We present a rare case of native right knee infection due to identified using next-generation sequencing of microbial cell-free DNA testing and confirmed with PCR assays.

Rare case of lung abscess.

genus comprises of obligate anaerobic, gram-negative bacteria that are commensal organisms of oral cavity, gut and vaginal mucosa. Although many species have well-established pathogenicity with respect to pulmonary infections, rarely has been isolated as a cause of lung abscess. We present a rare case of left lower lobe lung abscess due to identified using next-generation sequencing of microbial cell-free DNA testing.

Spontaneous coronary artery dissection, a commonly overlooked etiology of acute coronary syndrome.

Spontaneous coronary artery dissection (SCAD) is a type of non-atherosclerotic coronary artery disease, initially thought to be uncommon but is now being increasingly recognized as a cause of acute coronary syndrome in females. The exact incidence of this remains unknown and most of these cases undergo emergent percutaneous intervention (PCI) due to concern for acute coronary syndrome (ACS). Prior studies have shown that PCI can be detrimental in these cases.

Testicular Adrenal Rest Tumour (TART) or Testicular Malignancy: A Clinical Dilemma.

Unlabelled: Testicular adrenal rest tumour (TART) is a known entity in patients with congenital adrenal hyperplasia. An adult patient presenting with testicular enlargement raises a concern for malignancy and this creates a diagnostic dilemma between non-malignant conditions such as TART versus testicular malignancy. We describe a case where the patient underwent orchiectomy due to clinical concern for malignancy but, retrospectively, this outcome could have been prevented by medical treatment.

abscess following breast nipple piercing.

is a non-tuberculous rapidly growing mycobacteria (RGM). We present a case of a 30 year old female who developed a right breast subareolar abscess due to fortuitum four months after a nipple piercing. She failed to respond to an initial three-week course of monotherapy with trimethoprim-sulfamethoxazole despite aspiration of abscess and removal of offending nipple piercing.