Background:Whipple’s Disease(WD)is a chronic and recurrent multisystem disease caused by Tropheryma whipplei(TW).Typically,MTB infection compromises the immune system.However,clinical reports of MTB and TW co-infecti...Background:Whipple’s Disease(WD)is a chronic and recurrent multisystem disease caused by Tropheryma whipplei(TW).Typically,MTB infection compromises the immune system.However,clinical reports of MTB and TW co-infection are rare.Methods:This study retrospectively analyzed the admission symptoms and biochemical test results of 39 patients co-infected with MTB and TW between January 1,2023,and August 31,2024,at the Infectious Disease Hospital of Heilongjiang Province,China.This study further compared the admission indicators between individuals with co-infections involving more than two pathogens(multi-infected)and those infected with only MTB and TW(Co-Infected).Results:The hospitalized patients had a median age of 50(39–58)years.Most of the patients were male(69.23%,27/39).Most patients presented with cough(87.18%,34/39),sputum production(76.92%,30/39),shortness of breath(64.10%,25/39),and reduced appetite or even anorexia(53.85%,21/39).However,fever(41.03%,14/39)and fatigue(41.03%,16/39)were less common.Among the patients who underwent these four biochemical tests,the majority(86.36%,19/22)had an A/G ratio below the normal range at the time of admission,primarily due to an increase in serum globulin levels.Multi-Infected group had higher levels of alanine aminotransferase than the Co-Infected group(17 vs.10,p=0.035),and aspartate aminotransferase is also higher in the multi-infected group compared to the Co-Infected group(20 vs.14,p=0.034).Conclusion:This is the first study to report the coinfection of Tropheryma whipplei(TW)and Mycobacterium tuberculosis(MTB)in Heilongjiang Province,China.However,this study did not find significant differences from descriptions in existing literature.Therefore,this study has provided a descriptive analysis to serve as a reference for further understanding TW infections.展开更多
BACKGROUND An epidemic of Mycobacterium chimaera (M. chimaera) infections following cardiac surgery is ongoing worldwide. The outbreak was first discovered in 2011, and it has been traced to a point source contaminati...BACKGROUND An epidemic of Mycobacterium chimaera (M. chimaera) infections following cardiac surgery is ongoing worldwide. The outbreak was first discovered in 2011, and it has been traced to a point source contamination of the LivaNova 3T heater-cooler unit, which is used also in Italy. International data are advocated to clarify the spectrum of clinical features of the disease as well as treatment options and outcome. We report a series of M. chimaera infections diagnosed in Treviso Hospital, including the first cases notified in Italy in 2016. CASE SUMMARY Since June 2016, we diagnosed a M. chimaera infection in nine patient who had undergone cardiac valve surgery between February 2011 and November 2016. The time between cardiac surgery and developing symptoms ranged from 6 to 97 mo. Unexplained fever, psychophysical decay, weight loss, and neurological symptoms were common complaints. The median duration of symptoms was 32 wk, and the longest was almost two years. A new cardiac murmur, splenomegaly, choroidoretinitis, anaemia or lymphopenia, abnormal liver function tests and hyponatremia were common findings. All the patients presented a prosthetic valve endocarditis, frequently associated to an ascending aortic pseudoneurysm or spondylodiscitis. M. chimaera was cultured from blood, bioprosthetic tissue, pericardial abscess, vertebral tissue, and bone marrow. Mortality is high in our series, reflecting the poor outcome observed in other reports. Three patients have undergone repeat cardiac surgery. Five patients are being treated with a targeted multidrug antimycobacterial regimen. CONCLUSION Patients who have undergone cardiac surgery in Italy and presenting with signs and symptoms of endocarditis must be tested for M. chimaera.展开更多
Introduction: Every year, nearly 4 million people pass away from acute respiratory infections. 98% of such deaths are due to lower respiratory tract infections. Even though studies have been carried on lower respirato...Introduction: Every year, nearly 4 million people pass away from acute respiratory infections. 98% of such deaths are due to lower respiratory tract infections. Even though studies have been carried on lower respiratory infections x-ray aspects in Mali, very few studies have been done to reveal bacteriological and virological evidence of this disease. Materials and methods: It is about a descriptive prospective study carried out from January to December 2018 having involved patients of all ages, coming for medical consultation at the Yirimadio Community-based health center as well as children from 6 months to 15 years old coming at the pediatric department of UHC Hôpital du Mali for a lower respiratory infection. They had all undergone chest X-ray and a PCR. The purpose: of this work is to study etiological and x-ray aspects of acute lower respiratory infections at the Yirimadio Community-based Health Center and at the UHC pediatric department of Hôpital du Mali. Findings: From January to December 2018, we recorded a frequency of 1.19%. The age group 0 - 5 years was the most represented (64.5%) with a sex ratio of 0.97 for women. Cough was the most common clinical sign (98.7%) followed by fever (58.9%). Standard frontal chest X-ray was pathological in 70% of our patients. It was bronchitis in 75.4% of cases, pneumonia (13.5%), and bronchopneumonia (12.3%). PCR positive was in 83.9% of patients. It revealed a co-infection in more than half of the patients (52.5%), bacterial infection (16.1%) and viral infection (15.2%). Pathogens isolated ranked by frequency were Streptococcus pneumoniaa (87.6%) followed by Staphylococcus aureus (24.9%) and human rhinovirus (17%). The most common viral causes were human rhinovirus (17%), followed by influenza A and B virus (7%) and human parainfluenza virus (7%). Conclusion: It stemed from the study that lower respiratory infections were mainly due to Streptococcus pneumonea and human rhinovirus during pre-COVID at the Yirimadio Community-based health center and UHC Hôpital du Mali.展开更多
BACKGROUND Mycobacterium abscessus(M.abscessus)is a rapidly growing mycobacterium and ubiquitous in the environment,which infrequently causes disease in humans.However,it can cause cutaneous or respiratory infections ...BACKGROUND Mycobacterium abscessus(M.abscessus)is a rapidly growing mycobacterium and ubiquitous in the environment,which infrequently causes disease in humans.However,it can cause cutaneous or respiratory infections among immunocompromised hosts.Due to the resistance to most antibiotics,the pathogen is formidable and difficult-to-treat.CASE SUMMARY Here,we present a case of catheter-related M.abscessus infections in a patient with motor neurone disease.Catheter and peripheral blood cultures of the patient showed positive results during Gram staining and acid-fast staining.The alarm time of catheter blood culture was 10.6 h earlier than that of peripheral blood.After removal of the peripherally inserted central catheter,secretion and catheter blood culture were positive.M.abscessus was identified by matrix-assisted laser desorption ionization-time of flight mass spectrometry and 16S rDNA sequencing.CONCLUSION For catheter-related M.abscessus infection,rapid diagnosis and timely and adequate antimicrobial therapy are crucial.展开更多
BACKGROUND Infections by non-tuberculous mycobacteria(NTM)have become more common in recent years.Mycobacterium canariasense(M.canariasense)was first reported as an opportunistic pathogen in 2004,but there have been v...BACKGROUND Infections by non-tuberculous mycobacteria(NTM)have become more common in recent years.Mycobacterium canariasense(M.canariasense)was first reported as an opportunistic pathogen in 2004,but there have been very few case reports since then.Nocardia is a genus of aerobic and Gram-positive bacilli,and these species are also opportunistic pathogens and in the Mycobacteriales order.Conventional methods for diagnosis of NTM are inefficient.Metagenomic next-generation sequencing(mNGS)can rapidly detect many pathogenic microorganisms,even rare species.Most NTM and Nocardia infections occur in immunocompromised patients with atypical clinical symptoms.There are no previous reports of infection by M.canariasense and Nocardia farcinica(N.farcinica),especially in immunocompetent patients.This case report describes an immunocompetent 52-year-old woman who had overlapping infections of M.canariasense,N.farcinica,and Candida parapsilosis(C.parapsilosis)based on mNGS.CASE SUMMARY A 52-year-old woman presented with a productive cough and chest pain for 2 wk,and recurrent episodes of moderate-grade fever for 1 wk.She received antibiotics for 1 wk at a local hospital,and experienced defervescence,but the productive cough and chest pain persisted.We collected samples of a lung lesion and alveolar lavage fluid for mNGS.The lung tissue was positive for M.canariasense,N.farcinica,and C.parapsilosis,and the alveolar lavage fluid was positive for M.canariasense.The diagnosis was pneumonia,and application of appropriate antibiotic therapy cured the patient.CONCLUSION Etiological diagnosis is critical for patients with infectious diseases.mNGS can identify rare and novel pathogens,and does not require a priori knowledge.展开更多
Solid organ transplantation(SOT)is the best treatment option for end-stage organ disease.Newer immunosuppressive agents have reduced the incidence of graft rejection but have increased the risk of infection,particular...Solid organ transplantation(SOT)is the best treatment option for end-stage organ disease.Newer immunosuppressive agents have reduced the incidence of graft rejection but have increased the risk of infection,particularly due to the reactivation of latent infections due to opportunistic agents such as Mycobacterium tuberculosis.Active tuberculosis(TB)after SOT is a significant cause of morbidity and mortality.Most cases of posttransplant TB are secondary to reactivation of latent tuberculosis infection(LTBI)due to the effects of long-term immunosuppressive therapy.Risk minimization strategies have been developed to diagnose LTBI and initiate treatment prior to transplantation.Isoniazid with vitamin B6 supplementation is the treatment of choice.However,liver transplantation(LT)candidates and recipients have an increased risk of isoniazid-induced liver toxicity,leading to lower treatment completion rates than in other SOT populations.Fluoroquinolones(FQs)exhibit good in vitro antimycobacterial activity and a lower risk of drug-induced liver injury than isoniazid.In the present review,we highlight the disease burden posed by posttransplant TB and summarize the emerging clinical evidence supporting the use of FQs for the treatment of LTBI in LT recipients and candidates.展开更多
Mycobacterium paragordonae(M.paragordonae),a slow-growing,acid-resistant mycobacterial species,was first isolated from the sputum of a lung infection patient in South Korea in 2014.Infections caused by M.paragordonae ...Mycobacterium paragordonae(M.paragordonae),a slow-growing,acid-resistant mycobacterial species,was first isolated from the sputum of a lung infection patient in South Korea in 2014.Infections caused by M.paragordonae are rare.CASE SUMMARY Herein,we report the case of a 53-year-old patient who presented with fever and low back pain.Lumbar nuclear magnetic resonance imaging revealed the destruction of the lumbar vertebra with peripheral abscess formation.After antiinfective and diagnostic anti-tuberculosis treatment,the patient had no further fever,but the back pain was not relieved.Postoperatively,the necrotic material was sent for pathological examination,and all tests related to tuberculosis were negative,but pus culture suggested nontuberculous mycobacteria.The necrotic tissue specimens were subjected to metagenomic next-generation sequencing,which indicated the presence of M.paragordonae.Finally,the infecting pathogen was identified,and the treatment plan was adjusted.The patient was in good condition during the follow-up period.CONCLUSION M.paragordonae,a rare nontuberculous mycobacterium,can also cause spinal infections.In the clinic,it is necessary to identify nontuberculous mycobacteria for spinal infections similar to Mycobacterium tuberculosis.展开更多
BACKGROUND: This study was to clarify the high riskfactors for subphrenic infection (SI) after liver resection forpatients with hepatic malignancy.METHODS: Three hundred and sixty-eight patients whohad undergone hepat...BACKGROUND: This study was to clarify the high riskfactors for subphrenic infection (SI) after liver resection forpatients with hepatic malignancy.METHODS: Three hundred and sixty-eight patients whohad undergone hepatectomy from January 1985 throughJune 2002 were randomly divided into 2 groups accordingto resection of liver parenchyma, hepatic cirrhosis, primaryliver cancer, intraoperative blood loss, and subphrenicdrainage. The chi-square was used for statistical analysis.RESULTS: Thirteen patients (3.53%) of the 368 patientshad SI. The high-risk factors for SI after hepatectomy wererelated to resection of liver parenchyma and hepatic cirrho-sis ; but the course or stage of primary liver cancer was notrelated to the incidence of SI. Intraoperative blood loss ofover 1500 ml was found to be a significant risk factor forpostoperative SI. Adequate drainage of the subdiaphragmand the raw surface of the liver after operation was essentialto decreasing SI after liver resection.CONCLUSION: Inadequate subphrenic drainage maylargely contribute to SI in patients with hepatic malignancyundergoing hepatectomy apart from other factors. Com-prehensive measures should be taken to prevent the infec-tion after hepatectomy.展开更多
Objectives: We analyzed the clinical characteristics of patients with pulmonary mycobacterial disease diagnosed as coincidental pulmonary infection due to Mycobacterium species. Materials and Methods: One hundred sixt...Objectives: We analyzed the clinical characteristics of patients with pulmonary mycobacterial disease diagnosed as coincidental pulmonary infection due to Mycobacterium species. Materials and Methods: One hundred sixty patients satisfied the diagnostic criteria of nontuberculous mycobacterial disease proposed by American Thoracic Society during the last seven years. Six patients (3.8%) were coincidental pulmonary infection due to two Mycobacterium species. We investigated the background, laboratory findings, microbiological findings, radiological findings, treatment and prognosis. Results: There were six patients, 3 males and 3 females, with a mean age of 71.7 years. The causative microorganisms of coincidental pulmonary infection consisted of Mycobacterium avium + Mycobacterium intracellulare in two patients, Mycobacterium avium + Mycobacterium kansasii in one, Mycobacterium intracellulare + Mycobacterium chelonae in one, Mycobacterium intracellulare + Mycobacterium abscessus in one, and Mycobacterium intracellulare + Mycobacterium tuberculosis in one. Regarding the radiological findings, the distribution of the lesion was frequently shown in both the right middle and left lingula lobes, but the extent of the lesion was limited within the unilateral lung field. Centrilobular small nodules with bronchiectasis were recognized in all patients and cavities or infiltration shadows were recognized in half of them on chest computed tomography. A definite diagnosis was obtained by bronchoalveolar lavage fluid in four patients and expectorated sputum in two. Combined chemotherapy was performed for two patients and that for pulmonary tuberculosis in one. Conclusions: Coincidental pulmonary infection due to Mycobactterium species occurred at a low percentage. Although most patients were elderly with underlying disease and clinical features were compatible with pulmonary Mycobacterium avium complex disease, the prognosis was comparatively good with and without treatment.展开更多
BACKGROUND In recent years,the cosmetic intervention related infections caused by nontuberculous mycobacteria(NTM)are increasing as the informal cosmetic treatments are performed.However,many dermatologists are inexpe...BACKGROUND In recent years,the cosmetic intervention related infections caused by nontuberculous mycobacteria(NTM)are increasing as the informal cosmetic treatments are performed.However,many dermatologists are inexperienced in the diagnosis and management of similar cases.Here we report a case of subcutaneous infection caused by Mycobacterium abscessus(M.abscessus)following cosmetic injections of botulinum toxin.CASE SUMMARY A 53-year-old woman presented with multiple abscesses and nodules on her forehead and both temporal sites for half a month after cosmetic injections of botulinum toxin.Her lesions did not show any alleviation after 2-wk prescription of antibiotics.Laboratory examinations indicated that she had no sign of immunodeficiency and the whole body of computed tomography did not find any systemic infection or diseases.The pathology of skin tissue showed inflammatory cell infiltration with the negative results of Periodic acid Schiff(PAS)and Acidfast staining and the culture yielded no microbiome.Afterwards,the puncture on abscess was performed and M.abscessus was successfully isolated.The pathogen was identified by acid-fast staining and DNA sequencing.The patient was treated with the strategy of clarithromycin,ofloxacin,and amikacin according to the result of drug sensitivity test and got complete remission of the lesions.CONCLUSION The case presents the whole process of diagnosis and management of NTM infection after cosmetic intervention and highlights the diagnostic thoughts.In a word,the mycobacterium infection should be aware in patients after cosmetic performance.展开更多
<b><span style="font-family:Verdana;">Objective: </span></b><span style="font-family:;" "=""><span style="font-family:Verdana;">To under...<b><span style="font-family:Verdana;">Objective: </span></b><span style="font-family:;" "=""><span style="font-family:Verdana;">To understand the distribution of drug susceptibility test results of opportunistic infections of tuberculosis and non-tuberculous bacilli in AIDS patients. </span><b><span style="font-family:Verdana;">Methods: </span></b><span style="font-family:Verdana;">The AIDS patients who were hospitalized in our hospital from January 2016 to June 2019 were collected as the research objects, and patients with opportunistic tuberculosis and non-tuberculous bacilli from AIDS patients were screened for drug susceptibility tests, and the distribution characteristics of drug susceptibility were analyzed. </span><b><span style="font-family:Verdana;">Results: </span></b><span><span style="font-family:Verdana;">179 strains of tuberculosis and non-tuberculous mycobacteria were isolated from the specimens of AIDS patients, including 135 cases of tuberculosis mycobacteria and 44 cases of non-tuberculous mycobacteria. In the results of the drug susceptibility test, most strains of </span><i></i></span><i><i><span style="font-family:Verdana;">Mycobacterium tuberculosis</span></i><span></span></i><span style="font-family:Verdana;"> showed sensitivity to commonly used drugs, and a few strains showed resistance;most strains </span></span><span style="font-family:Verdana;">of non-tuberculous mycobacteria showed resistance, and a few strains showed</span><span style="font-family:Verdana;"> sensitivity. </span><b><span style="font-family:Verdana;">Conclusion: </span></b><span><span style="font-family:Verdana;">AIDS opportunistic infection of </span><i></i></span><i><i><span style="font-family:Verdana;">Mycobacterium tuberculosis</span></i><span></span></i><span style="font-family:Verdana;"> and non-tuberculous mycobacteria have significant differences in drug sensitivity test results. Timely detection and analysis are of great significance to the diagnosis and treatment of the disease.</span>展开更多
Extracellular vesicles(EVs)are cystic vesicles naturally released by most mammalian cells and bacteria.EV contents include proteins,lipids,and nucleic acids.EVs can act as messengers to transmit a variety of molecules...Extracellular vesicles(EVs)are cystic vesicles naturally released by most mammalian cells and bacteria.EV contents include proteins,lipids,and nucleic acids.EVs can act as messengers to transmit a variety of molecules to recipient cells and thus play important regulatory roles in intercellular signal transduction.EVs,released by either a host cell or a pathogen,can carry pathogen-associated antigens and thus act as modulators of immune responses.EVs derived from Mycobacterium tuberculosis(Mtb)-infected cells can regulate the innate immune response through various pathways,such as regulating the release of inflammatory cytokines.In addition,EVs can mediate antigen presentation and regulate the adaptive immune response by transmitting immunoregulatory molecules to T helper cells.In this review,we summarize the regulatory roles of EVs in the immune response against Mtb.展开更多
70 clinical Mycobacterium tuberculosis strains isolated from AIDS patients in two HIV/AIDS referral hospitals in Beijing were used in this study.M.tuberculosis and non-tuberculosis mycobacterium（NTM）were identified ...70 clinical Mycobacterium tuberculosis strains isolated from AIDS patients in two HIV/AIDS referral hospitals in Beijing were used in this study.M.tuberculosis and non-tuberculosis mycobacterium（NTM）were identified by using multi-locus PCR.M.tuberculosis was genotyped by using 15-locus MIRU-VNTR technique and spoligotyping afterwards.Meanwhile,the drug susceptibilities of the strains to the four first-line anti TB drugs（rifampin,isoniazid,streptomycin, and ethambutol） and the four second-line anti-TB drugs （capreomycin, kanamycin, ofloxacin, and ethionanide） were tested with proportional method. In this study, M. tuberculosis and NTM strains isolated from AIDS patients with TB-like symptoms were identified and genotyping analysis indicated that Beijing genotype was the predominant genotype. In addition, the prevalence of drug-resistant TB, especially the prevalence of XDR-TB, was higher than that in TB patients without HIV infection.展开更多
Background: Infectious keratitis after refractive surgery is uncommon, and mycobacterium abscess has never been observed in corneal infections in China. Purpose: To propose an unusual presentation of two cases about M...Background: Infectious keratitis after refractive surgery is uncommon, and mycobacterium abscess has never been observed in corneal infections in China. Purpose: To propose an unusual presentation of two cases about Mycobacterium abscess infection after laser in situ keratomileusis (LASIK). Participants: Both cases 1 and 2 were females who exhibited a corneal ulceration after LASIK in the same hospital. Methods: The first patient in the study was a 28-year-old woman who underwent Epi-LASIK surgery in both eyes. She developed an infectious corneal ulcer in one eye after 50 days post-surgery. She was referred to our out-patient clinic 3 months post-surgery with corneal perforation, and was treated with a therapeutic penetrating keratoplasty. The second patient was a 27-year-old woman who developed infectious keratitis in one eye after 2 months after bilateral LASIK and was referred to us 3 months later. Results: Cultures in both the cases were identified as a Mycobacterium abscess, and case 1 was treated with penetrating keratoplasty eventually, while case 2 recovered after sensitive treatment. Conclusions: Infectious keratitis after refractive surgery is uncommon, and Mycobacterium abscess has never been observed in corneal infections. An accurate diagnosis and identification of the causative agent is very important.展开更多
BACKGROUND The incidence of infection with Mycobacterium abscessus(M.abscessus)has increased in recent years.This increase is partly associated with invasive cosmetic procedures.CASE SUMMARY The purpose of this case s...BACKGROUND The incidence of infection with Mycobacterium abscessus(M.abscessus)has increased in recent years.This increase is partly associated with invasive cosmetic procedures.CASE SUMMARY The purpose of this case summary is to increase clinicians'awareness of M.abscessus infection and reduce mycobacterial infection caused by cosmetic procedures.We report the case of a 45-year-old woman who received acetyl hexapeptide-8(argireline)injections in the forehead and temples,and erythema,nodules,and abscesses appeared at the injection sites after one week.The pus specimens were examined by microbiological culture and confirmed to be positive for M.abscessus.Clarithromycin 500 mg twice daily and moxifloxacin 400 mg once daily were administered for 5 mo and the lesions gradually subsided.CONCLUSION We report here for the first time a case of infection with M.abscessus after argireline injection.This condition is easily misdiagnosed as a common bacterial infection.Microbiological examinations are helpful for diagnosis and standardized cosmetic procedures can prevent infection with M.abscessus.展开更多
Epididymo-Orchitis (EO) is a disease that may affect males in all ages. Neonates and elderly patients may suffer from bacterial infection due to congenital or aging processes affecting the urinary tract. In sexually a...Epididymo-Orchitis (EO) is a disease that may affect males in all ages. Neonates and elderly patients may suffer from bacterial infection due to congenital or aging processes affecting the urinary tract. In sexually active post pubertal and young males sexually transmitted organisms may cause EO. EO is also prevalent in pre pubertal healthy boys;however in this group the etiology, the needed imaging modalities and proper management are not clearly defined yet. This manuscript will systematically review the various etiologies causing EO in pre-pubertal boys, discus about the needed proper imaging, and image interpretation, will give treatment and follow-up recommendations.展开更多
The notion that Crohn’s Disease (CD) occurs as a result of an aberrant reaction to the commensal microbiota in genetically susceptible hosts is widely regarded by physicians and scientists as fact. Yet although it is...The notion that Crohn’s Disease (CD) occurs as a result of an aberrant reaction to the commensal microbiota in genetically susceptible hosts is widely regarded by physicians and scientists as fact. Yet although it is undisputed that Crohn’s Disease is immune-mediated, an aberrant reaction to one’s own native flora is far from proven. The aim of the current review is to present a summary of the known infectious causes of Crohn’s Disease, whilst highlighting the limitations of using outdated methods to attempt to classify the disease as a single entity. We propose a re-classification of Crohn’s Disease, and suggest that the disease is best conceptualized as a syndrome, an “umbrella-like” term comprising a group of diseases with varying infective etiologies, which clinically, endoscopically and histologically are indistinguishable from CD.展开更多
BACKGROUND Mycobacterium species(Mycobacterium sp)is an emerging cause of hip and knee prosthetic joint infection(PJI),and different species of this organism may be responsible for the same.AIM To evaluate the profile...BACKGROUND Mycobacterium species(Mycobacterium sp)is an emerging cause of hip and knee prosthetic joint infection(PJI),and different species of this organism may be responsible for the same.AIM To evaluate the profile of hip and knee Mycobacterium PJI cases as published in the past 30 years.METHODS A literature search was performed in PubMed using the MeSH terms“Prosthesis joint infection”AND“Mycobacterium”for studies with publication dates from January 1,1990,to May 30,2021.To avoid missing any study,another search was performed with the terms“Arthroplasty infection”AND“Mycobacterium”in the same period as the previous search.The Preferred Reporting Items for Systematic Reviews and Meta-Analyses chart was used to evaluate the included studies for further review.In total,51 studies were included for further evaluation of thecases,type of pathogen,and treatment of PJI caused by Mycobacterium sp.RESULTS Seventeen identified Mycobacterium sp were reportedly responsible for hip/knee PJI in 115 hip/knee PJI cases,whereas in two cases there was no mention of any specific Mycobacterium sp.Mycobacterium tuberculosis(M.tuberculosis)was detected in 50/115(43.3%)of the cases.Nontuberculous mycobacteria(NTM)included M.fortuitum(26/115,22.6%),M.abscessus(10/115,8.6%),M.chelonae(8/115,6.9%),and M.bovis(8/115,6.9%).Majority of the cases(82/114,71.9%)had an onset of infection>3 mo after the index surgery,while in 24.6%(28/114)the disease had an onset in≤3 mo.Incidental intraoperative PJI diagnosis was made in 4 cases(3.5%).Overall,prosthesis removal was needed in 77.8%(84/108)of the cases to treat the infection.Overall infection rate was controlled in 88/102(86.3%)patients with Mycobacterium PJI.Persistent infection occurred in 10/108(9.8%)patients,while 4/108(3.9%)patients died due to the infection.CONCLUSION At least 17 Mycobacterium sp can be responsible for hip/knee PJI.Although M.tuberculosis is the most common causal pathogen,NTM should be considered as an emerging cause of hip/knee PJI.展开更多
BACKGROUND Mycobacterium mucogenicum(M.mucogenicum)belongs to the group of rapidly growing Nontuberculous mycobacteria.This microorganism is associated with a wide spectrum of infectious diseases.Due to a low detectio...BACKGROUND Mycobacterium mucogenicum(M.mucogenicum)belongs to the group of rapidly growing Nontuberculous mycobacteria.This microorganism is associated with a wide spectrum of infectious diseases.Due to a low detection rate or the time required for conventional culture methodology,a rapid and broad-spectrum method is necessary to identify rare pathogens.CASE SUMMARY A 12-year-old immunocompetent girl presented with painful masses for five months.The first mass was found in the right upper quadrant of the abdomen,and was about 1 cm×1.5 cm in size,tough but pliable in texture,with an irregular margin and tenderness.An abscess gradually formed and ulcerated with suppuration of the mass.Three new masses appeared on the back one by one.Chest computed tomography showed patchy and streaky cloudy opacities in both lungs.Needle aspiration of the abscess was performed,but the smear and conventional culture were negative,and the pathological examination showed no pathogens.We then performed next-generation sequencing using a formalinfixed,paraffin-embedded specimen to identify the pathogen.A significantly high abundance of M.mucogenicum was detected.The patient’s abscesses gradually decreased in size,while inflammation in both lungs improved following 12-wk of treatment.No recurrence was observed four months after the end of the one-year treatment period.CONCLUSION Next-generation sequencing is a promising tool for the rapid and accurate diagnosis of rare pathogens,even when using a formalin-fixed,paraffin-embedded specimen.展开更多
Introduction: In emerging countries where studies are rarer, the epidemiological profile of infective endocarditis resembles that of developed countries at the beginning of the antibiotic era. There is little data ava...Introduction: In emerging countries where studies are rarer, the epidemiological profile of infective endocarditis resembles that of developed countries at the beginning of the antibiotic era. There is little data available in Mali on this subject, motivating this study, the aim of which was to study the etiological factors of infective endocarditis in children aged between 1 month and 15 years hospitalised in the paediatric department of the CHU Gabriel Touré. Patients and Methods: We conducted a cross-sectional and descriptive study, which took place from August 2018 to August 2019 (13 months), in children aged between 1 month and 15 years hospitalised in the paediatric department of the Gabriel Touré University Hospital with an ultrasound- confirmed cardiac disease and a temperature above 38°C. Results: The hospitalization rate was 0.4%. The average age was 11 months, the sex ratio was 1.35. Respiratory distress (63.6%) and fever (30.3%) were the most common reasons for referral. Congenital heart disease (87.9%) and dyspnoea on feeding (24.2%) were the most common medical histories. IVC was the most frequent congenital heart disease (36.4%). The mean temperature was 39.1°C. Blood cultures were taken in 24 patients (72.7%) and were positive in 27.3%. Staphylococcus aureus was found in 55.6% of cases. Trans-thoracic ultrasound found vegetations in 03 cases. According to the modified DUKE criteria, the diagnosis of endocarditis was retained in 27.30%. The evolution was marked by a high case fatality rate (45.45%). Conclusion: Endocarditis is an uncommon disease in children with a pulmonary portal of entry and Staphylococcus aureus as the main germ. Its mortality remains high.展开更多
文摘Background:Whipple’s Disease(WD)is a chronic and recurrent multisystem disease caused by Tropheryma whipplei(TW).Typically,MTB infection compromises the immune system.However,clinical reports of MTB and TW co-infection are rare.Methods:This study retrospectively analyzed the admission symptoms and biochemical test results of 39 patients co-infected with MTB and TW between January 1,2023,and August 31,2024,at the Infectious Disease Hospital of Heilongjiang Province,China.This study further compared the admission indicators between individuals with co-infections involving more than two pathogens(multi-infected)and those infected with only MTB and TW(Co-Infected).Results:The hospitalized patients had a median age of 50(39–58)years.Most of the patients were male(69.23%,27/39).Most patients presented with cough(87.18%,34/39),sputum production(76.92%,30/39),shortness of breath(64.10%,25/39),and reduced appetite or even anorexia(53.85%,21/39).However,fever(41.03%,14/39)and fatigue(41.03%,16/39)were less common.Among the patients who underwent these four biochemical tests,the majority(86.36%,19/22)had an A/G ratio below the normal range at the time of admission,primarily due to an increase in serum globulin levels.Multi-Infected group had higher levels of alanine aminotransferase than the Co-Infected group(17 vs.10,p=0.035),and aspartate aminotransferase is also higher in the multi-infected group compared to the Co-Infected group(20 vs.14,p=0.034).Conclusion:This is the first study to report the coinfection of Tropheryma whipplei(TW)and Mycobacterium tuberculosis(MTB)in Heilongjiang Province,China.However,this study did not find significant differences from descriptions in existing literature.Therefore,this study has provided a descriptive analysis to serve as a reference for further understanding TW infections.
文摘BACKGROUND An epidemic of Mycobacterium chimaera (M. chimaera) infections following cardiac surgery is ongoing worldwide. The outbreak was first discovered in 2011, and it has been traced to a point source contamination of the LivaNova 3T heater-cooler unit, which is used also in Italy. International data are advocated to clarify the spectrum of clinical features of the disease as well as treatment options and outcome. We report a series of M. chimaera infections diagnosed in Treviso Hospital, including the first cases notified in Italy in 2016. CASE SUMMARY Since June 2016, we diagnosed a M. chimaera infection in nine patient who had undergone cardiac valve surgery between February 2011 and November 2016. The time between cardiac surgery and developing symptoms ranged from 6 to 97 mo. Unexplained fever, psychophysical decay, weight loss, and neurological symptoms were common complaints. The median duration of symptoms was 32 wk, and the longest was almost two years. A new cardiac murmur, splenomegaly, choroidoretinitis, anaemia or lymphopenia, abnormal liver function tests and hyponatremia were common findings. All the patients presented a prosthetic valve endocarditis, frequently associated to an ascending aortic pseudoneurysm or spondylodiscitis. M. chimaera was cultured from blood, bioprosthetic tissue, pericardial abscess, vertebral tissue, and bone marrow. Mortality is high in our series, reflecting the poor outcome observed in other reports. Three patients have undergone repeat cardiac surgery. Five patients are being treated with a targeted multidrug antimycobacterial regimen. CONCLUSION Patients who have undergone cardiac surgery in Italy and presenting with signs and symptoms of endocarditis must be tested for M. chimaera.
文摘Introduction: Every year, nearly 4 million people pass away from acute respiratory infections. 98% of such deaths are due to lower respiratory tract infections. Even though studies have been carried on lower respiratory infections x-ray aspects in Mali, very few studies have been done to reveal bacteriological and virological evidence of this disease. Materials and methods: It is about a descriptive prospective study carried out from January to December 2018 having involved patients of all ages, coming for medical consultation at the Yirimadio Community-based health center as well as children from 6 months to 15 years old coming at the pediatric department of UHC Hôpital du Mali for a lower respiratory infection. They had all undergone chest X-ray and a PCR. The purpose: of this work is to study etiological and x-ray aspects of acute lower respiratory infections at the Yirimadio Community-based Health Center and at the UHC pediatric department of Hôpital du Mali. Findings: From January to December 2018, we recorded a frequency of 1.19%. The age group 0 - 5 years was the most represented (64.5%) with a sex ratio of 0.97 for women. Cough was the most common clinical sign (98.7%) followed by fever (58.9%). Standard frontal chest X-ray was pathological in 70% of our patients. It was bronchitis in 75.4% of cases, pneumonia (13.5%), and bronchopneumonia (12.3%). PCR positive was in 83.9% of patients. It revealed a co-infection in more than half of the patients (52.5%), bacterial infection (16.1%) and viral infection (15.2%). Pathogens isolated ranked by frequency were Streptococcus pneumoniaa (87.6%) followed by Staphylococcus aureus (24.9%) and human rhinovirus (17%). The most common viral causes were human rhinovirus (17%), followed by influenza A and B virus (7%) and human parainfluenza virus (7%). Conclusion: It stemed from the study that lower respiratory infections were mainly due to Streptococcus pneumonea and human rhinovirus during pre-COVID at the Yirimadio Community-based health center and UHC Hôpital du Mali.
文摘BACKGROUND Mycobacterium abscessus(M.abscessus)is a rapidly growing mycobacterium and ubiquitous in the environment,which infrequently causes disease in humans.However,it can cause cutaneous or respiratory infections among immunocompromised hosts.Due to the resistance to most antibiotics,the pathogen is formidable and difficult-to-treat.CASE SUMMARY Here,we present a case of catheter-related M.abscessus infections in a patient with motor neurone disease.Catheter and peripheral blood cultures of the patient showed positive results during Gram staining and acid-fast staining.The alarm time of catheter blood culture was 10.6 h earlier than that of peripheral blood.After removal of the peripherally inserted central catheter,secretion and catheter blood culture were positive.M.abscessus was identified by matrix-assisted laser desorption ionization-time of flight mass spectrometry and 16S rDNA sequencing.CONCLUSION For catheter-related M.abscessus infection,rapid diagnosis and timely and adequate antimicrobial therapy are crucial.
基金Supported by The Guangxi TCM Suitable Technology Development and Promotion Project,No.GZSY20-20.
文摘BACKGROUND Infections by non-tuberculous mycobacteria(NTM)have become more common in recent years.Mycobacterium canariasense(M.canariasense)was first reported as an opportunistic pathogen in 2004,but there have been very few case reports since then.Nocardia is a genus of aerobic and Gram-positive bacilli,and these species are also opportunistic pathogens and in the Mycobacteriales order.Conventional methods for diagnosis of NTM are inefficient.Metagenomic next-generation sequencing(mNGS)can rapidly detect many pathogenic microorganisms,even rare species.Most NTM and Nocardia infections occur in immunocompromised patients with atypical clinical symptoms.There are no previous reports of infection by M.canariasense and Nocardia farcinica(N.farcinica),especially in immunocompetent patients.This case report describes an immunocompetent 52-year-old woman who had overlapping infections of M.canariasense,N.farcinica,and Candida parapsilosis(C.parapsilosis)based on mNGS.CASE SUMMARY A 52-year-old woman presented with a productive cough and chest pain for 2 wk,and recurrent episodes of moderate-grade fever for 1 wk.She received antibiotics for 1 wk at a local hospital,and experienced defervescence,but the productive cough and chest pain persisted.We collected samples of a lung lesion and alveolar lavage fluid for mNGS.The lung tissue was positive for M.canariasense,N.farcinica,and C.parapsilosis,and the alveolar lavage fluid was positive for M.canariasense.The diagnosis was pneumonia,and application of appropriate antibiotic therapy cured the patient.CONCLUSION Etiological diagnosis is critical for patients with infectious diseases.mNGS can identify rare and novel pathogens,and does not require a priori knowledge.
基金“Plan Nacional de I+D+I”Instituto de Salud Carlos III(Fondo de Investigaciones Sanitarias [FIS] PI14/00174)+1 种基金ubdirección General de Redes y Centros de Investigación Cooperativa,Spanish Ministry of Science,Innovation and Universities,Spanish Network for Research in Infectious Diseases(REIPI RD16/0016)cofinanced by the European Development Regional Fund(EDRF)"A way to achieve Europe"
文摘Solid organ transplantation(SOT)is the best treatment option for end-stage organ disease.Newer immunosuppressive agents have reduced the incidence of graft rejection but have increased the risk of infection,particularly due to the reactivation of latent infections due to opportunistic agents such as Mycobacterium tuberculosis.Active tuberculosis(TB)after SOT is a significant cause of morbidity and mortality.Most cases of posttransplant TB are secondary to reactivation of latent tuberculosis infection(LTBI)due to the effects of long-term immunosuppressive therapy.Risk minimization strategies have been developed to diagnose LTBI and initiate treatment prior to transplantation.Isoniazid with vitamin B6 supplementation is the treatment of choice.However,liver transplantation(LT)candidates and recipients have an increased risk of isoniazid-induced liver toxicity,leading to lower treatment completion rates than in other SOT populations.Fluoroquinolones(FQs)exhibit good in vitro antimycobacterial activity and a lower risk of drug-induced liver injury than isoniazid.In the present review,we highlight the disease burden posed by posttransplant TB and summarize the emerging clinical evidence supporting the use of FQs for the treatment of LTBI in LT recipients and candidates.
文摘Mycobacterium paragordonae(M.paragordonae),a slow-growing,acid-resistant mycobacterial species,was first isolated from the sputum of a lung infection patient in South Korea in 2014.Infections caused by M.paragordonae are rare.CASE SUMMARY Herein,we report the case of a 53-year-old patient who presented with fever and low back pain.Lumbar nuclear magnetic resonance imaging revealed the destruction of the lumbar vertebra with peripheral abscess formation.After antiinfective and diagnostic anti-tuberculosis treatment,the patient had no further fever,but the back pain was not relieved.Postoperatively,the necrotic material was sent for pathological examination,and all tests related to tuberculosis were negative,but pus culture suggested nontuberculous mycobacteria.The necrotic tissue specimens were subjected to metagenomic next-generation sequencing,which indicated the presence of M.paragordonae.Finally,the infecting pathogen was identified,and the treatment plan was adjusted.The patient was in good condition during the follow-up period.CONCLUSION M.paragordonae,a rare nontuberculous mycobacterium,can also cause spinal infections.In the clinic,it is necessary to identify nontuberculous mycobacteria for spinal infections similar to Mycobacterium tuberculosis.
文摘BACKGROUND: This study was to clarify the high riskfactors for subphrenic infection (SI) after liver resection forpatients with hepatic malignancy.METHODS: Three hundred and sixty-eight patients whohad undergone hepatectomy from January 1985 throughJune 2002 were randomly divided into 2 groups accordingto resection of liver parenchyma, hepatic cirrhosis, primaryliver cancer, intraoperative blood loss, and subphrenicdrainage. The chi-square was used for statistical analysis.RESULTS: Thirteen patients (3.53%) of the 368 patientshad SI. The high-risk factors for SI after hepatectomy wererelated to resection of liver parenchyma and hepatic cirrho-sis ; but the course or stage of primary liver cancer was notrelated to the incidence of SI. Intraoperative blood loss ofover 1500 ml was found to be a significant risk factor forpostoperative SI. Adequate drainage of the subdiaphragmand the raw surface of the liver after operation was essentialto decreasing SI after liver resection.CONCLUSION: Inadequate subphrenic drainage maylargely contribute to SI in patients with hepatic malignancyundergoing hepatectomy apart from other factors. Com-prehensive measures should be taken to prevent the infec-tion after hepatectomy.
文摘Objectives: We analyzed the clinical characteristics of patients with pulmonary mycobacterial disease diagnosed as coincidental pulmonary infection due to Mycobacterium species. Materials and Methods: One hundred sixty patients satisfied the diagnostic criteria of nontuberculous mycobacterial disease proposed by American Thoracic Society during the last seven years. Six patients (3.8%) were coincidental pulmonary infection due to two Mycobacterium species. We investigated the background, laboratory findings, microbiological findings, radiological findings, treatment and prognosis. Results: There were six patients, 3 males and 3 females, with a mean age of 71.7 years. The causative microorganisms of coincidental pulmonary infection consisted of Mycobacterium avium + Mycobacterium intracellulare in two patients, Mycobacterium avium + Mycobacterium kansasii in one, Mycobacterium intracellulare + Mycobacterium chelonae in one, Mycobacterium intracellulare + Mycobacterium abscessus in one, and Mycobacterium intracellulare + Mycobacterium tuberculosis in one. Regarding the radiological findings, the distribution of the lesion was frequently shown in both the right middle and left lingula lobes, but the extent of the lesion was limited within the unilateral lung field. Centrilobular small nodules with bronchiectasis were recognized in all patients and cavities or infiltration shadows were recognized in half of them on chest computed tomography. A definite diagnosis was obtained by bronchoalveolar lavage fluid in four patients and expectorated sputum in two. Combined chemotherapy was performed for two patients and that for pulmonary tuberculosis in one. Conclusions: Coincidental pulmonary infection due to Mycobactterium species occurred at a low percentage. Although most patients were elderly with underlying disease and clinical features were compatible with pulmonary Mycobacterium avium complex disease, the prognosis was comparatively good with and without treatment.
文摘BACKGROUND In recent years,the cosmetic intervention related infections caused by nontuberculous mycobacteria(NTM)are increasing as the informal cosmetic treatments are performed.However,many dermatologists are inexperienced in the diagnosis and management of similar cases.Here we report a case of subcutaneous infection caused by Mycobacterium abscessus(M.abscessus)following cosmetic injections of botulinum toxin.CASE SUMMARY A 53-year-old woman presented with multiple abscesses and nodules on her forehead and both temporal sites for half a month after cosmetic injections of botulinum toxin.Her lesions did not show any alleviation after 2-wk prescription of antibiotics.Laboratory examinations indicated that she had no sign of immunodeficiency and the whole body of computed tomography did not find any systemic infection or diseases.The pathology of skin tissue showed inflammatory cell infiltration with the negative results of Periodic acid Schiff(PAS)and Acidfast staining and the culture yielded no microbiome.Afterwards,the puncture on abscess was performed and M.abscessus was successfully isolated.The pathogen was identified by acid-fast staining and DNA sequencing.The patient was treated with the strategy of clarithromycin,ofloxacin,and amikacin according to the result of drug sensitivity test and got complete remission of the lesions.CONCLUSION The case presents the whole process of diagnosis and management of NTM infection after cosmetic intervention and highlights the diagnostic thoughts.In a word,the mycobacterium infection should be aware in patients after cosmetic performance.
文摘<b><span style="font-family:Verdana;">Objective: </span></b><span style="font-family:;" "=""><span style="font-family:Verdana;">To understand the distribution of drug susceptibility test results of opportunistic infections of tuberculosis and non-tuberculous bacilli in AIDS patients. </span><b><span style="font-family:Verdana;">Methods: </span></b><span style="font-family:Verdana;">The AIDS patients who were hospitalized in our hospital from January 2016 to June 2019 were collected as the research objects, and patients with opportunistic tuberculosis and non-tuberculous bacilli from AIDS patients were screened for drug susceptibility tests, and the distribution characteristics of drug susceptibility were analyzed. </span><b><span style="font-family:Verdana;">Results: </span></b><span><span style="font-family:Verdana;">179 strains of tuberculosis and non-tuberculous mycobacteria were isolated from the specimens of AIDS patients, including 135 cases of tuberculosis mycobacteria and 44 cases of non-tuberculous mycobacteria. In the results of the drug susceptibility test, most strains of </span><i></i></span><i><i><span style="font-family:Verdana;">Mycobacterium tuberculosis</span></i><span></span></i><span style="font-family:Verdana;"> showed sensitivity to commonly used drugs, and a few strains showed resistance;most strains </span></span><span style="font-family:Verdana;">of non-tuberculous mycobacteria showed resistance, and a few strains showed</span><span style="font-family:Verdana;"> sensitivity. </span><b><span style="font-family:Verdana;">Conclusion: </span></b><span><span style="font-family:Verdana;">AIDS opportunistic infection of </span><i></i></span><i><i><span style="font-family:Verdana;">Mycobacterium tuberculosis</span></i><span></span></i><span style="font-family:Verdana;"> and non-tuberculous mycobacteria have significant differences in drug sensitivity test results. Timely detection and analysis are of great significance to the diagnosis and treatment of the disease.</span>
基金Natural Science Foundation of the Inner Mongolia Autonomous Region for Distinguished Young Scholars,No.2020JQ07General Programs of Natural Science Foundation of the Inner Mongolia Autonomous Region,No.2020MS08126and"Zhiyuan"Talent Project of the Inner Mongolia Medical University,No.ZY0130013.
文摘Extracellular vesicles(EVs)are cystic vesicles naturally released by most mammalian cells and bacteria.EV contents include proteins,lipids,and nucleic acids.EVs can act as messengers to transmit a variety of molecules to recipient cells and thus play important regulatory roles in intercellular signal transduction.EVs,released by either a host cell or a pathogen,can carry pathogen-associated antigens and thus act as modulators of immune responses.EVs derived from Mycobacterium tuberculosis(Mtb)-infected cells can regulate the innate immune response through various pathways,such as regulating the release of inflammatory cytokines.In addition,EVs can mediate antigen presentation and regulate the adaptive immune response by transmitting immunoregulatory molecules to T helper cells.In this review,we summarize the regulatory roles of EVs in the immune response against Mtb.
基金funded by(2013ZX10003006-002-001 and 2011ZX10004-001)National Key Program of Mega Infectious DiseaseNational Natural Science Foundation(30973388)Capital Medical Development Scientific Research Fund(2009-1057)
文摘70 clinical Mycobacterium tuberculosis strains isolated from AIDS patients in two HIV/AIDS referral hospitals in Beijing were used in this study.M.tuberculosis and non-tuberculosis mycobacterium（NTM）were identified by using multi-locus PCR.M.tuberculosis was genotyped by using 15-locus MIRU-VNTR technique and spoligotyping afterwards.Meanwhile,the drug susceptibilities of the strains to the four first-line anti TB drugs（rifampin,isoniazid,streptomycin, and ethambutol） and the four second-line anti-TB drugs （capreomycin, kanamycin, ofloxacin, and ethionanide） were tested with proportional method. In this study, M. tuberculosis and NTM strains isolated from AIDS patients with TB-like symptoms were identified and genotyping analysis indicated that Beijing genotype was the predominant genotype. In addition, the prevalence of drug-resistant TB, especially the prevalence of XDR-TB, was higher than that in TB patients without HIV infection.
文摘Background: Infectious keratitis after refractive surgery is uncommon, and mycobacterium abscess has never been observed in corneal infections in China. Purpose: To propose an unusual presentation of two cases about Mycobacterium abscess infection after laser in situ keratomileusis (LASIK). Participants: Both cases 1 and 2 were females who exhibited a corneal ulceration after LASIK in the same hospital. Methods: The first patient in the study was a 28-year-old woman who underwent Epi-LASIK surgery in both eyes. She developed an infectious corneal ulcer in one eye after 50 days post-surgery. She was referred to our out-patient clinic 3 months post-surgery with corneal perforation, and was treated with a therapeutic penetrating keratoplasty. The second patient was a 27-year-old woman who developed infectious keratitis in one eye after 2 months after bilateral LASIK and was referred to us 3 months later. Results: Cultures in both the cases were identified as a Mycobacterium abscess, and case 1 was treated with penetrating keratoplasty eventually, while case 2 recovered after sensitive treatment. Conclusions: Infectious keratitis after refractive surgery is uncommon, and Mycobacterium abscess has never been observed in corneal infections. An accurate diagnosis and identification of the causative agent is very important.
基金The Scientific Research Project of Peking University Shenzhen Hospital,No.JCYJ2018011the San-ming Project of Medicine in Shenzhen,No.SZSM201812059.
文摘BACKGROUND The incidence of infection with Mycobacterium abscessus(M.abscessus)has increased in recent years.This increase is partly associated with invasive cosmetic procedures.CASE SUMMARY The purpose of this case summary is to increase clinicians'awareness of M.abscessus infection and reduce mycobacterial infection caused by cosmetic procedures.We report the case of a 45-year-old woman who received acetyl hexapeptide-8(argireline)injections in the forehead and temples,and erythema,nodules,and abscesses appeared at the injection sites after one week.The pus specimens were examined by microbiological culture and confirmed to be positive for M.abscessus.Clarithromycin 500 mg twice daily and moxifloxacin 400 mg once daily were administered for 5 mo and the lesions gradually subsided.CONCLUSION We report here for the first time a case of infection with M.abscessus after argireline injection.This condition is easily misdiagnosed as a common bacterial infection.Microbiological examinations are helpful for diagnosis and standardized cosmetic procedures can prevent infection with M.abscessus.
文摘Epididymo-Orchitis (EO) is a disease that may affect males in all ages. Neonates and elderly patients may suffer from bacterial infection due to congenital or aging processes affecting the urinary tract. In sexually active post pubertal and young males sexually transmitted organisms may cause EO. EO is also prevalent in pre pubertal healthy boys;however in this group the etiology, the needed imaging modalities and proper management are not clearly defined yet. This manuscript will systematically review the various etiologies causing EO in pre-pubertal boys, discus about the needed proper imaging, and image interpretation, will give treatment and follow-up recommendations.
文摘The notion that Crohn’s Disease (CD) occurs as a result of an aberrant reaction to the commensal microbiota in genetically susceptible hosts is widely regarded by physicians and scientists as fact. Yet although it is undisputed that Crohn’s Disease is immune-mediated, an aberrant reaction to one’s own native flora is far from proven. The aim of the current review is to present a summary of the known infectious causes of Crohn’s Disease, whilst highlighting the limitations of using outdated methods to attempt to classify the disease as a single entity. We propose a re-classification of Crohn’s Disease, and suggest that the disease is best conceptualized as a syndrome, an “umbrella-like” term comprising a group of diseases with varying infective etiologies, which clinically, endoscopically and histologically are indistinguishable from CD.
文摘BACKGROUND Mycobacterium species(Mycobacterium sp)is an emerging cause of hip and knee prosthetic joint infection(PJI),and different species of this organism may be responsible for the same.AIM To evaluate the profile of hip and knee Mycobacterium PJI cases as published in the past 30 years.METHODS A literature search was performed in PubMed using the MeSH terms“Prosthesis joint infection”AND“Mycobacterium”for studies with publication dates from January 1,1990,to May 30,2021.To avoid missing any study,another search was performed with the terms“Arthroplasty infection”AND“Mycobacterium”in the same period as the previous search.The Preferred Reporting Items for Systematic Reviews and Meta-Analyses chart was used to evaluate the included studies for further review.In total,51 studies were included for further evaluation of thecases,type of pathogen,and treatment of PJI caused by Mycobacterium sp.RESULTS Seventeen identified Mycobacterium sp were reportedly responsible for hip/knee PJI in 115 hip/knee PJI cases,whereas in two cases there was no mention of any specific Mycobacterium sp.Mycobacterium tuberculosis(M.tuberculosis)was detected in 50/115(43.3%)of the cases.Nontuberculous mycobacteria(NTM)included M.fortuitum(26/115,22.6%),M.abscessus(10/115,8.6%),M.chelonae(8/115,6.9%),and M.bovis(8/115,6.9%).Majority of the cases(82/114,71.9%)had an onset of infection>3 mo after the index surgery,while in 24.6%(28/114)the disease had an onset in≤3 mo.Incidental intraoperative PJI diagnosis was made in 4 cases(3.5%).Overall,prosthesis removal was needed in 77.8%(84/108)of the cases to treat the infection.Overall infection rate was controlled in 88/102(86.3%)patients with Mycobacterium PJI.Persistent infection occurred in 10/108(9.8%)patients,while 4/108(3.9%)patients died due to the infection.CONCLUSION At least 17 Mycobacterium sp can be responsible for hip/knee PJI.Although M.tuberculosis is the most common causal pathogen,NTM should be considered as an emerging cause of hip/knee PJI.
基金Supported by the Clinical Research Foundation of the Third Affiliated Hospital of Sun Yat-Sen University,No.YHJH201904National Science and Technology Major Project,No.2018ZX10302204.
文摘BACKGROUND Mycobacterium mucogenicum(M.mucogenicum)belongs to the group of rapidly growing Nontuberculous mycobacteria.This microorganism is associated with a wide spectrum of infectious diseases.Due to a low detection rate or the time required for conventional culture methodology,a rapid and broad-spectrum method is necessary to identify rare pathogens.CASE SUMMARY A 12-year-old immunocompetent girl presented with painful masses for five months.The first mass was found in the right upper quadrant of the abdomen,and was about 1 cm×1.5 cm in size,tough but pliable in texture,with an irregular margin and tenderness.An abscess gradually formed and ulcerated with suppuration of the mass.Three new masses appeared on the back one by one.Chest computed tomography showed patchy and streaky cloudy opacities in both lungs.Needle aspiration of the abscess was performed,but the smear and conventional culture were negative,and the pathological examination showed no pathogens.We then performed next-generation sequencing using a formalinfixed,paraffin-embedded specimen to identify the pathogen.A significantly high abundance of M.mucogenicum was detected.The patient’s abscesses gradually decreased in size,while inflammation in both lungs improved following 12-wk of treatment.No recurrence was observed four months after the end of the one-year treatment period.CONCLUSION Next-generation sequencing is a promising tool for the rapid and accurate diagnosis of rare pathogens,even when using a formalin-fixed,paraffin-embedded specimen.
文摘Introduction: In emerging countries where studies are rarer, the epidemiological profile of infective endocarditis resembles that of developed countries at the beginning of the antibiotic era. There is little data available in Mali on this subject, motivating this study, the aim of which was to study the etiological factors of infective endocarditis in children aged between 1 month and 15 years hospitalised in the paediatric department of the CHU Gabriel Touré. Patients and Methods: We conducted a cross-sectional and descriptive study, which took place from August 2018 to August 2019 (13 months), in children aged between 1 month and 15 years hospitalised in the paediatric department of the Gabriel Touré University Hospital with an ultrasound- confirmed cardiac disease and a temperature above 38°C. Results: The hospitalization rate was 0.4%. The average age was 11 months, the sex ratio was 1.35. Respiratory distress (63.6%) and fever (30.3%) were the most common reasons for referral. Congenital heart disease (87.9%) and dyspnoea on feeding (24.2%) were the most common medical histories. IVC was the most frequent congenital heart disease (36.4%). The mean temperature was 39.1°C. Blood cultures were taken in 24 patients (72.7%) and were positive in 27.3%. Staphylococcus aureus was found in 55.6% of cases. Trans-thoracic ultrasound found vegetations in 03 cases. According to the modified DUKE criteria, the diagnosis of endocarditis was retained in 27.30%. The evolution was marked by a high case fatality rate (45.45%). Conclusion: Endocarditis is an uncommon disease in children with a pulmonary portal of entry and Staphylococcus aureus as the main germ. Its mortality remains high.
