Erratum: Nocardia Brain Abscess in an Immunocompetent Patient

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Nocardia Brain Abscess in an Immunocompetent Patient

Nocardia cerebral abscess is rare, constituting approximately 1-2% of all cerebral abscesses. Mortality for a cerebral abscess of Nocardia is three times higher than that of other bacterial cerebral abscesses, therefore, early diagnosis and therapy is important. Nocardia cerebral abscess is generally occur among immunocompromised patients, and critical infection in immunocompetent patients is extremely rare. We report on a case of a brain abscess by Nocardia farcinica in an immunocompetent patient who received treatment with surgery and antibiotics. This is the second case of a brain abscess caused by N. farcinica in an immunocompetent patient in Korea.

Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS) Syndrome Induced by Ethambutol and Rifampin

Drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome is a disorder which can be caused by treatment with a diverse collection of drugs, and it is characterized by fever, rash, lymphadenopathy, and internal organ involvement with eosinophilia. Although ethambutol and rifampin are popularly used to treat tuberculosis, there has been only one reported case of DRESS syndrome associated with ethambutol. DRESS syndrome associated with administration of rifampin have not been reported. In this report and discussion, we present the case of a patient suffering from DRESS syndrome induced by both ethambutol and rifampin.

Primary psoas abscess caused by Streptococcus agalactiae

Group B streptococcus (Streptococcus agalactiae, GBS), a primary pathogen in postpartum infection, has rarely been reported in psoas abscess. Primary proas abscess occurs less frequently than secondary abscess, which originates from infections of adjacent organs, such as intraabdominal infection, osteomyelitis, perirenal abscess, and retroperitoneal hematomas. We describe a case of primary psoas abscess caused by GBS. A 44-year-old woman with type 2 diabetes mellitus presented with left flank pain, intermittent fever, dysuria, and discomfort during walking. Abdominal CT showed multiseptated cystic mass in wide areas of the retroperitoneal space. Pus culture showed Streptococcus agalactiae. The patient responded to penicillin G treatment for 3 weeks.

Pyomyositis Caused by Non-O1 Vibrio Cholerae in a Patient with Liver Cirrhosis / 대한내과학회지

A 63-year-old man with underlying liver cirrhosis was admitted with painful swelling of the right thigh. We identified a non-O1 Vibrio cholerae strain in blood cultures and multiple pyomyositis in the lower limbs. Non-O1 V. cholerae strains have caused several well-studied food-borne outbreaks of gastroenteritis and have been responsible for sporadic cases of otitis media, skin and soft tissue infection, and bacteremia. Skin and soft tissue infection due to non-O1 V. cholerae is rare and is commonly associated with the presence of chronic underlying disease, such as liver cirrhosis, diabetes mellitus, an immunocompromised state, or a hematological malignancy. We report the first case of pyomyositis caused by non-O1 V. cholerae in Korea. Physicians should consider non-O1 V. cholerae strains as a pathogen that can cause pyomyositis.

A Case of Endocarditis due to Granulicatella adiacens

Granulicatella species are nutritionally variant streptococci first described in 1961. Granulicatella species form a part of the normal flora of the oral cavity, genitourinary tract, and intestinal tract. These micro-organisms cause bacteremia or local infections such as endocarditis, central nervous system infections, arthritis, and osteomyelitis. Since isolation of Granulicatella species is difficult, only a few cases of infection caused by this microorganism have been reported. Herein, we report a case of endocarditis caused by Granulicatella adiacens in a 46-year-old patient with ventricular septal defect.

A Case of Central Nervous System Actinomycosis Presenting as Brain Abscess

Actinomyces normally colonizes the mouth, colon, and vagina. Although disruption of mucosa may lead to infection at virtually any site, central nervous system actinomycosis is rare. A 45-year-old man presented with seizure and magnetic resonance imaging showed brain abscess. He was diagnosed with actinomycotic and streptococcal infection of brain by histologic and microbiologic examination. After stereotactic aspiration and biopsy, he was treated successfully by prolonged antibiotic therapy using intravenous penicillin-G and oral amoxicillin.

A Case of Syphilitic Uveitis in an Immunocompetent Patient

Syphilis is re-emerging worldwide due to the HIV epidemic. Prior to the introduction of penicillin, syphilis was the second most common primary cause of all cases of uveitis. Today, ocular syphilis is a rare disease, especially in an immunocompetent patient. Variable manifestation without pathognomonic signs of ocular syphilis often lead to delayed diagnosis, resulted in irreversibile loss of vision. In Korea, syphilitic uveitis has not been reported in an immunocompetent patient since 1984. We experienced a case of syphilitic uveitis in an immunocompetent man with visual deterioration. As the incidence of syphilis is increasing in these days, a high degree of clinical suspicion should be considered in patients with unexplained ocular inflammation and visual disturbances.

A Case of Central Nervous System Actinomycosis Presenting as Brain Abscess

Actinomyces normally colonizes the mouth, colon, and vagina. Although disruption of mucosa may lead to infection at virtually any site, central nervous system actinomycosis is rare. A 45-year-old man presented with seizure and magnetic resonance imaging showed brain abscess. He was diagnosed with actinomycotic and streptococcal infection of brain by histologic and microbiologic examination. After stereotactic aspiration and biopsy, he was treated successfully by prolonged antibiotic therapy using intravenous penicillin-G and oral amoxicillin.

A Case of Syphilitic Uveitis in an Immunocompetent Patient

Syphilis is re-emerging worldwide due to the HIV epidemic. Prior to the introduction of penicillin, syphilis was the second most common primary cause of all cases of uveitis. Today, ocular syphilis is a rare disease, especially in an immunocompetent patient. Variable manifestation without pathognomonic signs of ocular syphilis often lead to delayed diagnosis, resulted in irreversibile loss of vision. In Korea, syphilitic uveitis has not been reported in an immunocompetent patient since 1984. We experienced a case of syphilitic uveitis in an immunocompetent man with visual deterioration. As the incidence of syphilis is increasing in these days, a high degree of clinical suspicion should be considered in patients with unexplained ocular inflammation and visual disturbances.

A case of Tsukamurella tyrosinosolvens peritonitis associated with continuous ambulatory peritoneal dialysis / 대한내과학회지

A case of Tsukamurella peritonitis associated with continuous ambulatory peritoneal dialysis (CAPD) in a 54-year-old woman is described. Peritonitis is a common complication of peritoneal dialysis in patients with end-stage renal disease. Tsukamurella has been reported to cause rare opportunistic infections in humans, and most cases have been reported in immunocompromised patients or patients with indwelling foreign bodies. This organism is difficult to identify and has been mistaken for Corynebacterium and atypical Mycobacteria. Here, we describe the first case of CAPD-related peritonitis caused by Tsukamurella tyrosinosolvens in Korea. It was treated with CAPD catheter removal.

A Case of Primary Infective Endocarditis Caused by Community-Associated Methicillin-Resistant Staphylococcus aureus in a Healthy Individual and Colonization in the Family

Primary community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) endocarditis has rarely been reported in healthy individuals without risk factors, such as skin and soft tissue infections, and intravenous drug abuse. We describe a case of infective endocarditis by CA-MRSA (ST72-PVL negative-SCCmec IVA) in previously healthy individuals with no underlying medical condition and CA-MRSA colonization in the family.

Peritonitis due to Leclercia adecarboxylata in a Patient Receiving Automated Peritoneal Dialysis / 대한신장학회지

Peritonitis in patients undergoing peritoneal dialysis is a major complication and the leading cause of peritoneal dialysis failure. Leclercia adecarboxylata is a motile, gram-negative, facultative anaerobic bacillus of the Enterobacteriaceae family. These bacteria are uncommon pathogen, and rarely isolated from environmental and clinical specimens. Some cases have been reported about peritonitis due to Leclercia adecarboxylata in a patient receiving continuous ambulatory peritoneal dialysis (CAPD). However, there has never been any report about peritonitis in a patient receiving automated peritoneal dialysis (APD). We have isolated Leclercia adecarboxylata from peritoneal fluid in a patient receiving APD, and the patient completely recovered with 14-day treatment of intraperitoneal antibiotics without catheter removal.

A Case of Humeral Osteomyelitis and Soft Tissue Abscess Accompanied with Streptococcus anginosus Bacteremia

Streptococcus anginosus is a normal flora found in multiple body sites and belongs to the Streptococcus milleri group. It has often been associated with pyogenic infection, such as perio-dontitis, endocarditis, pulmonary abscess and abdominal or cerebral abscess. Also uncommonly, it can cause osteomyelitis. A 42-year-old man was admitted due to gastric ulcer perforation. At 12th hospital day, left humeral osteomyelitis and soft tissue abscess developed. Streptococcus anginosus grew in blood culture. He was treated with intravenous penicillin and surgical debridement of the necrotic tissue which lead to a satisfactory result. We report a rare case of Streptococcus anginosus-induced humeral osteomyelitis and soft tissue abscess.

A Case of Vertebral Osteomyelitis with Spinal Epidural Abscess Caused by Streptococcus constellatus

We report a case of vertebral osteomyelitis with epidural abscess caused by Streptococcus constellatus. The patient was present with fever, back pain, and dyspnea for 1 week. The patient was previously healthy and did not have any predisposing factor. After evaluation, the patient was diagnosed as Streptococcus constellatus vertebral osteomyelitis. He was successfully treated with surgical debridement and antibiotic therapy. To the best of our knowledge, this is the first case of S. constellatus vertebral osteomyeltis with epidural abscess to be reported in Korea.

A Case of Stevens-Johnson Syndrome Associated with Mycoplasma pneumoniae Pneumonia in an Adult Patient

Stevens-Johnson syndrome is an acute mucocutaneous syndrome that is related to drugs and infections. Mycoplasma pneumoniae infection is known as one of the causes of Stevens-Johnson syndrome in children and young adults. In Korea, Mycoplasma pneumoniae infection is rarely reported as a cause of Stevens-Johnson syndrome in adults. We report a case of Stevens-Johnson syndrome associated with Mycoplasma pneumoniae pneumonia in an adult patient. A 34-years old woman was admitted to our hospital and was diagnosed with mycoplasma pneumonia. At the time of admission, she had hemorrhagic crusts on her lips. On the 2nd day of admission, target lesions also developed on her skin. We diagnosed her disease as Stevens-Johnson syndrome associated with Mycoplasma pneumoniae pneumonia. She completely recovered from pneumonia and Stevens-Johnson syndrome after treatment with antibiotics and conservative management.

A Case of Humeral Osteomyelitis and Soft Tissue Abscess Accompanied with Streptococcus anginosus Bacteremia

Streptococcus anginosus is a normal flora found in multiple body sites and belongs to the Streptococcus milleri group. It has often been associated with pyogenic infection, such as perio-dontitis, endocarditis, pulmonary abscess and abdominal or cerebral abscess. Also uncommonly, it can cause osteomyelitis. A 42-year-old man was admitted due to gastric ulcer perforation. At 12th hospital day, left humeral osteomyelitis and soft tissue abscess developed. Streptococcus anginosus grew in blood culture. He was treated with intravenous penicillin and surgical debridement of the necrotic tissue which lead to a satisfactory result. We report a rare case of Streptococcus anginosus-induced humeral osteomyelitis and soft tissue abscess.

A Case of Vertebral Osteomyelitis with Spinal Epidural Abscess Caused by Streptococcus constellatus

We report a case of vertebral osteomyelitis with epidural abscess caused by Streptococcus constellatus. The patient was present with fever, back pain, and dyspnea for 1 week. The patient was previously healthy and did not have any predisposing factor. After evaluation, the patient was diagnosed as Streptococcus constellatus vertebral osteomyelitis. He was successfully treated with surgical debridement and antibiotic therapy. To the best of our knowledge, this is the first case of S. constellatus vertebral osteomyeltis with epidural abscess to be reported in Korea.

A Case of Stevens-Johnson Syndrome Associated with Mycoplasma pneumoniae Pneumonia in an Adult Patient

Stevens-Johnson syndrome is an acute mucocutaneous syndrome that is related to drugs and infections. Mycoplasma pneumoniae infection is known as one of the causes of Stevens-Johnson syndrome in children and young adults. In Korea, Mycoplasma pneumoniae infection is rarely reported as a cause of Stevens-Johnson syndrome in adults. We report a case of Stevens-Johnson syndrome associated with Mycoplasma pneumoniae pneumonia in an adult patient. A 34-years old woman was admitted to our hospital and was diagnosed with mycoplasma pneumonia. At the time of admission, she had hemorrhagic crusts on her lips. On the 2nd day of admission, target lesions also developed on her skin. We diagnosed her disease as Stevens-Johnson syndrome associated with Mycoplasma pneumoniae pneumonia. She completely recovered from pneumonia and Stevens-Johnson syndrome after treatment with antibiotics and conservative management.

A case of gas gangrene caused by Streptococcus constellatus / 대한내과학회지

Gas gangrene is usually caused by clostridial species; non-clostridial gas gangrene is infrequently reported. S. constellatus belongs to the Streptococcus milleri group, which are considered part of the normal flora and frequently associated with abscess formation. We report a rare case of spontaneous gas gangrene caused by S. constellatus. An 86-year-old man was admitted with gas gangrene of the left hip. He was treated with surgical debridement of the necrotic tissue, and antibiotic therapy, and had a satisfactory clinical course.