Résumé
Rothia mucilaginosa is a gram-positive coccus of the family Micrococcaceae. R. mucilaginosa is considered a part of the normal flora of the human oropharynx and upper respiratory tract and lower respiratory tract infections attributable to R. mucilaginosa are not frequent. We present a case of pneumonia, in which the R. mucilaginosa infection was diagnosed by quantitative cultures of a bronchoalveolar lavage (BAL) specimen. A 46-yr-old woman with B lymphoblastic lymphoma was admitted to the hospital for scheduled chemotherapy. Her chest computed tomography (CT) scan revealed bilateral multifocal nodular and patchy consolidation in both lungs. Investigation of the BAL specimen revealed that 7% of leukocytes had intracellular gram-positive cocci. The quantitative cultures of the BAL specimen grew mucoid, non-hemolytic, and grayish convex colonies on blood agar at a count of approximately 200,000 colony-forming units/mL. The colonies were identified as R. mucilaginosa. The patient was empirically treated with levofloxacin for 7 days, after which findings on the chest radiograph and CT scan improved. She was discharged with improvement on hospital day 46. To our knowledge, this is the first report of R. mucilaginosa pneumonia diagnosed in Korea. Quantitative culture of BAL specimen and examination of intracellular organisms are crucial for assessing the clinical significance of R. mucilaginosa recovered from the lower respiratory tract.
Sujets)
Femelle , Humains , Adulte d'âge moyen , Liquide de lavage bronchoalvéolaire/microbiologie , Poumon/imagerie diagnostique , Lymphomes/complications , Micrococcaceae/isolement et purification , Pneumopathie infectieuse/complications , TomodensitométrieRésumé
Helicobacter cinaedi is an enterohepatic species. It can cause bacteremia, gastroenteritis, and cellulitis, particularly in immunocompromised individuals, such as those with acquired immunodeficiency syndrome, malignancy, or alcoholism. There are no previous reports of H. cinaedi infection in Korea. A 71-yr-old man was admitted to the emergency room because of dyspnea on November 9, 2011. He had undergone splenectomy 3 yr ago because of immune hemolytic anemia. Chest plain radiography revealed bilateral pleural effusion. He developed fever on hospital day (HD) 21. Three sets of blood cultures were taken, and gram-negative spiral bacilli were detected in all aerobic vials. The isolate grew in tiny colonies on chocolate agar after 3-day incubation under microaerophilic conditions. This organism tested positive for catalase and oxidase, and negative for urease. The 16S rRNA gene sequence of this isolate exhibited 99.8% homology with the published sequence of H. cinaedi CCUG 18818T (GenBank accession no. ABQT01000054) and 98.5% homology with the sequence of Helicobacter bilis Hb1T (GenBank accession no. U18766). The patient was empirically treated with piperacillin/tazobactam and levofloxacin, and discharged with improvement on HD 31. To our knowledge, this is the first report of H. cinaedi bacteremia in an asplenic patient. Asplenia appears to be a risk factor for H. cinaedi bacteremia.
Résumé
BACKGROUND: Direct antigen test (DAT) and culture are primary tests to diagnose infections by respiratory viruses, but are mainly available for the traditional viral pathogens such as respiratory syncytial virus (RSV), influenza virus, parainfluenza virus (PIV), and adenovirus in clinical laboratories. The objective of this study was to evaluate a multiplex reverse transcriptase-PCR method using Seeplex(TM) RV Detection kit (Seegene, Korea) for the detection of rhinovirus, coronavirus, and human metapneumovirus (hMPV). METHODS: From January to May 2007, nasopharyngeal aspirates (NPAs) from pediatric patients negative for culture and DAT of traditional viral pathogens were tested with Seeplex(TM). All the amplicons were directly sequenced and homology of the sequences was searched in the National Center for Biotechnology Information (NCBI) database. Patients' medical records were reviewed for clinical and demographic features. RESULTS: Forty-seven (26.4%) of 178 NPAs were positive: 18 rhinovirus, 15 hMPV, 4 RSV A, 3 coronavirus OC43, 3 influenza virus A, 2 adenovirus, 1 coronavirus NL63, and 1 RSV B. Based on maximum identity, each of the sequences indicating rhinovirus, hMPV, and coronavirus OC43 matched to the corresponding viruses with homology of 94-98%, 96-99%, and 98-100%, respectively. Seeplex(TM) positive patients were 0-11 yr old with a male:female ratio of 1.5:1. Clinical diagnoses included 9 pneumonia, 6 bronchiolitis, 2 cold, 1 asthma exacerbation for rhinovirus; 10 pneumonia, 4 bronchiolitis, and 1 clinical sepsis for hPMV; and 1 pneumonia, 2 croup, and 1 cold for coronavirus. CONCLUSIONS: Multiplex reverse transcriptase-PCR method using Seeplex(TM) RV Detection kit is a reliable test to detect rhinovirus, hMPV, and coronavirus. It may improve the diagnostic sensitivity for RSV, influenza virus, PIV, and adenovirus.
Sujets)
Adolescent , Enfant , Enfant d'âge préscolaire , Femelle , Humains , Nourrisson , Nouveau-né , Mâle , Coronavirus/classification , Coronavirus humain 229E/classification , Coronavirus humain OC43/classification , Metapneumovirus/classification , Phylogenèse , Trousses de réactifs pour diagnostic , Infections de l'appareil respiratoire/diagnostic , RT-PCR/méthodes , Rhinovirus/classification , Analyse de séquence d'ADNRésumé
Beauveria bassiana is a hyaline Hypomycetes, which is known as an insect pathogen causing infections in silkworm. It is a rare opportunistic pathogen of human accounted for pulmonary infection, keratitis, and deep tissue infection. We report the first case of B. bassiana keratitis in Korea. A 64-year-old man with a 10-year history of herpetic keratitis was referred for the treatment of infectious keratitis in the right eye. Corneal scrapings showed septate hyaline hyphae on calcoflour white-KOH preparation and their cultures grew B. bassiana. At the beginning, the patient was treated empirically with an antiviral and antibiotics, and then the treatment was changed with antifungal agents including voriconazole, when the culture results were available. Since the inflammation had been aggravated despite medical treatments, he underwent a penetrating keratoplasty (PKP). The excised button of cornea showed the hyphae. The treatment with voriconazole was continued until 2 months after PKP, and fungal keratitis did not relapse during a 6-month follow-up period.
Sujets)
Humains , Adulte d'âge moyen , Antibactériens , Antifongiques , Beauveria , Bombyx , Cornée , Études de suivi , Champignons , Substance hyaline , Hyphae , Inflammation , Insectes , Kératite , Kératite herpétique , Kératoplastie transfixiante , Corée , RécidiveRésumé
BACKGROUND: We evaluated the performance of a newly developed real-time polymerase chain reaction (PCR) method using TaqMan probe (TP) and internal control (IC) for quantitation of BK virus (BKV) DNA. METHODS: PCR primers and TP were targeted for the VP1 of BKV and 300 bp-region of VP1 was cloned to prepare a standard DNA. Threshold cycles (Ct) of IC was set at 33+/-3. The recovery rates, precision, linearity, and limit of detection (LOD) were measured using the standard DNA. To correlate TP with previous hybridization probe (HP) method, Ct of those were compared using 35 HP-positive and 15 HP-negative specimens, and the interpretation agreement was analyzed in 63 consecutive clinical specimens including 32 urines and 31 plasmas. Fifty-three53 specimens measured for IC were analyzed for positive rates and levels of BKV according to Ct of IC. RESULTS: The average recovery rate was 101.1% and intra-assay and inter-assay coefficiency variations were 0.017~0.059 and 0.036, respectively, with the specimens of 3 log/mL, and 0.041~0.063 and 0.045, respectively, with the specimens of 6 log/mL. LOD was 183 copies/mL and linearity range was 2.7 log- 12 log/mL. Ct of TP were correlated with those of HP with the function of y=0.8912x+0.3164 (R2=0.9062). Among 63 clinical specimens, 16 were positive in TP and 12 were positive in HP with an agreement of 90.4%. Ct of IC were over 36 in 31 specimens (22 urines and 9 plasmas), of which BKV DNA was much higher in 7 (22.5%) BKV-positive specimens (5.9+/-1.7 log/mL) than in 4 (18.1%) BKV-positive specimens (3.9+/-1.0 log/mL) of 22 having Ct of IC < or =36.; 5.9+/-1.7 vs. 3.9+/-1.0 log/mL. CONCLUSION: TP warrants to be a reliable method for quantification of BKV. IC seemed to be essential to differentiate false-negative results or underestimation of BKV in clinical specimens, especially in urine.
Sujets)
Virus BK , Clones cellulaires , ADN , Limite de détection , Plasma sanguin , Réaction de polymérisation en chaîne , Réaction de polymérisation en chaine en temps réelRésumé
Arcanobacterium haemolyticum is a beta-hemolytic coryneform bacillus. It has been implicated as an etiologic agent of non-streptococcal pharyngitis and less frequently a cause of skin and wound infections, osteomyelitis, pneumonia, endocarditis, sepsis, and central nervous system infections. We describe a case of A. hemolyticum sepsis reported for the first time in Korea. A 61-year-old man with a diabetic foot was admitted due to a high fever. Three sets of blood cultures taken at the emergency room yielded coryneform bacilli. The organism was beta-hemolytic on blood agar plate, catalase-negative, and non-motile. It was identified as A. haemolyticum by Rapid CB Plus (Remel, Kansas, USA) and API Coryne (BioMerieux SA, Marcy l`Etoile, France) and confirmed by CAMP inhibition reaction. It was susceptible to penicillin, ceftriaxone, erythromycin, ciprofloxacin, and vancomycin by the disk diffusion method using the breakpoint criteria of National Committee for Clinical Laboratory Standards for streptococci other than Streptococcus pneumoniae. The patient was improved with partial amputation of the right big toe and antimicrobial therapy with ampicillin/sulbactam. If Arcanobacterium is isolated from normally sterile sites or culture specimens properly collected from infected tissues, it should be identified to the species level. Commercial biochemical test kits specialized in corynebacteria and CAMP test are useful for species identification of A. haemolyticum.
Sujets)
Humains , Adulte d'âge moyen , Agar-agar , Amputation chirurgicale , Arcanobacterium , Bacillus , Ceftriaxone , Infections du système nerveux central , Ciprofloxacine , Pied diabétique , Diffusion , Service hospitalier d'urgences , Endocardite , Érythromycine , Fièvre , Kansas , Corée , Ostéomyélite , Pénicillines , Pharyngite , Pneumopathie infectieuse , Sepsie , Peau , Streptococcus pneumoniae , Orteils , Vancomycine , Infection de plaieRésumé
Scedosporium apiospermum, an anamorph of Pseudallescheria boydii, is a ubiquitous saprophytic mold. Now a day, S. apiospermum is an emerging pathogen related to a significant morbidity and high mortality in transplant recipients. For the first time in Korea, we report a case of disseminated infection caused by S. apiospermum after liver transplantation. A 47-year-old woman underwent living donor liver transplantataion for billiary cirrhosis. She was treated with cyclosporine A, methylprednisolone, and prophylactic antibiotics including amphotericin B. She was found to have developed pneumonia and brain abscess at postoperative day 9 and 17 by chest X-ray and brain CT, respectively. Cultures of endotracheal aspirates and aspirates of brain abscess yielded S. apiospermum. Despite of antifungal therapy with amphotericin B, voriconazole, and caspofungin and removal of mycotic aneurysm of the brain, the patient died on postoperative day 33.
Sujets)
Femelle , Humains , Adulte d'âge moyen , Amphotéricine B , Anévrysme infectieux , Antibactériens , Encéphale , Abcès cérébral , Ciclosporine , Fibrose , Champignons , Corée , Foie , Transplantation hépatique , Donneur vivant , Méthylprednisolone , Mortalité , Pneumopathie infectieuse , Pseudallescheria , Scedosporium , Thorax , TransplantationRésumé
Tetrasomy for the short arm of chromosome 12 (Pallister-Killian syndrome) is an uncommon mosaic aneuploidy, which may present in the prenatal period with an ultrasonographically detected fetal abnormalities or following karyotyping for maternal age and other causes. In this syndrome the chromosome abnormalities, isochromosome is present in amniocyte with a much greater percentage than fetal lymphocyte. The most consistent reported prenatal ultrasound findings for tetrasomy 12p include polyhydramnios with short femurs and a diaphragmatic hernia. We report a case identified by prenatal karyotyping diagnosis.
Sujets)
Aneuploïdie , Bras , Aberrations des chromosomes , Chromosomes humains de la paire 12 , Diagnostic , Fémur , Hernie diaphragmatique , Isochromosomes , Caryotypage , Lymphocytes , Âge maternel , Mosaïcisme , Polyhydramnios , Tétrasomie , ÉchographieRésumé
Stomatococcus mucilaginosus is a Gram-positive coccus normally found in the oropharynx and upper respiratory tract. Recently, S. mucilaginosus has been increasingly reported to cause seri-ous infections in immunocompromised patients. A 42-year-old male patient with chronic myeloge-nous leukemia developed the clinical signs and symptoms of septicemia in the state of neutropenia due to the failure of a bone marrow transplant. The blood cultures revealed Gram-positive cocci in three sets of aerobic blood culture bottles. The bacteria were identified as S. mucilaginosus by an API STAPH Identification Panel (bioMerieux SA, Marcy 1 'Etoile, France). The patient was cured bacteriologically with a vancomycin treatment for 20 days. Here we report the first case of S. mucilaginosus septicemia in Korea.
Sujets)
Adulte , Humains , Mâle , Bactéries , Moelle osseuse , Cocci à Gram positif , Sujet immunodéprimé , Corée , Leucémies , Leucémie myéloïde chronique BCR-ABL positive , Neutropénie , Partie orale du pharynx , Appareil respiratoire , Sepsie , VancomycineRésumé
OBJECTIVES: To analyze 2942 cases of prenatal genetic amniocentesis with their cytogenetic results. METHODS: This study reviewed 2942 genetic amniocentesis results which were perfomed at Ilsin Christian Hospital from 1993 to 1999, as prenatal genetic diagnosis for the possibility of chromosomal abnormality of fetus. Age distribution, gestational weeks, indications of amniocentesis and cytogenetic results were the key factors for the analysis. RESULTS: Maternal ages were ranged from 20 to 45, mostly 25-39. Of indications of prenatal genetic amniocentesis, abnormal maternal serum marker was the most common(57.9%) and followed by advanced maternal age(29.3%). The frequency of abnormal karyotypes was 3.1%(90/2942). Down syndrome(trisomy 21) and inversion of chromosome were found at 0.8%(24/2942) and 1.0%(30/2942). The incidence of abnormal karyotype according to indication had statistical significance in family history and abnormal ultrasonographic findings.(p<0.001) CONCLUSIONS: Midtrimester genetic amniocentesis is an important diagnostic tool in prenatal genetic diagnosis. In addition to the maternal serum markers and maternal ages, complete family history takings and ultrasonograms should be considered in prenatal genetic counseling.
Sujets)
Femelle , Humains , Grossesse , Caryotype anormal , Répartition par âge , Amniocentèse , Marqueurs biologiques , Aberrations des chromosomes , Analyse cytogénétique , Cytogénétique , Diagnostic , Foetus , Conseil génétique , Incidence , Âge maternel , Deuxième trimestre de grossesse , Diagnostic prénatal , ÉchographieRésumé
Supernumerary isochromosome resulting in autosomal tetrasomy are rare and have been described only for 12P, 18P, and 9P. Tetrasomy 9P, initially described by Ghymer et al, is a rare chromosomal aberration that has been described in 20 patients. Affected subjects show both cytogenetic and ohenotypic variability. Some patients have the abnormal cell line in all cells, but many display tissue limited mosaicism. The phenotype varies in severity from prenatal death to mild developmental delay and minor anomalies. We reported a infant with mild manifestations of tetrasomy 9p with brief review of related literatures.
Sujets)
Humains , Nourrisson , Lignée cellulaire , Aberrations des chromosomes , Cytogénétique , Isochromosomes , Mosaïcisme , Phénotype , TétrasomieRésumé
No abstract available.
Sujets)
Femelle , Humains , Grossesse , Avortement spontané , Chorion , Villosités chorialesRésumé
No abstract available.
Sujets)
Femelle , Humains , Grossesse , Deuxième trimestre de grossesseRésumé
No abstract available.