Infective Endocarditis Caused by Pseudomonas luteola in a Pediatric Patient. A Case Report and Review of Literature.

BACKGROUND Pseudomonas luteola (P. luteola) is a Gram-negative, oxidase-negative is an environmental organism that is isolated from soil, water, and damping areas, and is rarely found as a human pathogen. Most infections in which P. luteola is implicated are associated with a breach in immune barrier, such as indwelling catheters, prosthetic devices, immunocompromised conditions and surgical wounds. CASE REPORT A 9 years old girl, known case of Chron's disease and recurrent urinary tract infections on prophylactic antibiotics, presented with an acute-onset abdominal pain associated with fever reaching 40C and vomiting. She was placed on a peripherally inserted central line for total parenteral nutrition and developed sepsis on the 30th day of admission. Septic workup revealed P. letuola infection with right atrial vegetation. Treatment with Piperacillin/tazobactam yielded an uneventful recovery. CONCLUSIONS P. luteola can be involved in serious infections in susceptible individuals. Serious outcomes may be associated with infective endocarditis especially on a background of valvular prosthesis and central lines. The definitive treatment of catheter related infective endocarditis caused by P. leuteola is the removal of the lines along with an appropriate antibiotic regimen-based AST result.

Molecular Characterization and Antibiotic Susceptibility Pattern of Acinetobacter Baumannii Isolated in Intensive Care Unit Patients in Al-Hassa, Kingdom of Saudi Arabia.

BACKGROUND: Acinetobacter baumannii, is an emerging nosocomial multidrug resistance pathogen with the rapid spread of clones being reported in health-care settings and hospitals worldwide. Carbapenem resistance in this bacterium has been attributed to D OXA ß-lactamases with OXA-51-like ß-lactamase, being present in all A. baumannii isolate. The present study looks into the antibiotics susceptibility and molecular characterization of clinical A. baumannii isolates from Intensive Care Unit (ICU) samples in Al-Hofuf, South-eastern region of Saudi Arabia. MATERIALS AND METHODS: Eleven strains of ICU A. baumanni i isolates were used for the investigation. Bacteria isolation was by basic microbiological techniques. Organisms identification and antibiogram susceptibility testing was by the BioMerieux VITEK 2 compact automated system (BioMerieux, Marcy I'Etoile France), according to the manufacturers guidelines. Confirmation of A. baumannii was by the presence of the OX-51 gene, also, carbapenemase encoding resistant genesblaOXA-23, blaOXA-40, and blaOXA-51, were analyzed using multiplex PCR. The Student's t test was used to analyze the obtained data for between group comparisons with statistically significance level set at P < 0.05. RESULTS: Eight of the isolates were confirmed to be A. baumannii. Five of which were resistant to the carbapenems against which they had been tested. One isolate was resistant to tigecycline, whereas three tested intermediate to the drug. OXA-23 was detected in isolates 1, 4, 5, 6, and 7. CONCLUSION: It can, therefore, be concluded that the probable predominate carbapenems resistant genes in ICU isolates from the present investigation, are those associated with OXA-23.

An Atypical Porencephalic Cyst Manifesting as a Simple Partial Seizure: A Case Report and Literature Review.

BACKGROUND: Porencephaly is an extremely rare neurological disease characterized by the presence of solitary or multiple degenerative cerebrospinal fluid (CSF) cavities within the brain parenchyma. CASE REPORT: We describe a case involving a 23-year-old male who presented with involuntary movements of the left upper limb of 6 months' duration. A diagnosis of porencephaly was confirmed by magnetic resonance imaging (MRI). CONCLUSION: The rarity of occurrence and atypical presentation of such a lesion present a challenge to clinicians. Little is known about the pathogenesis and appropriate management of porencephaly. Further studies of the implications of porencephaly for neurodevelopment and behavior are needed.

Challenging Pitfalls and Mimickers in Diagnosing Anastomosing Capillary Hemangioma of the Kidney: Case Report and Literature Review.

BACKGROUND Vascular tumors of the kidney are rare tumors that are usually diagnosed and confirmed by histopathological examination due to the difficulty in definitive diagnosis by clinical and radiological examination. Anastomosing hemangioma is a rare variant of capillary hemangioma that mimics angiosarcoma. CASE REPORT Here, we present a case of a 55-year-old female with a history of partial nephrectomy due to clear cell renal cell carcinoma three years earlier, who presented with a contralateral anastomosing capillary hemangioma. The diagnosis was confirmed by histopathology and immunohistochemistry studies. CONCLUSIONS Anastomosing hemangioma is a rare variant of capillary hemangioma. It has a sinusoidal growth pattern which resembles splenic parenchyma. It mimics malignant neoplasms, thus, clinical and radiological examination are not enough for accurate diagnosis. In this paper, we discuss the most crucial differential diagnoses and the pitfalls in diagnosing this rare variant of hemangioma. Furthermore, we present a literature review of all cases reported in the English-language literature.