Surgical management of subcutaneous Colletotrichum gloeosporioides.

A 52-year-old male patient with a history of sarcoidosis and over 10 years of chronic low-dose glucocorticoid use, cirrhosis and type 2 diabetes mellitus presented with two painful, enlarging subcutaneous nodules ultimately identified as Colletotrichum gloeosporioides. Two attempts at needle aspiration of the larger nodule resulted in rapid reaccumulation. Complete surgical excision of both nodules resulted in complete resolution without the use of any concomitant antifungals. Patient had no recurrence at 2 years of follow-up.

Bronchiectatic air bronchograms in pulmonary tuberculosis: a case report and literature review.

We report a case of a 61-year-old Filipino-American male who developed pulmonary tuberculosis after travel to the Philippines. His history, presentation, imaging findings, and clinical course are presented as well as a discussion of the interesting imaging features in his case. Our case highlights the importance of having a high index of suspicion for tuberculosis in the setting of "bronchiectatic air bronchograms" as well as the value of computed tomography (CT) imaging in pulmonary tuberculosis.

Detection of Latin American strains of Histoplasma in a murine model by use of a commercially available antigen test.

During a Histoplasma outbreak in a colony of fruit bats at a southern United States zoo, it was observed that although Histoplasma was recovered in culture from multiple sites at necropsy, none of the samples collected from those bats tested positive for Histoplasma antigen (HAg). Five of the Histoplasma isolates from the bats were subsequently identified as Latin American (LA) clade A, restriction fragment length polymorphism (RFLP) class 6. These observations raised concern as to whether the commercially available HAg test could detect Histoplasma antigen not of the North American clade upon which the HAg test had been developed. To evaluate this concern, a murine model of disseminated histoplasmosis was established, and mice were infected with multiple LA Histoplasma isolates, including clinical isolates recovered from Brazilian AIDS patients (RFLP class 5 and class 6) and isolates recovered from the bats during the outbreak (RFLP class 6). Histoplasma antigen was detected in all infected mice in our experiments, even when Histoplasma was not recovered in culture. Because the currently available HAg test is able to detect Histoplasma antigen in mice infected with Latin American isolates, this suggests that bat host factors rather than differences among Histoplasma RFLP classes were responsible for the inability to detect HAg in infected bats.

Cholera-like presentation in Vibrio fluvialis enteritis.

We describe a patient who presented with cholera-like diarrhea seven days after eating shellfish at a seafood buffet on the Gulf Coast. The patient's stool culture grew only Vibrio fluvialis on TCBS agar, and his diarrhea and profound acidosis completely resolved within 24 hours of initiating antibiotics. To our knowledge, a detailed case of V fluvialis diarrhea with cholera-like symptoms has not been reported.