A Microbiologist's Mexico Trip Ends with Multiple Tiny Ring-Like Pelvic Abscesses.

BACKGROUND Iliacus muscle abscess is a rare condition that frequently presents with nonspecific clinical symptoms. Abscesses in the iliacus muscle can arise from contiguous spread from adjacent structures or from distant sites via hematogenous or lymphatic routes. CASE REPORT We report a case of iliacus muscle abscess in a 22-year-old female microbiologist who presented to the emergency department with severe back pain and lower-extremity weakness after returning from a trip to Mexico. She was found to have urinary tract infection due to Salmonella. The patient was found to have left iliacus muscle abscess and septic arthritis of the sacroiliac joint. She was initially treated with piperacillin-tazobactam, vancomycin, and metronidazole, which were later switched to intravenous ceftriaxone and oral levofloxacin. She was successfully treated with antibiotics, with a complete resolution of the multiple tiny abscesses. CONCLUSIONS Iliacus muscle abscess presents with nonspecific symptoms that can mimic neurologic diseases such as spinal cord compression. A high index of suspicion is required to make an early diagnosis and initiate prompt treatment with antibiotics and abscess drainage, if accessible. A detailed history is essential to assess risk factors and establish likely causative organisms. Delay in treatment can lead to an increase in morbidity and mortality. Long-term follow-up is crucial, as the incidence of relapse is high.

Empedobacter brevis Bacteremia in a Patient Infected with HIV: Case Report and Review of Literature.

Clinical disease caused by Empedobacter brevis (E. brevis) is very rare. We report the first case of E. brevis bacteremia in a patient with HIV and review the current literature. A 69-year-old man with human immunodeficiency virus (HIV) and CD4 count of 319 presented with chief complaints of black tarry stools, nausea and vomiting for 2 days. Physical exam was significant for abdominal pain on palpation with no rebound or guarding. His total leukocyte count was 32,000 cells/µL with 82% neutrophils and 9% bands. Emergent colonoscopy and endoscopic esophagogastroduodenoscopy showed esophageal candidiasis, a nonbleeding gastric ulcer, and diverticulosis. Blood cultures drawn on days 1, 2, and 3 of hospitalization grew E. brevis. Patient improved with intravenous antibiotics. This case is unusual, raising the possibility of gastrointestinal colonization as a source of the patient's bacteremia. In conclusion, E. brevis is an emerging pathogen that can cause serious health care associated infections.