Subject(s)
Foot Dermatoses/diagnosis , Madurella , Mycetoma/diagnosis , Adult , Antifungal Agents/therapeutic use , Female , Foot Dermatoses/drug therapy , Humans , Magnetic Resonance Imaging , Mycetoma/drug therapy , Pyrimidines/therapeutic use , Treatment Outcome , Triazoles/therapeutic use , Voriconazole , Young AdultABSTRACT
Mycobacterium avium complex (MAC) continues to be a challenging problem in some patients with advanced human immunodeficiency virus (HIV) infection despite the availability of potent chemotherapeutic agents. The use of adjunctive immunomodulatory therapy has shown promise in vitro, but there is currently limited supportive clinical evidence [Kemper CA, Bermudez LE, Derenski SC. Immunomodulatory treatment of Mycobacterium avium complex bacteraemia in patients with AIDS by use of recombinant granulocyte-macrophage colony-stimulating factor. J Infect Dis 1998;177:914-20; Kedzierska K, Johnson M, Mijch A, Cooke I, Rainbird M, Roberts S, et al. Granulocyte-macrophage colony-stimulating factor augments phagocytosis of Mycobacterium avium complex by human immunodeficiency virus type-1 infected monocytes/macrophages in vitro and in vivo. J Infect Dis 2000;181:390-94]. We report the resolution of MAC disease resistant to traditional therapy, in an HIV-infected individual, following the addition of granulocyte-macrophage colony-stimulating factor (GM-CSF).
Subject(s)
AIDS-Related Opportunistic Infections/therapy , Adjuvants, Immunologic/therapeutic use , Granulocyte-Macrophage Colony-Stimulating Factor/therapeutic use , HIV Infections/complications , Mycobacterium avium Complex/drug effects , Mycobacterium avium-intracellulare Infection/therapy , AIDS-Related Opportunistic Infections/immunology , AIDS-Related Opportunistic Infections/microbiology , Adjuvants, Immunologic/pharmacology , Granulocyte-Macrophage Colony-Stimulating Factor/pharmacology , HIV Infections/immunology , HIV-1 , Humans , Macrophages/drug effects , Macrophages/microbiology , Male , Middle Aged , Mycobacterium avium-intracellulare Infection/immunology , Mycobacterium avium-intracellulare Infection/microbiology , Treatment OutcomeABSTRACT
We report a case of vertebral osteomyelitis due to the coagulase-negative staphylococcus, Staphylococcus lugdunensis. This is only the second such case reported in the literature in an immunocompetent host. When the patient's lumbar spine inflammatory mass was drained, the coagulase-negative staphylococcus obtained was discarded as a likely contaminant. We discuss the situation when coagulase-negative staphylococci require further identification and look at the unique features of S. lugdunensis. Isolation of S. lugdunensis is usually significant, and the organism should not be discarded as a contaminant without careful consideration.
