ABSTRACT
Germ cell tumors (GCTs) are associated with pure gonadal dysgenesis or Swyer syndrome. Swyer syndrome usually presents with primary amenorrhea, streak ovaries, and mixed GCT. However, our patient presented with secondary amenorrhea, normal female external genitalia, and a mixed GCT. Constitutional karyotype was suggestive of 46,XY. Management comprised chemotherapy, followed by surgery. Histopathology was suggestive of dysgerminoma complicating a gonadoblastoma. The purpose of reporting this case is its rarity and the importance of diagnosing an XY karyotype, as the incidence of GCTs is higher in these patients.
Subject(s)
Dysgerminoma , Gonadal Dysgenesis, 46,XY , Gonadoblastoma , Neoplasms, Germ Cell and Embryonal , Ovarian Neoplasms , Humans , Female , Ovarian Neoplasms/pathology , Amenorrhea/complications , Dysgerminoma/diagnosis , Dysgerminoma/therapy , Dysgerminoma/pathology , Gonadoblastoma/complications , Gonadoblastoma/diagnosis , Gonadoblastoma/pathology , Gonadal Dysgenesis, 46,XY/diagnosis , Gonadal Dysgenesis, 46,XY/genetics , Gonadal Dysgenesis, 46,XY/complications , Neoplasms, Germ Cell and Embryonal/therapy , Neoplasms, Germ Cell and Embryonal/complicationsABSTRACT
The diagnosis of blood-borne infections in immunocompromised patients is a major challenge for the clinical microbiology laboratory. Isolation of bloodborne pathogens in these patients has profound clinical implications, yet is fraught with technical problems, including the presence of unusual and difficult to isolate pathogens. Coupled with this is the problem of false-positive blood culture signals from automated blood culture systems which further delays the definitive diagnosis. Here, we present a case of an 8-year-old boy with Ph +ve acute lymphoblastic leukaemia who has repeated 'false positive' blood cultures and later grew an uncommon organism.
Subject(s)
Blood Culture/standards , Blood-Borne Infections/diagnosis , Mycobacterium Infections, Nontuberculous/diagnosis , Mycobacterium abscessus/isolation & purification , Precursor Cell Lymphoblastic Leukemia-Lymphoma/complications , Amikacin/therapeutic use , Anti-Bacterial Agents/therapeutic use , Azithromycin/therapeutic use , Blood-Borne Infections/blood , Child , Clofazimine/therapeutic use , Diagnosis, Differential , False Positive Reactions , Humans , Immunocompromised Host , Levofloxacin/therapeutic use , Male , Mycobacterium Infections, Nontuberculous/drug therapy , Mycobacterium abscessus/drug effects , Precursor Cell Lymphoblastic Leukemia-Lymphoma/bloodABSTRACT
Brevibacteria are a part of the normal skin flora and may be dismissed in blood cultures as contaminants. They have been reported as opportunistic pathogens in immunocompromised patients. We report a catheter-related bloodstream infection with Brevibacterium casei in a 6-year-old child with aplastic anaemia. Treatment with appropriate antibiotics along with the removal of the catheter resulted in complete cure in our patient.
