ABSTRACT
Emphysematous gastritis is a rare entity that has not much literature available. It is known to manifest as a diffused wall inflammation and air within the wall of the stomach and has been associated with gas-forming organisms. We present a complex case of a middle-aged woman with a previous history of fulminant Clostridium difficile complicated with colectomy and diverting colostomy. She was admitted due to diabetic ketoacidosis, later complicated with worsening abdominal pain, and a CT scan of the abdomen and pelvis without contrast revealed findings consistent with ischemic bowel, severe pneumatosis intestinalis, and extensive portal venous gas. A stomach biopsy revealed hemorrhagic necrosis; a Gomori methenamine silver stain was compatible with fungal organisms, Candida species, correlating with Candida emphysematous gastritis. This case highlights the importance of early diagnosis of this syndrome in order to provide appropriate management, and early identification, to improve survival.
ABSTRACT
Gonorrhea is one of the most common sexually transmitted infections (STIs). In a minority of cases, a disseminated infection can occur including gonococcal osteoarticular disease. With the steep and sustained increase in STIs in the US, we could see invasive gonococcal disease more often. Most cases of gonococcal osteomyelitis receive prolonged courses of antibiotic therapy. We report here the successful treatment of gonococcal osteomyelitis with one week of antibiotic therapy. Given the emergence of bacterial resistance worldwide and associated side effects, it is crucial to limit antibiotic exposures to the smallest effective dose possible.
Subject(s)
Anti-Bacterial Agents/therapeutic use , Gonorrhea/drug therapy , Neisseria gonorrhoeae/drug effects , Osteomyelitis/microbiology , Administration, Intravenous , Adult , Gonorrhea/diagnosis , Humans , Male , Neisseria gonorrhoeae/isolation & purification , Osteomyelitis/diagnosis , Osteomyelitis/drug therapy , Time Factors , Treatment OutcomeABSTRACT
We report a case of a 64-year-old woman who developed transfusion-dependent anemia after cardiac transplantation, the etiology of which was unknown after initial comprehensive evaluation. At the suggestion of the Transplant Infectious Diseases consultant, microbial agents with red blood cell tropism pertinent to this patient such as Parvovirus B 19 (B19V) were investigated. The B19V viral load by PCR in peripheral blood was >100 000 000 copies/ml and after treatment with intravenous immunoglobulin (IVIG), her anemia resolved. Here, we summarize the clinical and virologic characteristics, treatment, and outcome of fifteen cases of B19V-induced anemia in heart transplant recipients. Spontaneous recovery from anemia secondary to B19V has also been reported in some heart transplant recipients, possibly due to an absence of their B19V P-antigen receptor and/or reduction in their immunosuppression. Therefore, in heart transplant patients, B19V should be suspected early as a cause of severe anemia of unknown etiology. The extent that B19V-induced anemia is underdiagnosed in heart transplant recipients is unknown.
