Rapid diagnosis of Mycobacterium abscessus endophthalmitis.

Nontuberculous mycobacteria are widely distributed in the environment and have the potential to cause a wide spectrum of infections including pulmonary, bone, soft tissue or ocular infections. They are a rare cause of endophthalmitis, a potentially devastating condition, which may be acquired through contamination of water or antiseptic solutions. Diagnosis is often delayed due to low clinical suspicion, resulting in poor clinical outcomes. Newer laboratory techniques such as real-time PCR can be used for rapid detection, identification and speciation of mycobacteria and allow for initiation of focused antibiotic therapy. We describe a case of Mycobacterium abscessus endophthalmitis that developed 30 years after traumatic loss of cornea in a patient with diabetes mellitus.

Management of Scedosporium apiospermum in a pre- and post-lung transplant patient with cystic fibrosis.

Although the predominant type of infection seen in the cystic fibrosis lung remains bacterial, fungal organisms are being isolated more frequently and are associated with a high mortality rate in lung transplant recipients. We present a case of a patient with CF with sputum cultures positive for Scedosporium apiospermum prior to a successful lung transplant. She remains without evidence of infection 18 months later following treatment with a combination of triazoles and terbinafine.

Development of daptomycin resistance in a bone marrow transplant patient with vancomycin-resistant Enterococcus durans.

Daptomycin has demonstrated antibacterial activity against several antibiotic-resistant strains, including vancomycin-resistant enterococci. A paucity of data exists concerning in vivo development of daptomycin resistance of enterococci. We describe an allogeneic bone marrow transplant patient, who was found to have vancomycin-resistant Enterococcus durans bacteremia, which subsequently developed resistance to daptomycin.