Salmonella Group B Ileitis Mimicking Crohn's Disease: A Case Report.

Salmonellae, considered among the enteric-fever-causing pathogens, is associated with a range of human infections, including gastroenteritis, bacteremia, and osteomyelitis. Salmonella-induced mesenteric adenitis and terminal ileitis resembling acute appendicitis have been reported in the literature. Here, we present a rare case of a patient presenting with severe acute active ileitis and colitis mimicking Crohn's disease with no prior history of inflammatory bowel disease and found to have Salmonella group B bacteremia.

A Rare Case of Acute Myeloid Leukemia Initially Presenting With Fever of Unknown Origin and Rapidly Progressing Pericardial Effusion.

This case report highlights a patient who had persistent fevers for weeks and rapidly progressing pericardial effusion following a positive test for coronavirus disease 2019 (COVID-19) two weeks before presentation to the hospital. The initial thought was that her fever was of infectious etiology, but relevant investigations led to the diagnosis of acute myeloid leukemia (AML). AML, which is characterized by clonal expansion of immature "blast cells" in the peripheral blood and bone marrow resulting in ineffective erythropoiesis and bone marrow failure, is the most prevalent form of leukemia. It is the most aggressive form of leukemia, which has varying prognoses determined by the subtypes. This report explores the association between AML, fever of unknown origin, and pericardial effusion, shedding light on a notable clinical aspect. Fever in AML may be attributed to underlying inflammatory processes, cytokine dysregulation, or bone marrow failure. Recognition of fever as a potential indicator of AML contributes to enhanced clinical vigilance. Pericardial effusions and cardiac tamponade, although rare, can be a presenting feature of AML, and can present side by side with fever of unknown origin as seen in this case report.

A Rare Case of Polymerase Chain Reaction-Negative Severe Clostridioides difficile Infection.

Accurately diagnosing Clostridioides difficile infection (CDI) is crucial for effective patient management. A misdiagnosis poses risks to patients, leads to treatment delays, and contributes to infection transmission in healthcare settings. While using polymerase chain reaction (PCR) to amplify the toxin B gene is a sensitive method for detecting toxigenic C. difficile, there is still a risk of false-negative results. These inaccuracies could have significant consequences for diagnosing and treating CDI, emphasizing the need for careful consideration and other diagnostic approaches. This case report highlights a patient with severe CDI who had negative PCR and toxin and a biopsy showing pseudomembranous colitis on further testing due to persistence and worsening of symptoms. In the diagnosis of C. difficile infection, healthcare providers should consider clinical symptoms, although diarrhea, which is a major sign of CDI, can be due to other causes. Even in the presence of negative PCR results, if a patient displays symptoms consistent with C. difficile-associated disease, healthcare providers may still contemplate treatment.

Roles and Interplay of SARS-CoV-2 Serology With Clinical Stages of Disease in COVID-19.

Background Currently, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) serology is recommended only for seroprevalence. We think it could be useful in differentiating coronavirus disease 2019 (COVID-19) stages, which could in terms of helping improve our therapeutic interventions. Methods The medical records of adult patients admitted to the hospital with probable COVID-19 were extracted and analyzed. We excluded patients with no serology and no clear outcome at the end of data collection. Patient demographics, medical history, and biochemical and clinical data were retrieved. Results A total of 202 patients were included; 57% were males, the majority were Hispanic (45%), followed by African Americans (22%). Hypertension is the most common comorbidity, followed by diabetes mellitus and chronic kidney disease. We classified them into three groups based on their serology: subacute stage (47 patients) with both immunoglobulin M (IgM) and IgG negative; acute stage (116 patients) with IgM positive and late-stage (39 patients) with IgM negative and IgG positive. We found that elevated lactate dehydrogenase (LDH) and ferritin were present in the IgM+ and IgM-/IgG+ subgroups (p-value of 0.0061 and p-value 0.0013, respectively) while C-reactive protein (CRP) and D-dimer were more elevated in the IgM-/IgG- and IgM+ subgroups (P <0.0001 and p-value of 0.0452, respectively). The IgM+ group had the worst prognosis, with high mortality despite receiving remdesivir and dexamethasone. Conclusion Our findings suggest that the use of serology in patients hospitalized with COVID-19 could predict prognosis; this will need to be validated in a larger prospective study.

Marantic Endocarditis Associated with COVID-19: A Rare Case Report of a Potentially Deadly Disease.

Coronavirus disease 2019 (COVID-19) has overwhelmed healthcare globally with millions of cases and over 2 million deaths worldwide. The hypercoagulable state associated with COVID-19 is a well-recognized complication that carries a poor prognosis. Marantic endocarditis, or non-bacterial thrombotic endocarditis (NBTE), is caused by a sterile vegetation on the cardiac valves resulting from the deposition of fibrin and platelet aggregates. It is highly associated with the hypercoagulable and acquired inflammatory states. Herein, we report a unique and rare case of COVID-19 presenting with NBTE. LEARNING POINTS: COVID-19 has caused a major global pandemic, with high morbidity and mortality.One of the complications of COVID-19 infection is a hypercoagulable state.To the best of our knowledge, we present only the second case of marantic endocarditis in a patient with COVID-19, in the hope of raising awareness among physicians of this potential rare association.

A case of an atypical resistant granulomatous HSV-1 and HSV-2 ulceration in an AIDS patient treated with intralesional cidofovir.

We report a case of a granulomatous skin lesion in an AIDS patient whereby biopsy revealed both HSV-1 and HSV-2. This lesion was resistant to acyclovir and successfully treated with intralesional cidofovir without recurrence to date. This is the only known reported case of a granulomatous skin lesion in an HIV patient, whereby both HSV-1 and HSV-2 were isolated.

(1→3)-ß-D-Glucan Assay in Monitoring Response to Anti-Fungal Therapy in Fungal Endocarditis.

BACKGROUND AND AIM OF THE STUDY: A case is reported of Candida glabrata infective endocarditis (IE) treated without surgical intervention. The study aim was to: (i) briefly discuss the outcomes of other documented cases of fungal IE managed medically with fluconazole; (ii) discuss the (1→3)-ß-D-glucan assay and its previously studied role in the diagnosis of invasive fungal infections; and (iii) examine a possible application of the (1→3)-ß-D-glucan assay to monitor response to antifungal treatment in patients with Candida endocarditis. METHODS: The serum Fungitell assay was used to trend (1→3)-ß-D-glucan in a patient with Candida endocarditis to determine treatment effectiveness with fluconazole, to provide an appropriate end date for antifungal therapy, and to survey infection suppression while off treatment. RESULTS: The (1→03)-ß-D-glucan assay began trending downwards at 197 days into treatment with oral fluconazole. After 16 months of therapy, fluconazole was stopped due to transaminitis. (1→3)-ß-Dglucan levels were checked six weeks after the discontinuation of treatment and were negative. The patient has now been off therapy for 21 weeks with no signs of clinical disease, and values remain negative. CONCLUSIONS: The present case indicates that a trending (1→3)-ß-D-glucan assay may have valuable application in monitoring treatment response and infection suppression for Candida endocarditis.

AIDS-related lymphoma: resolution with antiretroviral therapy alone.

Patients with HIV are at increased risk of malignancy, particularly lymphoma, which is the most common malignancy leading to death. With the advent of highly active antiretroviral therapy (HAART), patients live longer but have a longer duration of antigenic stimulation, increasing the prevalence of AIDS-related lymphoma (ARL) in the population living with HIV. Highly active antiretroviral therapy plays a direct role in preserving the immune system, helping to decrease the incidence of ARL. We present a case of a female patient with HIV (CD4 count of 576 cells/mm3) diagnosed with a stage Ill-B non-Hodgkin lymphoma in 2009 while off HAART. She was subsequently started on HAART, leading to full resolution of her lymphoma without any chemotherapeutic intervention. She was last seen in the clinic in December 2013 without any evidence of recurrence of her lymphoma. To our knowledge, this is the first case report of a stage III-B non-Hodgkin

AIDS-related lymphoma: resolution with antiretroviral therapy alone.

Patients with HIV are at increased risk of malignancy, particularly lymphoma, which is the most common malignancy leading to death. With the advent of highly active antiretroviral therapy (HAART), patients live longer but have a longer duration of antigenic stimulation, increasing the prevalence of AIDS-related lymphoma (ARL) in the population living with HIV. Highly active antiretroviral therapy plays a direct role in preserving the immune system, helping to decrease the incidence of ARL. We present a case of a female patient with HIV (CD4 count of 576 cells/mm3) diagnosed with a stage Ill-B non-Hodgkin lymphoma in 2009 while off HAART. She was subsequently started on HAART, leading to full resolution of her lymphoma without any chemotherapeutic intervention. She was last seen in the clinic in December 2013 without any evidence of recurrence of her lymphoma. To our knowledge, this is the first case report of a stage III-B non-Hodgkin