First Report of Clivus Osteomyelitis Caused by Nocardia veterana in a Lung Transplant Recipient.

Nocardia species have been implicated as a cause of pulmonary, cutaneous, ocular, and disseminated central nervous system disease. Dissemination to the bones, commonly the spine, has also been described in the literature. However, isolated osteomyelitis of the skull base is rare. Additionally, advances in the use of molecular techniques have identified many new Nocardia species, including Nocardia veterana that was thought to be clinically insignificant when it was first identified. Here, we report the clinical features and treatment approach for a lung transplant patient who developed N. veterana clivus osteomyelitis secondary to sphenoid sinusitis. It is the first case of skull base osteomyelitis caused by this rare species of Nocardia.

A Report of Haemophilus influenzae Bacteremia With Acute Pelvic Inflammatory Disease.

Sexually-transmitted organisms that frequently originate from the flora of the lower genital tract are often implicated in pelvic inflammatory disease (PID). Haemophilus influenzae, a pathogen found primarily in the upper respiratory tract, has been rarely associated with PID. Here we report a case of a young woman with PID whose blood cultures grew H . influenzae biotype II, a reminder that the endometrium can be the source of systemic H. influenzae infection when no typical primary focus is found.

Review of respiratory syncytial virus infection among older adults and transplant recipients.

Respiratory syncytial virus (RSV) is a common cause of pulmonary infection among children and has been increasingly recognized as an important respiratory pathogen in older adults and immunocompromised hosts. Among older adults, RSV can lead to exacerbations of underlying lung and cardiac disease. It is also associated with significant morbidity and mortality in hematopoietic stem cell transplant (HSCT) and solid organ transplant (SOT) recipients and may be associated with acute rejection and chronic lung allograft dysfunction among lung transplant recipients (LTRs). Current treatment options for severe RSV disease are limited, and there is a paucity of guidance on RSV treatment among older adults. This narrative review provides a comprehensive overview of RSV disease in older adults, HSCT recipients, and SOT recipients. Nosocomial spread has been reported, thus highlighting the importance of infection prevention and control measures to prevent outbreaks. Antivirals, monoclonal antibodies for immunoprophylaxis, and vaccine development are underway; however, future research is still needed in these critical areas.

Heart failure exacerbation as only presenting sign of COVID-19.

With the increasing number of confirmed cases and accumulating clinical data, our understanding of COVID-19 continues to evolve. Here we describe the case of a patient who was initially admitted for decompensated heart failure with reduced ejection fraction (HFrEF). Only later in his course did he develop fever that led to testing for severe acute respiratory syndrome coronavirus-2 (SARS-COV-2). Although we are aware of the common respiratory failure induced by SARS-COV-2, we have scant information that describes cardiac manifestations caused by this novel virus.