Tissiarella praeacuta bacteremia, a rare complication of osteomyelitis.

Tissierella praeacuta, also known as Clostridium hastiforme is an anaerobic gram negative bacteria, first isolated in 1908, by P.H. Tissier. To date, there are currently six documented cases of this environmental organism causing infection in humans. Here, we present a patient who was admitted to hospital with osteomyelitis of his right calcaneus, found to subsequently have T. praeacuta bacteremia isolated from anaerobic blood cultures. During his inpatient course, he was treated with IV vancomycin, cefepime, and metronidazole in addition to surgical debridement of his foot wound. The patient was discharged on a course of oral Levofloxacin and Amoxicillin-Clavulanate with significant clinical improvement.

Fever of unknown origin caused by tuberculosis.

Tuberculosis is an important cause of fever of unknown origin. Travel, age, dialysis, diabetes, birth in a country with a high prevalence of tuberculosis, and immunoincompetence are among the most salient risks. Associated physical findings, radiologic evaluation, and hematologic and endocrinologic abnormalities may provide clues to the diagnosis. Both noninvasive and invasive diagnostic modalities are reviewed. Because diagnosis may be elusive, therapeutic and diagnostic trials of antituberculous therapy should be considered in all patients with fever of unknown origin who defy diagnosis.

Bacterial peritonitis caused by Kingella kingae.

Kingella kingae is a commensal of the upper respiratory tract that occasionally causes skeletal infections in children and endocarditis in children and adults. We report a case of a 55-year-old man with liver disease and tense ascites who performed a paracentesis on himself and developed K. kingae peritonitis and bacteremia.