Pneumonia caused by Sphingomonas paucimobilis infection after a dental intervention.

INTRODUCTION: Sphingomonas paucimobilis can be found in air, water systems, dialysis fluid, nebulizers and laboratory instruments in hospitals. Despite its low pathogenicity, it can cause severe infections. CASE REPORT: A 54-year-old man presented with fever, cough and pain in the right hemithorax. The laboratory results showed elevated inflammatory parameters. Chest radiography showed right upper lobe pneumonia. Empiric antibiotic therapy (cephalosporin) was prescribed. On control examination chest radiography showed incomplete regression. Chest computer tomography (CT) finding was bronchopneumonia in the right upper lobe. Bacteriological examination of fiberaspirate revealed Sphingomonas paucimobils. Trimethoprim-sulfamethoxazole was prescribed based on the antibiogram. After two weeks the control laboratory analysis was normal. The patient was fully recovered. CONCLUSIONS: Our patient had no comorbidities or malignancies, and no hospitalization in the recent past. He had a dental intervention 5 days prior to the onset of symptoms. We propose that it was an infection after the dental intervention.

Soluble sPD-L1 and Serum Amyloid A1 as Potential Biomarkers for Lung Cancer.

BACKGROUND: The objective of this prospective study was to evaluate whether soluble programmed cell death-1/programmed cell death-ligand 1 (PD-1/PD-L1) and serum amyloid A1 (SAA1) are potential diagnostic, predictive or prognostic biomarkers in lung cancer. METHODS: Lung cancer patients (n=115) with advanced metastatic disease, 101 with non-small cell lung cancer, NSCLC (77 EGFR wild-type NSCLC patients on chemotherapy, 15 EGFR mutation positive adenocarcinoma patients, 9 patients with mPD-L1 Expression ≥50% NSCLC - responders to immunotherapy), and 14 patients with small cell lung cancer (SCLC) were examined. ELISA method was used to determine sPD-L1 and SAA1 concentrations in patients' plasma. RESULTS: Significantly higher blood concentrations of sPD-L1 and SAA1 were noted in lung cancer patients compared with a healthy control group. In PD-L1+ NSCLC patients, a significantly higher sPD-L1 level was noticed compared to any other lung cancer subgroup, as well as the highest average SAA1 value compared to other subgroups. CONCLUSIONS: It seems that sPD-1/PD-L1 might be a potential biomarker, prognostic and/ or predictive, particularly in patients treated with immunotherapy. Serum amyloid A1 has potential to act as a good predictor of patients' survival, as well as a biomarker of a more advanced disease, with possibly good capability to predict the course of disease measured at different time points.