Fusobacterium Necrophorum bacteremia involving multi-organ systems.

A 62-year-old African American man with a history of avascular necrosis (AVN) of the right hip joint presented with severe right hip pain, dyspnea, fever, tachycardia, and hypertension. Computed tomography (CT) scan showed bilateral airspace opacities with a mild tree-in-bud nodularity in the left lower lobe. Ultrasonography of the lower extremities revealed a deep venous thrombus (DVT) in the right deep veins. Blood cultures grew Fusobacterium necrophorum. CT and magnetic resonance imaging showed right hip joint destruction and septic arthritis. The patient had a complicated hospital course leading to total hip arthroplasty with antibiotic-impregnated cementing.

An Unusual Case of Perirenal Abscess Caused by Campylobacter and Peptostreptococcus Species.

Intra-abdominal abscesses mostly derive from the intra-abdominal viscera. Campylobacter spp. are Gram-negative rods which are known to cause oral infections but rarely have been documented to cause extra-intestinal infections resulting in abscesses. We report an atypical case of Campylobacter rectus (C. rectus) and Peptostreptococcus spp. bacteria isolated from a perinephric abscess presenting as abdominal pain. Abscesses originating from outside the gastrointestinal tract have been reported in other similar case reports infecting the head, brain, and thoracic wall amongst others. The potential source and development of such a Campylobacter infection could be due to multiple hypotheses. This is a first case report of perinephric abscess development. Studies have suggested person-to-person (fecal-oral) transmission along with insects serving as primary reservoirs. Seeding of bacteria through infections in the oral cavity or through infections in the bowel microperforations has also been considered as plausible reasons. Since C. rectus has been isolated in such rare instances, it should be kept in mind when considering differential diagnosis of potential causative agents for extra-oral infections such as invasive abscess formations.

Seborrheic keratoses of florid eruption.

We report the case of a 79-year-old Caucasian man, who developed numerous pruritic seborrheic keratoses on his chest and back within one year. An underlying malignant disease was suspected. Upper and lower endoscopies were performed and the patient was diagnosed with adenocarcinoma of the ascending colon. We discuss the clinical significance of his cutaneous symptoms/signs, and review the medical literature on the paraneoplastic sign of Leser-Trélat.

Bacteremia due to Comamonas species possibly associated with exposure to tropical fish.

Comamonas species are environmental gram-negative rods that grow forming pink-pigmented colonies. Despite their common occurrence in nature, they rarely cause human infection. We present a case of Comamonas bacteremia that we think may have been related to tropical fish exposure. The patient was treated successfully with levofloxacin.

Thyroid abscess due to Acinetobacter calcoaceticus: case report and review of the causes of and current management strategies for thyroid abscesses.

Thyroid abscess was a common condition in the era before antibiotics. In the current medical environment, however, it is a clinical entity that is seldom encountered. We report the case of a unique cause of thyroid abscess, the environmental Gram-negative bacterium Acinetobacter calcoaceticus. Review of the published causes of thyroid abscess since 1980 demonstrated that although Gram-positive bacteria (Staphylococcus and Streptococcus species) remain the most common causes, there has been a marked decrease in the number of cases caused by mycobacteria, Salmonella species, and anaerobes when compared with the early part of the 20th century. Patients infected with the human immunodeficiency virus, however, still develop mycobacterial and fungal thyroid infections with some regularity. Reported modes of management of thyroid abscess vary, but drainage remains an integral component of therapy for resolution of the infection.

Symptoms associated with anthrax exposure: suspected "aborted" anthrax.

Anthrax is a naturally occurring organism with a low incidence of infection. There are no known cases of human-to-human transmission. Bioterrorism-related anthrax in the United States has been seen in three high-risk groups: (1) postal workers, (2) politicians and their staffs, and (3) the press. It appears as though the bioterrorism-related anthrax cases of fall 2001 have been transmitted through the US Postal Service. The authors present a case in which a person at high risk for anthrax exposure was inadequately treated and had symptoms that do not fall into any specific category of disease. It emphasizes the need for someone who has been started on prophylaxis for anthrax to complete a full 60-day course of treatment. It also shows the effectiveness of antibiotic therapy, even in those with high exposure to weaponized anthrax. Further, we would like to suggest that there may exist a new clinical entity of "aborted anthrax infection."