First Case Report of Sepsis Due to Rothia aeria in a Neonate

Rothia aeria, a gram-positive coccoid- to rod-shaped bacterium with irregular morphology, is an extremely rare causative organism of infections in humans. We report the first case of R. aeria sepsis clinically manifested in a female neonate soon after birth.     

Rothia aeria Neck Abscess in A Patient with Chronic Granulomatous Disease: Case Report and Brief Review of the Literature

Rothia aeria caused a necrotic lymphadenitis and neck abscess in a patient with CGD. This infection was aggressive, crossed tissue planes, required two surgeries, as well as prolonged antibiotics for complete resolution. Rothia aeria is a rare pathogen that can be added to the spectrum of agents causing disease in CGD, a finding that further reinforces the importance of microbiologic identification of infections in this patient population.     

Burkholderia Sepsis in Children as a Hospital-Acquired Infection

Purpose

Hospital-acquired Burkholderia cepacia (B. cepacia) infection are not commonly recorded in patients without underlying lung disease, such as cystic fibrosis and chronic granulomatous disease. However, in 2014, B. cepacia appeared more frequently in pediatric blood samples than in any other year. In order to access this situation, we analyzed the clinical characteristics of B. cepacia infections in pediatric patients at our hospital.

Materials and Methods

We conducted a retrospective study of blood isolates of B. cepacia taken at our hospital between January 2004 and December 2014. Patient clinical data were obtained by retrospective review of electronic medical records. We constructed a dendrogram for B. cepacia isolates from two children and five adult patients.

Results

A total of 14 pediatric patients and 69 adult patients were identified as having B. cepacia bacteremia. In 2014, higher rates of B. cepacia bacteremia were observed in children. Most of them required Intensive Care Unit (ICU) care (12/14). In eleven children, sputum cultures were examined, and five of these children had the same strain of B. cepacia that grew out from their blood samples. Antibiotics were administered based on antibiotic sensitivity results. Four children expired despite treatment. Compared to children, there were no demonstrative differences in adults, except for history of ICU care.

Conclusion

Although there were not many pediatric cases at our hospital, awareness of colonization through hospital-acquired infection and effective therapy for infection of B. cepacia is needed, as it can cause mortality and morbidity.     

Septic Arthritis of a Native Knee Joint Due to Corynebacterium striatum

We report a case of septic arthritis of a native knee joint due to Corynebacterium striatum, a rare and unusual cause of septic arthritis of native joints. The isolate was identified by a combination of phenotypic, mass spectrometric, and nucleic acid-based assays and exhibited high-level resistance to most antimicrobials.     

Immunostimulatory effect of Rothia dentocariosa in mice.

In mice killed Rothia dentocariosa cells in doses of about 1.5 mg dry weight activated anti-infection immunity to Listeria antigens and anti-tumour immunity to the ascitic form of mouse sarcoma S-180. Their probable target site is the macrophage. The Rothia-activated macrophages in human gingiva may take part in the pathogenesis of periodontal disease. Three models were employed to verify the immunostimulating properties of preventively administered Rothia dentocariosa bacterin-1) a spleen macrophage migration test, using mice immunized with Listeria innocua, with the soluble listeria Ei antigen as the antigenic signal, 2) determination of the increase in the Listeria monocytogenes LD50 for mice and 3) the prolongation of survival of mice carrying the S-180 tumour. In all three cases, the administration of Rothia bacterin stimulated the immune response to the later administration of other antigens. Furthermore, in the macrophage migration inhibition test, the chemotaxis of non-immune mouse macrophages was found to be stimulated. This gives evidence of the fact that Rothia bacterin has an activating effect on these macrophages.     

Sepsis as an unusual event in dyskeratosis follicularis

Dyskeratosis follicularis is a genetic disorder characterized by pathogenetic changes of keratinization. We report on a severe case of the disease with an unusual manifestation involving Staphylococcal sepsis. The patient was treated systemically with infusions, oral antibiotics, and retinoids. Antiseptics, keratolytic ointments, and creams were given topically to promote epithelization. His condition improved dramatically after 14 days of treatment. All erosions of the trunk, extremities, neck, and head had epithelized. We suspect that extreme sun exposure and neglect of care on genetically susceptible sites triggered the sepsis.     

Metarrhizium anisopliae as a Cause of Sinusitis in Immunocompetent Hosts

Metarrhizium anisopliae is a common pathogen of insects and has even been used to control insect populations. It is rarely isolated from human or animal sources, but recently, there have been three reported cases of disease, two in humans and one in a cat. We present our experience with five isolates from human sources, including two that were the apparent causes of two cases of sinusitis in immunocompetent hosts. The first patient was a 36-year-old male with frontal and ethmoid sinusitis, and the second was a 79-year-old female with chronic sinusitis. Both patients underwent surgery, and pathology of the surgical specimens revealed branching hyphae. Cultures grew only Metarrhizium species. Neither patient received antifungal therapy, and both did well postoperatively. The other three isolates were cultured from bronchoalveolar lavage specimens but were not felt to be clinically significant. Antifungal susceptibility testing using the National Committee for Clinical Laboratory Standards macrobroth method revealed that all isolates were resistant to amphotericin B, 5-flucytosine, and fluconazole. Itraconazole and newer azole compounds were more active. Metarrhizium species may cause disease in humans, even those without evidence of immunosuppression, and are apparently highly resistant to amphotericin B in vitro.     

Rothia dentocariosa septicemia without endocarditis in a neonatal infant with meconium aspiration syndrome

Rothia dentocariosa, a gram-positive coccoid- to rod-shaped bacterium with irregular morphology, is a rare cause of bacteremia in patients without endocarditis. We report the first case of R. dentocariosa septicemia without endocarditis, which occurred in a neonatal infant with meconium aspiration syndrome.     

Rothia dentocariosa septicaemia in a patient with chronic lymphocytic leukaemia and toxic granulocytopenia

Rothia dentocariosa is part of the human oral flora and has only rarely been reported as a cause of clinical infection. We report the isolation of Rothia dentocariosa from the blood of a septicaemic patient with chronic lymphocytic leukaemia and bone marrow depression following treatment with clomipramine and zuclopentixol.     

Ureaplasma parvum as a Cause of Sternal Wound Infection

Few reports in the literature have documented the isolation of Ureaplasma species from sternal wounds. A case of sternal wound infection likely due to Ureaplasma parvum is described. When routine bacterial cultures from a sternal wound infection fail to yield a pathogen, diagnostic testing for mycoplasmas and ureaplasmas should be considered.     

Case of Triple Endocarditis Caused by Rothia dentocariosa and Results of a Survey in France

This is the first case of endocarditis in which Rothia dentocariosa was cultured from three affected valves. In addition, the records of two microbiology laboratories in France showed that R. dentocariosa was rarely involved in severe infection and that positive blood cultures were not associated with endocarditis.     

Joint mechanics as a determinant of motor unit organization in man

To support a given weight a muscle which inserts close to the axis of a single joint must develop more force than a muscle which inserts further from the axis. Using available anatomical and histochemical data we have shown an association between the mechanical leverage of a muscle at a joint and the proportion of type II (fast twitch, large tension) muscle fibres. We suggest that the mechanical leverage at joints determines the proportion of fast and slow motor units within a muscle in a teleologically appropriate manner. This determination probably occurs before the differentiation of motorneurones into fast and slow types.     

Pathogen Infection as a Possible Cause for Autoimmune Hepatitis

Autoimmune disorders afflicting the liver comprise the bona fide autoimmune diseases, primary biliary cirrhosis, primary sclerosing cholangitis, and autoimmune hepatitis as well as drug-induced autoimmune-like diseases, such as halothane hepatitis. Whereas drug-induced forms of acute or chronic hepatitis often have a clear triggering factor, the etiology of classical autoimmune liver diseases is only poorly understood. Besides a genetic component present in disease susceptible individuals, environmental triggering factors are likely to play a role in the initiation and/or propagation of the disease. In this article, we will review on current evidence obtained from epidemiological associations, case studies, and findings in animal models for pathogens, to be involved in the etiology of autoimmune liver disease with a special focus on autoimmune hepatitis.