Disseminated gonococcal infection in an immunocompetent patient caused by an imported Neisseria gonorrhoeae multidrug-resistant strain

We herein report the microbiological features of a Neisseria gonorrhoeae strain isolated from an immunocompetent patient with disseminated gonococcal infection (DGI). The strain expressed the IA/IB serovar; was resistant to penicillin, tetracycline, and ciprofloxacin; and had presumably been acquired in Southeast Asia. To date, this is the first case reported in our country of DGI due to an imported multidrug-resistant strain.     

Disseminated Paecilomyces lilacinus infection in a patient with AIDS

We describe a case of disseminated Paecilomyces lilacinus infection occurring in a patient with advanced HIV infection. P lilacinus is a ubiquitous environmental fungus that has been associated with infection in various immunocompromised hosts, in patients with invasive medical devices, and in contact-lens wearers. The clinical features, morphologic characteristics, and response to antifungal therapy in our patient are similar to findings reported in disseminated infection due to Penicillium marneffei, another opportunistic fungal infection in HIV-infected patients. We believe this to be the first report of infection with P lilacinus in a patient with AIDS.     

Disseminated infection caused by Scedosporium prolificans in a patient with acute multilineal leukemia

In this report, we describe a case of disseminated infection caused by Scedosporium prolificans (S. inflatum) in a patient affected by chemotherapy-induced acute multilineal leukemia and neutropenia. For the fungus isolated in four blood cultures, high MICs of currently available antifungal agents were found. Postmortem examination revealed multiorgan involvement.     

Disseminated infection by Histoplasma capsulatum with AIDS

Histoplasmosis is an illness which occurs very rarely in Europe and it is especially rare in Germany. A generalised infection with Histoplasma capsulatum, a systemic mycosis of the mononuclear phagocyte system (MPS), occurs only in individuals with weakened immune systems. Within the framework of diagnostics, a pathologist can be confronted with histoplasmosis since there has been an increase in travel to and from endemic regions, as well as an increase in the number of diseases of the immune system. The presented case reports the histological intravital and post-mortem diagnostics of disseminated histoplasmosis in existing HIV-infection in the stage of manifest AIDS.     

Disseminated histoplasmosis in an AIDS patient diagnosed on bone marrow

A 29 year old male drug addict, who was HIV positive presented with fever and hepatosplenomegaly. Bone marrow examination revealed Histoplasma capsulatum confirmed by PAS & GMS stains. However patient had a rapid downhill course with multiorgan failure and died before specific treatment could be instituted.     

Disseminated infection with Nattrassia mangiferae in an immunosuppressed patient

Disseminated infection with the coelomycetous fungus Nattrassia mangiferae is a very rare disease affecting only the immunocompromised host. We report the first case of a disseminated infection with spondylodiscitis and granular skin lesions due to N. mangiferae in a renal transplant patient.     

Disseminated microsporidiosis caused by Encephalitozoon cuniculi III (dog type) in an Italian AIDS patient: a retrospective study.

We report a case of disseminated microsporidiosis in an Italian woman with AIDS. This study was done retrospectively using formalin-fixed, paraffin-embedded tissue specimens obtained at autopsy. Microsporidia spores were found in the necrotic lesions of the liver, kidney, and adrenal gland and in ovary, brain, heart, spleen, lung, and lymph nodes. The infecting agent was identified as belonging to the genus Encephalitozoon based on transmission electron microscopy and indirect immunofluorescence. Additional molecular studies, including sequence of the rDNA internal transcribed spacer region, identified the agent as E. cuniculi, Genotype III. We believe that this is the first report of a human case of disseminated microsporidial infection involving the ovary.     

DisseminatedNocardia farcinica infection in an AIDS patient

This report describes an AIDS patient presenting with disseminatedNocardia farcinica infection diagnosed by percutaneous kidney biopsy. The isolate was initially identified asNocardia asteroides. ThoughNocardia asteroides remains sensitive to most antimicrobial agents,Nocardia farcinica is resistant to gentamicin, tobramycin and cephalosporins and is indistinguishable fromNocardia asteroides by regular laboratory methods. In view of the rising incidence of infections withNocardia farcinica, third-generation cephalosporins should not be used in the initial management ofNocardia infections, and all isolates should be submitted for antibiotic susceptibility testing.     

Disseminated infection caused by urease-negative Cryptococcus neoformans.

We report a case of fungemia and disseminated disease caused by a urease-negative strain of Cryptococcus neoformans in a patient with the acquired immune deficiency syndrome. Except for failure to hydrolyze urea, the microbiological characteristics of the isolate were typical of C. neoformans. Laboratory specialists should be aware of the occurrence of atypical strains of C. neoformans, particularly those recovered from patients with the acquired immune deficiency syndrome.     

Disseminated pneumocystis carinii infection in AIDS.

Eight patients with AIDS and Pneumocystis carinii infection were studied. Protean manifestations were a feature not untypical of disseminated pneumocystosis. Aerosolised pentamidine as prophylaxis against P carinii pneumonia was ineffective at suppressing dissemination. The knowledge that extrapulmonary infection can occur has implications for the detection and treatment of, and prophylaxis against, P carinii infection. The survival of patients with disseminated pneumocystosis is particularly poor, and may be due to a lack of clinical awareness and consequent delay in diagnosis.     

Prosthetic joint infection caused by Mycobacterium alvei in an elderly patient

We report the first case of prosthetic joint infection caused by Mycobacterium alvei, which was identified by PCR-restriction fragment length polymorphism and verified by analysis of nucleotide sequences of its amplified 16S ribosomal DNA. The pathogen was susceptible to linezolid, amikacin, ciprofloxacin, tigecycline, and trimethoprim-sulfamethoxazole. The clinical implications are discussed.