Cytomegalovirus ileitis in an immunocompetent elderly adult

Cytomegalovirus enteritis is most usually associated with patients positive for human immunodeficiency virus or immunosuppressed transplant patients. The gastrointestinal tract may be affected anywhere from the esophagus to the colon, but the small bowel involvement is rare. We report a case of cytomegalovirus ileitis in an immunocompetent adult, which was confirmed by histopathologic findings through colonoscopic biopsy.     

Imaging findings of vertebral osteomyelitis caused by nontuberculous mycobacterial organisms: Three case reports and literature review

Rationale:Prompt diagnosis of nontuberculous Mycobacterial (NTM) vertebral osteomyelitis is challenging, yet necessary to prevent serious morbidity and mortality. Here, we report 3 cases of vertebral osteomyelitis caused by NTM with imaging findings.Patient concerns:Case 1, a 58-year-old male patient, was admitted to our hospital because of the presence of a pulmonary mass for 6 months with cough and chest pain.Case 2, a 50-year-old male patient, had fever and cough for 3 years and was diagnosed with tuberculosis. Antituberculosis treatment was ineffective, accompanied by lymph node enlargement and osteosclerotic changes involving vertebral bodies.Case 3, a 66-year-old female patient, was admitted to our hospital with a mass on the top of her head for 1 month, which ruptured in the last 2 weeks.Diagnoses:Case 1: Sputum culture revealed Mycobacterium (M.) avium.Case 2: The final culture results of the lymph node biopsy samples were M. intracellulare.Case 3: Culture results of the sputum and pus from the abscess were M. gordon.We found sclerosing lesions in the spine in all 3 NTM patients, which were easily misdiagnosed as metastatic tumors. In 2 cases, there was bone destruction in the ilium with limbic sclerosis, and there were abscesses near the ilium and in front of the sacrum in 1 case.Interventions:Case 1 was transferred to other specialist hospital.Case 3 received surgical treatment for cranial lesions and abscess drainage.Case 2 and case 3 received targeted treatment for nontuberculous mycobacteria in our hospital.Outcome:The condition of case 1 was unknown.Recovery of case 2 was uneventful because of prolonged illness; however, inflammation gradually improved overall.Case 3 had no recurrence following surgical treatment.Lessons:In our 3 cases of NTM vertebral osteomyelitis, bone lesions were often misdiagnosed as bony metastases because of the presence of multiple sclerotic lesions. Diagnoses were challenging and delayed. It is important to consider osteomyelitis by NTM when disseminated osteosclerosis with or without osteolytic bone lesions is present in conjunction with continuous inflammatory symptoms and signs. Moreover, an open biopsy of the lesion should be performed for a definitive diagnosis.     

Cytomegalovirus-associated colitis causing diarrhea in an immunocompetent patient

INTRODUCTION The seroprevalence of cytomegalovirus (CMV) in the general population is high (40%-100%)[1]. Most CMV infections are acquired in the perinatal period, infancy or early adulthood[2]. The majority of primary CMV infections in immunocompetent ad…     

An unusual cause of vertebral osteomyelitis: Candida species

Candida species rarely cause spondylodiscitis. During 3 y, 3 cases of vertebral osteomyelitis due to Candida spp. (Candida albicans and Candida tropicalis) were diagnosed, 2 of which were associated with a spinal epidural abscess.     

Multifocal osteoarticular tuberculosis and pleuropulmonary involvement in an immunocompetent patient

Introduction

Multifocal tuberculosis is an uncommon presentation in immune-competent patients; it’s associated more with an immune-depression like HIV (Human Immunodeficiency Virus) infection. Here, we are presenting unusual multifocal osteoarticular localizations including the wrist and tarsal joint which are rare and pleura-pulmonary tuberculosis.

Recurrent septicemia due to Campylobacter fetus and Campylobacter lari in an immunocompetent patient

We describe a severe and recurrent septicemia due to Campylobacter in a 75-year-old immunocompetent patient. Two Campylobacter strains were detected in several blood cultures. Campylobacter fetus and Campylobacter lari were identified with PCR tests based on species-specific nucleotide sequences for the 16S rRNA gene. Received: August 10, 2001 · Revision accepted: December 27, 2001     

Tenosynovitis due toMycobacterium avium intracellulare andMycobacterium chelonei: Report of two cases with review of the literature

Atypical mycobacteria can induce soft tissue infections such as tenosynovitis. We observed one case of finger flexor tendon tenosynovitis infected withMycobacterium avium intracellulare and one case of knee and ankle arthritis with lateral peroneal tendon tenosynovitis due toM. chelonei. In the first patient, a tenosynovectomy only was performed leading to resolution of the infection. The second patient was immunocompromised as a result of corticosteroid therapy and the mycobacterial infection was treated with tenosynovectomy and multidrug chemotherapy. This patient died from infectious pneumonitis. Previously reported cases of infectious tenosynovitis due to these atypical mycobacteria are reviewed.