Rhodococcus Bacteremia in Cancer Patients Is Mostly Catheter Related and Associated with Biofilm Formation

Rhodococcus is an emerging cause of opportunistic infection in immunocompromised patients, most commonly causing cavitary pneumonia. It has rarely been reported as a cause of isolated bacteremia. However, the relationship between bacteremia and central venous catheter is unknown. Between 2002 and 2010, the characteristics and outcomes of seventeen cancer patients with Rhodococcus bacteremia and indwelling central venous catheters were evaluated. Rhodococcus bacteremias were for the most part (94%) central line-associated bloodstream infection (CLABSI). Most of the bacteremia isolates were Rhodococcus equi (82%). Rhodococcus isolates formed heavy microbial biofilm on the surface of polyurethane catheters, which was reduced completely or partially by antimicrobial lock solution. All CLABSI patients had successful response to catheter removal and antimicrobial therapy. Rhodococcus species should be added to the list of biofilm forming organisms in immunocompromised hosts and most of the Rhodococcus bacteremias in cancer patients are central line associated

Gastrointestinal variant of Lemierre's syndrome complicating ruptured appendicitis

Fusobacterium necrophorum is a non-spore-forming, obligate anaerobic, filamentous, gramnegative bacillus that frequently colonizes the human oral cavity, respiratory tract, and gastrointestinal tract. Fusobacterium species have rarely been implicated in cases of gastrointestinal variant of Lemierre's syndrome. We describe a case of F. necrophorum bacteremia associated with suppurative porto-mesenteric vein thrombosis (PVT) following acute ruptured appendicitis. In addition, we list the documented twelve cases of Fusobacterium pylephlebitis. Recanalization of the porto-mesenteric veins and relief of the extrahepatic portal hypertension were achieved with early empiric antibiotic and local thrombolytic therapy. Our patient's case underscores the importance of recognizing Fusobacterium bacteremia as a possible cause of suppurative PVT after disruption of the gastrointestinal mucosa following an acute intraabdominal infectious process. Early treatment of this condition using anticoagulation and endovascular thrombolysis as adjunctive therapies may prevent PVT complications

Bacterial Endocarditis of Anatomically Normal Native Pulmonic Valve with No Predisposing Risk Factors: Case Report and Review

Right-sided native valve infective endocarditis (IE) includes tricuspid valve (TV) and pulmonic valve (PV). It represents 10% of all cases. However, it is more common in persons who inject drugs or in presence of cardiac implantable electronic device (CIED). Pulmonic valve endocarditis is a rare infection and represents ∼1% of all cases. Our case represents a patient with large pulmonic valve vegetation with no known common risk factors for right-sided IE

Extranodal Natural Killer/T-Cell Lymphoma of the Nasal Type with Skin Metastases

Extranodal natural killer/T-cell lymphoma (ENKL) of the nasal type is a rare, clinically aggressive disease. ENKL of the nasal type is often localized in the upper aerodigestive tract, including the nasal cavity, nasopharynx, paranasal sinuses, tonsils, hypopharynx and larynx, and usually presents as stage I/II. Extranasal involvement can occur, and a common site of extranasal involvement or metastatic disease includes the skin. Identifying skin metastases is important for the appropriate staging and treatment. We report a case of ENKL of the nasal type that presented with localized disease and subsequent skin lesions that were consistent with skin metastases

Uncommon Pathogen, Lactobacillus, Causing Infective Endocarditis: Case Report and Review

Lactobacillus is not a common pathogen; however, it can contribute to opportunistic infections such as infective endocarditis (IE). Nonetheless, it has been reported as case reports in correlation with increased probiotic use, dental caries, and intravenous drug abuse

Central Venous Catheter–associated Nocardia Bacteremia in Cancer Patients

TOC Summary: Heavy biofilm growth can be reduced through use of antimicrobial lock solutions

Formation of <i>Rhodococcus</i> biofilm on 1 cm polyurethane catheter segments.

<p>There was no significant difference in biofilm formation on the surface of the catheter when comparing <i>Rhodococcus</i> non-<i>equi</i> and <i>R. equi</i> isolates (p = 0.13).</p