Acid-fast bacteria as causative agents of skin and soft tissue infections: case presentations and literature review

Acid-fast bacteria can be implicated in skin and soft tissue infections. Diagnostic identification can be challenging or not feasible by routine laboratory techniques, especially if there is no access to the Matrix Assisted Laser Desorption Ionization Time of Flight Mass Spectrometry (MALDI-TOF MS) technology. Here, we present two cases of skin and soft tissue infections caused by two different acid-fast bacteria, Nocardia brasiliensis and Mycobacterium marinum. They both grew on Löwenstein–Jensen medium, Sabouraud agar medium and blood agar medium. Both bacteria appeared acid-fast by Ziehl–Neelsen stain and Gram-positive by Gram stain. The identification was performed by MALDI-TOF MS and gene analysis. N. brasiliensis and nontuberculous mycobacterium M. marinum represent rare pathogens that cause severe skin and soft tissue infections. Failure to identify the causative agent and subsequent inappropriate or inadequate treatment may lead to severe complications or even disseminated disease, especially in immunocompromised individuals

Brucellosis presenting as piriformis myositis: a case report

<p>Abstract</p> <p>Introduction</p> <p>Myositis is a rare bacterial muscle infection. Involvement of the piriformis muscle has been rarely reported in the literature. In this report we describe a case of piriformis myositis due to <it>Brucella melitensis</it>, which to the best of our knowledge is the first such case presented in the literature.</p> <p>Case presentation</p> <p>We report the case of a 19-year-old Caucasian man who presented to our institution with fever and right hip pain. Brucellosis was suspected, but the clinical suspicion was for spondylodiscitis. A pelvic magnetic resonance imaging scan allowed prompt diagnosis of inflammatory involvement of the right piriformis muscle. Blood culture results were positive for <it>B. melitensis</it>. Our patient was treated with antibiotics, and follow-up magnetic resonance imaging scans showed resolution of the inflammation.</p> <p>Conclusion</p> <p>Brucellosis can present as piriformis myositis. The clinical diagnosis of piriformis myositis is difficult, as it can mimic other common entities such as referred back pain from spondylodiscitis. Magnetic resonance imaging is the method of choice for establishing the diagnosis in the early stages of the disease, as late diagnosis can lead to abscess formation and the need for drainage.</p

Acremonium nail bed mycetoma masquerading as subungual squamous cell carcinoma

Acremonium is a large fungal genus that is comprised of approximately 150 species, found ubiquitously in nature. Although the majority are recognized as being saprophytes in soil and pathogens of plants, several species are emerging as causative agents of a variety of human infections, including mycetomas. Herein, we present a young man that was referred to our department with a painful subungual mass that developed following traumatic inoculation of Acremonium spp. In recent years, the role of Acremonium spp. has been increasingly recognized in localized infections, such as mycetoma, in humans. Other locally invasive as well as disseminated infections are also described. Optimal treatment of Acremonium spp. mycetoma is not well defined owing to the rarity of cases, thus posing a therapeutic challenge

Bacillus simplex as the Most Probable Culprit of Penetrating Trauma Infection: A Case Report

Bacillus simplex is an environmental microorganism found in soil. Herein, we present the case of a 69-year-old Greek male patient who attended the Emergency Department at our hospital. The patient complained of lower right extremity swelling and pain, after suffering penetrating trauma whilst doing farm work in a rural area. Swab aerobic cultures revealed Bacillus simplex as identified by MALDI-TOF Mass Spectrometry. The strain was susceptible to vancomycin, imipenem, clindamycin, and ciprofloxacin. Our patient refused hospitalization; therefore, both ciprofloxacin and clindamycin were registered for a total of 19 days. No complications were experienced, and he recovered fully. In our case, the thorough cleaning of the ulcer bed prior to sample collection, the fact that it was the only microorganism isolated, and the wound&rsquo;s aggravating mechanism led the authors of the present study to the conclusion that B. simplex was the most probable culprit of the infection. To our knowledge, this is the second probable case of B. simplex infection described worldwide, and the first in Greece

Prevalence of anti-HAV antibodies in multitransfused patients with beta-thalassemia

AIM: To detect the prevalence of anti-HAV IgG antibodies in adult multitransfused beta-thalassemic patients