1/4. mycobacterium marinum infection in a lung transplant recipient.We report a case of mycobacterium marinum infection in a lung transplant recipient who presented with nodules on the hand and forearm following exposure to fish-tank water of a superficial hand burn. skin biopsy revealed granulomatous inflammation and fibrosis. Tissue culture grew mycobacterium marinum. The patient underwent surgical excision of the lesions and treatment with ethambutol and azithromycin for 12 months and experienced complete resolution of the infection. Transplant recipients who receive immunosuppressive therapy are at increased risk for opportunistic infections. For a patient with nodular lesions on the extremities, exposure to fish, fish-tank water, or swimming should suggest infection with mycobacterium marinum.- - - - - - - - - - ranking = 1keywords = opportunistic infection (Clic here for more details about this article) |
2/4. Cutaneous nocardiosis complicating management of Crohn's disease with infliximab and prednisone.Infliximab is a chimeric anti-tumour necrosis factor-alpha antibody that is efficacious in treating Crohn's disease. However, its immunomodulatory properties increase susceptibility to opportunistic infections. We present a case of cutaneous nocardia infection in a patient who was taking infliximab for Crohn's disease. The case illustrates the challenges in the diagnosis and management of this disease and serves as a reminder of the complications associated with the use of immunomodulatory agents.- - - - - - - - - - ranking = 1keywords = opportunistic infection (Clic here for more details about this article) |
3/4. Cervicofacial nocardiosis in an immunocompetent child.Nocardiosis occurs primarily as an opportunistic infection in an immunocompromised host. The infection may on rare occasion occur in a normal host confounding the diagnosis. It is also notably an uncommon infection in children. We report a 1-y-old girl with cervicofacial nocardial infection who presented with acute suppurative otitis media and lymphadenitis. This child did not have any predisposing risk factors for this infection and responded well to treatment with co-trimoxazole and chloramphenicol. She is doing well on follow-up. CONCLUSION: Nocardiosis in an immunocompetent small child is reported.- - - - - - - - - - ranking = 1keywords = opportunistic infection (Clic here for more details about this article) |
4/4. Pulmonary sarcoidosis and chronic cutaneous atypical mycobacter ulcer.This interesting case of pulmonary sarcoidosis and mycobacterium ulcerans ulcers raises many issues: 1. Our paucity of knowledge of deficient immune status in individuals; the multifarious presentation as recognisable ill health, its early detection, treatment and its prevention. In this present case the management of the immune status of the patient has not yet been fully addressed. The relationship between his pulmonary sarcoidosis as being an 'immune' response to the mycobacterium ulcerans remains speculative; for example, did this patient have the Mycobacterium infection before he was diagnosed as having sarcoidosis? There is no evidence of this. With the history of repeated cellulitis associated with his business trips to asia and the middle east, the likelihood seems speculative--as would infection with mycobacterium ulcerans contracted from swimming in pools and rivers. 2. As sarcoidosis is thought to have an association with mycobacterium tuberculosis it is tempting to suggest that as, in this case, the mycobacterium ulcerans is the caus-ative agent for his sarcoidosis. Additionally, should we be looking for sarcoidosis in every other case of mycobacterium ulcerans infection? Other cases of mycobacterium ulcerans could be assessed. 3. It is suggested that corticosteroids do pave the way for opportunistic infection as in this case. How often does this occur in 'usual practice' where patients are exposed to corticosteroids? Further comments are invited. 4. The question of sterility techniques in the home (daily dressings), the surgery, and at work as a food handler, is noted as a matter of concern. 5. The implications of the problem having any work-related association is also noted in passing.- - - - - - - - - - ranking = 1keywords = opportunistic infection (Clic here for more details about this article) |