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Aga M, Okubo S, Ikeda T, Higashi Y, Hamakawa Y, Matsuzaka S, Miyazaki K, Taniguchi Y, Misumi Y, Agemi Y, Nakamura Y, Shimokawa T, Aisa Y, Okamoto H. Multiple lung abscesses and cold agglutinin syndrome following coronavirus disease 2019: a case report. J Med Case Rep 2024; 18:318. [PMID: 38997782 PMCID: PMC11245837 DOI: 10.1186/s13256-024-04648-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2023] [Accepted: 06/09/2024] [Indexed: 07/14/2024] Open
Abstract
BACKGROUND Cold agglutination syndrome is a subtype of autoimmune hemolytic anemia. The condition is referred to as "cold" because the antibodies become active and induce hemolysis at cold temperatures, typically 3-4 °C, which is not always the case in other kinds of autoimmune hemolytic anemia. Whereas primary cold agglutination syndrome may occur in the absence of underlying conditions, secondary cold agglutination syndrome is associated with the presence of underlying infections, including coronavirus disease 2019. CASE PRESENTATION We report the case of a 69-year-old Japanese woman with periodontitis who was referred to our hospital with complaints of brown-colored urine and chest pain. Her hemoglobin level was 6.1 g/dL. Computed tomography revealed multiple lung abscesses. Her direct antibody test results were positive (2+) for anti-complement direct antiglobulin and negative for immunoglobulin G, and her cold agglutinin titer was elevated at 1:4096. Workup for anemia revealed a positive result for cold agglutination syndrome. The patient had received the fourth dose of coronavirus disease 2019 vaccination. Nasopharyngeal swab test for detecting severe acute respiratory syndrome coronavirus 2 using a real-time reverse-transcription polymerase chain reaction gave a cycle threshold value of 42.3, and the level of virus-specific immunoglobulin G was elevated at 7.71 S/C (normal range -1.4 S/C). CONCLUSION A decrease in hemoglobin in patients with coronavirus disease 2019 may be associated with secondary cold agglutination syndrome. The patient was hypothesized to have developed multiple lung abscesses with secondary cold agglutination syndrome following coronavirus disease 2019. Thus, following coronavirus disease 2019, patients can develop secondary cold agglutination syndrome, which could worsen owing to associated bloodstream bacterial infections.
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Affiliation(s)
- Masaharu Aga
- Department of Respiratory Medicine, Yokohama Municipal Citizen's Hospital, 1-1, Mitsuzawa Nishi Machi, Kanagawa Ku, Yokohama Shi, Kanagawa Ken, 221-0855, Japan.
| | - So Okubo
- Department of Hematology, Yokohama Municipal Citizen's Hospital, Yokohama, Kanagawa, Japan
| | - Toshiki Ikeda
- Department of Respiratory Medicine, Yokohama Municipal Citizen's Hospital, 1-1, Mitsuzawa Nishi Machi, Kanagawa Ku, Yokohama Shi, Kanagawa Ken, 221-0855, Japan
| | - Yuko Higashi
- Department of Respiratory Medicine, Yokohama Municipal Citizen's Hospital, 1-1, Mitsuzawa Nishi Machi, Kanagawa Ku, Yokohama Shi, Kanagawa Ken, 221-0855, Japan
| | - Yusuke Hamakawa
- Department of Respiratory Medicine, Yokohama Municipal Citizen's Hospital, 1-1, Mitsuzawa Nishi Machi, Kanagawa Ku, Yokohama Shi, Kanagawa Ken, 221-0855, Japan
| | - Suguru Matsuzaka
- Department of Transitional and Palliative Care, Iizuka Hospital, Iizuka, Japan
| | - Kazuhito Miyazaki
- Department of Respiratory Medicine, Yokohama Municipal Citizen's Hospital, 1-1, Mitsuzawa Nishi Machi, Kanagawa Ku, Yokohama Shi, Kanagawa Ken, 221-0855, Japan
| | - Yuri Taniguchi
- Department of Respiratory Medicine, Yokohama Municipal Citizen's Hospital, 1-1, Mitsuzawa Nishi Machi, Kanagawa Ku, Yokohama Shi, Kanagawa Ken, 221-0855, Japan
| | - Yuki Misumi
- Department of Respiratory Medicine, Yokohama Municipal Citizen's Hospital, 1-1, Mitsuzawa Nishi Machi, Kanagawa Ku, Yokohama Shi, Kanagawa Ken, 221-0855, Japan
| | - Yoko Agemi
- Department of Respiratory Medicine, Yokohama Municipal Citizen's Hospital, 1-1, Mitsuzawa Nishi Machi, Kanagawa Ku, Yokohama Shi, Kanagawa Ken, 221-0855, Japan
| | - Yukiko Nakamura
- Department of Respiratory Medicine, Yokohama Municipal Citizen's Hospital, 1-1, Mitsuzawa Nishi Machi, Kanagawa Ku, Yokohama Shi, Kanagawa Ken, 221-0855, Japan
| | - Tsuneo Shimokawa
- Department of Respiratory Medicine, Yokohama Municipal Citizen's Hospital, 1-1, Mitsuzawa Nishi Machi, Kanagawa Ku, Yokohama Shi, Kanagawa Ken, 221-0855, Japan
| | - Yoshinobu Aisa
- Department of Hematology, Yokohama Municipal Citizen's Hospital, Yokohama, Kanagawa, Japan
| | - Hiroaki Okamoto
- Department of Respiratory Medicine, Yokohama Municipal Citizen's Hospital, 1-1, Mitsuzawa Nishi Machi, Kanagawa Ku, Yokohama Shi, Kanagawa Ken, 221-0855, Japan
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Ayogu CI, Valluru B. Septic arthritis of the native hip joint and septic pulmonary embolism in an adult with sickle cell trait after a complicated dental extraction. BMJ Case Rep 2024; 17:e254945. [PMID: 38802256 DOI: 10.1136/bcr-2023-254945] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/29/2024] Open
Abstract
Septic arthritis (SA) is a serious infection of the joint which can lead to irreversible destruction of the joint.We report a case of right hip SA with septic pulmonary embolism following a complicated dental extraction in a woman in her early 40s with sickle cell trait (SCT).The patient presented with severe right thigh pain and left jaw pain.Initial workup revealed raised C reactive protein and positive blood cultures. Right hip joint SA was confirmed following intraoperative joint aspiration. The patient had right hip debridement with long-term intravenous antibiotics.The incidence of SA in adults with sickle cell disease is low: 0.3% in a study in France and Brazil and 10.3% incidence of haematogenous osteoarticular infection in children with SCT in West Africa.
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Borgheresi A, Agostini A, Pierpaoli L, Bruno A, Valeri T, Danti G, Bicci E, Gabelloni M, De Muzio F, Brunese MC, Bruno F, Palumbo P, Fusco R, Granata V, Gandolfo N, Miele V, Barile A, Giovagnoni A. Tips and Tricks in Thoracic Radiology for Beginners: A Findings-Based Approach. Tomography 2023; 9:1153-1186. [PMID: 37368547 DOI: 10.3390/tomography9030095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Revised: 06/03/2023] [Accepted: 06/12/2023] [Indexed: 06/29/2023] Open
Abstract
This review has the purpose of illustrating schematically and comprehensively the key concepts for the beginner who approaches chest radiology for the first time. The approach to thoracic imaging may be challenging for the beginner due to the wide spectrum of diseases, their overlap, and the complexity of radiological findings. The first step consists of the proper assessment of the basic imaging findings. This review is divided into three main districts (mediastinum, pleura, focal and diffuse diseases of the lung parenchyma): the main findings will be discussed in a clinical scenario. Radiological tips and tricks, and relative clinical background, will be provided to orient the beginner toward the differential diagnoses of the main thoracic diseases.
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Affiliation(s)
- Alessandra Borgheresi
- Department of Clinical, Special and Dental Sciences, University Politecnica delle Marche, Via Tronto 10/a, 60126 Ancona, Italy
- Department of Radiology, University Hospital "Azienda Ospedaliero Universitaria delle Marche", Via Conca 71, 60126 Ancona, Italy
| | - Andrea Agostini
- Department of Clinical, Special and Dental Sciences, University Politecnica delle Marche, Via Tronto 10/a, 60126 Ancona, Italy
- Department of Radiology, University Hospital "Azienda Ospedaliero Universitaria delle Marche", Via Conca 71, 60126 Ancona, Italy
- Italian Society of Medical and Interventional Radiology (SIRM), SIRM Foundation, 20122 Milan, Italy
| | - Luca Pierpaoli
- School of Radiology, University Politecnica delle Marche, Via Tronto 10/a, 60126 Ancona, Italy
| | - Alessandra Bruno
- School of Radiology, University Politecnica delle Marche, Via Tronto 10/a, 60126 Ancona, Italy
| | - Tommaso Valeri
- School of Radiology, University Politecnica delle Marche, Via Tronto 10/a, 60126 Ancona, Italy
| | - Ginevra Danti
- Department of Radiology, Azienda Ospedaliero-Universitaria Careggi, 50134 Florence, Italy
| | - Eleonora Bicci
- Department of Radiology, Azienda Ospedaliero-Universitaria Careggi, 50134 Florence, Italy
| | - Michela Gabelloni
- Nuclear Medicine Unit, Department of Translational Research, University of Pisa, 56126 Pisa, Italy
| | - Federica De Muzio
- Department of Medicine and Health Sciences V. Tiberio, University of Molise, 86100 Campobasso, Italy
| | - Maria Chiara Brunese
- Department of Medicine and Health Sciences V. Tiberio, University of Molise, 86100 Campobasso, Italy
| | - Federico Bruno
- Italian Society of Medical and Interventional Radiology (SIRM), SIRM Foundation, 20122 Milan, Italy
- Department of Diagnostic Imaging, Area of Cardiovascular and Interventional Imaging, Abruzzo Health, Unit 1, 67100 L'Aquila, Italy
| | - Pierpaolo Palumbo
- Italian Society of Medical and Interventional Radiology (SIRM), SIRM Foundation, 20122 Milan, Italy
- Department of Diagnostic Imaging, Area of Cardiovascular and Interventional Imaging, Abruzzo Health, Unit 1, 67100 L'Aquila, Italy
| | - Roberta Fusco
- Medical Oncology Division, Igea SpA, 80013 Naples, Italy
| | - Vincenza Granata
- Division of Radiology, Istituto Nazionale Tumori IRCCS Fondazione Pascale-IRCCS di Napoli, 80131 Naples, Italy
| | - Nicoletta Gandolfo
- Diagnostic Imaging Department, Villa Scassi Hospital-ASL 3, 16149 Genoa, Italy
| | - Vittorio Miele
- Italian Society of Medical and Interventional Radiology (SIRM), SIRM Foundation, 20122 Milan, Italy
- Department of Radiology, Azienda Ospedaliero-Universitaria Careggi, 50134 Florence, Italy
| | - Antonio Barile
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, 67100 L'Aquila, Italy
| | - Andrea Giovagnoni
- Department of Clinical, Special and Dental Sciences, University Politecnica delle Marche, Via Tronto 10/a, 60126 Ancona, Italy
- Department of Radiology, University Hospital "Azienda Ospedaliero Universitaria delle Marche", Via Conca 71, 60126 Ancona, Italy
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Castro DV, Costa S, Gomes O, Ferreira N, Pereira L. Septic Embolism Associated With Periodontal Disease: A Case Report. Cureus 2023; 15:e40468. [PMID: 37456495 PMCID: PMC10349590 DOI: 10.7759/cureus.40468] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/14/2023] [Indexed: 07/18/2023] Open
Abstract
Parvimonas micra and Provetella oralis are two commensal anaerobic bacteria of the human oral cavity. Anaerobic bacteria infections are uncommon and require a high index of suspicion and a quick start of appropriate treatment. We present a patient with multifocal infiltrates compatible with septic embolism (lung, liver, and spleen emboli) and polymicrobial bacteremia with Parvimonas micra and Provetella oralis. Periodontal disease appears to be the main cause of this disseminated infection.
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Affiliation(s)
- Diana V Castro
- Intensive Care Unit, Centro Hospitalar de Leiria, Leiria, PRT
| | - Simone Costa
- Intensive Care Unit, Centro Hospitalar de Leiria, Leiria, PRT
| | - Odete Gomes
- Intensive Care Unit, Centro Hospitalar de Leiria, Leiria, PRT
| | - Nuno Ferreira
- Intensive Care Unit, Centro Hospitalar de Leiria, Leiria, PRT
| | - Luís Pereira
- Intensive Care Unit, Centro Hospitalar de Leiria, Leiria, PRT
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Elmeazawy R, El Amrousy D. Baseline characteristics and analysis of predictors of the Outcome of septic pulmonary embolism in children: a retrospective observational study. BMC Pediatr 2023; 23:215. [PMID: 37147610 PMCID: PMC10161177 DOI: 10.1186/s12887-023-03998-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Accepted: 04/07/2023] [Indexed: 05/07/2023] Open
Abstract
BACKGROUND Septic pulmonary embolism is a rare disease in children. We aimed to assess the clinical, microbiological, and radiological characteristics and outcomes of pediatric septic pulmonary embolism (SPE) and to identify any predictive factors for in-hospital mortality in patients with this unusual disease to enhance prognosis and treatment. METHODS A retrospective study to search the electronic medical records of children admitted to the pediatric pulmonology unit, Tanta University hospital with the diagnosis of SPE between January 2015 and June 2022. RESULTS Seventeen pediatric patients were identified; ten males and seven females with a mean age of 9.4 ± 5.2 years. The most common presenting complaints were fever and shortness of breath (n = 17) followed by chest pain (n = 9), pallor (n = 5), limb swelling (n = 4), and back pain (n = 1). Methicillin-resistant Staphylococcus aureus (MRSA) was the most common causative pathogen in nine patients. The most common extra-pulmonary septic foci were septic arthritis in five patients (29.4%), septic thrombophlebitis in four patients (23.5%), and infective endocarditis in two patients (11.8%). All patients exhibited wedge-shaped peripheral lesions and feeding vessel sign in CT chest, whereas bilateral diffuse lesions, nodular lesions, and cavitation were present in 94.1% of patients, pleural effusion was identified in 58.8% of patients, and pneumothorax was detected in 41.2% of patients. Fifteen patients improved and survived (88.2%), while two patients died (11.8%). CONCLUSION Early diagnosis of SPE with vigorous early therapy is critical for a better outcome, including appropriate antibiotics and timely surgical interference to eradicate extra-pulmonary septic foci.
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Affiliation(s)
- Rehab Elmeazawy
- Department of Pediatrics, Faculty of Medicine, Tanta University, Tanta, Egypt.
| | - Doaa El Amrousy
- Department of Pediatrics, Faculty of Medicine, Tanta University, Tanta, Egypt.
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Devi OM, Gupta J, Chahal GS, Jain A. Is periodontal infection a risk factor for thromboembolic disease? A systematic review. J Indian Soc Periodontol 2023; 27:238-250. [PMID: 37346852 PMCID: PMC10281308 DOI: 10.4103/jisp.jisp_576_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Revised: 06/11/2022] [Accepted: 07/10/2022] [Indexed: 06/23/2023] Open
Abstract
Background Venous thromboembolism (VTE) is a rising major health problem comprising pulmonary embolism (PE) and deep vein thrombosis. It is of concern due to premature mortality, increased morbidity, and associated healthcare costs and hospitalization. Periodontitis can increase the risk of VTE by way of systemic inflammation induced by infection that can contribute to hypercoagulability and platelet aggregation. This systematic review aims to synthesize all the evidence concerning periodontal infection as a risk factor for thromboembolic disease. Materials and Methods A search for articles published from 1967 till December 2020 was conducted in the PubMed (MEDLINE), Scopus, and EMBASE data bases. Results Five hundred and five articles were retrieved after running search strategies in PubMed, Scopus, and EMBASE search databases. Based on the inclusion criteria, three clinical studies, two case series, and ten case reports were included for qualitative analysis. The presence of periodontal disease was reported to influence the occurrence of venous thromboembolic disease with a statistical significance of <0.010. Case series and case reports of septic PE due to periodontal disease showed complete resolution of lung lesions and subsiding of symptoms after dental treatment and antimicrobial therapy. Conclusions The results of this systematic review suggested for an association between periodontal disease and the incidence of thromboembolic disease. As most of the included/available studies are case series and case reports, the strength of evidence is weak. Evidence generated from well-designed longitudinal controlled clinical trials may be helpful to further assess the strength of the association.
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Affiliation(s)
- Oinam Monica Devi
- Department of Periodontology, Dr. Harvansh Singh Judge Institute of Dental Sciences and Hospital, Panjab University, Chandigarh, India
| | - Jyoti Gupta
- Department of Periodontology, Dr. Harvansh Singh Judge Institute of Dental Sciences and Hospital, Panjab University, Chandigarh, India
| | - Gurparkash Singh Chahal
- Department of Periodontology, Dr. Harvansh Singh Judge Institute of Dental Sciences and Hospital, Panjab University, Chandigarh, India
| | - Ashish Jain
- Department of Periodontology, Dr. Harvansh Singh Judge Institute of Dental Sciences and Hospital, Panjab University, Chandigarh, India
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Sirbu O, Sorodoc V, Floria M, Statescu C, Sascau R, Lionte C, Petris OR, Haliga RE, Morariu PC, Tirnoveanu A, Burduloi VM, Ursulescu C, Sorodoc L. Nontrombotic Pulmonary Embolism: Different Etiology, Same Significant Consequences. J Pers Med 2023; 13:jpm13020202. [PMID: 36836436 PMCID: PMC9963227 DOI: 10.3390/jpm13020202] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Revised: 01/16/2023] [Accepted: 01/20/2023] [Indexed: 01/26/2023] Open
Abstract
Nontrombotic pulmonary embolism represents the embolization of different types of materials (cells, organisms, gas, foreign material) into pulmonary circulation. The disease is uncommon, and clinical presentation together with laboratory findings are nonspecific. Its pathology is usually misdiagnosed based on imaging findings as pulmonary thromboembolism, but the correct diagnosis is essential because different therapeutic approaches are required. In this context, knowledge of the risk factors associated with nontrombotic pulmonary embolism and specific clinical symptoms is fundamental. Our objective was to discuss the specific features of the most common etiologies of nontrombotic pulmonary embolism, gas, fat, amniotic fluid, sepsis and tumors, to provide assistance for a rapid and correct diagnosis. Because the most common etiologies are iatrogenic, knowledge of the risk factors could be an important tool for prevention or rapid treatment if the disease develops during different procedures. The diagnosis of nontrombotic pulmonary embolisms represent a laborious challenge, and endeavors should be made to prevent development and increase awareness of this disease.
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Affiliation(s)
- Oana Sirbu
- Department of Internal Medicine, Clinical Emergency Hospital “Sfântul Spiridon”, 700111 Iasi, Romania
- Faculty of General Medicine, University of Medicine and Pharmacy “Grigore T. Popa”, 16 Universitatii Street, 700115 Iasi, Romania
| | - Victorita Sorodoc
- Department of Internal Medicine, Clinical Emergency Hospital “Sfântul Spiridon”, 700111 Iasi, Romania
- Faculty of General Medicine, University of Medicine and Pharmacy “Grigore T. Popa”, 16 Universitatii Street, 700115 Iasi, Romania
- Correspondence: (V.S.); (C.S.)
| | - Mariana Floria
- Department of Internal Medicine, Clinical Emergency Hospital “Sfântul Spiridon”, 700111 Iasi, Romania
- Faculty of General Medicine, University of Medicine and Pharmacy “Grigore T. Popa”, 16 Universitatii Street, 700115 Iasi, Romania
| | - Cristian Statescu
- Faculty of General Medicine, University of Medicine and Pharmacy “Grigore T. Popa”, 16 Universitatii Street, 700115 Iasi, Romania
- Department of Cardiology, Institute of Cardiovascular Diseases “Dr. George I.M. Georgescu”, 700503 Iasi, Romania
- Correspondence: (V.S.); (C.S.)
| | - Radu Sascau
- Faculty of General Medicine, University of Medicine and Pharmacy “Grigore T. Popa”, 16 Universitatii Street, 700115 Iasi, Romania
- Department of Cardiology, Institute of Cardiovascular Diseases “Dr. George I.M. Georgescu”, 700503 Iasi, Romania
| | - Catalina Lionte
- Department of Internal Medicine, Clinical Emergency Hospital “Sfântul Spiridon”, 700111 Iasi, Romania
- Faculty of General Medicine, University of Medicine and Pharmacy “Grigore T. Popa”, 16 Universitatii Street, 700115 Iasi, Romania
| | - Ovidiu Rusalim Petris
- Department of Internal Medicine, Clinical Emergency Hospital “Sfântul Spiridon”, 700111 Iasi, Romania
- Faculty of General Medicine, University of Medicine and Pharmacy “Grigore T. Popa”, 16 Universitatii Street, 700115 Iasi, Romania
| | - Raluca Ecaterina Haliga
- Department of Internal Medicine, Clinical Emergency Hospital “Sfântul Spiridon”, 700111 Iasi, Romania
- Faculty of General Medicine, University of Medicine and Pharmacy “Grigore T. Popa”, 16 Universitatii Street, 700115 Iasi, Romania
| | - Paula Cristina Morariu
- Department of Internal Medicine, Clinical Emergency Hospital “Sfântul Spiridon”, 700111 Iasi, Romania
- Faculty of General Medicine, University of Medicine and Pharmacy “Grigore T. Popa”, 16 Universitatii Street, 700115 Iasi, Romania
| | - Andreea Tirnoveanu
- Faculty of General Medicine, University of Medicine and Pharmacy “Grigore T. Popa”, 16 Universitatii Street, 700115 Iasi, Romania
| | - Vladut Mirel Burduloi
- Faculty of General Medicine, University of Medicine and Pharmacy “Grigore T. Popa”, 16 Universitatii Street, 700115 Iasi, Romania
| | - Corina Ursulescu
- Faculty of General Medicine, University of Medicine and Pharmacy “Grigore T. Popa”, 16 Universitatii Street, 700115 Iasi, Romania
- Department of Radiology, Clinical Emergency Hospital “Sfântul Spiridon”, 700111 Iasi, Romania
| | - Laurentiu Sorodoc
- Department of Internal Medicine, Clinical Emergency Hospital “Sfântul Spiridon”, 700111 Iasi, Romania
- Faculty of General Medicine, University of Medicine and Pharmacy “Grigore T. Popa”, 16 Universitatii Street, 700115 Iasi, Romania
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Feng Y, Wu C, Huang X, Huang X, Peng L, Guo R. Case report: Successful management of Parvimonas micra pneumonia mimicking hematogenous Staphylococcus aureus pneumonia. Front Med (Lausanne) 2022; 9:1017074. [DOI: 10.3389/fmed.2022.1017074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Accepted: 09/30/2022] [Indexed: 11/13/2022] Open
Abstract
Parvimonas micra is an anaerobic Gram-positive coccus frequently found in the oral cavity and gastrointestinal tract, but rarely in the lung. Therefore, pneumonia caused by P. micra is also rare. Although there are some reports of P. micra related pneumonia due to aspiration or blood-borne infection with definite remote infection source, there are no reported cases of hematogenous P. micra pneumonia in healthy adults lacking a remote source of infection. Herein, we described the intact disease of P. micra-related pneumonia mimicking hematogenous Staphylococcus aureus pneumonia in terms of chest imagery and diagnosed via metagenomic next-generation sequencing (mNGS). Interestingly, there was no clear remote pathogenic source identified in the patient. Microbiome analysis revealed dysbiosis of the oral flora possibly related to poor oral hygiene and a long history of smoking. The patient was treated with moxifloxacin for 3 months. Ultimately, computed tomography (CT) of the chest showed total resolution of the lung lesion. Clinicians need to update the etiology of community-acquired pneumonia. When antibiotic therapy is not effective, pathogen examination becomes very important. New methods of pathogen detection such as mNGS should be employed to this end. For the treatment of P. micra pneumonia, no standardized course of treatment was reported. Imaging absorption of lung infections may provide a more objective guidance for the duration of antibiotics in P. micra pneumonia.
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Ghosen J, Lucasti C, Daoust S. Parvimonas micra Causing Emphysematous Osteomyelitis: A Case Report. JBJS Case Connect 2022; 12:01709767-202212000-00007. [PMID: 36240293 DOI: 10.2106/jbjs.cc.22.00247] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Accepted: 07/10/2022] [Indexed: 11/06/2022]
Abstract
CASE We present an interesting case of femoral emphysematous osteomyelitis (EO) in a 67-year-old patient with the offending pathogen to be Parvimonas micra. Two knee arthrotomies with lateral thigh exploration were performed to debride and irrigate the bone and compartments. Although the patient initially improved, definitive treatment with an antibiotic intramedullary rod was necessary and resulted in complete resolution. CONCLUSION We present the first case of EO secondary to P. micra described in the literature and recommend aggressive surgical management for complete resolution and preserved functional outcome.
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Affiliation(s)
- James Ghosen
- University at Buffalo Jacobs School of Medicine, Buffalo, New York
| | | | - Susan Daoust
- UBMD Orthopaedics and Sports Medicine, Buffalo, New York
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Shimizu K, Horinishi Y, Sano C, Ohta R. Infection Route of Parvimonas micra: A Case Report and Systematic Review. Healthcare (Basel) 2022; 10:1727. [PMID: 36141340 PMCID: PMC9498800 DOI: 10.3390/healthcare10091727] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2022] [Revised: 08/30/2022] [Accepted: 09/06/2022] [Indexed: 11/25/2022] Open
Abstract
Parvimonas micra (P. micra), a bacterium that colonizes the gastrointestinal tract, is often isolated from periodontitis and abscesses as part of a complex bacterial infection. However, reports of monobacterium infections due to P. micra are limited. Here, we report a case of monobacterial bacteremia caused by P. micra with the aim of identifying the source of the invasion and clarifying the clinical features. A 54-year-old patient presented with bacteremia due to P. micra and with an oral invasion that we suspected resulted from prior dental treatment. Using PubMed and Google Scholar databases, we undertook a systematic review of monobacteremia caused by P. micra. We identified 26 patients (mean age, 70.15 years) in our systematic review. P. micra bacteremia and its associated phenotypes were most frequently identified in spinal discitis, followed by epidural and lumbar abscesses, and infective endocarditis. The major risk factors were malignancy, diabetes mellitus, and post-arthroplasty. When P. micra is detected in blood cultures, evaluation and intervention for oral contamination may be indicated.
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Affiliation(s)
- Kai Shimizu
- Community Care, Unnan City Hospital, Unnan 699-1221, Japan
| | - Yuta Horinishi
- Community Care, Unnan City Hospital, Unnan 699-1221, Japan
| | - Chiaki Sano
- Department of Community Medicine Management, Faculty of Medicine, Shimane University, Izumo 693-8501, Japan
| | - Ryuichi Ohta
- Community Care, Unnan City Hospital, Unnan 699-1221, Japan
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Swelling of the masticator space and cavitating pulmonary nodules. Eur Ann Otorhinolaryngol Head Neck Dis 2021; 138:307-309. [PMID: 33386252 DOI: 10.1016/j.anorl.2020.12.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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12
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Nishimura Y, Hagiya H, Obika M, Otsuka F. Comparison of the Clinico-Microbiological Characteristics of Culture-Positive and Culture-Negative Septic Pulmonary Embolism: A 10-Year Retrospective Study. Pathogens 2020; 9:pathogens9120995. [PMID: 33260940 PMCID: PMC7759841 DOI: 10.3390/pathogens9120995] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2020] [Revised: 11/20/2020] [Accepted: 11/25/2020] [Indexed: 11/16/2022] Open
Abstract
Septic pulmonary embolism (SPE) is a rare yet serious infectious disorder with nonspecific clinical findings due to microorganism-containing emboli disseminating from extrapulmonary infectious foci. It is unknown whether a positive blood culture correlates with a worse clinical outcome. We compared the clinical and microbiologic characteristics of patients with SPE divided into the culture-positive group and the culture-negative one. This study was a retrospective observational study of the patients diagnosed with SPE and treated in an academic hospital from April 2010 to May 2020. We identified six culture-positive and four culture-negative patients with SPE during the study period. The culture-positive group had significantly longer periods of hospitalization (median: 75 days, range: 45-125 days) than the culture-negative group (median: 14.5 days, range: 3-43 days) (p < 0.05), as well as significantly elevated serum C-reactive protein and procalcitonin. Patients with culture-negative SPE more commonly had odontogenic infections as the primary infectious foci. Our study highlights the importance of giving extra attention to SPE patients who have a positive blood culture, as they may have worse clinical outcomes. Physicians need to collaborate with dentists when faced with patients with culture-negative SPE, since they may have primary odontogenic infections.
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