Background Nocardia-related endocarditis is rare. Intravenous drug use with nonsterile injection practices is a potential risk factor for nocardia infection. Disseminated nocardiosis with endovascular involvement is rarely reported in immunocompetent individuals. Case presentation A 54-year-old male was diagnosed with infective endocarditis due to Nocardia asteroides with septic emboli in the brain and spleen. The use of a matrix-assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF MS) rapid diagnostic system was beneficial in identifying the causative organism. He was empirically treated with combination therapy consisting of three antibiotics. Antimicrobial susceptibility testing indicated that all three antibiotics had favorable minimum inhibitory concentrations (MICs). Due to his clinical status, he was not a surgical candidate. Patient passed away after discharge to hospice. Conclusions This case demonstrates unique challenges in the identification, diagnosis, and management of Nocardia-related infective endocarditis. A detailed history of injection practices should guide clinicians in assessing the risk for environmental pathogens. Valvular surgery and combination antibiotic therapy should be recommended for all eligible patients to improve the chances of survival.
Colon polyposis, such as familial adenomatous polyposis, Puetz-Jegher's Syndrome, mutY homolog-associated polyposis, and hyperplastic/serrated polyposis syndrome, have been linked to several different types of cancer, including cancers of the gastrointestinal tract, thyroid, liver, central nervous system, genital tract, breast, pancreas, bone, sebaceous glands, ovaries, bladder, and skin. However, to date there have been no reports of an association between any of the aforementioned types of colon polyposis and lymphoma. Here, we report the case of a 79-year-old man with multiple hyperplastic polyps in the colon who was diagnosed with diffuse large B cell lymphoma of the pelvic bone. Future reporting of such associations and follow-up genetic testing is necessary to determine if there is a familial association and whether steps are needed to prevent occurrence by screening.
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