Background: Mycobacterium abscessus frequently causes severe infections, yet its pathophysiological features and treatment regimens have not been established. Case Report: We present five cases of severe pneumonia due to Mycobacterium abscessus infection in Japan. All cases were diabetic patients, with possible acceleration to pneumonia due to co-infection with other microorganisms. However, following a short period of hospitalization and combination therapy with intravenous imipenem/cilastatin and amikacin, all the cases were successfully treated as outpatients with oral clarithromycin and sitafloxacin. Conclusion: M. abscessus infections can become severe in the presence of diabetes mellitus and co-infection with other chronic infectious organisms. Sitafloxacin might be a key drug in the treatment of M. abscessus infection in future.
Objective: Rare disease Background: Mycobacterium abscessus is one of the most important mycobacteria, but its associated peritonitis in patients on continuous ambulatory peritoneal dialysis (CAPD) appears relative rare, and the treatment regimen of the antibiotics are still unclear. Case Report: A 38-year-old female with chronic glomerulonephritis on CAPD who was diagnosed with M. abscessus-associated peritonitis. Symptoms exacerbated despite treatment with a 3-antibiotic regimen combining clarithromycin, imipenem/cilastatin (IPM/CS), and minocycline (MINO). However, after changing IPM/CS and MINO to linezolid (LZD), her condition and inflammation improved, and she was able to be maintained on oral tedizolid (TZD). Conclusions: Oxazolidinones such as LZD and TZD might be candidate antibiotics for the treatment of M. abscessus-associated diseases with chronic renal failure due to their immunomodulatory effects and non-renal excretion.
Background
Exophiala dermatitidis
is an environmental black fungus that rarely causes respiratory infections, yet its pathophysiological features and treatment regimens have not been established.
Case Series
Two cases of exacerbations of chronic bronchitis and sinusitis due to
E. dermatitidis
infection in Japan are presented. Both patients were women, and non-tuberculous
Mycobacterium
(NTM) infection was suspected based on chest radiological findings, but
E. dermatitidis
was detected from bronchial lavage fluid and nasal mucus, respectively. Both cases were successfully treated by antifungal agents such as liposomal amphotericin B, voriconazole, and itraconazole, but clarithromycin, rifampicin, ethambutol, and sitafloxacin for NTM were not effective.
Conclusion
E. dermatitidis
can become a respiratory pathogen, especially in patients with chronic sinobronchial syndrome.
Background
We hypothesised that the radiomics signature, which includes texture information of dopamine transporter single-photon emission computed tomography (DAT-SPECT) images for Parkinson’s disease (PD), may assist semi-quantitative indices. Herein, we constructed a radiomics signature using DAT-SPECT-derived radiomics features that effectively discriminated PD from healthy individuals and evaluated its classification performance.
Results
We analysed 413 cases of both normal control (NC, n = 101) and PD (n = 312) groups from the Parkinson’s Progression Markers Initiative database. Data were divided into the training and two test datasets with different SPECT manufacturers. DAT-SPECT images were spatially normalised to the Montreal Neurologic Institute space. We calculated 930 radiomics features, including intensity- and texture-based features in the caudate, putamen, and pallidum volumes of interest. The striatum uptake ratios (SURs) of the caudate, putamen, and pallidum were also calculated as conventional semi-quantification indices. The least absolute shrinkage and selection operator was used for feature selection and construction of the radiomics signature. The four classification models were constructed using a radiomics signature and/or semi-quantitative indicator. Furthermore, we compared the classification performance of the semi-quantitative indicator alone and the combination with the radiomics signature for the classification models. The receiver operating characteristics (ROC) analysis was used to evaluate the classification performance. The classification performance of SURputamen was higher than that of other semi-quantitative indicators. The radiomics signature resulted in a slightly increased area under the ROC curve (AUC) compared to SURputamen in each test dataset. When combined with SURputamen and radiomics signature, all classification models showed slightly higher AUCs than that of SURputamen alone.
Conclusion
We constructed a DAT-SPECT image-derived radiomics signature. Performance analysis showed that the current radiomics signature would be helpful for the diagnosis of PD and has the potential to provide robust diagnostic performance.
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