Staphylococcus warneri is a gram-positive coagulasenegative Staphylococcus species (CoNS). 1 It can be isolated in approximately 50% of healthy adults and constitutes around 1% of all skin staphylococci. 2 Staphylococcus warneri (S. warneri) is generally considered non-pathogenic. 2 However, it constitutes one of the CoNS species sporadically capable of causing human infections. It can present with a variety of infections including bacteremia, linerelated infections, osteomyelitis, and ventriculoperitoneal infections. 3,4 Immunocompromised patients, elderly individuals, patients with a prolonged hospital stay, and invasive medical devices are usually at risk. 3 Staphylococcus warneri rarely manifests as endocarditis in the native valves, particularly in immunocompetent hosts. The initial clinical presentation and diagnosis are usually indistinguishable between S. warneri-related endocarditis and other typical CoNS endocarditis. 5 Similarly, distinguishing contamination from true bacteremia may be challenging when encountering positive cultures of S. warneri and can lead to delayed diagnosis and devastating consequences. 1 Characteristically slow-progressing infections with subsequent valve destruction are frequently observed if not recognized and promptly treated. 5 Usually, prolonged antibiotic therapy targeting the organism is the mainstay of management. 6 Herein, we report an unusual case of S. warneri-related endocarditis leading to valve perforation in an otherwise healthy young male patient who was successfully treated with a prolonged course of cefazolin and valve repair. In addition, we reviewed the literature for similar cases. | CASE PRESENTATIONA 45-year-old gentleman presented to the hospital with a 1-day history of rigor, pleuritic chest pain, and shortness of breath. He reported on and off fever for the past 3 weeks
Introduction and Importance: Measles is an acute febrile viral illness with a characteristic rash. It is usually present in children. Due to the vaccine’s development and wide use, serious complications are quite infrequent in vaccine-covered areas. Case Presentation: A 36-year-old immunocompetent woman presented with a fever and a macular rash affecting the face and upper trunk. She was found to have transaminitis and later developed bilateral pulmonary infiltrates with decreased oxygen saturation. After extensive work, the measles PCR returned positive results. The patient was treated conservatively until she recovered. Discussion: Measles pneumonitis is a rare complication that usually occurs in immunosuppressed patients. Due to the coronavirus disease pandemic, diagnosis can be difficult, especially if the presentation is not classic. Conclusion: We report this case to emphasize the importance of correct diagnosis and proper management.
Pulmonary tuberculosis is a common endemic disease in developing countries but its thrombogenic tendency is not well-studied and established yet. Pulmonary embolism is rarely reported in Mycobacterium tuberculosis infection. There are reports stating the relation of pulmonary embolism (PE) and deep vein thrombosis (DVT) with a severe infection of tuberculosis but no data is available to establish a mutual association between pulmonary tuberculosis and pulmonary thromboembolism. Herein, we report the case of a 51-year-old male who presented with a one-month history of productive cough, shortness of breath, and fever associated with chills and night sweating. He reported an 8 kg weight loss in the last month. He was found to have pulmonary tuberculosis. On further investigations for leg swelling and tachycardia. Deep vein thrombosis and sub-massive saddle bilateral pulmonary embolism were diagnosed, which was treated with thrombolysis therapy (alteplase). He responded well to initial therapy and was discharged on anticoagulation with anti-tuberculous therapy (ATT).
Rationale:Kidney involvement with COVID-19 infection is a well-known complication, and the majority of kidney involvement is related to ischemic injury/acute tubular injury. However, there are some cases of glomerulonephritis, the etiology of which is not yet known, but an immune process is likely to be the trigger.Patient concerns:A 27-year-old man presented to our hospital with facial puffiness and lower-limb swelling.Diagnosis:Laboratory assessment revealed features of impaired kidney function with proteinuria and hematuria; COVID-19 polymerase chain reaction was positive, which was consistent with pauci-immune crescentic focal segmental glomerulonephritis.Intervention:After renal biopsy, the patient was started on methylprednisolone and rituximab. Due to worsening kidney parameters, he underwent intermittent hemodialysis as needed.Outcome:Kidney function tests partially improved; he was discharged on oral steroids with follow-up in the nephrology clinic to observe for the need for further hemodialysis.Lessons:We conducted a literature review of cases of glomerulonephritis associated with COVID-19 and described numerous types of glomerulonephritis. This report highlights the importance of recognizing emerging glomerulonephritis with COVID-19, the different pathological patterns of renal biopsies, and management interventions and responses.
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