IDCases
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A 65-year-old woman with chronic osteoarthritis of the knees presented with a one-week history of acutely worsening right knee pain and swelling. Arthrocentesis was performed and synovial fluid was indicative of septic arthritis with a negative Gram stain for bacteria. Magnetic Resonance Imaging (MRI) was obtained, revealing a large anterior periarticular abscess with concomitant septic arthritis. ⋯ Synovial fluid culture grew Kingella kingae and the patient was treated with four weeks of ceftriaxone with improvement in both clinical symptoms and laboratory values. Kingella kingae is a common cause of pediatric bone and joint infection but remains an exceedingly rare cause of native joint septic arthritis among immunocompetent adults. Kingella spp are largely susceptible to beta-lactam antimicrobials.
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Case Reports
Methemoglobinemia and hemolytic anemia after COVID-19 infection without identifiable eliciting drug: A case-report.
We report a second case of methemoglobinemia and non-autoimmune hemolytic anemia after contracting the SARS-CoV-2 infection in the absence of an identifiable eliciting drug. A 35-year old male without previous known comorbidities was admitted after he was diagnosed with the COVID-19 infection and had large pulmonary involvement. Seven days later, he desaturated but was without any signs of respiratory distress. ⋯ A second G6PD test was ordered at the 5-month follow-up appointment and revealed decreased levels. Clinicians should thus be aware of possible false negative tests when testing for G6PD during hemolytic crisis. In addition, whether the COVID-19 infection alone would be responsible for this chain of events remains a challenging question.
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Cutaneous blastomycosis is the most common extrapulmonary manifestation of disseminated blastomycosis, a disease caused by Blastomyces dermatitidis, a dimorphic fungus endemic of North America. Initially, the organism enters the respiratory system by inhalation of the infectious conidia and produces an acute pulmonary infection that may eventually disseminate if it is left untreated. ⋯ The objective of this case report is to highlight the importance of the skin exam and tissue biopsy in the diagnosis of blastomycosis. We present a previously healthy patient with chronic pneumonia, evaluated at Pulmonary clinic with non-diagnostic thoracentesis and bronchoscopy, found to have disseminated blastomycosis after biopsy of a scalp lesion in Dermatology clinic.
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Human orf, also called ecthyma contagiosum, is a zoonotic infection that causes self-resolving skin lesions after contact with infected livestock. We present the case of a 45-year-old Moroccan-born man who developed multiple painful erythematous, violaceous plaques on his hands after butchering a sheep to celebrate the Muslim holiday Eid al-Adha. The diagnosis of orf virus infection was established based on exposure history, histopathology, and classic skin lesions. Although orf virus infection is traditionally seen in individuals with frequent animal contact such as farmers and veterinarians, clinicians evaluating suspicious lesions in patients without occupational risk factors should consider additional cultural practices that may expose the patient to orf virus.
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We present a case of Guillain- Barré Syndrome (GBS) in a patient with confirmed COVID-19 infection. GBS in commonly encountered after an antecedent trigger, most commonly an infection. To date, only one case of GBS associated with this infection has been described. Clinicians should consider this entity since it may warrant appropriate isolation precautions especially in a patient who may not present primarily with typical constitutional and respiratory symptoms associated with COVID-19.