Journal of the College of Physicians and Surgeons--Pakistan : JCPSP
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J Coll Physicians Surg Pak · Apr 2022
Case ReportsFrom Gut to Heart: Extensively Drug-resistant Salmonella typhi with Multi System Involvement.
Extensively drug-resistant (XDR) salmonella typhi is a gram-negative bacillus, transmitted by feco-oral route. Its systemic manifestations are protean. Untreated enteric fever carries high morbidity and mortality. ⋯ Multi-drug-resistant (MDR) salmonella typhi was isolated from blood cultures. Her symptoms resolved after intravenous antibiotics and she completely recovered. Key Words: Myocarditis, Salmonella typhi, Coagulopathy.
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J Coll Physicians Surg Pak · Apr 2022
Case ReportsChryseobacterium indologenes Bacteraemia: A Potential Cause of Early-onset Neonatal Sepsis in a Full-term Baby.
Chryseobacterium indologenes is considered as an emerging pathogen known to cause pneumonia, bacteremia, and meningitis in children. It has been reported previously, mainly from the Indian subcontinent, as a rare cause of early-onset neonatal infection, mostly affecting preterm infants. ⋯ A positive neonatal blood culture of C. indologenes should not automatically be considered as a contaminant; and a joint discussion between neonatologists and microbiologists should determine the appropriate management and antibiotic regimen. Key Words: Early-onset neonatal sepsis, Bacteremia, Chryseobacterium indologenes, Contaminant, Antibiotics.
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J Coll Physicians Surg Pak · Apr 2022
Case ReportsCryptococcal Meningoencephalitis in an Immunocompetent Patient.
Cryptococcal meningitis (CM) is an uncommon opportunistic infection in immunocompetent hosts; and causes significant mortality and long-term morbidity. Cryptococci primarily cause disease in immunocompromised hosts, but rarely can lead to severe disease in immunocompetent individuals. A 64-year man, with no known immunosuppressive illnesses, presented in the Emergency Department with gait disturbances and lethargy for one year, which got worsened recently. ⋯ The patient was treated with anti-fungal medications. It is highly essential for emergency physicians and other clinicians to think of atypical neurological manifestations of meningitis in immunocompetent individuals. Key Words: Cryptococcus, Immunocompetent, Antifungal treatment, Meningitis.
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J Coll Physicians Surg Pak · Apr 2022
Case ReportsSubglottic Hemangioma: Now You See it, Now You Don't.
Subglottic hemangiomas may be missed on flexible laryngoscopy or even bronchoscopy requiring a contrast-enhanced computed tomography scan to clinch the diagnosis. We report an otherwise healthy three-month baby girl presenting with recurrent upper airway obstruction with a history of multiple admissions requiring intubation and artificial ventilation. An initial contrast-enhanced computed tomography scan was performed when the child was intubated, which showed no airway anomalies. ⋯ Following the surgical intervention, the child had persistent stridor and a repeat contrast-enhanced computed tomography scan clinched a diagnosis of a localised subglottic hemangioma at the age of 7 months. In the presence of an endotracheal tube, airway hemangiomas may be missed on bronchoscopy and contrast-enhanced computed tomography scan. Key Word: Subglottic stenosis, Congenital, Hemangiomas, Computed tomography.