It is known that the incidence of fungal endocarditis is increasing as the precipitating factors, such as organ transplantation, use of immunosuppressive agents, previous cardiac surgery, AIDS, chemotherapy, and long-term antibiotic use are on the rise. However, the diagnosis and adequate treatment of fungal endocarditis is likely to be delayed as blood cultures are rarely positive. We report a case of native valve endocarditis in a patient who underwent liver transplantation and was taking immunosuppressive agents. Because of no improvement despite empirical antibiotic treatment, a mitral valve replacement was performed. Tissue culture and biopsy of the vegetations revealed Aspergillus spp., and A. fumigatus was identified by analysis of internal transcribed spacer DNA sequences of the pathogenic fungus using a polymerase chain reaction. Despite surgical intervention, she died of an acute cerebral infarction with cerebral edema.
Aspergillus ; Aspergillus fumigatus ; Biopsy ; Cerebral Infarction ; DNA, Intergenic ; Endocarditis ; Fungi ; Humans ; Immunosuppressive Agents ; Incidence ; Liver ; Liver Transplantation ; Mitral Valve ; Organ Transplantation ; Polymerase Chain Reaction ; Precipitating Factors ; Thoracic Surgery ; Transplants

Endometriosis is a benign gynecologic disease, characterized by the presence and growth of functional endometrial-like tissue outside uterus. This ectopic endometrial tissue is most commonly found in the peritoneum, ovaries and uterosacral ligaments, but extremely rarely there is involvement of the appendix or cecum. Here we report a case of cecal endometriosis presenting as a subepithelial tumor diagnosed by surgical excision.
Appendix ; Cecum ; Colonic Neoplasms ; Endometriosis* ; Female ; Genital Diseases, Female ; Ligaments ; Ovary ; Peritoneum ; Uterus

We report a case in which an intramural and intraluminal hematoma of the jejunum served as the lead point of intussusception in a 77-year-old man with warfarinization. The patient presented with cramping abdominal pain and vomiting. Palpation of the abdomen revealed periumbilical tenderness. Abdominal computed tomography revealed a circular mass with a concentric ring, consistent with an intussuscepted jejunum. Because of warfarinization, which was due to atrial fibrillation and lacunar infarction, the patient's prothrombin time was prolonged. Laparotomy revealed reducible jejuno-jejunal intussusception, and we performed a segmental resection of the intussuscepted jejunum. We identified an intramural and intraluminal jejunal hematoma as the lead point. Upon histopathological examination, angiodysplasia of the intussuscepted jejunum was found to be the bleeding focus. No similar case was found in the literature.
Abdomen ; Abdominal Pain ; Adult ; Aged ; Angiodysplasia ; Atrial Fibrillation ; Hematoma ; Hemorrhage ; Humans ; Intussusception ; Jejunum ; Laparotomy ; Muscle Cramp ; Palpation ; Prothrombin Time ; Stroke, Lacunar ; Vomiting ; Warfarin

The emergence and prevalence of methicillin-resistant Staphylococcus aureus (MRSA) and methicillin-susceptible S. aureus (MSSA) in livestock animals have become a worldwide public health concern. While the prevalence and genetic profiles of MRSA strains in pigs and pork meat have been actively studied, livestock-associated MSSA strains have only been characterized in a few small-scale studies. In this investigation, we assessed the nationwide prevalence of MSSA in the Korean pig production chain, including pig farms, slaughterhouses, and retail markets. Among the 41 MSSA strains, the predominant clonal lineages were sequence type (ST) 398 (n = 15, 37%) and ST5 (n = 13, 32%). Although the overall prevalence of MSSA (2.58%) was low and mostly restricted to pig farms, ST398 MSSA strains showed higher level of multidrug resistance phenotype versus non-ST398 MSSA strains. In addition to the MDR phenotype, all of the ST398 MSSA strains exhibited resistance to tetracycline as they harbored the tet(K), tet(L), and/or tet(M) genes. However, ST398 MSSA strains did not exhibit increased resistance to zinc compared with the non-ST398 strains. This study is the first to provide evidence of ST398 MSSA emergence in livestock animals in Korea. Further studies are necessary to elucidate the potential of ST398 MSSA strains for human transmission. Our findings suggest that the MDR phenotype and high levels of tetracycline resistance may have played an important role in the emergence and prevalence of ST398 MSSA in pig farms in Korea.
Abattoirs ; Agriculture ; Animals ; Drug Resistance, Multiple ; Humans ; Korea ; Livestock ; Meat ; Methicillin-Resistant Staphylococcus aureus ; Phenotype ; Prevalence ; Public Health ; Red Meat ; Staphylococcus aureus ; Staphylococcus ; Swine ; Tetracycline ; Tetracycline Resistance ; Zinc

Abattoirs ; Agriculture ; Animals ; Drug Resistance, Multiple ; Farmers ; Korea ; Livestock ; Methicillin Resistance ; Methicillin-Resistant Staphylococcus aureus ; Multilocus Sequence Typing ; Phenotype ; Prevalence ; Red Meat ; Staphylococcus aureus ; Swine ; Tetracycline ; Zinc

Plasmodium vivax has been the predominant Plasmodium species in the Republic of Korea and reemerged in 1993. Spontaneous rupture of malarial spleen is a rare but important complication associated with P. vivax infection. Only one case of spontaneous rupture of malarial spleen was reported in Korea in 1999. Splenectomy is still accepted as the treatment of choice in cases of spontaneous rupture of the spleen. But, considering increased risk of postsplenectomy infecion, splenectomy should be reserved for those patients with severe rupture or those with continued or recurrent bleeding. And conservative treatment should be considered in selected, closely monitored patients. We report a patient with P. vivax malaria who developed a spontaneous splenic rupture and was improved by conservative treatment.
Hemorrhage ; Humans ; Korea ; Malaria ; Malaria, Vivax* ; Plasmodium ; Plasmodium vivax ; Republic of Korea ; Rupture ; Rupture, Spontaneous ; Spleen ; Splenectomy ; Splenic Rupture*

Actinomyces is a normal flora of the oral cavity but lesions localized to the oral mucosa are very rare. We herein present a rare case of actinomycosis presenting as ulcers of hard palate which developed after esophagogastroduodenoscopy.
Actinomyces ; Actinomycosis ; Endoscopy, Digestive System ; Mouth ; Mouth Mucosa ; Oral Ulcer ; Palate, Hard ; Ulcer

Plasmodium vivax has been the predominant Plasmodium species in the Republic of Korea and reemerged in 1993. Spontaneous rupture of malarial spleen is a rare but important complication associated with P. vivax infection. Only one case of spontaneous rupture of malarial spleen was reported in Korea in 1999. Splenectomy is still accepted as the treatment of choice in cases of spontaneous rupture of the spleen. But, considering increased risk of postsplenectomy infecion, splenectomy should be reserved for those patients with severe rupture or those with continued or recurrent bleeding. And conservative treatment should be considered in selected, closely monitored patients. We report a patient with P. vivax malaria who developed a spontaneous splenic rupture and was improved by conservative treatment.
Hemorrhage ; Humans ; Korea ; Malaria ; Malaria, Vivax* ; Plasmodium ; Plasmodium vivax ; Republic of Korea ; Rupture ; Rupture, Spontaneous ; Spleen ; Splenectomy ; Splenic Rupture*

Actinomyces is a normal flora of the oral cavity but lesions localized to the oral mucosa are very rare. We herein present a rare case of actinomycosis presenting as ulcers of hard palate which developed after esophagogastroduodenoscopy.
Actinomyces ; Actinomycosis ; Endoscopy, Digestive System ; Mouth ; Mouth Mucosa ; Oral Ulcer ; Palate, Hard ; Ulcer

As many Koreans now travel abroad, they are at increased risk for a variety of infectious diseases that are endemic to developing countries in the tropics and subtropics. We report two cases of co-infection with Giardia lamblia and Salmonella species not susceptible to nalidixic acid, after travel abroad.
Coinfection ; Communicable Diseases ; Developing Countries ; Giardia ; Giardia lamblia ; Nalidixic Acid ; Salmonella