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

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

Shigellosis may mimic acute appendicitis clinically, but Shigella species rarely cause appendicitis. We experienced acute appendicitis with perforation caused by Shigella sonnei in a 24-year-old woman who had traveled abroad.
Appendicitis ; Dysentery, Bacillary ; Female ; Humans ; Hydrazines ; Shigella ; Shigella sonnei ; Young Adult

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

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*

Background: Coronavirus disease 2019 (COVID-19) during pregnancy is associated with increased disease severity and an increased risk of perinatal complications. However, few studies of pregnant women with COVID-19 have been conducted in Korea. The purpose of this study was to describe the clinical course and pregnancy outcomes of pregnant women admitted to our hospital with COVID-19 according to the severity. Materials and Methods: This retrospective cohort study included women aged 18 years of age or older who were hospitalized in the Gachon University Gil Medical Center with COVID-19 during pregnancy between July 1, 2021 and January 31, 2022. COVID-19 severity was classified according to the “Criteria for severity classification by symptoms of COVID-19” presented by the Korea Disease Control and Prevention Agency. Severe cases were defined as those who required oxygen treatment administered via a high-flow nasal cannula or invasive mechanical ventilation or should be applied extracorporeal membrane oxygenation (ECMO) or continuous renal replacement therapy. Results: A total of 103 pregnant women were hospitalized with COVID-19 during the study period. Their mean age was 33 (± 4.14) years, and 4 (3.9%) had been vaccinated against COVID-19. At the time of diagnosis of COVID-19, 3 (2.9%), 33 (32.0%), and 67 (65.1%) patients were in the first, second, and third trimester, respectively. The most common symptoms were cough (99 patients, 96.1%) and fever (85 patients, 82.5%). There was 1 (1.0%) asymptomatic patient. Forty patients (38.8%) required supplemental oxygen and 19 patients (18.4%) had severe disease. Of the 19 severe cases, 7 were in the 2nd trimester and 12 were in the 3rd trimester. Forty-one (39.8%) patients delivered, including two twin deliveries. Of the 41 cases of delivery, 14 were premature, 4 out of 21 (19.0%) in mild, 4 out of 12 (25.0%) in moderate, and 6 out of 8 (75.0%) in severe. Severe disease was associated with an increased rate of preterm birth (P = 0.012). Four of the 43 neonates (9.1%) received oxygen treatment. Conclusion Pregnant women with COVID-19 had a high rate of severe disease and a high preterm delivery rate, especially among those with severe disease.

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

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*