Q fever is a zoonotic infection caused by Coxiella burnetii. Acute Q fever usually develops as a self-limited flu-like illness, atypical pneumonia, or hepatitis. We experienced a case of Q fever in a 50-year-old male who had a prolonged fever. The bone marrow and lymph node biopsy revealed fibrin-ring granulomas, which is a distinct finding of Q fever. The diagnosis was proven by high titers of C. burnetii anti-phase II antibody (IgM 1:512 and IgG >,048) and positive nested PCR for the com-1 gene. Q fever is rare in Korea, but should be considered in the differential diagnosis of fever of unknown origin
Biopsy ; Bone Marrow ; Coxiella burnetii ; Diagnosis, Differential ; Fever ; Fever of Unknown Origin ; Granuloma ; Hepatitis ; Humans ; Immunoglobulin G ; Korea ; Lymph Nodes ; Male ; Middle Aged ; Pneumonia ; Polymerase Chain Reaction ; Q Fever

Nocardiosis is well-known opportunistic infection in immunocompromised patients. The timely diagnosis and treatment, however, is still a difficult problem. Recently, as newer molecular techniques, particularly 16S rRNA sequencing, are implemented, the diagnosis and management of the infection are improving. We report a case of lung abscess in a 39-year-old-man who underwent kidney transplantation. He was diagnosed of Nocardia elegans by 16S rRNA sequencing and was cured of the infection with appropriate antibiotic therapy.
Immunocompromised Host ; Kidney ; Kidney Transplantation ; Lung ; Lung Abscess ; Nocardia ; Nocardia Infections ; Opportunistic Infections

Nocardiosis is well-known opportunistic infection in immunocompromised patients. The timely diagnosis and treatment, however, is still a difficult problem. Recently, as newer molecular techniques, particularly 16S rRNA sequencing, are implemented, the diagnosis and management of the infection are improving. We report a case of lung abscess in a 39-year-old-man who underwent kidney transplantation. He was diagnosed of Nocardia elegans by 16S rRNA sequencing and was cured of the infection with appropriate antibiotic therapy.
Immunocompromised Host ; Kidney ; Kidney Transplantation ; Lung ; Lung Abscess ; Nocardia ; Nocardia Infections ; Opportunistic Infections

It is possible to compare three-dimensional image of patterned injury in virtual space with object using 3D/CAD supported photogrammetry(FPHG). this method make it possible to examine patterned injuries of skin, soft tissue and bone for matching instruments in shape, size and angle without altering. Generally, 3D measuring of objects require 3D digitizer or series of photographs taking by metric camera. We developed program which calibrate pictures taken by non-calibrated commercial camera and un distorted image. This image and objet model n can be examined with respect to matching shapes using 3D/CAD system.
Imaging, Three-Dimensional ; Photogrammetry ; Skin ; United Nations

Septic arthritis is an uncommon finding of invasive Aspergillosis. It can be caused by direct inoculation, post-surgical infection, and hematogenous spread. Articular aspergillosis often involves the knee. A 49-year-old man who received a liver transplant in China on two months ago, due to liver cirrhosis caused by hepatitis B virus was admitted because of left side hip pain. Hip MRI showed joint effusion and bony destruction of the left hip and acetabulum. Incision and drainage was done and Aspergillus fumigatus was isolated from the resected tissue. After eight weeks of amphotericin B therapy, total hip replacement arthroplasty was done. Oral itraconazole 400mg/day was prescribed for six months after operation. The patient is now doing well without physical restriction
Acetabulum ; Amphotericin B ; Arthritis ; Arthritis, Infectious ; Arthroplasty ; Arthroplasty, Replacement, Hip ; Aspergillosis ; Aspergillus ; Aspergillus fumigatus ; China ; Drainage ; Hepatitis B virus ; Hip ; Humans ; Itraconazole ; Joints ; Knee ; Liver ; Liver Cirrhosis ; Liver Transplantation ; Middle Aged ; Transplants

Septic arthritis is an uncommon finding of invasive Aspergillosis. It can be caused by direct inoculation, post-surgical infection, and hematogenous spread. Articular aspergillosis often involves the knee. A 49-year-old man who received a liver transplant in China on two months ago, due to liver cirrhosis caused by hepatitis B virus was admitted because of left side hip pain. Hip MRI showed joint effusion and bony destruction of the left hip and acetabulum. Incision and drainage was done and Aspergillus fumigatus was isolated from the resected tissue. After eight weeks of amphotericin B therapy, total hip replacement arthroplasty was done. Oral itraconazole 400mg/day was prescribed for six months after operation. The patient is now doing well without physical restriction
Acetabulum ; Amphotericin B ; Arthritis ; Arthritis, Infectious ; Arthroplasty ; Arthroplasty, Replacement, Hip ; Aspergillosis ; Aspergillus ; Aspergillus fumigatus ; China ; Drainage ; Hepatitis B virus ; Hip ; Humans ; Itraconazole ; Joints ; Knee ; Liver ; Liver Cirrhosis ; Liver Transplantation ; Middle Aged ; Transplants

Cryptococcosis is a disseminated infection caused by Cryptococcus neoformans. It usually causes pulmonary infection and meningitis in immunocompromised patients. However, osteomyelitis due to C. neoformans is extremely rare. It is generally known that cryptococcal osteomyelitis is a complication of disseminated cryptococcosis, appearing in 5-10%. We experienced a case of cryptococcal osteomyelitis with paraspinal abscess in a liver transplant patient.
Abscess ; Cryptococcosis ; Cryptococcus neoformans ; Humans ; Immunocompromised Host ; Liver ; Meningitis ; Osteomyelitis ; Transplants

Cryptococcosis is a disseminated infection caused by Cryptococcus neoformans. It usually causes pulmonary infection and meningitis in immunocompromised patients. However, osteomyelitis due to C. neoformans is extremely rare. It is generally known that cryptococcal osteomyelitis is a complication of disseminated cryptococcosis, appearing in 5-10%. We experienced a case of cryptococcal osteomyelitis with paraspinal abscess in a liver transplant patient.
Abscess ; Cryptococcosis ; Cryptococcus neoformans ; Humans ; Immunocompromised Host ; Liver ; Meningitis ; Osteomyelitis ; Transplants

Background: Pyomyositis (PM) is a serious soft tissue infection and despite its clinical importance, previous studies have not been able to fully determine the clinical characteristics and microbial epidemiology of PM in Korea, which we therefore aimed to investigate. Materials and Methods: We retrospectively identified 140 adult patients diagnosed with PM from 13 general hospitals between January 2012 and December 2015. We analyzed the clinical and microbial characteristics of community-onset PM and compared them with communityacquired (CA) and healthcare-associated (HCA) PM. Results: One hundred eleven organisms were isolated from 96 (68.6%) patients with PM.Staphylococcus aureus (38 patients) was the most common pathogen, followed by streptococci (24 patients), and enteric Gram-negative organisms (27 patients). Methicillin-resistant S.aureus (MRSA) was identified in four (2.9%) patients and in-hospital mortality reached 8.6% (12/140). Enterococci isolates were identified in the HCA PM subgroup only The proportion of MRSA isolates was not comparable between CA and HCA PM subgroups. In the 83 patients with PM infected by monomicrobial pathogens, isolates of Gram-negative organisms were more commonly found in HCA PM subgroup than in CA PM subgroup (47.6% [10/21] of patients with HCA PM vs. 20.7% [12/58] of patients with CA PM; P = 0.01). Conclusion Gram-positive cocci such as S. aureus and streptococci were dominant etiologies in community-onset PM, whereas MRSA appears to an uncommon causative organism of PM in Korea. Enteric Gram-negative organisms should also be considered as major etiologies, especially in HCA PM patient population in Korea.

Background: Pyomyositis (PM) is a serious soft tissue infection and despite its clinical importance, previous studies have not been able to fully determine the clinical characteristics and microbial epidemiology of PM in Korea, which we therefore aimed to investigate. Materials and Methods: We retrospectively identified 140 adult patients diagnosed with PM from 13 general hospitals between January 2012 and December 2015. We analyzed the clinical and microbial characteristics of community-onset PM and compared them with communityacquired (CA) and healthcare-associated (HCA) PM. Results: One hundred eleven organisms were isolated from 96 (68.6%) patients with PM.Staphylococcus aureus (38 patients) was the most common pathogen, followed by streptococci (24 patients), and enteric Gram-negative organisms (27 patients). Methicillin-resistant S.aureus (MRSA) was identified in four (2.9%) patients and in-hospital mortality reached 8.6% (12/140). Enterococci isolates were identified in the HCA PM subgroup only The proportion of MRSA isolates was not comparable between CA and HCA PM subgroups. In the 83 patients with PM infected by monomicrobial pathogens, isolates of Gram-negative organisms were more commonly found in HCA PM subgroup than in CA PM subgroup (47.6% [10/21] of patients with HCA PM vs. 20.7% [12/58] of patients with CA PM; P = 0.01). Conclusion Gram-positive cocci such as S. aureus and streptococci were dominant etiologies in community-onset PM, whereas MRSA appears to an uncommon causative organism of PM in Korea. Enteric Gram-negative organisms should also be considered as major etiologies, especially in HCA PM patient population in Korea.