Thirty nine-year-old man who required urgent shunt operation due to rapidly deteriorating visual acuity suffered from ventriculitis after aneurysmal operation. Daily dose of 20mg of vancomycin and amikyn were given intraventricularly via external ventricular catheter after failure of various kinds of systemic antibiotics. The exit of the catheter was made on the upper chest wall to prevent superinfection. External ventricular drainage could finally be switched to ventriculo-peritoneal shunt and he was discharged with clinical improvement.
Aneurysm ; Anti-Bacterial Agents ; Catheters ; Drainage ; Hydrocephalus* ; Superinfection ; Thoracic Wall ; Vancomycin ; Ventriculoperitoneal Shunt ; Ventriculostomy* ; Visual Acuity

Herpes simplex virus infection of the hand in children occurs after auto-inoculation from herpetic gingivostomatitis or herpes labialis. Herpetic whitlow should be suspected based on clinical signs. Diagnosis can be made by PCR or virus culture. Many misdiagnosed cases suggests that this disease is not sufficiently known. Surgical interventions may be harmful and should be avoided. We report a case of herpetic whitlow with bacterial superinfection in a three-year-old girl.
Child ; Diagnosis ; Female ; Hand ; Herpes Labialis ; Humans ; Polymerase Chain Reaction ; Simplexvirus ; Stomatitis, Herpetic ; Superinfection*

Dermatomyositis ; diagnosis ; Diagnostic Errors ; Hepatitis B ; diagnosis ; Hepatitis D ; diagnosis ; Humans ; Male ; Middle Aged ; Superinfection ; diagnosis

Bacterial Infections ; Humans ; Male ; Middle Aged ; Mycoses ; Pneumoconiosis ; microbiology ; Superinfection ; Tuberculosis, Pulmonary

We had performed six times (4 in right lung, 2 in left lung) bronchoalveolar lavages in a patient who has hypertension and suffered cerebral vascular accident previously. The diagnosis of PAP was confirmed by an open lung biopsy and multiple bronchoalveolar lavages were done for two and a half months. Even though she showed slight improvement in chest radiographs, she showed minimal improvement in her clinical course until the third lavage was done. She had to receive tracheostomy and prolonged ventilatory care because her PAP was progressed rapidly and complicated with superinfection. In addition, she sustained pneumothorax as a complication of the prolonged ventilatory care and the lavages. She was discharged one month after the last lavage and her clinical course has been uneventful 10 months thereafter.
Biopsy ; Bronchoalveolar Lavage* ; Diagnosis ; Humans ; Hypertension ; Lung ; Pneumothorax ; Pulmonary Alveolar Proteinosis* ; Radiography, Thoracic ; Superinfection ; Therapeutic Irrigation ; Tracheostomy

The autoinfective filariform larva of Strongyloides stercoralis causes hyperinfection in immunosuppressed hosts. Here we report on the case of a male patient who was admitted to the emergency room at Gwangju Veterans Hospital with a complaint of dyspnea, and who was receiving corticosteroid therapy for asthma. Many slender larvae of S. stercoralis with a notched tail were detected in Papanicolaou stained sputum. They measured 269 +/- 21.2 micrometer in length and 11 +/- 0.6 micrometer in width. The esophagus extended nearly half of the body length. The larvae were identified putatively as autoinfective third-stage filariform larvae, and their presence was fatal. The autoinfective filariform larva of S. stercoralis has not been previously reported in Korea.
Aged ; Animals ; Fatal Outcome ; Humans ; Immunocompromised Host ; Larva ; Male ; Sputum ; Strongyloides/growth & development/*isolation & purification ; Strongyloidiasis/*etiology ; Superinfection/*parasitology

Cytomegalovirus (CMV) infection is an uncommon association with idiopathic inflammatory bowel disease (IBD) often leading to a variety of serious complications. A total of 41 resected cases of IBD were examined to elucidate the pathologic features of intestinal CMV infection which was assessed by histologic examination and confirmed by immunohistochemistry with CMV antibody. Six cases were positve for CMV antibody; five cases in 19 ulcerative colitis (UC, 26.3%) and one case in 22 Crohn's disease (CD, 4.5%). Of 7 cases of the steroid-treated UC group, five cases were superinfected with CMV (71.4%) but none in 12 cases of the steroid-untreated UC group. All of the five CMV-positive cases in UC showed deep ulceration and transmural inflammation, while none of 10 UC cases without above features were CMV positive. Fibrinoid necrosis and thrombi were found in 83.3% of the CMV infected group, while none in the CMV-negative group of UC cases (p=0.01). We conclude that IBD, particularly UC, is susceptible to the CMV infection when steroid hormone is administered, and that deep colonic ulceration, transmural inflammation and fibrinoid necrosis of vasculature may suggest superinfection of CMV in UC patients. It seems that deep colonic ulceration may be the consequence of an ischemic change following vascular luminal occlusion or vasculitis by CMV infection.
Colitis, Ulcerative ; Colon ; Crohn Disease ; Cytomegalovirus Infections* ; Cytomegalovirus* ; Humans ; Immunohistochemistry ; Inflammation ; Inflammatory Bowel Diseases* ; Necrosis ; Phenobarbital ; Superinfection ; Ulcer ; Vasculitis

CD4-Positive T-Lymphocytes ; HIV ; HIV Infections ; virology ; Hepacivirus ; classification ; Hepatitis C ; virology ; Humans ; Liver Transplantation ; Postoperative Period ; Superinfection ; virology

OBJECTIVESTo compare the influence of hepatitis E virus (HEV) infection on the replication of hepatitis B virus (HBV) by observing clinical features, the relationship between the number of HBV DNA copies in serum, the degree of hepatic function impairments and prognosis of chronic hepatitis B patients with hepatitis E superinfection.

METHODSOne hundred and fifteen chronic hepatitis B (CHB) patients and 115 CHB patients with hepatitis E (HE) superinfection were studied and compared. 74 liver tissue biopsy samples of the CHB and 51 of the CHB-HE sufferers were obtained. HBsAg, anti-HBs, HBeAg, anti-HBe, anti-HBc, anti-HBc-IgG, anti-HBc-IgM, HBV DNA and anti-HEVIgM were detected respectively by enzyme linked immunosorbent assay and polymerase chain reaction.

RESULTSThe number of HBV DNA copies in sera in the CHB-HE group and the severity of the clinical features were significantly higher than those in the CHB group. The former group had a poorer prognosis with a 49.6% occurrence rate of severe hepatitis and a 25.2% death rate while in the latter group the corresponding rates were just 4.4% and 1.7%.

CONCLUSIONRe-infection with HEV, in those CHB patients, severely damaged their hepatic functions and increased their mortality; the older the patient and the higher the level of HBV DNA, the poorer the prognosis.

Female ; Hepatitis B virus ; Hepatitis B, Chronic ; virology ; Hepatitis E ; virology ; Hepatitis E virus ; Humans ; Male ; Middle Aged ; Prognosis ; Superinfection

Renal transplantation has become a well-established, definitive, highly successful therapy for end stage renal disease and been increased in previous decades. Korean Network for Organ Sharing reports that renal transplantation has been performed over 800 cases per year during five years. Although graft survival after renal transplantation has increased with the development of numerous new immunosupressive agents, infectious complications remain a significant cause of morbidity and mortality in renal transplant recipients.Cytomegalovirus (CMV) is a major virus in organ transplant recipients and is associated with opportunistic superinfection with a range of different microorganisms including Pneumocystis jirovecii, fungi, gram negative bacterias. In this paper, we report a case of pneumonia caused by fungus, Pneumocystis jirovecii, CMV in patient with renal transplantation. Based on the strong suspicion of superinfection, we aggressively diagnosed by performing surgical method and successfully treated the condition. Patients with CMV pneumonitis may be predisposed to superinfection by other pathogen and is associated with high mortality. Therefore, if superinfection is suspected, prompt diagnosis involving invasive methods and early initiation of antiviral, antifungal therapy are essential to reduce the mortality.
Coinfection ; Cytomegalovirus ; Cytomegalovirus Infections ; Fungi ; Graft Survival ; Gram-Negative Bacteria ; Humans ; Kidney Failure, Chronic ; Kidney Transplantation ; Pneumocystis ; Pneumocystis jirovecii ; Pneumonia ; Superinfection ; Transplants ; Viruses