A 36-year-old-male was admitted complaining of headache, right sided weakness and numbness of upper and lower extremity, and multiple cranial nerve deficits. Cranial magnetic resonance imaging revealed an abscess in the pontomesencephalic junction. Patient was then diagnosed to have Human Immunodeficiency Virus with a CD 4 count of 32 cells/ uL, his CSF assay was positive for Toxoplasmosis IgG and was managed as a case of probable brainstem toxoplasmosis. Patient was treated with Co-Trimoxazole 800/160mg 2 tablets twice a day. Upon discharge the patient clinically improved and was tolerating oral feeding. A repeat cranial magnetic resonance imaging after 6 weeks of antibiotic treatment revealed a decrease of size in the previous lesion. To our knowledge, there are no reported cases in the Philippines that shows the documentation of CNS toxoplasmosis in the brainstem. In this paper, a case of CNS toxoplasmosis in the pons of a newly diagnosed HIV patient is presented and how its course led to a good outcome.
Toxoplasmosis ; Immunocompromised Host

ABSTRACT Hepatocellular utility is observed by measuring the hepatocellular enzymes. Changes in its serum levels are related to liver dysfunction. Liver is one of the immunoprotective organs. Continuous use of immunosuppressive drugs can cause oral candidiasis and give effects to liver function. Hyperbaric oxygen treatment (HBOT), while reducing fungal infections, can also repair the liver function. The aim of this study was to investigate the alanine transaminase (ALT) and aspartate transaminase (AST) levels of immunosuppressed rats with oral candidiasis treated with hyperbaric oxygen. Twelve Wistar rats were divided into three groups: K− (normal/ healthy), K+ (oral candidiasis immunosuppressed rats), and P (oral candidiasis immunosuppressed rats treated hyperbaric oxygen). K+ and P groups were immunosuppressed by giving dexamethasone 0.5 mg/day/rat orally for 14 days, added with tetracycline 1 mg/day/rat. HBOT was given in five days successively. Blood serum of rats in all groups were taken to calculate the ALT and AST levels. ALT and AST levels in K+ showed higher value than K− and P groups. The data were analysed with one-way ANOVA test and showed significant difference in ALT levels (p < 0.05), while in AST levels there was no significant difference among the groups (p > 0.05). This study showed that HBOT affected the ALT and AST levels of immunosuppressed rats with oral candidiasis.
Carcinoma, Hepatocellular ; Hyperbaric Oxygenation ; Immunocompromised Host ; Candidiasis, Oral--therapy ; Alanine Transaminase ; Aspartate Aminotransferases

Inflatable penile prostheses are an important tool in the treatment of medically refractory erectile dysfunction. One of the major complications associated with these prostheses is infections, which ultimately require device explanation and placement of a new device. Over the past several decades, significant work has been done to reduce infection rates and optimize treatment strategies to reduce patient morbidity. This article reviews the current state of knowledge surrounding penile prosthesis infections, with attention to the evidence for methods to prevent infection and best practices for device reimplantation.
Anti-Bacterial Agents/therapeutic use* ; Anti-Infective Agents, Local/therapeutic use* ; Antibiotic Prophylaxis/methods* ; Bandages ; Carrier State/drug therapy* ; Chlorhexidine/therapeutic use* ; Coated Materials, Biocompatible ; Device Removal ; Diabetes Mellitus/epidemiology* ; Erectile Dysfunction/surgery* ; Gram-Negative Bacterial Infections/therapy* ; Hair Removal/methods* ; Humans ; Immunocompromised Host/immunology* ; Male ; Penile Implantation/methods* ; Penile Prosthesis ; Preoperative Care/methods* ; Prosthesis-Related Infections/therapy* ; Reoperation ; Risk Factors ; Spinal Cord Injuries/epidemiology* ; Staphylococcal Infections/therapy* ; Staphylococcus aureus ; Staphylococcus epidermidis ; Surgical Drapes ; Surgical Instruments ; Surgical Wound Infection/therapy*

The coronavirus disease 2019 (COVID-19) is an emerging infectious disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Within a matter of months, this highly contagious novel virus has led to a global outbreak and is still spreading rapidly across continents. In patients with COVID-19, underlying chronic diseases and comorbidities are associated with dismal treatment outcomes. Owing to their immunosuppressive status, patients with hematological malignancies (HMs) are at an increased risk of infection and have a worse prognosis than patients without HMs. Accordingly, intensive attention should be paid to this cohort. In this review, we summarize and analyze specific clinical manifestations for patients with coexisting COVID-19 and HMs. Furthermore, we briefly describe customized management strategies and interventions for this susceptible cohort. This review is intended to guide clinical practice.
COVID-19/prevention & control* ; Diagnosis, Differential ; Disease Management ; Hematologic Neoplasms/virology* ; Hospitalization ; Humans ; Immunocompromised Host ; Risk Factors

Strongyloides stercoralis is an intestinal nematode that often causes chronic diarrhea and may develop severe complicated form of hyperinfection or disseminated infection in immunocompromised patients. Here, we report a case of recurrent strongyloidiasis presenting with pulmonary and meningeal involvement. A 55-year-old male diagnosed with pancreatic cancer 4 months ago was admitted due to chronic diarrhea, abdominal pain, and weight loss for 2–3 months. He had been treated with albendazole for chronic recurrent strongyloidiasis 13 years ago and again 2 years ago. He developed sepsis of Klebsiella pneumoniae and Escherichia coli on Days 3 and 7, respectively, and then meningitis of E. coli on Day 42. Strongyloidiasis was diagnosed by detection of abundant filariform larvae in sputum specimens on Day 15. He was treated for disseminated strongyloidiasis with albendazole and ivermectin for five weeks until clearance of larvae was confirmed in sputum and stool specimens. Laboratory diagnosis is important to guide appropriate treatment and to prevent chronic and recurrent strongyloidiasis.
Abdominal Pain ; Albendazole ; Clinical Laboratory Techniques ; Diarrhea ; Escherichia coli ; Humans ; Immunocompromised Host ; Ivermectin ; Klebsiella pneumoniae ; Larva ; Male ; Meningitis ; Middle Aged ; Pancreatic Neoplasms ; Sepsis ; Sputum ; Strongyloides stercoralis ; Strongyloidiasis ; Weight Loss

Strongyloides stercoralis is endemic to tropical and subtropical regions, and infections are usually asymptomatic. However, immunocompromised patients, such as those receiving immunosuppressive therapy, high-dose steroids, or chemotherapy, can develop fatal hyperinfections. An 84-year-old man without any symptoms was diagnosed with strongyloidiasis during a regular screening colonoscopy. His medical history only involved a gastric endoscopic submucosal dissection for early gastric cancer 6 months previously. Few cases have been published about asymptomatic strongyloidiasis diagnosed in an immunocompetent host via endoscopic mucosal resection with characteristic colonoscopic findings. We report a case of colon-involved asymptomatic strongyloidiasis with specific colonic findings of yellowish-white nodules. This finding may be an important marker of S. stercoralis infection, which could prevent hyperinfections.
Aged, 80 and over ; Colon ; Colonoscopy ; Drug Therapy ; Humans ; Immunocompromised Host ; Mass Screening ; Steroids ; Stomach Neoplasms ; Strongyloides stercoralis ; Strongyloidiasis

Bacillus cereus causes serious central nervous system infections, especially in immunocompromised patients. Successful treatment requires adequate antimicrobial concentrations in the cerebrospinal fluid; however, in some cases, achieving this with systemic treatment alone is difficult. We treated intractable B. cereus ventriculitis with intraventricular vancomycin, with no major adverse events.
Bacillus cereus ; Bacillus ; Central Nervous System Infections ; Cerebral Ventriculitis ; Cerebrospinal Fluid ; Immunocompromised Host ; Injections, Intraventricular ; Pharmacokinetics ; Vancomycin

Staphylococcus pettenkoferi is a coagulase-negative staphylococci (CoNS) of growing concern. As CoNS could be an important cause of infections in hospitalized patients, especially in immunocompromised patients, accurate identification is critical to timely and effective treatment. In the past, S. pettenkoferi was not identifed by conventional methods or was misidentified as another Staphylococcus species or another genus. To the best of our knowledge, this is the first case of S. pettenkoferi identified using Vitek MS (bioMérieux, France). Two patients admitted to our hospital were confirmed to have bacteremia caused by S. pettenkoferi, which was identified in blood cultures using Vitek MS (bioMérieux). Therefore, we recommend using the Vitek MS (bioMérieux) for rapid and accurate identification of the pathogen causing bloodstream infection when CoNS is suspected.
Bacteremia ; Humans ; Immunocompromised Host ; Staphylococcus

An inflammatory myofibroblastic tumor (IMT) is a solid tumor of unknown etiology frequently affecting children and young adults and commonly affecting the lung or orbital region. We present a case involving a 41-year-old man who had an IMT combined with Mycobacterium tuberculosis infection in the retroperitoneum. He presented with only pain in the right lower abdomen without accompanying symptoms; a retroperitoneal mass was found on computed tomography. The tumor had invaded the end of the ileum and was attached to the omentum, so mass excision could not be performed. The tumor was completely excised surgically and had histological features diagnostic of an IMT. Histologic findings of the omentum were positive for Ziehl-Nielsen staining for acid-fast bacilli and for a positive polymerase chain reaction for M. tuberculosis. The patient had no apparent immune disorder. These findings made this case exceptional because IMTs, which are mostly due to atypical mycobacteria, have been found mainly in immunocompromised patients.
Abdomen ; Adult ; Child ; Humans ; Ileum ; Immune System Diseases ; Immunocompromised Host ; Inflammation ; Lung ; Mycobacterium tuberculosis ; Myofibroblasts ; Nontuberculous Mycobacteria ; Omentum ; Orbit ; Polymerase Chain Reaction ; Tuberculosis ; Young Adult

Microsphaeropsis arundinis is a dematiaceous fungus capable of causing soft tissue infections known as phaeohyphomycosis, mostly in immunocompromised individuals. These infections arise from the traumatic inoculation of fungal materials into the subcutis, and can spread to adjacent subcutaneous tissues or via the lymphatics in a sporotrichoid manner. A 76-year-old man presented with diffuse erythematous plaques and swelling on both forearms and dorsal hands, and rhinalgia. He had been undergoing treatment for hypertension, angina pectoris, and diabetes. Histopathologic examinations of the skin, painful nasal septum, and molecular identification using internal transcribed spacer regions confirmed a diagnosis of subcutaneous and intranasal phaeohyphomycosis caused by M. arundinis. The patient was treated with oral itraconazole for over 5 months, and no recurrence was observed until the time of writing this manuscript. We report a rare case of subcutaneous and intranasal phaeohyphomycosis caused by M. arundinis and propose that confirmation of the causative strains is necessary, as it could affect the prognosis and treatment of the disease.
Aged ; Angina Pectoris ; Diagnosis ; Forearm ; Fungi ; Hand ; Humans ; Hypertension ; Immunocompromised Host ; Itraconazole ; Mucormycosis ; Nasal Septum ; Phaeohyphomycosis ; Prognosis ; Recurrence ; Skin ; Soft Tissue Infections ; Subcutaneous Tissue ; Writing