Shigemi Hitomi

Bacterial Arthritis Caused by Leptotrichia amnionii

ABSTRACT Leptotrichia amnionii is an organism that rarely causes female genital tract infection. We describe a case of a male patient with arthritis on the left knee joint due to this organism.

A case of Ascaris suum visceral larva migrans diagnosed by using A. suum larval excretory-secretory (ES) antigen

A 42-y-old female presented with common cold-like symptoms. Laboratory data showed mild liver dysfunction together with peripheral blood eosinophilia. She was suspected of having a helminthic infection, however parasite eggs or larvae were not detected by repeated stool examinations. Eventually she transpired to have a high IgG antibody titer against excretory-secretary (ES) antigen of Ascaris suum larvae, but not of Toxocara canis larvae, suggesting that she had been suffering from visceral larva migrans (VLM) caused by A. suum. Her sickness improved without any treatment. Current results clearly highlight the usefulness of ES antigens derived from larvae of A. suum for the fine discrimination of VLM caused by A. suum and by T. canis. Application of A. suum derived ES antigens as a diagnostic tool may reveal the distinctive clinical features of VLM caused by A. suum.

Urosepsis caused by Edwardsiella tarda

Edwardsiella tarda is a rare causative agent of human infection, predominantly associated with gastroenteritis. We describe a fatal case of urosepsis caused by E. tarda. The patient’s underlying condition of advanced uterine cancer may have contributed to the development of the infection.

Bacteremia caused by VanC-type enterococci in a university hospital in Japan: a 6-year survey

We retrospectively examined the clinical and microbiological characteristics of bacteremia caused by intrinsically vancomycin-resistant (VanC-type) enterococci in a university hospital in Japan. Five cases of Enterococcus gallinarum and four of Enterococcus casseliflavus bacteremia were identified during the 6 years of the survey. Of the nine cases, five were related to neutropenic states with hematologic diseases and four were related to biliary tract infection with hepatobiliary or pancreatic diseases. VanC-type enterococci were associated with 12% of all the enterococcal bacteremias, indicating that these species cause bacteremia more frequently in Japan than in previously reported areas.

Nosocomial diarrhea caused by Clostridium perfringens in the Tsukuba-Tsuchiura district, Japan

We examined the incidence of nosocomial diarrhea caused by Clostridium perfringens enterotoxin (CPEnt) in three tertiary hospitals in the Tsukuba-Tsuchiura district, Japan. In addition, isolated strains were genomically characterized. Among 294 stool specimens submitted for C. difficile toxin A (CDTxA) assay during a period of 6 months, 6 (0.42 cases per 1000 beds monthly) and 79 (5.5) were positive for CPEnt and CDTxA, respectively. C. perfringens with the cpe gene was detected in 15 (5%) of the specimens. Genomically indistinguishable strains were isolated from one pair of specimens submitted from one hospital, and from three submitted from different hospitals. Four specimens submitted from one hospital contained C. perfringens with the cpe and the cpb2 genes. We concluded that C. perfringens caused nosocomial diarrhea one-tenth as frequently as C. difficile did in this district, and that strains causing nosocomial diarrhea might have already been acquired in the community.

Bacteremia caused by Desulfovibrio fairfieldensis

Desulfovibrio species are anaerobic gramnegative, pleomorphic bacilli rarely causing infection in humans. In the present report, we describe a case of bacteremia caused by Desulfovibrio fairfieldensis. The patient, for whom biapenem was administered, rapidly improved without any sequelae. As far as we know, this is the first case report of infection by Desulfovibrio species in Japan.

Native valve endocarditis caused by Neisseria elongata Subsp. nitroreducens.

Neisseria elongata, a normal resident in the human oral cavity, rarely causes invasive infections. We herein report a case of endocarditis caused by Neisseria elongata subsp. nitroreducens that occurred in a patient without any apparent cardiac complications. The patient received aortic valve replacement following the administration of intravenous beta-lactam for five weeks. To our knowledge, this is the first published case in Japan of N. elongata infection in a patient without a prosthetic device.

Surgical-site infection with toxin A-nonproducing and toxin B-producing Clostridium difficile

To date, few cases of extraintestinal infection with Clostridium difficile have been reported. We describe a case of surgical-site infection with C. difficile following a colonic operation. Administration of metronidazole was considered to be effective for treatment of the infection. The isolate was a toxin A-nonproducing and toxin B-producing strain.

Bloodstream Infection due to Mycoplasma arginini in an Immunocompromised Patient

ABSTRACT Mycoplasma arginini, an organism usually recovered from mammals, was isolated from the blood of a febrile patient with advanced non-Hodgkin lymphoma. The patients condition improved without administration of antimycoplasmal drugs. Simulation of blood culture showed that automated blood culture instruments may fail to detect the organism.

Chronic active EB virus infection complicated with IgG3 subclass deficiency: An adult case treated with intravenous immunoglobulin and IFN-α

A 60-year-old man presented with recurrent genital and oral ulcers, necrotic papules on his face and scalp, spiking fever and indurated skin erythema on the trunk. A diagnosis of chronic active Epstein-Barr virus infection and IgG3 subclass deficiency was made, and he was supplemented by intravenous gammaglobulin injection. The spiking fever was resistant to treatment, but the addition of systemic interferon-alpha therapy was partially effective in treating his clinical symptoms, although the patient eventually died from pulmonary effusions and cardiac insufficiency.