Archive for February 22, 2017

Skin and soft tissue infections following marine injuries and exposures in travelers.

J Travel Med. 2014 May-Jun;21(3):207-13.

doi: 10.1111/jtm.12115. Epub 2014 Mar 14.

Diaz JH1.

Author information

1Environmental and Occupational Health Sciences, School of Public Health; Department of Anesthesiology, School of Medicine, Louisiana State University Health Sciences Center (LSUHSC), New Orleans, LA, USA.



Bacterial skin and soft tissue infections (SSTIs) in travelers often follow insect bites and can present a broad spectrum of clinical manifestations ranging from impetigo to necrotizing cellulitis. Significant SSTIs can also follow marine injuries and exposures in travelers, and the etiologies are often marine bacteria.


To meet the objectives of describing the pathogen-specific presenting clinical manifestations, diagnostic and treatment strategies, and outcomes of superficial and deep invasive infections in travelers caused by commonly encountered and newly emerging marine bacterial pathogens, Internet search engines were queried with the key words as MESH terms.


Travel medicine practitioners should maintain a high index of suspicion regarding potentially catastrophic, invasive bacterial infections, especially Aeromonas hydrophila, Vibrio vulnificus, Chromobacterium violaceum, and Shewanella infections, following marine injuries and exposures.


Travelers with well-known risk factors for the increasing severity of marine infections, including those with open wounds, suppressed immune systems, liver disease, alcoholism, hemochromatosis, hematological disease, diabetes, chronic renal disease, acquired immunodeficiency syndrome, and cancer, should be cautioned about the risks of marine infections through exposures to marine animals, seawater, the preparation of live or freshly killed seafood, and the accidental ingestion of seawater or consumption of raw or undercooked seafood, especially shellfish. With the exception of minor marine wounds demonstrating localized cellulitis or spreading erysipeloid-type reactions, most other marine infections and all Gram-negative and mycobacterial marine infections will require therapy with antibiotic combinations.



February 22, 2017 at 1:26 pm

Aeromonas hydrophila ecthyma gangrenosum without bacteraemia in a diabetic man: the first case report in Italy.

Infez Med. 2009 Sep;17(3):184-7.

Avolio M1, La Spisa C, Moscariello F, De Rosa R, Camporese A.

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1Microbiologia e Virologia, Dipartimento di Medicina di Laboratorio, Azienda Ospedaliera S. Maria degli Angeli, Pordenone, Italy.


Ecthyma gangrenosum is a well recognized cutaneous manifestation of severe, invasive infection by Pseudomonas aeruginosa usually in immunocompromised and critically ill patients. This type of infection is usually fatal. Aeromonas infection is infrequently reported as the cause of ecthyma gangrenosum. Here we show the first case described in Italy of Aeromonas hydrophila ecthyma gangrenosum in the lower extremities in an immunocompetent diabetic without bacteraemia. A 63-year-old obese diabetic male was admitted with an ulcer on his left leg, oedema, pain and fever. Throughout his hospitalization blood cultures remained sterile, but a culture of A. hydrophila was isolated following punctures from typical leg pseudomonal-ecthyma gangrenosum lesions developed after admission. The patient, questioned again, stated that a few days before he had worked in a well near his house without taking precautions. We conclude that early diagnosis and suitable antibiotic therapy are important for the management of ecthyma gangrenosum. The typical presentation of soft tissue infection of A. hydrophila should mimic a Gram-positive infection, which may result in a delay in administration of appropriate antibiotics. Moreover, A. hydrophila should be considered a possible agent for non-pseudomonal ecthyma gangrenosum in a diabetic man with negative blood cultures, in presence of anamnestical risk factors


February 22, 2017 at 1:23 pm

Maxillary Sinusitis Caused by Actinomucor elegans



Departamento Micologıa, INEI, ANLIS Dr. Carlos G. Malbran, Buenos Aires,1 and Hospital San Juan de Dios2 and Fundacion Jose Marıa Mainetti, Centro Oncologico,3 La Plata, Argentina

We report the first case of maxillary sinusitis caused by Actinomucor elegans in an 11-year-old patient. Histopathological and mycological examinations of surgical maxillary sinuses samples showed coenocytic hyphae characteristic of mucoraceous fungi. The fungi recovered had stolons and rhizoids, nonapophyseal and globose sporangia, and whorled branched sporangiophores and was identified as A. elegans. After surgical cleaning and chemotherapy with amphotericin B administered intravenously and by irrigation, the patient became asymptomatic and the mycological study results were negative.


February 22, 2017 at 8:46 am

Fatal Actinomucor elegans var. kuwaitiensis Infection following Combat Trauma


Charla C. Tully,1 Anna M. Romanelli,2 Deanna A. Sutton,3,4 Brian L. Wickes,2,4 and Duane R. Hospenthal4,5*

Department of Medicine, Wilford Hall Medical Center, Lackland Air Force Base, Lackland,1 Department of Microbiology and Immunology2 and Fungus Testing Laboratory, Department of Pathology,3 University of Texas Health Science Center at San Antonio, San Antonio, San Antonio Center for Medical Mycology, San Antonio,4 and Infectious Disease Service, Department of Medicine, Brooke Army Medical Center, Fort Sam Houston, Houston,5 Texas

A previously healthy 30-year-old male was injured by an improvised explosive device in Iraq, sustaining extensive wounds to his right side. He was evacuated to a military hospital in Iraq and taken immediately to the operating room for complex pelvic fracture debridement and fixation, right lower extremity disarticulation, right through-the-elbow amputation, and an exploratory laparotomy. He was stabilized and evacuated to a military medical center in Germany. After further evaluation and stabilization, including washing out of his right flank, hip, and forearm and washing out of his abdomen without evidence of bowel injury, a wound vacuum-assisted closure device was placed over his open abdomen, and he was transferred to Brooke Army Medical Center (BAMC) for further care …


February 22, 2017 at 8:45 am

Chapare Virus, a Newly Discovered Arenavirus Isolated from a Fatal Hemorrhagic Fever Case in Bolivia

PLOS Pathogens APRIL 2008

Simon Delgado, Bobbie R. Erickson, Roberto Agudo, Patrick J. Blair, Efrain Vallejo, César G. Albariño, Jorge Vargas, James A. Comer, Pierre E. Rollin, Thomas G. Ksiazek, James G. Olson, Stuart T. Nichol

Simon Delgado – Centro de Salud de Eterazama, Cochabamba, Bolivia

Bobbie R. Erickson – Special Pathogens Branch, Division of Viral and Rickettsial Disease, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America

Roberto Agudo – Servicio Departamental de Salud, Cochabamba, Bolivia

Patrick J. Blair – Naval Medical Research Center Detachment, Lima, Peru

Efrain Vallejo – Servicio Departamental de Salud, Cochabamba, Bolivia

César G. Albariño – Special Pathogens Branch, Division of Viral and Rickettsial Disease, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America

Jorge Vargas – Centro Nacional de Enfermedades Tropicales (CENETROP), Santa Cruz, Bolivia

James A. Comer – Special Pathogens Branch, Division of Viral and Rickettsial Disease, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America

Pierre E. Rollin – Special Pathogens Branch, Division of Viral and Rickettsial Disease, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America

Thomas G. Ksiazek – Special Pathogens Branch, Division of Viral and Rickettsial Disease, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America

James G. Olson – Naval Medical Research Center Detachment, Lima, Peru

Stuart T. Nichol – E-mail: – Special Pathogens Branch, Division of Viral and Rickettsial Disease, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America

A small focus of hemorrhagic fever (HF) cases occurred near Cochabamba, Bolivia, in December 2003 and January 2004.

Specimens were available from only one fatal case, which had a clinical course that included fever, headache, arthralgia, myalgia, and vomiting with subsequent deterioration and multiple hemorrhagic signs.

A non-cytopathic virus was isolated from two of the patient serum samples, and identified as an arenavirus by IFA staining with a rabbit polyvalent antiserum raised against South American arenaviruses known to be associated with HF (Guanarito, Machupo, and Sabiá).

RT-PCR analysis and subsequent analysis of the complete virus S and L RNA segment sequences identified the virus as a member of the New World Clade B arenaviruses, which includes all the pathogenic South American arenaviruses.

The virus was shown to be most closely related to Sabiá virus, but with 26% and 30% nucleotide difference in the S and L segments, and 26%, 28%, 15% and 22% amino acid differences for the L, Z, N, and GP proteins, respectively, indicating the virus represents a newly discovered arenavirus, for which we propose the name Chapare virus. In conclusion, two different arenaviruses, Machupo and Chapare, can be associated with severe HF cases in Bolivia.


February 22, 2017 at 8:34 am

Hantavirus en el Chapare Boliviano

Rev. de Enfermedades Infecciosas y Tropicales, Enero, 2009 V.1 N.1 P.21-23

Roxana Loayza; Jimmy Revollo; Yelin Roca; Jorge Vargas

A inicios del año 2005 se demostró por primera vez la circulación de hantavirus en la región tropical del Chapare, aplicando el flujograma de diagnóstico diferencial del laboratorio y empleando pruebas serológicas en una muestra de suero derivada al CENETROP de un paciente febril con sospecha clínica de dengue (fallecido) proveniente de Eterazama en el departamento de Cochabamba.

Luego de éste hallazgo se procesaron las muestras que ingresaron desde enero del 2005 y del 2006.

De las 487 muestras procesadas el 4% mostró reactividad de anticuerpo contra el virus Andes a través de la prueba de ELISA de captura para detección de IgM, por lo que sugerimos que este virus es el responsable de casos de síndromes febriles con síntomas respiratorios en esta área.


February 22, 2017 at 8:31 am


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