W hen I wrote my first case report and it was published in a premiere medical journal (1), I was thrilled. The acceptance meant the world to me. It was a remarkable case with a unique combination of coexisting problems. Most importantly, we thought it was a one-of-a-kind case of cryptococcal infection emerging in a Cushingoid patient who had become adrenally excessive by virtue of an ACTHsecret...

The clinical presentations of meningococcal diseases other than meningitis or meningococcemia may lead to erroneous diagnosis. Although several reports have described unusual meningococcal diseases, the Neisseria meningitidis strains involved in these forms have been poorly characterized. In this study, meningococcal arthritis and pericarditis were confirmed by isolation of N. meningitidis and/...

Septic shock caused by Neisseria meningitidis is typically rapidly evolving and often fatal despite antibiotic therapy. Further understanding of the mechanisms underlying the disease is necessary to reduce fatality rates. Postmortem samples from the characteristic purpuric rashes of the infection show bacterial aggregates in close association with microvessel endothelium but the species specifi...

Human parvovirus B19 infection can cause erythema infectiosum (EI) and several other clinical presentations. Central nervous system (CNS) involvement is rare, and only a few reports of encephalitis and aseptic meningitis have been published. Here, we describe 2 cases of B19 infection in a family presenting different clinical features. A 30 year old female with a 7-day history of headache, malai...

A healthy 72-year-old Japanese woman complained of a chilly sensation and arthralgia for the previous 4 days. She had a fever (37.7°C); a physical examination revealed bilateral swollen ankle bursae (Picture 1, 2). Thrombocytopenia (3.1×10/μL) and an elevated C-reactive protein level (29.23 mg/dL) were observed. Gram staining of the bursa fluid obtained by aspiration showed Gram-negative cocci ...

Diaz-Rubio (1946) observed that systemic infections caused a condition of relative corticoid activity. Penner and Bernheim (1942) noted adrenal insufficiency in patients suffering from bacillary dysentery. Beneficial effects of the administration of corticoids in the treatment of acute infections, such as malaria (Bahtiyar, 1947), pneumonia (Perla et al., 1940), meningococcemia (Harrel, 1947), ...

Extrameningeal complications of meningococcal septicaemia occur in about 11–19% of cases, and include myocarditis, acute renal failure, arthritis, pneumonia, skin gangrene, conjunctivitis, endocarditis, pericarditis, endophthalmitis, urethritis, WaterhouseFriderichsen syndrome, vasculitis, and digital ischaemia. We describe the use of a prostacyclin analogue in the treatment of cutaneous digita...

We present the first reported case of systemic infection with Neisseria meningitidis serogroup W-135 sequence type (ST)-11 in Japan. A 44-year-old woman presented with high fever, sore throat, and fatigue and was diagnosed with N. meningitidis bacteremia. The causative strain was identified as serogroup W-135 ST-11 by polymerase chain reaction and multilocus sequence typing. Approximately 1 mon...

Bacteremia and sepsis, along with other serious bacterial infections (SBIs), are still significant causes of morbidity and mortality among children worldwide despite the use of modern antibiotics and evidence-based resuscitation guidelines and treatments.1 Sepsis in neonates is a significant contributor to morbidity and mortality. Based on the onset, neonatal sepsis is classified into two major...