Patient:Female, 77Final Diagnosis:BacteremiaSymptoms:Chills • diarrhea • fever • nauseaMedication:—Clinical Procedure:X-Ray • CBC • urine and blood culturSpecialty:Infectious diseasesObjective:Rare diseaseBackground:Cedecea davisae is a gram negative, oxidase negative bacilli that include 5 species. In the medical literature there are very few reports that describe infections caused by different species of the Cedecea genus.Case Report:In this paper we report a fourth case of bacteremia in a 77 year-old patient with a chronic renal disease that was successfully treated with ceftazidim and ciprofloxacin. Additionally, we present a review of all the reported infections that were caused by C. davisae.Conclusions:Five cases (not including our report) of Cedecea bacteremia were reported so far. Cedecea infections and particularly C. davisae infections can be difficult to treat due to the antibiotic resistance of the bacterium. Therefore we propose to consider treating C. davisae bacteremia with a combined antibiotic treatment until getting laboratory results for antibiotic-sensitivity tests.

Esophagography is highly accurate in diagnosis of EV and can be considered a viable noninvasive alternative for determination of patients who should be selected for prophylactic treatment.

Small cell lung cancer (SCLC) is aggressive cancer with high mortality without appropriate early treatmenr. The patient can present with paraneoplastic syndromes, such as Cushing syndrome, because of an inappropriate secretion of ectopic adrenocorticotropic hormone (ACTH) with severe hypokalemic metabolic alkalosis, Parathyroid hormone with hypercalcemia, and hyponatremia due to inappropriate anti-diuretic hormone (ADH) secretion. Patients with SCLC and paraneoplastic syndrome, are with poor prognostic factor. Diagnosis must be made early with immediate treatment. We report a 57-year-old male patient who had severe refractory hypokalemia, metabolic alkalosis, and hypertension as manifestations of an inappropriate secretion of ACTH-secreting from small cell carcinoma of the lung. He was treated with high doses of spironolactone to control the symptomatic refractory hypokalemia, and Metyrapone to control the ectopic ACTH secretion. Aggressive chemotherapy was initiated soon after lung mass biopsy, with SCLC diagnosis.