Chryseobacterium indologenes (C. indologenes) is a nonmotile, gram-negative bacillus that is widely distributed in nature. Generally considered nonpathogenic, C. indologenes rarely infects humans and is not normally present in the human microflora. C. indologenes infections have been observed in cases of peritoneal dialysis (PD)-associated peritonitis, although the incidence of these infections is low. Although C. indologenes is generally susceptible to trimethoprim-sulfamethoxazole, levofloxacin, ciprofloxacin, piperacillin-tazobactam, and cefepime, no guidelines have been established for the treatment of PD-associated peritonitis. Here we report the first case of PD-associated peritonitis in Korea with C. indologenes identified as the sole etiologic agent. The patient recovered after intraperitoneal antibiotic treatment without the need for Tenckhoff catheter removal.
Acute interstitial nephritis (AIN) is an important cause of reversible acute kidney injury and pathologically characterized by inflammatory infiltrate in the renal interstitium. Solanum nigrum (S. nigrum) is a medicinal plant member of the Solanaceae family. Although S. nigrum has been traditionally used to treat various ailments such as pain, inflammation, and fever, it has also been reported to have a toxic effect, resulting in anticholinergic symptoms. However, there have been no reports of AIN caused by S. nigrum. Here, we report the first case of biopsy-confirmed AIN after ingestion of S. nigrum. The patient was successfully treated using corticosteroid therapy.
The Chicago classification (CC) defines an esophagogastric junction outflow obstruction (EGJOO) as the presence of several instances of intact or weak peristalsis, elevated median integrated relaxation pressure above 15 mmHg, and a discrepancy from the criteria of achalasia. The revised CC addresses the potential etiology of EGJOO, including the early forms of achalasia, mechanical obstruction, esophageal wall stiffness, or manifestation of hiatal hernia. A 58-year-old woman visited the Presbyterian Medical Center with swallowing difficulty. The patient underwent a high resolution manometry (HRM) examination and was diagnosed with EGJOO. Chest CT was performed to exclude a mechanical obstruction as a cause, and CT revealed a subepithelial tumor (SET) at the upper part of the esophagogastric junction. Therefore, laparoscopic surgery was performed and eccentric muscular hypertrophy of the distal esophagus was observed. Longitudinal myotomy and Dor fundoplication were also performed. The histology findings of the surgical specimens were consistent with achalasia. This paper reports a case of early achalasia that was finally diagnosed by the histology findings, but was initially diagnosed as EGJOO using HRM and misdiagnosed as SET in the image study.
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