Gliomatosis peritonei (GP) is commonly associated with ovarian teratoma and is not thought to have an adverse prognostic effect. However, the prognostic impact and characteristics of GP remain to be clarified. In this study, we investigated the clinicopathologic features of ovarian teratoma associated with GP, and we further compared ovarian immature teratoma (IT) with GP to ovarian IT without GP. During the study period, there were a total of 16 ovarian teratomas associated with GP. Among them, 15 cases were ovarian ITs of various grades. When ovarian IT with GP (n = 15) was compared to ovarian IT without GP (n = 27), it was found that ovarian IT patients with GP had larger tumor size (median, 19 vs. 13 cm; P < 0.001), more frequent recurrence (40 %, 6/15 vs. 3.7 %, 1/27; P = 0.005), and frequently elevated preoperative CA-125 level (100 %, 12/12 vs. 50 %, 10/20; P = 0.004). All recurrences occurred within 2 years of the initial surgery. Survival curves indicated that ovarian IT patients with GP had significantly shorter recurrence-free survival compared to those without GP (P = 0.002). The 2-year recurrence-free survival rates were 59.3 and 96.3 % in IT with GP and IT without GP, respectively. However, all but one case of IT with GP are currently alive. In conclusion, GP is an adverse prognostic factor characterized by frequent recurrence in patients with ovarian IT.

Identification of mite and tick bite sites provides important clinical information. The predominant mite species in Korea associated with scrub typhus are Leptotrombidium pallidum and Leptotrombidium scutellare The most abundant tick species is Haemaphysalis longicornis To date, there has been no comparative study on preferred bite sites between mites and ticks in humans. This study included a review of medical records and a field study. For mite bite sites, eschars were checked on 506 patients with scrub typhus, confirmed by indirect immunofluorescence assay or nested polymerase chain reaction on the 56-kDa type-specific antigen gene of Orientia tsutsugamushi Tick bite sites were identified and marked on a diagram for 91 patients who experienced tick bites within the previous year through a field epidemiological investigation. The mite and tick bite sites in Koreans were compared. The most frequently observed mite bite sites were the anterior chest, including the axillae (29.1%) and the abdominal region, including the inguinal area (26.1%). Tick bite sites were most frequent on the lower extremities (33.0%), followed by the abdominal region, including the inguinal area (26.4%), and upper extremities (26.4%). The distribution was significantly different between mite and tick bite sites (P < 0.001). There was a statistically significant difference in the mite bite (P = 0.001), but not tick bite sites (P = 0.985), between men and women. This is the first report on the differences between tick and mite bite sites, and may help clinicians reach a rapid diagnosis of mite- or tick-borne infection.

Nocardiosis is an infectious disease caused by Gram-positive rod-shaped bacteria and presents as a suppurative granulomatous disease in patients with compromised immune systems. Few studies have investigated the clinical utility of the universal 16S rRNA polymerase chain reaction (PCR) method using sterile body fluids for diagnosing nocardiosis. A 64-year-old female patient was admitted to Chosun University Hospital with the complaint of fever. Computed tomography scans of her chest revealed the presence of empyema and an abscess in the right lung. Pus samples were collected using closed chest thoracostomy and were cultured. The results revealed the presence of Gram-positive bacilli, but the culture tests were unable to identify the causative microorganism. Despite antibiotic treatment, the patient died of the suspected empyema and abscess. Universal 16S PCR of her sterile body fluids in combination with sequencing was performed, which led to the diagnosis of Nocardia farcinica infection. Postmortem, the remainder of the pus samples cultured for 8 days confirmed the presence of N. farcinica. This study illustrates the importance of using routine universal 16S rRNA PCR with sterile body fluids to help diagnose atypical bacterial infections such as nocardiosis.

Mucormycosis is an extremely rare but potentially life-threatening fungal infection. Gastrointestinal (GI) mucormycosis is very rare and occurs primarily in highly malnourished patients, especially in infants and children. A 55-year-old man with end-stage renal disease due to diabetic nephropathy, who had undergone deceased donor kidney transplantation 2 years prior, complained of abdominal pain and distension with a 3-day duration. Computed tomography revealed diffuse gastric wall thickening, and a huge amount of grey colored necrotic debris surrounded by erythematous erosive mucosa was observed at the antrum to upper body by GI endoscopy. The microscopic examination obtained from a GI endoscopic specimen demonstrated peptic detritus with numerous non-septate mucor hyphae in the mucosa and submucosa. Mucormycosis was diagnosed based on the clinical findings and morphological features. A total gastrectomy was performed and an antifungal agent was administered. A microscopic examination of the surgical specimen demonstrated invasive mucormycosis with numerous fungal hyphae with invasion into the mucosa to subserosa. The patient and graft were treated successfully by total gastrectomy and antifungal therapy.