Patel Atithi, Patel Soham, Blaszczak Alecia, Krueger Karen, Vakharia Paras
Dermatology, Northwestern University Feinberg School of Medicine, Chicago, USA.
Infectious Disease, Northwestern University Feinberg School of Medicine, Chicago, USA.
Cureus. 2024 Sep 9;16(9):e69012. doi: 10.7759/cureus.69012. eCollection 2024 Sep.
We present a case of a human cutaneous infection caused by in a 19-year-old male on adalimumab. While on a trip to Israel, the patient sustained a left knee abrasion after a fall while hiking, and subsequently went swimming in the Red Sea. The patient gradually developed a large, non-healing, erythematous, ulcerated plaque on the left knee. Initial biopsy and tissue cultures were negative for infection, but due to a high suspicion for infection, further diagnostic testing was conducted. Broad range polymerase chain reaction and next-generation sequencing was performed, and 28S rDNA sequencing was positive for Neosartorya hiratsukae, a rare infectious agent in humans. This case highlights the importance of considering uncommon sources, such as fungal etiologies, in the differential diagnosis of non-resolving lesions, particularly in immunosuppressed patients. Furthermore, this case emphasizes the significance of advanced molecular techniques in identifying uncommon pathogens.
我们报告一例19岁使用阿达木单抗的男性患者发生的由[未提及具体病菌名称]引起的人类皮肤感染病例。在前往以色列旅行期间,患者徒步时摔倒致左膝擦伤,随后在红海游泳。患者左膝逐渐出现一个大的、不愈合的、红斑性、溃疡性斑块。最初的活检和组织培养未发现感染迹象,但由于高度怀疑感染,进行了进一步的诊断检测。进行了广泛的聚合酶链反应和二代测序,28S rDNA测序显示平冢新萨托菌呈阳性,这是一种在人类中罕见的感染病原体。该病例突出了在鉴别诊断不愈合病变时考虑罕见病因(如真菌病因)的重要性,尤其是在免疫抑制患者中。此外,该病例强调了先进分子技术在识别罕见病原体方面的重要性。