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Deciphering and Imaging Pathogenesis and Cording of Mycobacterium abscessus in Zebrafish Embryos
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Non-tuberculosis cold abscess.
Ken-Ichi Muramatsu1, Hiroki Nagasawa1, Yuta Murai1
1Department of Acute Critical Care Medicine, Shizuoka Hospital, Juntendo University, Japan.
The American Journal of Emergency Medicine
|May 24, 2020
Summary
This case report details a rare cold abscess in an elderly man, caused by a mix of bacteria including Proteus mirabilis, Escherichia coli, and Prevotella melaninogenica, leading to fatal sepsis.
Area of Science:
- Infectious Diseases
- Medical Case Reports
- Microbiology
Background:
- Elderly patients, particularly those who are cachectic, may present with atypical infections.
- Subcutaneous abscesses can occur without typical signs of inflammation like redness or heat.
Observation:
- An 85-year-old unconscious and hypothermic man presented with a large, soft, non-erythematous abdominal mass.
- Computed tomography revealed subcutaneous fluid with gas formation in the abdominal mass.
Findings:
- Pus was aspirated from the abdominal mass, and surgical incision and drainage were performed.
- Cultures identified a polymicrobial infection involving Proteus mirabilis, Escherichia coli, and Prevotella melaninogenica.
- The patient succumbed to sepsis-induced multiple organ failure.
Implications:
- This is the first reported case of a cold abscess caused by this specific combination of bacteria.
- Highlights the importance of considering unusual presentations of infection in the elderly.
- Underscores the potential severity of polymicrobial subcutaneous abscesses, even without overt inflammatory signs.
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