Peer-reviewed veterinary case report
Subcutaneous pythiosis in human treated successfully with antimicrobial treatment, debridement and immunotherapy.
- Journal:
- BMJ case reports
- Year:
- 2024
- Authors:
- Roy, Moni et al.
- Affiliation:
- Department of Internal Medicine · United States
- Species:
- horse
Plain-English summary
Pythiosis is a rare infection caused by a type of microorganism that usually affects horses and cattle, but can occasionally occur in humans. In this case, a man in his 20s developed persistent ulcers on his legs after coming into contact with swamp water that contained animal remains. Despite taking several rounds of antibiotics, his condition didn't improve, so he was admitted to the hospital where doctors identified the infection through a deep wound culture. They consulted with specialists and decided to use a combination of immunotherapy, surgery to clean the wounds, and antibiotics, which led to a successful recovery and skin graft for the patient.
Abstract
Pythiosis is caused due to a filamentous eukaryotic micro-organism calledand the disease occurs commonly in horses and cattle. Subcutaneous pythiosis infection in humans is rare with no clear clinical guidelines for treatment. We present a case of a man in his 20s with non-resolving ulcers noted over lower extremity after exposure to swamp water draining animal remains. The patient received several courses of oral antibiotics with no improvement in symptoms before getting admitted to our institution. A diagnosis of subcutaneous pythiosis was made after deep wound culture following debridement detectedby use of PCR. Due to the rare incidence of such infection in humans and no clear guidelines available for treatment, the case was discussed with infectious disease specialists outside our institution and with veterinary physicians. An emergent approval for use of immunotherapy in conjunction with surgical debridement and antimicrobials was obtained from Food and Drug administration. The patient underwent successful treatment of infection and skin graft following treatment.
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Search related cases →Original publication: https://pubmed.ncbi.nlm.nih.gov/38499351/