[1, 2] Subcutaneous lumbar see more or abdominal localizations are exceptional and are almost exclusively secondary to local extension of tuberculosis (Pott’s disease, psoas abscess, and lymphadenitis) or to hematogenous dissemination.[3] Our patient had neither concurrent active tuberculosis (local or distant) nor a history of tuberculosis. Treatment is poorly defined. Although most thoracic wall abscesses (the most common) were treated surgically,[1] some authors proposed exclusive medical therapy.[2] Our patient received a multidrug regimen and underwent three needle aspirations and remains relapse free 2 years after

stopping treatment. “
“A 54-year-old Japanese man without underlying disease developed pneumococcal bacteremia and meningitis after traveling to the Philippines. The isolate demonstrated high affinity to the lung and invasiveness in vivo. The international travelers can

import indigenous high virulent strains even if the bacterium is commonly isolated in the home country. Streptococcus pneumoniae is an important bacterium which causes not only pneumonia but also invasive pneumococcal diseases such as bacteremia and meningitis. Invasive pneumococcal disease often occurs in immunocompromised patients and can be life-threatening in some cases. We report here a case with lethal pneumococcal disease that occurred in a seemingly healthy individual after international travel. Moreover, to confirm the virulence of the isolated strain, we experienced its invasiveness and lethality using the pneumococcal airway infection mouse model. A 54-year-old Japanese man visited the Philippines from December 29, 2007 to January 5, 2008, but his itinerary and foods during his selleck inhibitor stay were unknown. After coming back to Japan, he had sore throat, headache, and temperature. On January

7, he was referred to Kurume University Hospital by a local hospital for further examination as his laboratory findings represented bicytopenia. After his arrival at 15:30, suddenly, a clonic convulsion attacked him when he was waiting for results of his blood examination, and then his respiration and heartbeat were Reverse transcriptase arrested at 16:30 and he died at 21:30 despite of resuscitation. In his laboratory data, the white blood cell count was 1,100 cells per mL and platelet count was 5,000 per mL. C-reactive protein and procalcitonin were dramatically elevated at 31.89 mg/mL and 177.47 ng/mL, respectively. Biochemical data represented features of multiple organ failure and disseminated intravascular coagulation. Immunoglobulin G (IgG) slightly decreased at 700 mg/dL, but there were no findings of diabetes, syphilis, hepatitis B or C virus infection, adult T cell leukemia, and human immunodeficiency virus-1 (HIV-1) infection. The influenza virus antigen and the urine antigen of Legionella were negative. In radiological examination, no abnormal opacity was shown in head and chest. To determine the reason for the convulsion, the cerebrospinal fluid and the blood were sampled.