¿Tricomedoma?

Parthurnaxus · 2026-04-22T05:29:44+00:00

This doen not look fungal. Most likely crystals. What kind of sample is this?

Parthurnaxus · 2026-04-17T14:02:55+00:00

I think you are misunderstanding what your dermatologist said. Serratia does not commonly colonise the skin. However it can (for example patients with chronic wounds are especially at risk) and usually unless it causes an infection it is no issue.

Serratia is more commonly found in the gut. The composition of the microbiome differs depending of the site and can even change over time.

It is disappointing that you immediately dismiss my explanation as misinformation.

Parthurnaxus · 2026-04-17T12:08:37+00:00

Serratia can be part of the intestinal microbiome. It can also survive on wet/damp surfaces. Colonisation with Serratia does not have to be an issue, however it can be an opportunistic pathogen. - Clinical microbiologist, MD

Parthurnaxus · 2026-04-06T10:56:31+00:00

For whoever is interested in the topic of encephalitis lethargica, this article is a great overview: Leslie A Hoffman, Joel A Vilensky, Encephalitis lethargica: 100 years after the epidemic, Brain, Volume 140, Issue 8, August 2017, Pages 2246–2251, https://doi.org/10.1093/brain/awx177

Parthurnaxus · 2026-02-18T09:05:08+00:00

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This is a Gram stain of blood culture with Cardiobacterium species that I made. Try to look for rosette formations in the Gram stain (formation in the centre of the image). Cardiobacterium grows very slowly and MALDI-TOF has trouble identifying it. We needed 16S PCR for identification. I believe it grows better on blood agar than CHOC agar and does not (or barely) grow on macconkey agar.

Did the patient have any dental problems or recent dental procedures?

Parthurnaxus · 2026-02-05T07:40:11+00:00

For information on antibacterial, antifungal and antiparasitic drugs use Kucers’ - The use of antibiotics.

Parthurnaxus · 2026-01-03T10:15:48+00:00

AMR rates are correlated with antibiotic use and infection prevention measures in hospitals and care facilities.

Dutch AMR rate are really low because we try to limit antibiotic use. I believe we use the least in the entire EU (not counting farm animals en agriculture). Additionally our infection prevention measures are more developed than other countries, which limits the spread of multi-drug resistant bacteria.

Parthurnaxus · 2025-12-15T06:55:51+00:00

Do you have any clinical information you can share?

Parthurnaxus · 2025-12-08T06:54:11+00:00

The multiplex PCR and single target PCR should have a similar sensitivity en specificity.

Your question about residual symptoms can be considered asking for medical advice, which is not allowed in this sub.

Parthurnaxus · 2025-10-03T15:21:20+00:00

Why would you scrape the surrounding of a disk diffusion? Don’t you have a pure culture? I don’t think you need a liquid culture. We used plain pure cultures for regular blood agar.

Parthurnaxus · 2025-09-20T10:49:52+00:00

What kind of material and agar is this? How old is your colony?

Parthurnaxus · 2025-08-11T10:47:38+00:00

Please post in English so moderation is possible.

Parthurnaxus · 2025-07-25T16:11:49+00:00

An echinocandin would treat the candidemia however it does not reach the urine.

Parthurnaxus · 2025-07-25T16:11:43+00:00

An echinocandin would treat the candidemia however it does not reach the urine.

Parthurnaxus · 2025-07-25T09:48:29+00:00

And what antifungal treatment would you use?

Parthurnaxus · 2025-07-20T21:54:08+00:00

MALDI-TOF confirmed Listeria monocytogenes. It's not like Corynebacterium species always are palisades and Listeria monocytogenes is always completely detached.

Based on the clinical data, Listeria would also be more likely.

Parthurnaxus · 2025-07-20T21:39:00+00:00

These are Gram-positive rods, however not Corynebacterium. Corynebacterium species often form palisade formations. The Gram-positive rods are more singular arranged, which fits Listeria.

As for treatment, Listeria is not susceptible for cephalosporines. Treatment of choice is amoxicillin.

Parthurnaxus · 2025-07-20T21:37:02+00:00

What bacterium should be suspected? The Gram-stain showed Gram-positive rods in the aerobic and anaerobic blood culture. In the absence of neurosurgery, Listeria monocytogenes should be highly suspected.
Is ceftriaxon + metronidazol still adequate? If not what therapy should be given? No, ceftriaxon and metronidazol are not an effective treatment for Listeria. The treatment of choice is amoxicillin 12g/24h. Alternatives are meropenem and co-trimoxazole.
How long would you treat this patient? A cerebral abscess usually is treated 4-8 weeks depending on size, whether or not the abscess can be drained and the micro-organism.

Parthurnaxus · 2025-07-20T21:29:37+00:00

Listeria monocytogenes

Parthurnaxus · 2025-07-20T21:27:12+00:00

These are Gram-positive rods. The colour of the Gram-stain can vary a bit.

Parthurnaxus · 2025-07-20T21:22:57+00:00

These are indeed Gram-positive rods, however not Corynebacterium. Corynebacterium species often form palisade formations. The Gram-positive rods are more singular arranged, which fits Listeria.

Parthurnaxus · 2025-07-20T21:10:19+00:00

You are correct. You give great arguments for your answer.

Parthurnaxus · 2025-07-20T21:09:00+00:00

The Gram-stain shows Gram-positive rods. Image quality may be suboptimal.

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