1/118. Case studies in international travelers.family physicians should be alert for unusual diseases in patients who are returning from foreign travel. malaria is a potentially fatal disease that can be acquired by travelers to certain areas of the world, primarily developing nations. Transmitted through the bite of the anopheles mosquito, malaria usually presents with fever and a vague systemic illness. The disease is diagnosed by demonstration of plasmodium organisms on a specially prepared blood film. Travelers can also acquire amebic infections, which may cause dysentery or, in some instances, liver abscess. amebiasis is diagnosed by finding entamoeba histolytica cysts or trophozoites in the stool. Invasive amebic infections are generally treated with metronidazole followed by iodoquinol or paromomycin. Cutaneous larva migrans is acquired by skin contact with hookworm larvae in the soil. The infection is characterized by the development of itchy papules followed by serpiginous or linear streaks. Cutaneous larva migrans is treated with invermectin or albendazole. Case studies are presented.- - - - - - - - - - ranking = 1keywords = infection (Clic here for more details about this article) |
2/118. Acanthamoeba sinusitis with subsequent dissemination in an AIDS patient.Otolaryngologists can play an important role in the care of patients with acquired immunodeficiency syndrome (AIDS) and/or human immunodeficiency virus infection. We present the case of an AIDS patient who was hospitalized for dehydration and who was soon found to have sinusitis and subsequent disseminated infection caused by Acanthamoeba. To treat the Acanthamoeba infection, the patient was started on oral itraconazole and intravenous metronidazole; i.v. pentamidine was added 2 days later. Despite aggressive therapy, on the eleventh day of hospitalization, the patient was obtundent and provided minimal response to noxious stimuli. He died on the sixteenth day of hospitalization. This case is one of only six reported cases of Acanthamoeba associated with sinusitis. Current therapeutic regimens have not been successful for most of these patients, and the prognosis is poor.- - - - - - - - - - ranking = 1keywords = infection (Clic here for more details about this article) |
3/118. encephalitis due to a free-living amoeba (balamuthia mandrillaris): case report with literature review.BACKGROUND: Amebic infections can spread to the central nervous system with a lengthy but usually fatal course. A typical case is presented to raise awareness of this increasingly reported infectious process that may have a more favorable outcome if diagnosed in its early stages. CASE DESCRIPTION: A 38-year-old male presented with an ulcerating 10 x 8 cm mass on his thigh and smaller skin nodules. In less than 6 months seizures developed due to granulomatous lesions of the brain. Biopsies/excisions of the thigh lesion, a subcutaneous nodule, and a brain lesion were performed. He failed to respond to broad spectrum antibiotics and antineoplastic agents, and died within 6 weeks of the initial MRI scan of the brain.Rare amebic trophozoites were appreciated in the biopsy specimens on post-mortem review, and balamuthia mandrillaris confirmed as the infecting agent on immunofluorescence studies. CONCLUSIONS: Granulomatous amebic encephalitis is a parasitic infection with a lengthy clinical course before rapid deterioration due to extensive brain lesions is noted. Either early treatment with antimicrobials or-in rare cases-excision of the brain lesion(s) may offer the chance of a cure.- - - - - - - - - - ranking = 0.66666666666667keywords = infection (Clic here for more details about this article) |
4/118. Granulomatous amebic encephalitis in a patient with AIDS: isolation of acanthamoeba sp. Group II from brain tissue and successful treatment with sulfadiazine and fluconazole.A patient with AIDS, treated with highly active antiretroviral therapy and trimethoprim-sulfamethoxazole, presented with confusion, a hemifield defect, and a mass lesion in the right occipital lobe. A brain biopsy confirmed granulomatous amebic encephalitis (GAE) due to acanthamoeba castellanii. The patient was treated with fluconazole and sulfadiazine, and the lesion was surgically excised. This is the first case of AIDS-associated GAE responding favorably to therapy. The existence of a solitary brain lesion, absence of other sites of infection, and intense cellular response in spite of a very low CD4 count conditioned the favorable outcome. We review and discuss the diagnostic microbiologic options for the laboratory diagnosis of infections due to free-living amebae.- - - - - - - - - - ranking = 0.66666666666667keywords = infection (Clic here for more details about this article) |
5/118. Cutaneous Acanthamoeba in a patient with AIDS: a case study with a review of new therapy; quiz 386.GOAL: To describe the presenting signs of an Acanthamoeba infection. OBJECTIVES: Upon completion of this activity, dermatologists and general practitioners should be able to: 1. Discuss the clinical presentation of Acanthamoeba infection. 2. Describe the conditions that make a patient susceptible to Acanthamoeba. 3. Outline treatment options for Acanthamoeba infection. CME: This article has been peer reviewed and approved by Michael Fisher, MD, Professor of medicine, Albert Einstein College of medicine. review date: April 2001. This activity has been planned and implemented in accordance with the Essentials and Standards of the accreditation Council for Continuing Medical education through the joint sponsorship of Albert Einstein College of medicine and Quadrant HealthCom, Inc. The Albert Einstein College of medicine is accredited by the ACCME to provide continuing medical education for physicians. Albert Einstein College of medicine designates this educational activity for a maximum of 1.0 hour in category 1 credit toward the AMA Physician's Recognition Award. Each physician should claim only those hours of credit that he/she actually spent in the educational activity. This activity has been planned and produced in accordance with ACCME Essentials.- - - - - - - - - - ranking = 1keywords = infection (Clic here for more details about this article) |
6/118. amebiasis in Japanese homosexual men with human immunodeficiency virus infection.We report cases of amebiasis in 6 human immunodeficiency virus (hiv)-positive male patients. Five were confirmed homosexuals while one was suspected. Three patients had liver abscess and 5 had colitis with duration of 10 days to months. The patients with liver abscess showed a lower incidence of abdominal pain but a higher incidence of concomitant diarrhea. drainage therapy was effective for rapid afebrile results. Two invasive colitis cases died from perforation. This may have been due to delayed diagnosis. Invasive amebiasis is not common even in hiv-infected individuals. Among Japanese homosexual men, however, it may cause symptomatic diseases.- - - - - - - - - - ranking = 1.3333333333333keywords = infection (Clic here for more details about this article) |
7/118. An amebic lung abscess: report of a case.Recently the number of amebiasis cases has increased in japan. Pleuropulmonary amebiasis is a very rare complication of liver amebiasis. We report herein the case of a 54-year-old man presenting with an amebic lung abscess in his right lower lung. The diagnosis of lung amebiasis was established from a direct examination of the pus in which trophozoites of entamoeba histolytica were detected. After the oral administration of metronidazole, the laboratory findings improved and he thus underwent a right lower lobectomy. He was discharged without any relapse of infection 20 days after a thoracotomy. We conclude that a protozoan infection should thus be suspected in the case of a pleuropulmonary infection in which several types of antibiotics prove to be ineffective.- - - - - - - - - - ranking = 1keywords = infection (Clic here for more details about this article) |
8/118. Pediatric granulomatous cerebral amebiasis: a delayed diagnosis.We present four cases of cerebral amebae infection treated at our neurosurgical department. Patient 1 was a 12-year-old male with skin lesions of 2 years' progression involving the midface. He received a corticosteroid course, and, after that, he presented a right body hemiparesis. Patient 2 was a 5-year-old male, with a past surgical history of fibula fracture and osteomyelitis of 1-year evolution, associated with lesions of the surrounding skin that presented with partial seizures. Patient 3 was a 3-year-old female who presented with a stroke-like episode and with partial seizures. Patient 4 was a 6-year-old male who had ulcerative lesions in the face of 1-year evolution. After a corticosteroid course, he presented with right-body hemiparesis. All patients were human immunodeficiency virus-negative and died 1 month or less after surgery because of progressive evolution of the disease. Histopathology revealed granulomatous amebic encephalitis. All patients revealed infection from balamuthia mandrillaris (Leptomyxiidae). Treatment consisting of pentamidine, clarithromycin, fluconazole, and 5-fluorocytosine was ineffective. Although extremely uncommon, granulomatous amebic encephalitis should be considered in the differential diagnosis of cerebral lesions while nonspecific, associated granulomatous skin lesions support the diagnosis of amebiasis.- - - - - - - - - - ranking = 0.66666666666667keywords = infection (Clic here for more details about this article) |
9/118. Acanthamoeba: a rare primary cause of rhinosinusitis.Parasitic infections, especially Acanthamoeba, are rarely implicated as a specific cause of rhinosinusitis. It is a fatal disease found in the immunocompromised population, in particular in patients infected with the human immunodeficiency virus (hiv). Less than 10 cases of Acanthamebic rhinosinusitis have been reported in the literature, and only 1 has survived. This case report presents an Acanthamebic infection misdiagnosed as a squamous cell carcinoma of the nasal septum on a presumptive healthy, immunocompetent 35-year-old woman. She was later diagnosed with AIDS (AIDS) along with disseminated Acanthamoebiasis and became the second reported case surviving this deadly illness. This case report also discusses the difficulty in diagnosing this rare parasite, the pathogenesis, and the multidisciplinary treatment required to control and manage this uniformly fatal disease.- - - - - - - - - - ranking = 0.66666666666667keywords = infection (Clic here for more details about this article) |
10/118. Disseminated acanthamebiasis in a renal transplant recipient with osteomyelitis and cutaneous lesions: case report and literature review.Disseminated acanthamebiasis is a rare disease that occurs predominantly in patients with human immunodeficiency virus (hiv) infection or acquired immunodeficiency syndrome but also in immunosuppressed transplant recipients. Few reports have focused on non-hiv-infected patients, in whom the disease is more likely to go unsuspected and undiagnosed before death. We describe a renal transplant recipient with Acanthamoeba infection and review the literature. The patient presented with osteomyelitis and widespread cutaneous lesions. No causative organism was identified before death, despite multiple biopsies with detailed histological analysis and culture. Disseminated Acanthamoeba infection was diagnosed after death, when cysts were observed in histological examination of sections of skin from autopsy, and trophozoites were found in retrospectively reviewed skin biopsy and surgical bone specimens. In any immunosuppressed patient, skin and/or bone lesions that fail to show improvement with broad-spectrum antibiotic therapy should raise the suspicion for disseminated acanthamebiasis. Early recognition and treatment may improve clinical outcomes.- - - - - - - - - - ranking = 1keywords = infection (Clic here for more details about this article) |
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