1/37. A resuscitated case from asphyxia by large bronchial cast.A 62-year-old woman with bronchiectasis suffered from asphyxia due to a large bronchial cast that obstructed the bronchial tree. Immediate bronchoscopic suction of a bronchial cast of 17 cm in length through the intubated tube relieved the patients without any complications. Large bronchial casts appear to be rare in this century but it should be considered in patients with acute exacerbation of excessive sputa not only in patients with asthma or allergy but also in patients with respiratory tract infection.- - - - - - - - - - ranking = 1keywords = infection (Clic here for more details about this article) |
2/37. Pseudomembranous gastritis: a novel complication of aspergillus infection in a patient with a bone marrow transplant and graft versus host disease.A 36-year-old Hispanic man who had undergone allogeneic bone marrow transplantation, complicated by graft versus host disease, was admitted with acute gastrointestinal symptoms, including severe diarrhea and diffuse abdominal pain. He also had a persistent cough with sputum production. Blood cultures yielded escherichia coli, and sputum cultures grew Apergillus species. The patient was treated with antifungal agents and broad-spectrum antibiotics. Despite aggressive medical therapy, the patient died 10 days after admission. Postmortem examination disclosed severe, bilateral confluent bronchopneumonia, with numerous septated branching hyphae consistent with aspergillus species fungal organisms that involved the pulmonary parenchyma and tracheobronchial tree. Although the small and large bowels were only mildly congested, the entire gastric mucosa was covered with a 1.5-cm-thick pseudomembrane that contained numerous aspergillus organisms. Our report represents the first description, to our knowledge, of a diffuse inflammatory pseudomembrane in the stomach, a complication that to date has only been associated with small and large bowel involvement.- - - - - - - - - - ranking = 4keywords = infection (Clic here for more details about this article) |
3/37. actinomyces peritonitis associated with dialysis.A case of actinomyces peritonitis occurring in a young girl undergoing regular dialytic treatment is reported. The peritoneal localization was the only one detectable and occurred in a patient who at the beginning of the dialytic treatment had received peritoneal dialysis on two occasions. During 4 months of treatment the patient underwent surgical drainage of the peritoneal fluid and medical treatment with various antibiotics. Super-infection with escherichia coli and candida, and an acute episode of bronchopneumonia, complicated the course of the treatment which was finally successful- - - - - - - - - - ranking = 1keywords = infection (Clic here for more details about this article) |
4/37. herpes simplex virus bronchopneumonia in a non-immunocompromized individual.We report a rare case of herpes simplex virus (HSV) bronchopneumonia in an otherwise healthy middle-aged individual. bronchoscopy indicated scattered white-coated lesions in the bronchial mucosa. The diagnosis was established following immunohistopathological staining for HSV of specimens obtained by bronchial biopsy. This case suggests that HSV could be a pathological agent of not only oral and genital mucosal lesions but also lower respiratory tract infection.- - - - - - - - - - ranking = 1keywords = infection (Clic here for more details about this article) |
5/37. Sudden death of an infant with 'an early epileptic encephalopathy'.This article reports an autopsy case of sudden death of an infant with an infrequent encephalopathy involving epileptic episodes. The infant was a 1-year and 10-month-old boy, who had a history of the first convulsive seizures in the third month after birth. The clinical diagnosis was described as 'an early infantile epileptic encephalopathy with suppression-bursts' (Ohtahara syndrome). On a winter day, he was collapsed following a high fever and was already dead on the arrival at a hospital. The body was small for the age and poorly nourished. The autopsy and postmortem magnetic resonance imaging scan (MRI) of formalin-fixed brain revealed advanced unsymmetric brain atrophy with cortical dysplasia, which were prominent in the left temporal and right occipital lobes, and sclerotic atrophy of the parahippocampal gyri, additionally showing a feature of the olivo-ponto-cerebellar atrophy. However, the cause of death was pathologically and microbiologically determined as bacterial bronchopneumonia following pulmonary infection of the influenza a virus. In sudden death cases of physically handicapped infants, the investigation of viral infection in consideration of an epidemiological survey is important even when the death can be pathomorphologically explained.- - - - - - - - - - ranking = 2keywords = infection (Clic here for more details about this article) |
6/37. dyskeratosis congenita with isolated neutropenia and granulocyte colony-stimulating factor treatment.A 3-year-old Turkish boy with a history of chronic cough, recurrent bronchopneumonia, and a borderline sweat chloride test (40 mEq/L) was referred for further evaluation to our department. He was born at term (2100 g) to a marriage with no consanguinity. His mother and father were 40 and 46 years old, respectively. physical examination (Fig. 1) revealed hypopigmented, atrophic, and hyperkeratotic skin lesions surrounded by reticulate hyperpigmentation on the entire body, predominantly on the face, neck, arms, shoulders, and legs, which had been noticed initially at the age of 18 months. Dystrophic toenails, sparse and thin hair, and phimosis were also observed. Laboratory tests disclosed an isolated neutropenia (white blood cell count, 1800/mm3). Bone marrow (BM) aspiration showed a decreased myelopoiesis without myelodysplastic changes, but normal erythropoiesis, megakaryopoiesis, and normal stroma. Lymphocyte subgroups containing CD4, CD5, CD6, CD8, CD19, CD23, and CD25, and immunoglobulin g (IgG), IgM, IgA, and IgE, were in the normal range; hemoglobin F (HbF), 2.8%. Spontaneous and clastogen-induced chromosome breaks were not increased. A skin biopsy showed increased pigmentation at the basal layer, dyskeratotic epidermal cells, and marked IgM deposition and cytoid bodies and mild IgA and IgG deposits at the dermo-epidermal junction. Lactate response to glucose challenge, amino acid chromatography, and urine organic acid analysis were normal. A diagnosis of dyskeratosis congenita (DC) was made with typical skin lesions, dystrophic toenails, thin and sparse hair, and neutropenia with decreased myelopoiesis in BM. Treatment with granulocyte colony-stimulating factor (G-CSF) was considered for the neutropenia. As the increase in neutrophil count at a dose of 5 microg/kg was not adequate, 10 microg/kg G-CSF was tried (Fig. 2). With 10 microg/kg once to three times a week, a 1.8-4.8-fold increase in the absolute neutrophil count (ANC) was achieved with no side-effects. Treatment was more frequent during infection (days 22-28).- - - - - - - - - - ranking = 1keywords = infection (Clic here for more details about this article) |
7/37. fatal outcome of varicella in children.Varicella or chicken-pox are one of the most frequent diseases in childhood. Severe or even lethal complications are rare (in about 0.03 per thousand ). Our paper presents two cases of varicella infections leading to sudden deaths (3- and 7-year-old children). In one of these cases, the paediatrician in charge was accused of an impaired medical treatment. Both of the children showed multiple typical efflorescences in different stages. Furthermore were observed affections of the respiratory tracts and serious involvements of the hearts, the lungs, and the livers. In one case an immunological identification could be made of an acute varicella infection. Based on autoptical, histological, bacteriological, virological, and neuropathological findings is given an analysis of such uncommon and severe courses of chicken-pox in children being identified as haemorrhagic form and massive abscess-forming varicella pneumonia.- - - - - - - - - - ranking = 2keywords = infection (Clic here for more details about this article) |
8/37. Sudden death in growth hormone-treated children with prader-willi syndrome.A 4-year-old boy with prader-willi syndrome died suddenly while asleep on day 67 of growth hormone treatment. During treatment, snoring had worsened. autopsy showed multifocal bronchopneumonia. This case and two others recently published suggest that growth hormone may be associated with obstructive apnea, respiratory infection, and sudden death in this condition.- - - - - - - - - - ranking = 1keywords = infection (Clic here for more details about this article) |
9/37. Outbreak and persistence of chlamydia pneumoniae infection in an Italian family.We describe an outbreak of familial infection of chlamydia pneumoniae, an etiological agent for respiratory tract infections. In a family member detection of C. pneumoniae on a pharyngeal swab by polymerase chain reaction was positive until four months after the onset of symptoms, despite a course of antibiotics known to be effective against chlamydia species- - - - - - - - - - ranking = 6keywords = infection (Clic here for more details about this article) |
10/37. Congenital X-linked ataxia, progressive myoclonic encephalopathy, macular degeneration and recurrent infections.We report on 2 boys (maternal cousins), with severe congenital ataxia with generalized hypotonia, psychomotor retardation and recurrent bronchopulmonary infections. Later, they developed myoclonic encephalopathy and macular degeneration. Serial brain imaging investigations showed a cyst of the septum pellucidum, persistence of the cavum vergae, corpus callosum and cerebellar vermis hypoplasia without cortical atrophy. In the maternal pedigree, 5 males had recurrent bronchopneumonia associated with severe congenital hypotonia and died during the first years of life. Neurophysiological studies, including nerve conduction velocities, brainstem auditory evoked responses, somatosensory evoked potentials were normal. Electroretinogram showed normal wave morphology. Visual evoked potentials were mildly impaired. Extensive screening for metabolic disease gave normal results. Immunologic investigations showed normal T and B cell number, T cell function and immunoglobulin levels in both patients with a reduced level of IgG2 subclass in one.- - - - - - - - - - ranking = 5keywords = infection (Clic here for more details about this article) |
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