1/236. Invasive infections due to Clavispora lusitaniae.Three cases of Clavispora lusitaniae invasive fungal infections are reported. All three infections appeared in cancer patients presented with fungaemia, one additionally with meningitis. Two of them were breakthrough -- they developed during therapy with conventional amphotericin b with a dose of 0.5 mg kg(-1) day(-1) . All three were cured: two with intravenous fluconazol and one with an increasing dose (1 mg kg(-1) day(-1)) of amphotericin b. In one of two breakthrough cases the sensitivity of the strain to antifungals was tested against antifungal agents and showed in vitro resistance to amphotericin b (MIC 2 eta g ml(-1)).- - - - - - - - - - ranking = 1keywords = infection (Clic here for more details about this article) |
2/236. Candida dubliniensis candidemia in patients with chemotherapy-induced neutropenia and bone marrow transplantation.The recently described species Candida dubliniensis has been recovered primarily from superficial oral candidiasis in hiv-infected patients. No clinically documented invasive infections were reported until now in this patient group or in other immunocompromised patients. We report three cases of candidemia due to this newly emerging Candida species in hiv-negative patients with chemotherapy-induced immunosuppression and bone marrow transplantation.- - - - - - - - - - ranking = 0.16666666666667keywords = infection (Clic here for more details about this article) |
3/236. Fungal endocarditis in critically ill children.All cases of infective endocarditis occurring from January 1990 to December 1996 at our institution were reviewed, with a special focus on fungal endocarditis. Five critically ill children with fungal endocarditis and eleven children with bacterial endocarditis were recorded. The proportion of fungal endocarditis in our series was 5/16 (31%) and candida albicans (4/5) was the most common fungal pathogen. Only one patient required heart surgery because of a loose patch but all the others were treated only by medical management for cure. The hospital survival rate was 80% (4/5) and the overall long-term survival rate was 60% (3/5) with only one death directly related to fungal infection. CONCLUSION: Despite the small number of cases, a sole medical approach including amphotericin b and long-term fluconazole prophylaxis for the treatment of fungal endocarditis in critically ill children seems to offer an alternative to surgical treatment which may be kept for failure of medical treatment.- - - - - - - - - - ranking = 0.16666666666667keywords = infection (Clic here for more details about this article) |
4/236. Phialemonium fungemia: two documented nosocomial cases.Two fungal isolates recovered from the blood of two immunosuppressed patients are described as Phialemonium curvatum. One patient died, while the other, who was infected with exophiala jeanselmei at the same time, survived after successful treatment with itraconazole. Analysis of internal transcribed spacer sequences demonstrated that the isolates belonged to the same strain and that the source of infection was probably a catheter. The taxonomic position of P. curvatum is discussed, and Phialemonium dimorphosporum is considered a synonym. The in vitro inhibitory activities of six antifungal agents (amphotericin b, itraconazole, ketaconazole, miconazole, flucytosine, and fluconazole) were determined against seven isolates of Phialemonium. Except for flucytosine, all of them were remarkably effective. Phialemonium should be added to the list of potential causes of nosocomial fungemia in cancer patients.- - - - - - - - - - ranking = 0.16666666666667keywords = infection (Clic here for more details about this article) |
5/236. candida glabrata fungemia. Clinical features of 139 patients.Candida species are now the fourth leading cause of nosocomial bloodstream infection in hospitalized patients, and non-candida albicans species now surpass candida albicans. The clinical features of the most common non-candida albicans species, Candida (Torulopsis) glabrata, have not been well studied. We retrospectively reviewed the clinical features of 139 patients with C. glabrata blood-stream infection over a period of 7 years. The mean age of patients was 62 years, and the most common admitting diagnoses were malignancy (28%) and coronary artery disease (18%). The most common identified portals of entry were abdominal (22%) and intravascular catheters (16%). At the time of fungemia, 63% of patients had fever, 45% had change in mental status, and 30% were in septic shock. Three of 50 patients examined by an ophthalmologist had chorioretinitis. The overall hospital mortality was 49%. Factors associated with increased mortality in a regression model were prior abdominal surgery (odds ratio [OR] = 2.8; 95% confidence interval [CI] = 1.2-6.3, p = 0.01), and an elevated creatinine (OR = 2.2; 95% CI = 1.0-4.7, p = 0.05). When early deaths (< or = 72 hours) were censored, amphotericin b treatment and total dose were associated with reduced mortality (OR = 0.2; 95% CI = 0.1-0.4, p < 0.001). Nosocomial C. glabrata fungemia is not just a disease of debilitated and neutropenic patients, but affects a wide variety of patients and is associated with a high mortality.- - - - - - - - - - ranking = 0.33333333333333keywords = infection (Clic here for more details about this article) |
6/236. Successful treatment with methylprednisolone pulse therapy for a life-threatening pulmonary insufficiency in a patient with chronic granulomatous disease following pulmonary invasive aspergillosis and burkholderia cepacia infection.A 14-year-old boy with X-linked chronic granulomatous disease developed severe invasive pulmonary aspergillosis. He was treated with itraconazole and amphotericin b. However, he deteriorated with progressive pulmonary lesions. burkholderia cepacia was isolated from his bronchoalveolar lavage. Finally, he was given granulocyte transfusions. Following this procedure, his condition rapidly worsened leading to respiratory failure. His lung biopsy demonstrated organizing pneumonia at his right middle lobe. Then, a methylprednisolone pulse therapy was initiated together with the administration of appropriate antibiotics and adequate amounts of amphotericin b. Dramatically, his condition improved. Therefore, a methylprednisolone pulse therapy with appropriate antimicrobial drugs seems to be beneficial for severe pulmonary insufficiency in this type of patients. copyright copyright 1999 S. Karger AG, Basel- - - - - - - - - - ranking = 0.66666666666667keywords = infection (Clic here for more details about this article) |
7/236. fungemia due to fusarium sacchari in an immunosuppressed patient.The fungus fusarium sacchari was isolated repeatedly from the blood of an immunosuppressed host. The infection was treated successfully with a small dose of amphotericin b. The strain was resistant to this antifungal in vitro. MICs and minimum fungicidal concentrations of six antifungals for the clinical isolate are provided. To our knowledge, this is the first report involving this fungus in a case of fungemia.- - - - - - - - - - ranking = 0.16666666666667keywords = infection (Clic here for more details about this article) |
8/236. Fatal disseminated infection by scedosporium prolificans during induction therapy for acute leukemia: a case report and literature review.We report a case of fatal disseminated fungal infection by scedosporium prolificans which occurred in a patient with acute leukemia during induction chemotherapy. Rapid clinical deterioration despite high-dose empirical amphotericin b highlights both the pathogenicity of this fungus in immunocompromised hosts and its resistance to standard antifungal therapy.- - - - - - - - - - ranking = 0.83333333333333keywords = infection (Clic here for more details about this article) |
9/236. Candida dubliniensis fungemia: the first four cases in north america.We report the first four North American cases of Candida dubliniensis fungemia, including the first isolation of this organism from the bloodstream of an hiv-infected person. All isolates were susceptible in vitro to commonly used antifungal drugs. This report demonstrates that C. dubliniensis can cause bloodstream infection; however, the incidence of disease is not known.- - - - - - - - - - ranking = 0.16666666666667keywords = infection (Clic here for more details about this article) |
10/236. Possible role of catheters in saccharomyces boulardii fungemia.Four cases of saccharomyces boulardii fungemia, a very rare side effect of saccharomyces boulardii therapy, are reported. The clinical impact of saccharomyces boulardii infection appeared to be moderate. However, even though organ involvement was never demonstrated, septic shock with no other etiology was observed in one of our patients. All patients had an indwelling vascular catheter. Contamination of the air, environmental surfaces, and hands following the opening of a packet suggests that catheter contamination may have been a source of infection. To prevent catheter contamination it is recommended that packets or capsules of saccharomyces boulardii be opened with gloves, outside the patient's room.- - - - - - - - - - ranking = 0.33333333333333keywords = infection (Clic here for more details about this article) |
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