1/23. Isolation of stachybotrys from the lung of a child with pulmonary hemosiderosis.Recently, stachybotrys atra, a toxigenic fungus, has been implicated as a potential cause of pulmonary hemorrhage/hemosiderosis in infants living in water-damaged homes. Although epidemiologic evidence supports this association, neither the organism nor its toxic products has ever been recovered from humans. We report the first case in which stachybotrys was isolated from the bronchoalveolar lavage fluid of a child with pulmonary hemorrhage. stachybotrys was also recovered from his water-damaged home. The patient recovered completely after his immediate removal from the environment and subsequent cleaning of his home. This case provides further evidence that this fungus is capable of causing pulmonary hemorrhage in children.- - - - - - - - - - ranking = 1keywords = environment (Clic here for more details about this article) |
2/23. Multiple lung abscesses due to Ochroconis gallopavum, a dematiaceous fungus, in a nonimmunocompromised wood pulp worker.An occurrence of multiple chronic lung abscesses managed by lobectomy is described. These abscesses were present for 13 years in the patient, a nonimmunocompromised wood pulp worker. The patient had hemoptysis at presentation. The organism isolated was Ochroconis gallopavum, a dematiaceous fungus known to cause disease in immunocompromised patients and epidemic encephalitis in poultry. The fungus is typically found in warm environments and in decaying compost; for this reason, we postulate that his illness was occupationally acquired.- - - - - - - - - - ranking = 1keywords = environment (Clic here for more details about this article) |
3/23. Bioaerosol lung damage in a worker with repeated exposure to fungi in a water-damaged building.There has been increased concern over health effects related to potential exposure of building occupants to bioaerosols. We report the case of a worker with a respiratory illness related to bioaerosol exposure in a water-damaged building with extensive fungal contamination. We performed environmental tests to evaluate potential exposure to fungi, and we used mycotoxin-specific IgG antibody in serologic studies in the attempt to evaluate exposure to mycotoxins. Extensive fungal contamination was documented in many areas of the building. penicillium, aspergillus, and stachybotrys species were the most predominant fungi found in air sampling. Our serologic test was not useful in differentiating workers who were probably occupationally exposed to mycotoxins from those who were not; however, it did yield evidence that individuals may make specific IgG antibodies to macrocyclic tricothecene mycotoxins. Further research is needed concerning health effects related to bioaerosol exposures, particularly regarding markers of exposure to specific fungi that may produce mycotoxins. In the absence of clinical tools specific for evaluation of mycotoxin-related illness, a systematic clinical approach for evaluating persons with suspected building-related respiratory illness is warranted.- - - - - - - - - - ranking = 1keywords = environment (Clic here for more details about this article) |
4/23. Donor transfer of pulmonary coccidioidomycosis in lung transplantation.Transplant recipients living in endemic areas are at high risk of aerosol-transmitted fungal infections because of environmental exposure while on immunosuppressive drugs, as well as reactivation of latent infection from either the patient's or the donor's organs. The latter may account for early development of coccidioidomycosis after transplantation. We describe a case of pulmonary coccidioidomycosis in a lung transplant recipient who acquired the infection from the donor lung and presented with fulminant pneumonia in the immediate postoperative period.- - - - - - - - - - ranking = 1keywords = environment (Clic here for more details about this article) |
5/23. Nosocomial invasive aspergillosis in a heart transplant patient acquired during a break in the HEPA air filtration system.We report a case of nosocomially acquired invasive aspergillosis (IA) in a low-risk heart transplant recipient due to a break in the air conditioning system. A high overload of aspergillus spores in the intensive care unit room led this patient to acquire IA. Identical environmental and patient isolates allowed our hypothesis to be confirmed and a very precise incubation time to be estimated.- - - - - - - - - - ranking = 1keywords = environment (Clic here for more details about this article) |
6/23. Disseminated miliary blastomycosis leading to acute respiratory failure in an urban setting.Disseminated blastomycosis, usually a chronic slowly progressive illness, primarily occurs in individuals with a history of exposure to a rural environmental source. We report a case of disseminated blastomycosis leading to acute respiratory failure in a young man confined to prison in an urban area.- - - - - - - - - - ranking = 1keywords = environment (Clic here for more details about this article) |
7/23. hypersensitivity pneumonitis in a hardwood processing plant related to heavy mold exposure.Two workers employed in a hardwood floor plant presented symptoms suggestive of hypersensitivity pneumonitis (HP). At that plant, kiln-dried wood often shows moldy growth and is subsequently brought inside for processing. This study evaluated the environment in attempt to identify the causative antigen and verify whether other workers of this and similar plants had or were at risk of developing HP. dust from dust-removing systems and molds on the surface of wood planks were collected and air samples taken from a sister plant. blood samples, spirometry, and symptoms' questionnaires were obtained from 11 co-workers. Dense paecilomyces growth was observed on the surface of the dried processed wood in the index plant. This fungal genus was not detected in the sister plant. An additional worker had symptoms suggestive of HP, and his bronchoalveolar lavage revealed a lymphocytic alveolitis. The 3 confirmed cases of HP and the other 10 workers had positive specific IgG antibodies to paecilomyces. We report 3 cases of HP out of 13 workers and a 100% sensitization to molds in workers of a hardwood processing plant. This rate is much higher than what is commonly seen in other environments associated with HP. The drying process is suspected of being responsible for the massive paecilomyces contamination likely responsible for the HP.- - - - - - - - - - ranking = 2keywords = environment (Clic here for more details about this article) |
8/23. Isolation of exophiala dermatitidis from endotracheal aspirate of a cancer patient.exophiala (Wangiella) dermatitidis is a melanised (darkly pigmented) yeast-like organism that has been reported from the environment and wild animals. The organism is a frequent coloniser of lungs of patients with cystic fibrosis and causes occasional disseminated phaeohyphomycosis and fungaemia. exophiala dermatitidis is distributed worldwide, but cerebral cases are restricted to East asia. We report a case of 54-year-old Qatari female patient with a known history of cancer, suffering from pulmonary disorder. culture of endotracheal aspirate revealed the growth of E. dermatitidis concomitant with candida krusei. The final diagnosis of E. dermatitidis and attribution to genotype B was achieved by sequencing the rDNA internal transcribed spacer (ITS) region. The present case concerns a pulmonary colonisation by E. dermatitidis, similar to that commonly seen in cystic fibrosis patients. For the detection of E. dermatitidis in clinical specimens culturing techniques are required. The patient finally expired with persistent cancer and C. krusei fungaemia. review of literature and listing of E. dermatitidis cases published after 1992 show a sharp increase in clinical cases during the 1990s.- - - - - - - - - - ranking = 1keywords = environment (Clic here for more details about this article) |
9/23. Respiratory failure caused by adiaspiromycosis.Adiaspiromycosis is a rare pulmonary disorder caused by the fungus Emmonsia crescens (or chrysosporium parvum var crescens). According to the amount of inhaled conidia, man may develop symptomatic disease. After reaching the alveoli, the adiaconidia do not multiply or disseminate, but will induce a granulomatous inflammatory reaction that may lead to fatal respiratory failure. Up to now, only five cases of disseminated pulmonary infection have been documented. This work describes the occurrence, in brazil, of two further cases of symptomatic disease with diffuse interstitial infiltrates and severe functional impairment. Possible massive infestation during activities in closed and stuffy environments is suggested. The specific diagnosis was troublesome and could not be made by cultures, skin tests or bronchoalveolar lavage. Both patients were successfully treated, but a spontaneous resolution of the process is seriously considered.- - - - - - - - - - ranking = 1keywords = environment (Clic here for more details about this article) |
10/23. Disseminated aspergillus terreus infection in immunocompromised hosts.aspergillus terreus is ubiquitous in the environment but has rarely been found to be pathogenic. When recovered from clinical specimens, it is commonly considered a saprophyte. We report two cases of fatal disseminated A. terreus infection. The first patient was receiving corticosteroid therapy for immune thrombocytopenia when the condition developed, and the second patient was receiving immunosuppressive therapy after bone marrow transplantation for myelodysplasia. We also describe the frequency of recovery of A. terreus in our laboratory. The serious pathogenic potential of A. terreus in immunocompromised hosts should be recognized.- - - - - - - - - - ranking = 1keywords = environment (Clic here for more details about this article) |
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