1/28. acremonium keratitis in a patient with herpetic neurotrophic corneal disease.fungi belonging to the genus acremonium Link ex Fries 1821 are ubiquitous environmental contaminants and soil saprophytes, but are infrequent pathogens in humans. These filamentous fungi (previously known as Cephalosporium) are an uncommon cause of mycotic keratitis. As in the case of other filamentous fungi, corneal trauma with contaminated matter is the most frequent risk factor for the infection. We report in this paper a case of keratomycosis caused by Acremoniumpotronii, in a patient with a history of herpetic keratitis. Medical treatment with amphotericin b was unsuccessful and the infection eventually resolved with penetrating keratoplasty.- - - - - - - - - - ranking = 1keywords = environment (Clic here for more details about this article) |
2/28. hypersensitivity pneumonitis caused by fusarium napiforme in a home environment.BACKGROUND: We report a case of hypersensitivity pneumonitis (HP) in a 17-year-old male student caused by fusarium napiforme found in his home environment. methods: The patient was diagnosed according to history, chest radiograph, spirometry, high-resolution chest CT, and transbronchial lung biopsy. To identify the causative agent, cultured aeromolds were collected by the open-plate method. From the main fungi cultured, fungal antigens were prepared, and immunoblot analysis with the patient's serum and each fungal antigen was performed. RESULTS: Five fungal species were isolated from the patient's home. immunoblotting analysis with the patient's serum demonstrated more than 10 IgG-binding fractions to F. napiforme extract only, while little binding was noted with the other fungal antigens. CONCLUSIONS: We should be aware that HP may be caused by F. napiforme in the home environment.- - - - - - - - - - ranking = 6keywords = environment (Clic here for more details about this article) |
3/28. alternaria-associated asthma.In addition to house dust mites, there is increasing evidence that mold allergens, especially alternaria, are implicated in contributing to allergic reaction, rhinitis, and asthma indoors. Situations leading to the exacerbation of asthma in an employee were investigated and subsequent medical evaluations were performed. An industrial hygiene study was conducted and bioaerosol testing revealed several mold allergens were present. However, based on the medical evaluation and testing results (skin prick test and radioallergosorbent test [RAST]), it was concluded that alternaria was inducing the respiratory reaction. alternaria was present in the drip pan of the air conditioner unit and remedial actions were taken to remove the mold. Post-remedial bioaerosol sampling results revealed alternaria was no longer present in the air and the employee returned to the office without recurrence of symptoms. Practically, several factors should be considered prior to concluding an association between exposure and illness. First, the employee's symptoms and signs should be consistent with a medical diagnosis. Second, there should be either in vitro or in vivo evidence of exposure. Third, environmental assessment should reveal evidence of plausible biological exposure. Fourth, there should be substantial improvement or even resolution of the illness after appropriate remediation of the health hazard. This case study illustrates the importance of teamwork by industrial hygienists and occupational health physicians in treatment and prevention of occupational and environmental diseases.- - - - - - - - - - ranking = 2keywords = environment (Clic here for more details about this article) |
4/28. Successful treatment of disseminated fusarium infection in an infant with leukemia.Disseminated fusarium infection in an immunocompromised host is intractable and results in high mortality. We provide the first full case report on successful treatment of a disseminated fusarium infection in an infant. The 6-month-old infant, whose family raised livestock, had infantile leukemia. During the neutropenic period after intensive chemotherapy, vomiting, diarrhea, fever, subcutaneous nodes, and coughing appeared. pneumonia was diagnosed, and fusarium moniliforme was isolated from blood culture. A central venous catheter was removed. granulocyte colony-stimulating factor (G-CSF) and amphotericin b (AMPH-B) (total dose, 65 mg/kg) were administered continuously for 8 weeks. The infection was resolved according to improvement of clinical and laboratory findings, and intensive chemotherapy was restarted for the leukemia. cord blood stem cell transplantation from an unrelated donor was performed. The fusarium infection did not recur, but after transplantation, leukemia relapsed. Treatment of neutrophils using G-CSF, AMPH-B, and local treatment induced resolution of the disseminated fusarium infection in this immunocompromised host with malignancy. We suggest caution for patients living in an environment conducive to the development of fusarium infection because of the particular risk of infection.- - - - - - - - - - ranking = 1keywords = environment (Clic here for more details about this article) |
5/28. Fungal peritonitis caused by Curvularia species in a child undergoing peritoneal dialysis.We report the first case of peritonitis caused by Curvularia species in a child undergoing peritoneal dialysis. He presented with gray-black proteinaceous material obstructing the lumen of his Tenckhoff catheter. Although the peritoneal fluid was cloudy, the patient suffered neither significant abdominal tenderness nor systemic symptoms. Catheter removal and treatment with amphotericin b allowed complete recovery and return to peritoneal dialysis within 7 days. Outdoor play in a wooded environment may have allowed contact of this saprophytic fungus with the child's indwelling catheter transfer set.- - - - - - - - - - ranking = 1keywords = environment (Clic here for more details about this article) |
6/28. Fatal endocarditis in a neonate caused by the dematiaceous fungus Phialemonium obovatum: case report and review of the literature.Phialemonium species are grouped by most authorities among the dematiaceous fungi. Like several other darkly pigmented fungi, they appear to be an emerging cause of human disease, especially in the immunocompromised host. As numbers of immunocompromised patients increase, the trend of unusual fungi emerging as new pathogens is set to continue. Previous experience suggests that reports of rare fungal infections among selected patients often heralds the emergence of infection in a wider population of patients. We report a case of fatal endocarditis caused by Phialemonium obovatum in a premature neonate. To our knowledge this is the first documented case of native valve endocarditis due to this species, and we review the literature on invasive disease caused by the species. Unfamiliar fungal isolates are frequently misidentified or mistaken for environmental contaminants, and because of their relative rarity, data upon which to base antifungal treatment are limited. Thus, the diagnosis and treatment of unusual fungal pathogens present a significant challenge to clinicians and microbiologists alike. Early referral of such isolates to a specialist reference laboratory is advisable.- - - - - - - - - - ranking = 1keywords = environment (Clic here for more details about this article) |
7/28. Disseminated paecilomyces lilacinus infection in a patient with AIDS.We describe a case of disseminated paecilomyces lilacinus infection occurring in a patient with advanced hiv infection. P lilacinus is a ubiquitous environmental fungus that has been associated with infection in various immunocompromised hosts, in patients with invasive medical devices, and in contact-lens wearers. The clinical features, morphologic characteristics, and response to antifungal therapy in our patient are similar to findings reported in disseminated infection due to penicillium marneffei, another opportunistic fungal infection in hiv-infected patients. We believe this to be the first report of infection with P lilacinus in a patient with AIDS.- - - - - - - - - - ranking = 1keywords = environment (Clic here for more details about this article) |
8/28. Brainstem auditory evoked response in adolescents with acoustic mycotic neuroma due to environmental exposure to toxic molds.Indoor air contamination with toxic opportunistic molds is an emerging health risk worldwide. Some of the opportunistic molds include: stachybotrys chartarum, aspergillus species (A. fumigatus, A. flavus, A. niger, A. versicolor etc.), Cadosporium, alternaria, penicillium, trichoderma, fusarium graminearum etc. These molds flourish in homes that are moist and damp. Reports of floods are now evident in many parts of the world. With these global changes in climatic conditions that favor the opportunistic mode of living among these molds, some health authorities are beginning to feel concerned about the diversity and the extent to which opportunistic molds can cause adverse health effects in humans. mycotoxicosis is the collective name for all the diseases caused by toxic molds. Frequently, we have cases of acoustic neuroma due to mycotoxicity in our Center. Mycotic neuroma probably has not been reported before and the application of brainstem auditory evoked response (BAER) techniques in acoustic mycotic neuroma have not been reported either. The aim of this study, therefore, was to report cases and measurements of acoustic mycotic neuroma in adolescents using the brainstem auditory evoked response. The patients' case history, clinical neurological and neurobehavioral questionnaires were assessed. Then, the BAERs were recorded between Cz and Ai, with a second channel, Cz-Ac. The case histories and the questionnaires were analyzed in conjunction with the outcome of the objective brainstem auditory evoked response measurements. The prevalent subjective findings in the patients were headaches, memory loss, hearing loss, lack of concentration, fatigue, sleep disturbance, facial swelling, rashes, nosebleeds, diarrhea, abdominal pains and respiratory difficulties. Objective BAER showed overall abnormalities in all the patients. Although the waveform abnormalities varied, 1-3 interpeak latencies were abnormal in all the patients. overall results showed the presence of acoustic mycotic neuroma and confirmed the sensitivity and usefulness of BAER in screening acoustic mycotic neuroma and sensorineural auditory dysfunction.- - - - - - - - - - ranking = 4keywords = environment (Clic here for more details about this article) |
9/28. Indoor mold spore exposure: a possible factor in the etiology of multifocal choroiditis.PURPOSE: To report on the correlation between indoor mold exposure and a case of multifocal choroiditis (MFC). DESIGN: Observational case report. methods: A 37-year-old woman diagnosed with MFC who had had extensive mold exposure underwent an allergic evaluation, including a comprehensive environmental history, physical examination, radioallergosorbent test, and skin testing. RESULTS: The patient's vision deteriorated after numerous recurrences of MFC triggered by exposure to extremely high mold environments (mold counts recorded between 3,000 and 13,000 mold spores/m(3)). CONCLUSIONS: Exposure to high indoor mold count environments may be a factor in the etiology of MFC. Further studies are indicated.- - - - - - - - - - ranking = 3keywords = environment (Clic here for more details about this article) |
10/28. Postmortem isolation of Pseudotaeniolina globosa from a patient with aortic aneurysm.We describe the isolation of the melanized meristematic fungus Pseudotaeniolina globosa from the aortic wall of a patient who died while undergoing surgery for aortic aneurysm and aortic valve regurgitation as a result of dilated cardiomyopathy. Meristematic fungi related to P. globosa have until now been considered as environmental saprobes found predominantly in ecological niches with low water activity. The isolate was identified by phenotypic analyses and by sequencing of the rDNA internal-transcribed spacer domain. The clinical significance of this isolation remains unclear but isolation of meristematic fungi from clinical specimen should be thoroughly evaluated in terms of their significance in future.- - - - - - - - - - ranking = 1keywords = environment (Clic here for more details about this article) |
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