1/44. Successful treatment of candidal osteomyelitis with fluconazole following failure with liposomal amphotericin b.A case of multiple relapses of candida albicans infection of deep tissues is described. Treatment was complicated by renal impairment, but therapy with a liposomal amphotericin product failed to eradicate the third recurrence which subsequently resolved after protracted exposure to oral fluconazole.- - - - - - - - - - ranking = 1keywords = candida (Clic here for more details about this article) |
2/44. Reversible catecholamine-induced cardiomyopathy in a heart transplant candidate without persistent or paroxysmal hypertension.BACKGROUND: Both dilated and hypertrophic cardiomyopathy have been reported in patients with pheochromocytoma, who were almost always hypertensive. The outcome frequently has been fatal, yet cardiac dysfunction can be reversible after medical or surgical therapy for the pheochromocytoma. methods: We report the case of a patient with dilated cardiomyopathy without persistent or paroxysmal hypertension, who was found to have a pheochromocytoma during initial medical evaluation. RESULTS: The identification and treatment of the pheochromocytoma led to significant improvement in cardiac function and cardiac transplantation was avoided. CONCLUSIONS: This case illustrates some unusual features in pheochromocytoma-induced cardiomyopathy: (1) absence of persistent or paroxysmal hypertension, (2) initial presentation with acute myocardial infarction and normal coronary arteries, and (3) recurrent episodes of nonsustained ventricular tachycardia.- - - - - - - - - - ranking = 1keywords = candida (Clic here for more details about this article) |
3/44. Renal transplantation in scleroderma.Although the outcome of renal transplantation in patients with systemic lupus erythematosus (SLE) has been studied, there are few reports about the outcome of patients with systemic sclerosis who have undergone renal transplantation. We retrospectively collected data from the United Network for Organ Sharing (UNOS) Scientific Renal Transplant Registry from a 10-year period. From 1987 to 1997, 86 patients with systemic sclerosis who had renal transplantation were identified. Of these 86 patients, 70% were women, 86% were Caucasian, and the mean age at transplantation was 50.4 years. The overall mortality was 24% of the patient group; 44% (38/86) of renal grafts failed. First- through fifth-year graft survival rates were 62%, 60%, 57%, 50%, and 47%, respectively. The causes of graft failure could not be ascertained in 24 of 38 patients (63%). Among the known causes, 5 had acute rejection, 4 had chronic rejection, 3 had recurrence of scleroderma, and 1 each had infection and graft thrombosis. Immunosuppressive regimens used in the patients with systemic sclerosis consisted of antilymphocyte globulin in at least 25%. Sixty percent received a combination of steroids, azathioprine, and cyclosporine. The use of cyclosporine was not associated with either improvement of graft survival or an increased rate of graft failure. graft survival at 5 years in patients with systemic sclerosis was comparable to that of patients with SLE who received renal transplantation, according to existent medical literature. Based upon these data, renal transplantation is as effective a treatment for restoring renal function in patients with systemic sclerosis as it is in patients with SLE. Those patients with systemic sclerosis whose renal function did not improve with angiotensin-converting enzyme (ACE)-inhibitor treatments after scleroderma renal crisis should be considered as transplant candidates. Although the data are incomplete, the use of cyclosporine may not confer the advantage of improving graft survival in patients with systemic sclerosis as compared with SLE patients.- - - - - - - - - - ranking = 0.25keywords = candida (Clic here for more details about this article) |
4/44. Early aneurysm recurrence after technically satisfactory Guglielmi detachable coil therapy: is early surveillance needed? Case report.Guglielmi detachable coil (GDC) therapy was initially intended as a treatment for select patients harboring aneurysms deemed to be at high risk for clip ligation. As experience with the technique has grown, many centers are now offering GDC therapy as a primary treatment to patients who are also good surgical candidates. The authors report a case in which a ruptured anterior communicating artery aneurysm recurred within 2 weeks of a technically satisfactory GDC procedure. The patient subsequently underwent successful surgery for clip ligation of the lesion. This is the earliest reported recurrence of an aneurysm after angiographically confirmed successful GDC therapy and underscores the need for performing early control angiography in patients undergoing this procedure.- - - - - - - - - - ranking = 0.25keywords = candida (Clic here for more details about this article) |
5/44. Case studies of the hepatitis b patient: a panel discussion.In recent years, there have been significant advances in the treatment of patients with hepatitis b who are candidates for liver transplantation. This includes the prevention and management of hepatitis b posttransplantation. However, there is no established protocol for treating these patients. Ultimately, the goal would be to have patients HBV-dna negative pretransplantation and then to prevent HBV recurrence posttransplantation to help ensure their quality of life. Several clinical case scenarios are presented and possible treatment solutions have been suggested. The timing of a transplant is critical due to the risk of viral mutation while the patient is on a nucleoside analogue antiviral agent and waiting for an organ. One successful option might be to start therapy pretransplant and continue it posttransplant. Combination therapy appears to provide the most effective course of treatment. This should include a nucleoside analogue and patients should be covered with hepatitis b immune globulin throughout the course of therapy. Several other variations of combination therapy are discussed, but many clinical issues remain to be resolved. Guidelines for future studies designed to answer these questions are proposed.- - - - - - - - - - ranking = 0.25keywords = candida (Clic here for more details about this article) |
6/44. Recurrent endogenous candidal endophthalmitis in a premature infant.Endogenous Candida endophthalmitis resulting from candidemia in low-birth-weight infants usually occurs as a retinochoroiditis, which is effectively treated with systemic antifungal agents. We report a case of Candida endophthalmitis that recurred 4 months after completion of systemic antifungal therapy. The recurrent Candida infection affected primarily the iris and lens, rather than the retina and choroid. vitrectomy was required for diagnosis and treatment.- - - - - - - - - - ranking = 1keywords = candida (Clic here for more details about this article) |
7/44. Coexistence of factor v Leiden and primary antiphospholipid syndrome: a patient with recurrent myocardial infarctions and thrombocytopenia.Increased thrombin generation associated with resistance to activated protein C makes the latter a likely candidate for an increased risk of acute coronary events. activated protein c resistance (factor v Leiden) on its own, however, appears to have no significant effect in this regard. We describe a case of recurrent myocardial infarction caused by coronary thrombosis in a patient with persistent thrombocytopenia who was found to have a coexistence of heterozygous factor v Leiden and primary antiphospholipid syndrome. Since both thrombophilic disorders interfere with the protein C anticoagulant system, the simultaneous existence of inherited and acquired resistance against activated protein C could account for an increased thrombophilia with manifestation in the coronary arteries. This case suggests that evaluation of patients who present with recurrent acute coronary events should also consider these coagulation defects.- - - - - - - - - - ranking = 0.25keywords = candida (Clic here for more details about this article) |
8/44. Candidal infections as a cause of recurrent uretero-ileal anastomotic dehiscence.Fungal infections are common in immunocompromised patients. The presentation is often subtle and therefore treatment is delayed. Uretero-ileal anastomotic dehiscence due to candidal infection has never been reported before. This case represents an uncommon but potentially life-threatening complication in reconstructive surgery; that is, anastomotic dehiscence due to a unique etiology.- - - - - - - - - - ranking = 0.25keywords = candida (Clic here for more details about this article) |
9/44. Aortobronchial fistula presenting as recurrent hemoptysis and successfully treated with an endovascular stent graft.Aortobronchial fistula (ABF) (aortopulmonary fistula) may cause a massive fatal hemoptysis. We have recently seen a patient with ABF presenting with recurrent, massive hemoptysis. She was successfully treated with an endovascular stent graft. The endovascular stent graft may provide an alternative treatment of in patients considered to be poor surgical candidates.- - - - - - - - - - ranking = 0.25keywords = candida (Clic here for more details about this article) |
10/44. Reoperative transmyocardial laser revascularization for late recurrent angina.transmyocardial laser revascularization (TMR) reduces anginal class and is indicated for severely symptomatic patients who are not candidates for conventional revascularization. This report describes a 72-year-old man who presented 4 years following initially successful TMR with recurrent angina refractory to maximal medical management. Reoperative TMR was performed with substantial improvement in angina and functional class.- - - - - - - - - - ranking = 0.25keywords = candida (Clic here for more details about this article) |
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