1/13. Fatal fungal infection complicating aortic dissection following coronary artery bypass grafting.The case of a 52-year-old man with severe coronary atheroma/ischaemic heart disease, who underwent successful triple vessel coronary artery bypass grafting is described. One month later this was complicated by aortic dissection arising at the aortic cannulation site. An emergency resection and Dacron graft placement were performed. Five weeks later he represented with haemoptysis. Despite inconclusive investigations the patient went on to suffer a massive fatal haemoptysis. autopsy revealed Candida infection of the graft with a secondary aortobronchial fistula.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
2/13. Mycotic aneurysms affecting both lower legs of a patient with Candida endocarditis--endovascular therapy and open vascular surgery.The purpose of this study was to report the endovascular and open surgery treatment of Candida-associated mycotic aneurysms in both lower limbs. A 53-year-old patient suffering from Candida endocarditis following aortic valve replacement developed mycotic aneurysms in both lower limbs. The angiography revealed a large aneurysm of the tibioperoneal trunk affecting the right leg. In the left leg, sacculation had developed in section III of the popliteal artery. The right aneurysm was obliterated by embolization with coils. On the left side, the large aneurysm of the popliteal artery was resected; vascular continuity was re-established by interposing a segment of the patient's greater saphenous vein. The postoperative course was uneventful. Mycotic aneurysm is a rare disease. A site in the crural vessels is regarded as exceptionally seldom. To our knowledge, no Candida-associated mycotic aneurysm has been described in this region before. Both endovascular treatment and open surgery proved to be successful.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
3/13. Neonatal candida albicans septic thrombosis of the portal vein followed by cavernous transformation of the vessel.We report two premature neonates with candida albicans septic thrombosis of the portal vein who developed, in very early childhood, the sonographic appearance of cavernous transformation of the vessel and/or clinical signs of extrahepatic portal hypertension.- - - - - - - - - - ranking = 5keywords = vessel (Clic here for more details about this article) |
4/13. Operative intervention in active endocarditis in children: report of a series of cases and review.We describe in detail 14 children (age, less than or equal to 19 years) who underwent operative intervention during active infection of the heart and/or great vessels. The series included five children less than 6 years old, who constitute 10% of all such cases reported in this age group to date. We also review the 132 published reports in which children underwent operative intervention during active endocarditis. We found the following: (1) The survival rate for all cases was 77%. (2) Persistent infection, embolic phenomena, and increasing congestive heart failure were the most frequent indications for operative intervention. (3) Survival rates were independent of the duration of preoperative antibiotic treatment. (4) Survival rates were independent of positive results of cultures of blood or tissue obtained at operation. (5) The perioperative mortality in our series was 14%. (6) Only 67% of patients had conditions thought to predispose to endocarditis. (7) Except for removal of catheter-associated cardiac masses from neonates, operative intervention in active endocarditis was uncommon among children less than 4 years old. (8) staphylococcus aureus and viridans streptococci were the etiologic agents in the majority of cases of endocarditis requiring operation during active infection in children.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
5/13. Management of mycotic rupture of the ascending aorta after heart-lung transplantation.A 19-year-old woman underwent heart-lung transplantation for obstructive bronchiolitis. Eleven days later mycotic rupture of the ascending aorta occurred. Emergency cardiopulmonary bypass was instituted via the femoral vessels and the chest was reopened under cardiac massage. Perforation of the aorta at the site of insertion of the cardioplegic cannula in the donor aorta was seen. Under circulatory arrest the infected area was excised, a pericardial patch plasty was performed, and the region was covered with a muscle flap. Postoperatively, candida albicans was found in the excised specimen of the aorta, in drainage fluid, and in the bronchoalveolar lavage. High doses of antimycotics were administered intravenously and for irrigation of the mediastinum, which resulted in an eradication of fungi in all cultures 7 days later. Six weeks after reoperation the patient was discharged home, and she remains well 9 months postoperatively.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
6/13. Diffuse neonatal gastric infarction.Diffuse neonatal gastric infarction can be a devastating complication of invasion of the gastric wall and vessels by fungi colonizing the gastric mucosa. Even in the presence of extensive transmural necrosis, however, the radiographs do not necessarily show evidence of gastric mucosal abnormality. Instead, plain films and positive contrast studies may erroneously suggest a mechanical gastric outlet obstruction. Ancillary evidence of a devitalized viscus in a baby who appears to have complete gastric outlet obstruction should suggest the diagnosis of gastric infarction.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
7/13. Multiple mycotic aneurysms due to Candida endocarditis.Candida endocarditis is a serious condition which should be suspected in any patient with signs and symptoms compatible with bacterial endocarditis when cultures are negative. It should be managed by a medical-surgical approach which combines resection of all infected heart tissue and repair of any preexisting heart defects with appropriate antifungal therapy. Mycotic aneurysms should be treated by ligation of the vessel above and below the aneurysm, resection of the aneurysm, and implementation of appropriate antifungal or antibacterial therapy. Revascularization is not always necessary. When required, an extra-anatomic approach is preferable to placing a graft through the bed of the aneurysm.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
8/13. On the role of proteinases from candida albicans in the pathogenesis of acronecrosis.Evidence is presented for the involvement of proteinases from candida albicans in the pathogenesis of acronecrosis that occurred in a young woman and which coincided with Candida sepsis. Secretory acid Candida proteinase by immunofluorescence was traced in the obstructed blood vessels of necrotic skin that was infested with yeast. The specificity of immunofluorescence was proven by exclusion of cross reactivity with pepsin, cathepsin-D, acid erythrocyte proteinase and porcine renin. The possible molecular mechanisms of interference of fungal proteinases are discussed with respect to the renin-angiotensin system and blood coagulation.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
9/13. Pulmonary candidiasis. A clinical and pathological correlation.Thirty patients with systemic Candida infection underwent autopsy during a 13-year prospective study. Eleven patients had tissue-verified pulmonary candidiasis. Nine of these patients had hematogenous dissemination, as evidenced by multiple organ invasion; two had aspiration pneumonia with lung involvement only. Aspiration Candida pneumonia is rare. Pulmonary candidiasis usually arises from a focus of infection implanted during hematogenous dissemination. An infected indwelling venous catheter was the source of candidemia in six of these patients. Organisms in the lumen of pulmonary vessels caused a necrotizing vasculitis and appeared to invade the parenchyma from these areas.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
10/13. Ocular Candida with pale-centered hemorrhages.A 54-year-old man with severe thermal burns had Candida corneal ulcers and Candida septicemia develop, and he died 39 days after admission to the hospital. At autopsy examination, fungi were noted in the cornea to extend across the intact Descemet's membrane and were also found within foci of retinitis and choroiditis. Also, hemorrhages (some of which had pale centers) were present in both retinas. Histopathologic examination of these hemorrhages disclosed that the pale centers were comprised of a disrupted small blood vessel surrounded by an acellular material that most likely represented fibrin-platelet aggregates.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
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