1/260. Fatal disseminated trichoderma longibrachiatum infection in an adult bone marrow transplant patient: species identification and review of the literature.trichoderma longibrachiatum was recovered from stool surveillance cultures and a perirectal ulcer biopsy specimen from a 29-year-old male who had received an allogeneic bone marrow transplant for acute lymphoblastic leukemia. The amphotericin b (2.0 microgram/ml) and itraconazole (1.0 microgram/ml) MICs for the organism were elevated. Therapy with these agents was unsuccessful, and the patient died on day 58 posttransplantation. At autopsy, histologic sections from the lungs, liver, brain, and intestinal wall showed infiltration by branching septate hyphae. Cultures were positive for trichoderma longibrachiatum. While trichoderma species have been recognized to be pathogenic in profoundly immunosuppressed hosts with increasing frequency, this is the first report of probable acquisition through the gastrointestinal tract. Salient features regarding the identification of molds in the trichoderma longibrachiatum species aggregate are presented.- - - - - - - - - - ranking = 1keywords = organ (Clic here for more details about this article) |
2/260. Allergic fungal sinusitis. A report of two cases with diagnosis by intraoperative aspiration cytology.BACKGROUND: Allergic fungal sinusitis (AFS) is a newly recognized form of sinusitis characterized by opacification of the paranasal sinuses by "allergic mucin" (AM) admixed with scattered fungal organisms. AM consists of necrotic, or partially necrotic, eosinophils and Charcot-Leyden crystals suspended in lakes of laminated, mucinous material. AFS is characterized by the absence of bone or soft tissue invasion, purulent exudate or granulomatous inflammation. Clinically, it is important to differentiate AFS from both acute invasive fungal sinusitis and noninvasive mycetoma because the three diseases are treated with different modalities and have different prognoses. Although the radiologic features of AFS are often characteristic, occasionally it may be difficult to exclude neoplasia. CASES: Two cases of AFS, in which intraoperative diagnosis was made on the basis of the presence of both AM and fungal organisms, are reported. CONCLUSION: Cytologic diagnosis of AFS can be made from intraoperative sinus aspirates from the presence of AM and fungal elements. AM and fungi provide presumptive evidence for a noninvasive, allergic fungal disease and can help reassure clinicians intraoperatively and guide clinical management.- - - - - - - - - - ranking = 2keywords = organ (Clic here for more details about this article) |
3/260. Rapid and definitive diagnosis of infectious diseases using peripheral blood smears.A timely diagnosis is essential in the management of septicemia and septic shock. Three patients are described, all of whom presented with fever and one of whom was hypotensive at the time of admission. In each patient, rapid diagnosis of the cause of fever was possible because microorganisms were identified on a peripheral blood smear obtained at the time of admission. This identification permitted prompt initiation of appropriate antimicrobial therapy. In addition, a literature review of use of peripheral blood smears in the diagnosis of bacterial, fungal, and parasitic infections is provided.- - - - - - - - - - ranking = 1keywords = organ (Clic here for more details about this article) |
4/260. rhodotorula sp. infection in corneal interface following lamellar keratoplasty--a case report.PURPOSE: To report an unusual organism causing infection following lamellar keratoplasty. METHOD: Case report. RESULT: Both gram stain smear and culture from the interlamellar bed revealed rhodotorula sp., a red yeast as a causative agent. CONCLUSION: rhodotorula sp. can cause corneal lamellar graft infection.- - - - - - - - - - ranking = 1keywords = organ (Clic here for more details about this article) |
5/260. brain abscess caused by cladosporium trichoides (Bantianum): a case with paranasal sinus involvement.Dematiacious fungi (ie, fungi with dark hyphae) are a rare and usually fatal cause of central nervous system infection. cladosporium trichoides has been implicated most frequently. documentation of extra-CNS involvement has been rare. Our patient had a brain abscess and paranasal sinus infection due to C trichoides. The organism was sensitive to less than or equal 2mug/ml of flucytosine. Although our patient did not receive flucytosine, it is possible that this drug, because of its excellent penetration into the cerebrospinal fluid, may be a useful therapeutic agent in cerebral cladosporiosis.- - - - - - - - - - ranking = 1keywords = organ (Clic here for more details about this article) |
6/260. phaeohyphomycosis from Exphiala jeanselmei with concomitant nocardia asteroides infection in a renal transplant recipient: case report and review of the literature.A 59-year-old black man who received a cadaveric renal transplant 15 months earlier developed subcutaneous nodules on his right upper extremity that were identified as phaeohyphomycosis caused by exophiala jeanselmei. The man was admitted 4 weeks later with a swollen left arm and had nocardia asteroides in this area and in the apex of his left lung. He was treated with surgical excision, and itraconazole, imipenem-cilastatin, and trimethoprim-sulfamethoxazole. With the potential presence of more than one microorganism in an immunocompromised patient, it is important to identify and differentiate them correctly to direct appropriate therapy.- - - - - - - - - - ranking = 1keywords = organ (Clic here for more details about this article) |
7/260. Endogenous endophthalmitis: case report and brief review.Endogenous endophthalmitis is a potentially blinding ocular infection resulting from hematogenous spread from a remote primary source. The condition is relatively rare but may become more common as the number of chronically debilitated patients and the use of invasive procedures increase. Many etiologic organisms (gram-positive, gram-negative and fungal) have been reported to cause endogenous endophthalmitis. risk factors are well defined and include most reasons for immune suppression. A high clinical suspicion is needed for early diagnosis and treatment. Early intravenous antibiotic therapy remains the cornerstone of treatment. The roles of intravitreal antibiotics and vitrectomy are evolving and may become more widely accepted as therapeutic modalities. The authors report a case of endogenous endophthalmitis and provide a brief review of the literature.- - - - - - - - - - ranking = 1keywords = organ (Clic here for more details about this article) |
8/260. Disseminated penicillium marneffei infection: a report of five cases in singapore.penicillium marneffei has emerged as an important opportunistic pathogen in hiv-infected patients in Southeast asia. We report the first 5 cases of P. marneffei diagnosed in singapore. All the patients were hiv-infected and were either Thai nationals or had frequently travelled to thailand. fever, weight loss, anaemia and papular skin lesions were common clinical manifestations in our patients, all of whom had the organism isolated from blood. skin biopsy specimens showed histological evidence of P. marneffei in 2 patients. In 1 patient each, the organism grew in cultures of specimens from bone marrow and respiratory secretions. amphotericin b therapy followed by itraconazole were used in 3 of our 5 patients and was associated with good clinical response and outcome.- - - - - - - - - - ranking = 2keywords = organ (Clic here for more details about this article) |
9/260. Disseminated infection caused by scedosporium prolificans in a patient with acute multilineal leukemia.In this report, we describe a case of disseminated infection caused by scedosporium prolificans (S. inflatum) in a patient affected by chemotherapy-induced acute multilineal leukemia and neutropenia. For the fungus isolated in four blood cultures, high MICs of currently available antifungal agents were found. Postmortem examination revealed multiorgan involvement.- - - - - - - - - - ranking = 1keywords = organ (Clic here for more details about this article) |
10/260. trichosporon beigelii infection: experience in a regional burn center.trichosporon beigelii is a fungus once thought to cause only superficial infections, but recently has been increasingly identified as an opportunistic systemic pathogen in immunocompromised patients. There have been very limited reports of this organism in the burn patient population. We describe the first report of pharmacological management of invasive T. beigelii with a combination of amphotericin b and high dose fluconazole in a burn patient. Antifungal susceptibility testing of T. beigelii determined a change in minimum inhibitory concentrations (MICs) of amphotericin b and a consistent resistance pattern with the use of flucytosine. This paper will review our experience with T. beigelii fungus in a regional burn treatment center and review the literature on other experiences in the burn population.- - - - - - - - - - ranking = 1keywords = organ (Clic here for more details about this article) |
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