1/129. renal artery rupture secondary to pretransplantation Candida contamination of the graft in two different recipients.Infected graft transplantation is an unwelcome complication that may lead to serious consequences in the immunosuppressed host. It can be caused by infection of the donor or by contamination of the organ during harvest, preservation and handling, or at transplantation. With current donor evaluation protocols, the risk of transmitting infections by exogenous contaminated grafts seems to be more frequent than true donor-transmitted infections. Nevertheless, although rare and usually free of clinically significant sequelae, if contamination is by some virulent organisms such as staphylococcus aureus, gram-negative bacilli, or fungi, severe complications may occur. We report the clinical outcome of liver, heart, and kidney recipients from a single donor. Both renal allografts had to be removed because of renal artery rupture secondary to candida albicans infection. Careful donor evaluation before transplantation, unusually early presentation of mycosis leading to anastomotic renal artery disruption, the histopathologic findings of the grafts, and the absence of Candida infection in the liver and heart recipients make us believe that exogenous contamination of the grafts occurred during donor procedure, kidney processing, or at transplantation. In summary, because infected grafts can lead to serious complications, besides careful donor screening, it is important to achieve early recognition of contaminated organs by culturing the perfusate to start specific antibiotic or antifungal therapy after transplantation if necessary and avoid the rare but, in this case, fatal consequences of these infections.- - - - - - - - - - ranking = 1keywords = heart (Clic here for more details about this article) |
2/129. Echocardiographic diagnosis of large fungal verruca attached to mitral valve.In a patient with endocarditis due to candida tropicalis echocardiograms from mitral valve vegetations were found to mimic the typical pattern of a left atrial myxoma. A mass was shown occupying the mitral orifice posterior to the anterior mitral leaflet; densities also appeared in the left atrium.Though these echocardiographic findings were consistent with the diagnosis of a left atrial myxoma, there were other distinctive differential diagnostic features. Other diagnostic possibilities must, therefore, be considered in the interpretation of echocardiograms which suggest left atrial tumour.- - - - - - - - - - ranking = 15.483864102726keywords = valve (Clic here for more details about this article) |
3/129. Candida parapsilosis: an unusual organism causing prosthetic heart valve infective endocarditis.We report a case of Candida parapsilosis prosthetic heart valve infective endocarditis in a 67-year-old man. The infection was successfully treated with liposomal amphotericin b (AmBisome) and flucytosine. Surgical replacement of the infected valve was necessary. recurrence was prevented with oral fluconazole 400mg daily as maintenance therapy. The patient remained well after 2 years of follow-up.- - - - - - - - - - ranking = 66.588260947486keywords = heart valve, valve, heart (Clic here for more details about this article) |
4/129. Postmortem findings two weeks after oral treatment for metastatic Candida endophthalmitis with fluconazole.The purpose of this histological study was to present postmortem findings in both eyes of a 53-year-old male with liver dysfunction 2 weeks after short-time oral treatment with 200 mg/day fluconazole for metastatic Candida endophthalmitis due to intravenous hyperalimentation for 18 days. Candida had been demonstrated in the venous blood and on the tip of the intravenous catheter. The bilateral fungal endophthalmitis with hypopyon responded well to fungistatic therapy, but the patient suddenly died from heart failure. Both eyes were obtained at autopsy. Candida was demonstrated only in vitreous puff balls but not in the retina or uvea. fluconazole administered for a short period had little effect in eliminating fungus from vitreous puff balls, which have no blood supply. Prolonged administration of the antifungal drug or vitrectomy should be considered when treating an eye with vitreous puff balls in the presence of fungal endophthalmitis.- - - - - - - - - - ranking = 0.5keywords = heart (Clic here for more details about this article) |
5/129. Early fungal endocarditis in homograft recipients.Retrospective analysis of 200 homograft valve recipients at our institution revealed two cases of fungal endocarditis. Pathogenesis appears to be related to either recipient seeding in one elderly immunocompromised patient or a previously contaminated donor valve implanted in an otherwise healthy recipient. Therefore, our experience underscores the need for both meticulous prevention of fungal infection preoperatively in the recipient and elimination of previously contaminated homograft valves from the donor pool.- - - - - - - - - - ranking = 9.2903184616354keywords = valve (Clic here for more details about this article) |
6/129. Intra amniotic candidiasis. Case report and meta-analysis of 54 cases.We present a case of mid pregnancy loss with retained intrauterine contraceptive device associated with fetal Candida infection. review of English literature identified 53 additional cases of fetal candidal infection, with 17 associated with an IUCD in situ. The presence of an IUCD was associated with delivery at a statistically significant earlier gestational age when compared to cases not associated with an IUCD (23.3 /- 4.9 vs 31.6 /- 7.0, p < 0.001). Seventy-seven percent of fetal candidal infections associated with an IUCD were systemic (heart, brain, liver, gastrointestinal, lung) compared to 33% of cases not associated with an IUCD. In contrast to bacterial intraamniotic infections there was a low incidence of maternal febrile morbidity. An hypothesis as to the pathogenesis of Candidal infections in the presence and absence of an IUCD is offered as well as a paradigm for the management of the gravid patient with an IUCD in situ.- - - - - - - - - - ranking = 0.5keywords = heart (Clic here for more details about this article) |
7/129. Bivalve polymicrobial infective endocarditis.Polymicrobial infective endocarditis is uncommon, particularly vancomycin-resistant endocarditis and fugal endocarditis. The incidence of these infections is likely to. increase with advances in mediCAl technology and widespread use of central venous catheters. We report a case of bivalve endocarditis in which four organisms were identified, including vancomycin-resistant Enteroocausfaecium and Torulopsis glabrata.- - - - - - - - - - ranking = 15.483864102726keywords = valve (Clic here for more details about this article) |
8/129. Neonatal candidial endocarditis--a rare manifestation of systemic candidiasis.Infective candidial endocarditis in four premature neonates is reported. These occurred as a complication of systemic candidiasis. Vegetations were present on the right side of the heart in two cases and both sides in the other two. diagnosis requires a high degree of clinical suspicion. mortality rate is high despite appropriate therapy.- - - - - - - - - - ranking = 0.5keywords = heart (Clic here for more details about this article) |
9/129. 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 = 0.79361903175688keywords = heart, heart disease (Clic here for more details about this article) |
10/129. Successful non-surgical treatment of candida tropicalis endocarditis with liposomal amphotericin-B (AmBisome).Fungal endocarditis in children is most commonly a complication of palliative or curative surgery for congenital heart disease, rheumatic valvulitis and prolonged indwelling central venous and umbilical catheters. We describe here the case of a 3-y-old patient with chronic diarrhoea and prolonged total parenteral alimentation who developed severe C. tropicalis endocarditis and was treated successfully using a liposomal preparation of amphotericin-B (AmBisome) without surgical intervention.- - - - - - - - - - ranking = 0.79361903175688keywords = heart, heart disease (Clic here for more details about this article) |
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