1/6. Possibility of in-hospital infection by cryptococcus neoformans in patients with AIDS.The objective of the present work was to carry out a survey of soil samples taken from different areas of a hospital of infectious disease located in the city of Cordoba, where three AIDS patients were hospitalized during different periods in the same ward. The three of them returned with meningeal cryptococcosis between three or five months after having been discharged. cryptococcus neoformans was isolated in 8/10 samples collected outside the hospital, near the pigeon house. The samples collected from the AIDS patients ward and its surroundings were negative. These findings suggest that the patients may have been infected by the fungus during their first stay in hospital.- - - - - - - - - - ranking = 1keywords = near (Clic here for more details about this article) |
2/6. central nervous system aspergillus fumigatus infection after near drowning.AIMS: To report the case of a 26 year old white man, who developed chronic meningitis and intracerebral granulomata 15 days after an episode of near drowning in a swamp. methods: aspergillus fumigatus was isolated from cerebrospinal fluid cultures. RESULTS: The patient died 70 days after the symptoms were first noticed, and seven days after a subarachnoid haemorrhage. Aspergillus has never been reported before as a cause of intracranial infection after near drowning. CONCLUSIONS: physicians must be aware of this possibility when confronted with such a situation, because there are now effective therapeutic options for systemic aspergillosis.- - - - - - - - - - ranking = 6keywords = near (Clic here for more details about this article) |
3/6. infection of the CNS by scedosporium apiospermum after near drowning. Report of a fatal case and analysis of its confounding factors.This report describes a fatal case of central nervous system pseudallescheriasis. A 32 year old white man presented with headache and meningismus 15 days after nearly drowning in a swine sewage reservoir. Computerised tomography and magnetic resonance imaging of the head revealed multiple brain granulomata, which vanished when steroid and broad spectrum antimicrobial and antifungal agents, in addition to dexamethasone, were started. cerebrospinal fluid analysis disclosed a neutrophilic meningitis. Treatment with antibiotics and amphotericin b, together with fluconazole and later itraconazole, was ineffective. miconazole was added through an Ommaya reservoir, but was insufficient to halt the infection. pseudallescheria boydii was finally isolated and identified in cerebrospinal fluid cultures, a few days before death, three and a half months after the symptoms began. diagnosis was delayed because of a reduction in the lesions after partial treatment, which prevented a stereotactic biopsy. physicians should be aware of this condition, and provide prompt stereotactic biopsy. Confirmed cases should perhaps be treated with voriconazole, probably the most effective, currently available treatment for this agent.- - - - - - - - - - ranking = 5keywords = near (Clic here for more details about this article) |
4/6. meningitis caused by pseudallescheria boydii.We present a 43-year-old immunocompetent man who developed meningitis caused by pseudallescheria boydii. The patient had no history of near drowning, trauma, steroid administration, operations or any other underlying systemic disease. He presented with intermittent fever associated with headache, bilateral eye pain, and vomiting. Progressive hydrocephalus was noted during the course of the disease. cerebrospinal fluid (CSF) from the ventricular system allowed culture of the organism. Although the disease was diagnosed antemortemly, the patient died after antifungal treatment. This case is reported because of the unusual pathogen, unresponsiveness to amphotericin b combined with 5-fluocytocin, and immunocompetence of the patient without any predisposing factors.- - - - - - - - - - ranking = 1keywords = near (Clic here for more details about this article) |
5/6. candida albicans meningitis in a 27 weeks premature infant treated with liposomal amphotericin-B (AmBisome)We report a case of candida albicans meningitis in a neonate born after 27 weeks of gestation. To the best of our knowledge this is the first report of a premature infant with Candida-meningitis treated with liposomal amphotericin b (AmBisome(R)). The patient did not respond well to conventional amphotericin b, but was successfully cured with Ambisome(R). Liposomal amphotericin b was well tolerated and the baby recovered with a postinfectious hydrocephalus which necessitated a permanent ventriculo-peritoneal shunt. Six months after the infection the baby appears to have a near-normal cerebral development.- - - - - - - - - - ranking = 1keywords = near (Clic here for more details about this article) |
6/6. Intracranial fungal aneurysm caused by Candida endocarditis.We describe a 67-year-old man who died 4 days after suffering a subarachnoid hemorrhage. autopsy revealed a fresh subarachnoid hemorrhage and a ruptured fungal aneurysm near the trifurcation of the right middle cerebral artery. In comparison with 21 previously reported cases in which the fungal aneurysms were proved to be intracranial, the present case had several characteristic features: the causative fungus of the aneurysm was Candida (only one such case has been reported previously). The aneurysm was caused by direct Candida invasion of the arterial wall from the Candida embolus (previously reported aneurysms have been caused by direct invasion of the arterial wall during fungal meningitis). The source of the Candida was endocarditis (the main sources of fungus in previously reported cases have been sinusitis, dental extraction wounds, and some forms of surgery). We describe the features of this rare autopsy case of a ruptured fungal aneurysm caused by Candida originating from endocarditis and review the literature.- - - - - - - - - - ranking = 1keywords = near (Clic here for more details about this article) |