1/21. Laryngeal pathology in the acquired immunodeficiency syndrome: diagnostic and therapeutic dilemmas.The acquired immunodeficiency syndrome has produced a growing population of patients who, because of their associated immune system compromise, are prone to opportunistic infections and neoplastic diseases. The larynx, with its relatively inaccessible yet critical anatomic location, is a site in which these processes can produce clinical dilemmas, with respect to diagnosis as well as to therapy. By presenting 4 cases involving unusual laryngeal problems in patients infected with the human immunodeficiency virus (hiv), we emphasize these inherent diagnostic and therapeutic problems. Otolaryngologists must be familiar with the many diagnostic possibilities and therapeutic alternatives when hiv-infected patients present with laryngeal complaints.- - - - - - - - - - ranking = 1keywords = opportunistic infection (Clic here for more details about this article) |
2/21. Subcutaneous phaeohyphomycosis caused by Phaeoacremonium rubrigenum in an immunosuppressed patient.BACKGROUND: phaeohyphomycosis refers to infection by dematiaceous fungi with pigmented hyphae or yeast-like cells in the tissue. In humans, this disease is usually considered to be an opportunistic infection. The causal agents of phaeohyphomycosis include numerous species belonging to different genera and they are increasing as a result of the development of intensive medical therapy. observation: We report the case of a 61-year-old Japanese female under corticosteroid treatment for malignant rheumatoid arthritis. An asymptomatic subcutaneous tumor developed on the back of her left foot. Histological examination of the excised material revealed mixed cell granuloma (H&E) and the presence of branched hyphal elements (periodic acid-Schiff). A fungus grown in pure culture was identified as Phaeoacremonium rubrigenum. CONCLUSION: The hyphomycete genus, Phaeoacremonium, was proposed in 1996 by Crous et al. Three species belonging to this genus have been isolated from clinical specimens: P. inflatipes, from a human toenail, human synovial fluid and human mycetoma of the foot, P. parasiticum, from a subcutaneous lesion on a kidney transplant patient and several other sources, and P. rubrigenum, from a human patient with pneumonia. To our knowledge, however, this is the first report of phaeohyphomycosis caused by Phaeoacremonium rubrigenum.- - - - - - - - - - ranking = 1keywords = opportunistic infection (Clic here for more details about this article) |
3/21. Disseminated ochroconis gallopavum infection in a renal transplant recipient: the first reported case and a review of the literature.Ochroconis gallopavum is a potentially fatal dematiaceous fungus causing opportunistic infections in immunocompromised hosts. We report the first case of disseminated O. gallopavum infection in a 13-year-old renal transplant recipient, which involved the brain, lung and spleen. He was treated with amphotericin b, itraconazole and voriconazole, a new antifungal agent first used to treat such an infection. Besides antifungal treatment, all immunosuppressive agents were stopped and automated peritoneal dialysis was resumed. The initial infection was under control with both clinical and radiological improvements after treatment. However, the patient later acquired acremonium spp. peritonitis; he failed to respond to high-dose amphotericin b, and finally succumbed. A total of 13 reported O. gallopavum human infections, including the one described here, are reviewed. The most common site of involvement is the brain and the crude mortality rate is up to 46%. As the disease is potentially lethal in immunocompromised hosts, empirical antifungal coverage should be considered in post-renal transplant recipients with suspected brain abscess. Early biopsy of lesion for histopathological and microbiological diagnosis would be essential in managing such cases.- - - - - - - - - - ranking = 1keywords = opportunistic infection (Clic here for more details about this article) |
4/21. pneumonia and mesenteric lymphadenopathy caused by disseminated penicillium marneffei infection in a cadaveric renal transplant recipient.A38-year-old cadaveric kidney transplant recipient presented with fever, pneumonia, and mesenteric lymphadenopathy 9 months after transplant. blood culture, bone marrow culture, and fine-needle aspiration cytology of mesenteric lymph nodes confirmed the diagnosis of disseminated penicillium marneffei infection. He recovered after receiving parenteral amphotericin b followed by oral itraconazole therapy. P. marneffei infection is a dimorphic fungal opportunistic infection endemic in Southeast asia, southern china, taiwan, and hong kong. It has been well reported in human immunodeficiency virus (hiv)-positive patients in the endemic areas, and also in other immunocompromised patients. This diagnosis must be considered for all febrile transplant recipients who have the relevant clinical features and travel history to Southeast asia. Prompt treatment with anti-fungal therapy improves the survival and outcome of these patients.- - - - - - - - - - ranking = 1keywords = opportunistic infection (Clic here for more details about this article) |
5/21. Disseminated penicillium marneffei infection in hiv-infected subject.penicillium marneffei is a rare human pathogen predominantly affecting residents of South-east asia. We report four fatal cases from hong kong in human immunodeficiency virus-infected patients. The diagnosis was established by histological examination and confirmed by isolation of the fungus. The infection was disseminated with involvement of lymph nodes, liver, spleen, lung, intestine and bone marrow. The involved organs showed an exclusively anergic tissue reaction characterized by a diffuse infiltrate of fungi-laden macrophages, multiple co-existing opportunistic infections and lymphoid cell depletion. This organism has to be distinguished from histoplasma capsulatum and pneumocystis carinii. Establishment of the diagnosis is important not only because this infection is potentially curable, but also it is a likely indicator disease of AIDS in South-east asia. Penicilliosis marneffei should be suspected in any symptomatic hiv-positive patient who comes from or has visited endemic areas of South-east asia.- - - - - - - - - - ranking = 1keywords = opportunistic infection (Clic here for more details about this article) |
6/21. Disseminated Ochroconis gallopavum infection in a chronic lymphocytic leukemia: a case report and review of the literature on hematological malignancies.Disseminated fungal infection is an important cause of morbidity and mortality among patients with hematological malignancies. Ochroconis gallopavum is a dematiaceous and thermotolerant fungus that causes opportunistic infections in immunocompromised hosts. About only 30 cases of this organism infection have been reported worldwide. We report a disseminated Ochroconis gallopavum infection in a B-cell chronic lymphocytic leukemia patient. In spite of intensive anti-fungal treatment, no improvement in the clinical condition was observed and the patient died 4 months after diagnosis of the infection. Ochroconis gallopavum infection is a potentially fatal disease in hematological malignancies.- - - - - - - - - - ranking = 1keywords = opportunistic infection (Clic here for more details about this article) |
7/21. Case report: hypothyroidism due to pneumocystis carinii thyroiditis in a patient with acquired immunodeficiency syndrome.pneumocystis carinii is the most common cause of opportunistic pulmonary infection in AIDS patients and disseminated disease is being recognized with increasing frequency. We describe a patient with cavitary pulmonary disease, lymphadenopathy, thyroiditis, and associated hypothyroidism, all a result of P. carinii. The organism was easily demonstrated in a fine-needle aspirate specimen of the thyroid. This is the second reported case of clinically apparent Pneumocystis thyroiditis and the first reported case of hypothyroidism due to an opportunistic infection in a patient with AIDS. Clinicians should be aware of this entity and request a Grocott-Gomori methenamine-silver nitrate stain of appropriate cytology specimens to make the diagnosis.- - - - - - - - - - ranking = 1keywords = opportunistic infection (Clic here for more details about this article) |
8/21. fungemia with Saccharomycetaceae. Report of four cases and review of the literature.Invasive fungal disease with Saccharomycetaceae is very rarely reported and these fungi are usually considered nonpathogenic. We report here 4 cases of positive blood cultures with fungal species belonging to this family. Severe neutropenia, permanent central venous catheter, ongoing antibacterial chemotherapy, and major abdominal surgery were identified as risk factors for fungemia in patients. In the immunocompromised host isolation of such species from sterile fluids cannot be ignored but should be considered an opportunistic infection and treated as such.- - - - - - - - - - ranking = 1keywords = opportunistic infection (Clic here for more details about this article) |
9/21. malassezia fungemia in neonates and adults: complication of hyperalimentation.Until recently, malassezia furfur was thought to be a pathogen only in tinea versicolor. More recently, this lipophilic yeast has been recovered from sick neonates with catheter-related infections. malassezia fungemia was studied in seven patients, and the salient features of this infection in patients described in the literature were reviewed. Major risk factors include prolonged hospitalization, the presence of central venous catheters, and the use of intravenous fat emulsions. It is difficult to identify specific manifestations of fungemia in these complex cases occurring in patients with severe underlying disease; however, neonates often present with the signs and symptoms of sepsis and thrombocytopenia, whereas fever may be the only manifestation in adults. Some patients are asymptomatic. When symptoms are present, they resolve upon removal of the colonized catheter. The role of the lipophilic nature of malassezia in the pathogenesis of infection is apparent from the ability of intravenous fat emulsions to support the growth of the fungus in vitro. A special solid medium that can be used to determine the true prevalence of malassezia fungemia has been devised. M. furfur must be considered in the differential diagnosis of opportunistic infections in patients receiving central hyperalimentation and should be sought by the culture of blood on appropriate medium.- - - - - - - - - - ranking = 1keywords = opportunistic infection (Clic here for more details about this article) |
10/21. Disseminated trichosporon capitatum infection in a patient with acute leukemia.Disseminated trichosporon capitatum infection in a 14-year-old boy with acute lymphoblastic leukemia is described. T. capitatum causes opportunistic infection in immunocompromised hosts.- - - - - - - - - - ranking = 1keywords = opportunistic infection (Clic here for more details about this article) |
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