1/10. Liposomal amphotericin b and surgery in the successful treatment of invasive pulmonary mucormycosis in a patient with acute T-lymphoblastic leukemia.Pulmonary mucormycosis is a usually fatal opportunistic infection in immunocompromised patients. We describe the first case of an adult patient with hematological malignancy and profound neutropenia to survive a disseminated pulmonary rhizomucor pusillus infection. Early diagnostic procedures combined with high doses of liposomal amphotericin b and surgical resection may have contributed to the successful outcome.- - - - - - - - - - ranking = 1keywords = opportunistic infection (Clic here for more details about this article) |
2/10. Community-acquired acinetobacter radioresistens bacteremia in an hiv-positive patient.We describe the first case of community-acquired bacteremia caused by acinetobacter radioresistens; the patient was a 32-year-old hiv-positive neutropenic woman. Ambiguous Gram staining and poor biochemical reactivity of blood culture isolates misguided early diagnosis and therapy. Bacterial identification was based on 16S rDNA sequence analysis. A. radioresistens can be considered as a cause of opportunistic infection in immunodeficient patients.- - - - - - - - - - ranking = 1keywords = opportunistic infection (Clic here for more details about this article) |
3/10. Diagnosis of disseminated zygomycosis using a polymerase chain reaction assay.Invasive pulmonary zygomycosis is an uncommon opportunistic infection in patients with haematological malignancies. Clinical manifestations are in distinguishable from the more frequent invasive aspergillosis. Standard diagnostic methods like culture and microscopy from respiratory secretions have a low diagnostic sensitivity. A case in which proven invasive pulmonary zygomycosis was confirmed using a panfungal polymerase chain reaction assay in blood is presented. Since zygomycosis requires more aggressive treatment than aspergillosis (high-dose amphotericin b and surgical intervention), the polymerase chain reaction assay may improve the outcome of these often fatal infections by guiding the therapeutic approach through an early, non-invasive diagnosis.- - - - - - - - - - ranking = 1keywords = opportunistic infection (Clic here for more details about this article) |
4/10. An autopsy case of disseminated mucormycosis in a neutropenic patient receiving chemotherapy for the underlying solid malignancy.mucormycosis is a rare, opportunistic infection caused by fungi of the order mucorales, class Zygomycetes. These fungi produce fatal opportunistic infections in immunocompromised patients, especially in those with severe neutropenia. Recently, mucormycosis has become more widespread, because potent, myelosuppressive chemotherapies are performed more often than before. Nevertheless, this infection rarely occurs in patients with solid malignancies. Here, we describe an autopsy case of disseminated mucormycosis in a neutropenic patient who was receiving chemotherapy for an underlying solid malignancy. A 31-year-old Japanese man received cytotoxic chemotherapy with etoposide for the pulmonary metastasis of a secondary malignant fibrous histiocytoma. This patient had long been treated with chemotherapeutic agents for this solid cancer and for the preceding eosinophilic granuloma, both of which were highly resistant to the therapy. During the treatment with etoposide, his neutrophil count declined to less than 100/microl. He presented with high fever and severe dyspnea. pneumonia was highly suspected. The chemotherapy was discontinued, and granulocyte colony-stimulating factor was administered. Although the neutrophil count recovered, the pneumonia progressed. The patient experienced respiratory failure and died 17 days after the onset of this episode. An autopsy revealed dissemination of mucormycosis not only in the lungs but also in the liver, the spleen, the kidney, and in the digestive tract. The therapy-related severe neutropenia, and the probable impairment of the immune system, because of the previous chemotherapies, would have been responsible for this fatal infection.- - - - - - - - - - ranking = 2keywords = opportunistic infection (Clic here for more details about this article) |
5/10. Severe hematological side effects following Rituximab therapy in children.Rituximab use in severe auto-immune diseases has recently increased. Scattered reports of opportunistic infections were the only reported serious side effects related to rituximab in pediatric patients .Here, we report transient severe acute thrombocytopenia and neutropenia respectively a few days after rituximab infusion in two children with autoimmune haemolytic anaemia. In both cases, cytopenia was reversible in a few days. The occurrence of cytopenias shortly after an infusion and their rapid reversibility suggest that these hematological side-effects were attributable to a direct toxicity of rituximab. blood cell count must be carefully monitored after rituximab infusion in young children with autoimmune diseases.- - - - - - - - - - ranking = 1keywords = opportunistic infection (Clic here for more details about this article) |
6/10. pyomyositis complicating the acquired immunodeficiency syndrome. A report of two cases with coexistent neutropenia.OBJECTIVE: To identify some factors contributing to the development of pyomyositis in patients with the acquired immunodeficiency syndrome (AIDS) by a report of two cases and a review of the literature. CLINICAL FEATURES: A 36-year-old man with AIDS presented with tenderness of the left adductor longus muscle; a 28-year-old man with AIDS presented with fever and left leg pain. Both men had a history of severe neutropenia induced by drug treatment and opportunistic infections requiring treatment in hospital. The pyomyositis was defined by a gallium-67 scan (and, in one case, by a computed tomography scan). In one case staphylococcus aureus was cultured from blood; in the other it was cultured from pus from the pyomyositic abscess. INTERVENTIONS: Both patients had their abscesses drained. The first patient was treated with flucloxacillin (2 g every four hours, given intravenously) and rifampicin (450 mg by mouth each day). The second patient was treated with flucloxacillin (2 g every four hours, given intravenously) and ticarcillin (3 g every six hours, given intravenously). OUTCOME: After their symptoms abated, both patients were discharged from hospital, taking flucloxacillin by mouth as ongoing treatment. CONCLUSIONS: staphylococcal infections are increasingly common in neutropenic patients. neutropenia is likely to have contributed to the development of pyomyositis in these patients.- - - - - - - - - - ranking = 1keywords = opportunistic infection (Clic here for more details about this article) |
7/10. 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) |
8/10. fever, petechiae, and pulmonary infiltrates in an immunocompromised Peruvian man.The diagnostic considerations raised by immunocompromised patients with opportunistic infection continue to expand. When such patients harbor latent or persistent infection acquired in a tropical environment, the diagnostic challenge is even greater. The Infectious Disease Service at Yale-New Haven Hospital was asked to see a middle-aged man from peru with known T-cell lymphoma who had recently completed a course of chemotherapy. He presented to the hospital with fever, petechial skin rash, pulmonary infiltrates, and neutropenia. Ultimately this case illustrated the necessity for careful evaluation of such patients, looking, in particular, for evidence of opportunistic parasitic infection.- - - - - - - - - - ranking = 1keywords = opportunistic infection (Clic here for more details about this article) |
9/10. Infections in hairy-cell leukemia.In order to determine the nature of infectious complications in hairy-cell leukemia we studied 20 consecutive patients seen at UCLA and analyzed the available literature. The incidence of serious infection in our series was 40%, and pneumonia and septicemia due to pseudomonas and E. coli organisms were the leading types of infections. Fungal infections with Cryptococci and histoplasma organisms were documented, and a single case of pneumocystis carinii pneumonia was observed. Noninfectious fever occurred in 30% of our patients. There was a clear relationship between fungal disease and corticosteroid therapy, and the overall incidence of infection was correlated with the degree of neutropenia and corticosteroid treatment. No relationship was found between age, duration of disease, or the use of cytotoxic chemotherapy and infectious complications. Of the 13 infectious episodes, 11 occurred in patients prior to splenectomy. Only two episodes were seen in splenectomized patients, both occurring in the immediate postoperative period. We conclude that splenectomy has a beneficial effect in reducing the incidence of infections in hairy-cell leukemia and that corticosteroids should be used cautiously, since they predispose to opportunistic infection in this disease.- - - - - - - - - - ranking = 1keywords = opportunistic infection (Clic here for more details about this article) |
10/10. zygomycosis (mucormycosis) and hiv infection: report of three cases and review.We report three cases of zygomycosis (mucormycosis) occurring in three individuals infected with the human immunodeficiency virus (hiv) and review 12 other published cases. We present the only two case reports of disseminated zygomycosis in AIDS patients, and the only AIDS patient with renal zygomycosis to survive without nephrectomy, receiving intravenous (i.v.) amphotericin alone. coinfection with zygomycosis and hiv is rare, occurs primarily in patients with low CD4 lymphocyte counts, does not always require the usual predisposing conditions for zygomycosis, and may be the presenting opportunistic infection among hiv-infected persons. Transient episodes of neutropenia occurring within 4 months before presentation may be a risk factor for this disease. zygomycosis may arise in multiple sites including the basal ganglia, cutaneous tissue, kidney, respiratory tract, and may be disseminated. Occurring more commonly in, but not restricted to, injection drug users, it is significantly associated with sites other than basal ganglia in those patients with advanced hiv disease or AIDS. The presenting symptoms are related to the site of involvement, and the illness may develop insidiously or progress rapidly to a fulminant course. Successful therapy usually consists of surgical debridement and intravenous amphotericin b. overall mortality in this review is 40%, and is significantly associated with sites of disease inaccessible to surgical debridement.- - - - - - - - - - ranking = 1keywords = opportunistic infection (Clic here for more details about this article) |
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