1/14. Fulminant toxoplasmosis in a heart transplant recipient.toxoplasma gondii infections in heart transplant recipients emerge in most cases as newly acquired infections of the immunocompromised sero-negative patient from an exogenous source, usually the donor organ. We report on a 64-year-old heart transplant recipient who developed pneumonitis, myocarditis, and hyperacute encephalitis three weeks after transplantation. Histopathological examination of an endomyocardial biopsy revealed fulminant T. gondii infection. Although appropriate chemotherapy was administered immediately, the patient died the next day. Our case demonstrates that if a histological diagnosis is not rendered in time, fulminant toxoplasmosis may lead to a fatal outcome. In conclusion, a general screening of the donors and recipients for opportunistic infections, including toxoplasmosis, and an appropriate prophylaxis should always be considered.- - - - - - - - - - ranking = 1keywords = opportunistic infection (Clic here for more details about this article) |
2/14. toxoplasma gondii pneumonitis in patients infected with the human immunodeficiency virus.Pulmonary toxoplasmosis is a rarely recognized opportunistic infection in immunocompromised patients. A few case reports have described pulmonary toxoplasmosis in human immunodeficiency virus-infected patients in association with toxoplasma gondii central nervous system disease. We encountered six cases of pulmonary toxoplasmosis in human immunodeficiency virus-infected patients who presented with a protracted febrile illness, respiratory symptoms, and an abnormal chest roentgenogram in the absence of neurologic findings. No clinical or roentgenographic features distinguished T gondii pneumonitis from more common opportunistic pulmonary infections. As the acquired immunodeficiency syndrome epidemic progresses, the presenting illnesses have evolved. toxoplasma gondii must be considered a potential cause of pulmonary disease during the evaluation of human immunodeficiency virus-infected patients with respiratory symptoms.- - - - - - - - - - ranking = 1keywords = opportunistic infection (Clic here for more details about this article) |
3/14. common variable immunodeficiency in an adult with recurrent pneumonia.Primary immunodeficiency syndromes are rarely diagnosed among adults. common variable immunodeficiency (CVID) is a congenital immunological disorder characterized by defective antibody production. In this report, we describe a 35-year-old male suffering from a common variable immunodeficiency, referred to us because of a lobar pneumonia. He had a history of recurrent pulmonary infections, which was present months before presentation, suggesting hypogammaglobulinemia. We found a severe hypogammaglobulinemia, which confirmed the diagnosis of CVID. His immunoglobulin profiles upon admission before infusion of immunoglobulin (normal ranges) were: IgG < 1.41 (8-17) g/l, IgA 0.25 (0.85-4.9) g/l, IgM 0.182 (0.5-3.7) g/l, and IgE < 2 (< 120) IU/ml. His HLA profiles were HLA A2 A26, B18 B38, Cw7, DR11 and DQ7 DQ9. He was treated with intravenous immunoglobulin. After this regimen, his IgG was maintained at > 6.0 g/L. On follow up, he has been free of opportunistic infections. In conclusion, CVID should be considered in the differential diagnosis of recurrent pneumonia in adults.- - - - - - - - - - ranking = 1keywords = opportunistic infection (Clic here for more details about this article) |
4/14. Pneumonia due to cryptococcus neoformans in a patient receiving infliximab: possible zoonotic transmission from a pet cockatiel.The use of humanized antibody against tumor necrosis factor alpha (TNF-alpha) may increase the risk of various opportunistic infections, including tuberculosis and fungal infections. We report a case of cryptococcal pneumonia in a patient who was taking infliximab for rheumatoid arthritis. A temporally related exposure history raised the possibility that our patient acquired the infection from his pet cockatiel. It seems prudent to advise patients receiving infliximab to avoid exposure to pet avian excreta.- - - - - - - - - - ranking = 1keywords = opportunistic infection (Clic here for more details about this article) |
5/14. 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) |
6/14. sirolimus-induced pulmonary hypersensitivity associated with a CD4 T-cell infiltrate.The differential diagnosis of pulmonary infiltrates after solid-organ transplantation presents a broad differential diagnosis including opportunistic infections and drug-induced lung disease. We report an adult liver transplant recipient who had breathlessness and pulmonary infiltrates following the introduction of sirolimus, and in whom transbronchial biopsy demonstrated a granulomatous interstitial pneumonitis and an organizing pneumonia with a CD4 T-cell infiltrate suggesting a T-helper cell-associated reaction to a processed sirolimus protein complex. Withdrawal of sirolimus produced a rapid clinical and radiologic improvement. This case indicates that with the increasing use of sirolimus, clinicians need to be aware of pulmonary hypersensitivity from this agent.- - - - - - - - - - ranking = 1keywords = opportunistic infection (Clic here for more details about this article) |
7/14. An aspergilloma in an echinococcal cyst cavity.Aspergilloma is a saprophytic infection which can colonize preexisting lung cavities. The most common underlying diseases are tuberculosis, sarcoidosis, cavitary lung cancer, etc. Although aspergilloma can also occur in operated hydatid cyst cavities, only a few cases have been reported in literature. A 32-year-old female patient underwent cystectomy for the diagnosis of perforated intraparenchymal giant hydatid cyst located in the right upper lobe, reaching down to the hilum. Capitonnage was not performed and it was observed that a residual cavity remained in the cystectomy area. The patient was discharged; however, during clinical and radiological follow-ups, it was found that the residual cyst cavity had expanded. As it was thought that one of the drainage bronchi in the cyst cavity could have opened, the patient was reoperated. During the operation, it was noted that purulent fluid and necrotic tissues were present in the cystic cavity. It was seen that the posterior upper lobe segment was consolidated and not ventilated. Contents of the cavity were removed and the posterior upper lobe segment was resected. Histopathological examination revealed that the tissue in the cavity was that of an aspergilloma, and that chronic organized pneumonia and diffuse interstitial fibrosis were present in the resected segment. Refraining from surgical obliteration (capitonnage) of cyst cavities in cases of giant hydatid cysts extending to the hilum can lead to opportunistic infections such as aspergilloma.- - - - - - - - - - ranking = 1keywords = opportunistic infection (Clic here for more details about this article) |
8/14. Three opportunistic infections associated with ectopic corticotropin syndrome.cytomegalovirus pneumonia, pneumocystis carinii pneumonia, and pulmonary and disseminated aspergillosis occurred simultaneously in a 66-year-old white man with oat cell carcinoma and ectopic corticotropin production. hypokalemia, a recent normal chest roentgenogram, and a large left adrenal mass on a computed tomographic scan confused the initial clinical evaluation. The aspergillosis proved fulminant and lethal.- - - - - - - - - - ranking = 4keywords = opportunistic infection (Clic here for more details about this article) |
9/14. cytomegalovirus pneumonitis and lobar consolidation.This report describes the occurrence of localized lobar consolidation caused solely by cytomegalovirus infection in two heart transplant recipients. This highly atypical and previously unreported radiographic manifestation of cytomegalovirus pneumonitis underscores the need for vigorous diagnostic evaluation of immunosuppressed patients since localized pneumonitis in the immunocompromised host does not exclude the possibility of opportunistic infection.- - - - - - - - - - ranking = 1keywords = opportunistic infection (Clic here for more details about this article) |
10/14. rhodococcus equi pneumonia. An unusual early manifestation of the acquired immunodeficiency syndrome (AIDS).Infection with rhodococcus equi has been reported as an occasional cause of cavitary pneumonia in severely immunocompromised patients, including those with the acquired immunodeficiency syndrome (AIDS). We report two cases of R equi pneumonia presenting in one month in patients infected with human immunodeficiency virus (hiv) who had not previously had an opportunistic infection. The clinical and radiographic manifestations of the disease are distinctive and should suggest the diagnosis. R equi pneumonia in a person with hiv infection should be considered diagnostic of AIDS. Recognition of this entity is important since antibiotic therapy is different from that conventionally used in pneumonias in AIDS patients and must be prolonged.- - - - - - - - - - ranking = 1keywords = opportunistic infection (Clic here for more details about this article) |
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