11/32. Fungal peritonitis in 15 patients on continuous ambulatory peritoneal dialysis (CAPD).peritonitis is a frequent complication in patients with chronic renal failure on continuous ambulatory peritoneal dialysis (CAPD) treatment. The aim of this study was to know the prevalence of fungal peritonitis on patients undergoing CAPD, and to determine the antifungal susceptibility pattern of the identified isolates. Samples of the peritoneal dialysis fluid from 165 patients on CAPD treatment with peritonitis manifestations were submitted to mycological study (direct microscopic examination, culture and antifungal susceptibility test). Ten Candida isolates were identified, being C. albicans and C. parapsilosis the most common species. From isolates obtained, three species (C. albicans, C. parapsilosis, and C. guilliermondii) presented itraconazole resistance while C. glabrata was resistant to both itraconazole and ketoconazole. aspergillus fumigatus was associated to peritonitis in three cases and acremonium sp. in two.- - - - - - - - - - ranking = 1keywords = fumigatus (Clic here for more details about this article) |
12/32. Successful treatment of fusarium endophthalmitis with voriconazole and Aspergillus endophthalmitis with voriconazole plus caspofungin.PURPOSE: To report successful treatment of exogenous fusarium and Aspergillus endophthalmitis with new antifungal agents. DESIGN: Interventional case report. methods: Treatment of two cases is reviewed. RESULTS: A 64-year-old man developed post-cataract fusarium moniliforme endophthalmitis. Infection persisted despite removal of the intraocular lens, three vitrectomies, and five intravitreal injections of amphotericin. inflammation resolved and vision improved from 20/80 to 20/40 on 6 months of oral voriconazole. A 55-year-old man developed post-cataract intraocular inflammation. After three vitrectomies and removal of the intraocular lens, aspergillus fumigatus endophthalmitis was diagnosed. Intravitreal amphotericin and systemic voriconazole were given, but one week later there were early signs of recurrence. Intravenous caspofungin was added and the eye improved. Caspofungin was continued for 6 weeks and voriconazole for 6 months. Vision improved from counting fingers to 20/80 at 6 months and 20/25 at 23 months. CONCLUSION: Voriconazole is a promising new therapy for fusarium and Aspergillus endophthalmitis. Caspofungin may act synergistically with voriconazole in treating Aspergillus endophthalmitis.- - - - - - - - - - ranking = 1keywords = fumigatus (Clic here for more details about this article) |
13/32. Unusual aspects of allergic bronchopulmonary fungal disease: report of two cases due to Curvularia organisms associated with allergic fungal sinusitis.We report two cases of allergic bronchopulmonary fungal disease (ABPFD) caused by Curvularia sp and associated with allergic fungal sinusitis (AFS). Curvularia lunata was cultured in one case and Curvularia senegalensis was cultured in the other. Based on these cases and a review of the literature, we discuss unusual clinical and pathologic features that can occur in ABPFD. Unusual clinical aspects of ABPFD include associated AFS, absence of asthma, progression to Churg-Strauss angiitis and granulomatosis, concomitant hypersensitivity pneumonitis, and underlying cystic fibrosis. Atypical pathologic features that may occur in ABPFD include follicular bronchiolitis, xanthomatous bronchiolitis, limited tissue invasion, fungus balls, and association with unusual fungi. Prominent follicular bronchiolitis and xanthomatous bronchiolitis were misleading histologic features in one of our cases and led to a delay in recognition of the diagnosis. Both patients presented primarily with AFS; ABPFD was detected subsequently. This suggests that a small subset of patients with AFS may be at risk for ABPFD. The goal of this review is to increase awareness of unusual clinical and pathologic manifestations of ABPFD. It is hoped that this will result in accurate diagnosis and proper therapy, especially for patients who present with atypical features. Unusual fungal species should be considered in patients who have clinical findings compatible with ABPFD but who do not demonstrate immunologic reactivity to Aspergillus sp, especially aspergillus fumigatus. In addition, ABPFD should be considered in patients with AFS who develop new pulmonary lesions.- - - - - - - - - - ranking = 1keywords = fumigatus (Clic here for more details about this article) |
14/32. Serious infectious complications of corticosteroid therapy for COPD.We report seven elderly patients with COPD who developed serious infectious complications during prolonged treatment with high doses of corticosteroids. Infections included invasive pulmonary aspergillosis, herpes simplex stomatitis and esophagitis, cytomegalovirus pneumonia, bacterial sepsis, fungemia and meningitis due to cryptococcus neoformans. Each of the three patients who developed invasive aspergillus pneumonia died. The efficacy of prolonged therapy with high doses of corticosteroids in patients with COPD is not proven. These cases illustrate the potential for serious infections in patients with COPD treated with corticosteroids.- - - - - - - - - - ranking = 1.5209070925872keywords = aspergillus (Clic here for more details about this article) |
15/32. Early experience with itraconazole in vitro and in patients: pharmacokinetic studies and clinical results.The efficacy of itraconazole, a new triazole antifungal agent, was studied in vitro and assessed in patients. The MICs of itraconazole for 16 strains of aspergillus fumigatus were in the same range as those of amphotericin b: less than 0.09-0.36 microgram/ml vs. less than 0.09-0.78 microgram/ml, respectively. Eight adult patients with systemic fungal infections were treated orally with 100-200 mg of itraconazole two times a day. A patient with relapsing histoplasmosis (histoplasma capsulatum var. duboisii) was cleared of the infection; a patient with arthritis of the knee due to phialophora parasitica did not respond to treatment; four patients with semiinvasive pulmonary aspergillosis improved dramatically and were considered clinically cured; and two patients with aspergilloma improved. The duration of follow-up was one to nine months. Levels of itraconazole in body fluids were measured by a bioassay. Levels of drug in knee fluid were about 30% of the simultaneous levels in plasma. A progressive decrease in the level of itraconazole in plasma occurred in two patients, and a progressive increase in the levels occurred in five patients.- - - - - - - - - - ranking = 1keywords = fumigatus (Clic here for more details about this article) |
16/32. Corneal biopsy in the diagnosis of keratomycosis.In two patients, a 55-year-old man and a 49-year-old man, who had fungal keratitis initially undiagnosed by corneal scrapings the condition was successfully diagnosed by corneal biopsy. We compared corneal biopsy specimens and corneal scraping in the diagnosis of keratomycosis in rabbits with experimental bilateral fungal keratitis caused by fusarium solani, aspergillus fumigatus, and candida albicans. Corneal scrapings disclosed three specimens (30%) positive for Candida, five (50%) for fusarium, and six (60%) for Aspergillus keratitis, whereas corneal biopsy specimens showed fungal elements of fusarium, Aspergillus, and Candida in all inoculated eyes.- - - - - - - - - - ranking = 1keywords = fumigatus (Clic here for more details about this article) |
17/32. Direct examination vs culture of biopsy specimens for the diagnosis of keratomycosis.In two patients with fungal keratitis, direct examination of corneal biopsy specimens showed positive fungal elements, but cultures of biopsy specimens failed to disclose fungal growth. We compared the value of direct examination and culture of biopsy specimens in the diagnosis of keratomycosis in rabbits with experimental fungal keratitis caused by fusarium solani, aspergillus fumigatus, and candida albicans. Cultures disclosed seven specimens (70%) positive for Candida and eight (80%) for fusarium and Aspergillus keratitis, whereas direct examination showed positive fungal elements of fusarium, Aspergillus, and Candida in all specimens.- - - - - - - - - - ranking = 1keywords = fumigatus (Clic here for more details about this article) |
18/32. Allergic fungal sinusitis due to Curvularia lunata.The clinical and pathologic features of allergic fungal sinusitis caused by Curvularia lunata, as seen in two patients, are described. The findings are identical to those of allergic aspergillus sinusitis. patients have allergies, nasal polyposis, and, occasionally, eosinophilia. Radiographs show opacification of multiple sinuses without bone destruction. Surgical specimens consist of polyps and inspissated, mucoid material. Diagnostic microscopic features, termed "allergic mucin," include eosinophils, numerous Charcot-Leyden crystals, and hyphae embedded in pools of mucus. The recognition of allergic mucin may be impeded by extensive degranulation and fragmentation of the eosinophils. In addition, the fragments of mucin exhibit large, poorly stained central areas, probably due to incomplete penetration by the fixative. eosinophils are easier to recognize in well-fixed areas. Electron microscopy, though not of diagnostic necessity, confirms the eosinophilic nature of the infiltrate. It is important that surgical pathologists recognize this distinctive clinicopathologic entity and recommend appropriate cultures.- - - - - - - - - - ranking = 1.5209070925872keywords = aspergillus (Clic here for more details about this article) |
19/32. acquired immunodeficiency syndrome (AIDS). Clinical, immunological, pathological, and microbiological studies of the first case diagnosed in norway.The first case of acquired immunodeficiency syndrome (AIDS) in norway, diagnosed in January 1983, is presented, with results of clinical, immunological, and microbiological studies and the results of autopsy. Immunological studies showed several immunological abnormalities, including a profound deficiency of the T-cell system of the type usually associated with AIDS. During the 11 months of symptomatic disease the patient had a series of opportunistic infections, including recurrent candida esophagitis, probable pneumocystis carinii pneumonia, and severe and recurrent perioral herpes simplex virus infection. During the last months he had increasing signs and symptoms of disseminated cytomegalovirus infection, which was probably the major cause of death, as revealed by autopsy. autopsy also showed the presence of disseminated infection with a slowly growing, so far unclassified mycobacterium species, and signs of a focal aspergillus pneumonia.- - - - - - - - - - ranking = 1.5209070925872keywords = aspergillus (Clic here for more details about this article) |
20/32. Case report: prosthetic valve endocarditis caused by pseudallescheria boydii and clostridium limosum.This report describes a patient with a combined infection due to pseudallescheria boydii and clostridium limosum on a prosthetic dura mater aortic valve homograft. While this patient had C. limosum only growing in blood cultures, both organisms were isolated from the surgically resected aortic valve. Because P. boydii is generally resistant to amphotericin b but susceptible to miconazole, accurate differentiation of P. boydii from other fungi which may appear similarly in tissue sections (e.g., aspergillus) is important.- - - - - - - - - - ranking = 1.5209070925872keywords = aspergillus (Clic here for more details about this article) |
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