Cases reported "Mycoses"

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1/25. Unusual pulmonary manifestations of disseminated penicillium marneffei infection in three AIDS patients.

    penicillium marneffei is a rare fungal pathogen which can cause human infections in people predominantly living in South-east asia and the southern portion of china. We report three cases of systemic P. marneffei infection in patients infected with hiv who lived in or had travelled to endemic areas. The clinical manifestation includes high fever, chills, weight loss, general malaise, chronic cough, haemoptysis, multiple skin lesions, abnormal liver function, etc. Chest X-ray showed single or multiple cavitary lesions with smooth or irregular thin wall. P. marneffei is cultured from blood, sputum, skin biopsy, sono-guide aspiration and bronchoscopic biopsy. After antifungal therapy with intravenous amphotericin b or oral fluconazole, skin lesions resolved completely within 2 weeks and cavitary lesions in the lungs changed to chronic fibrotic and interstitial processes after several months to a few years later. Our two cases had been treated as either pulmonary tuberculosis or suspected malignancy. A definite diagnosis and early treatment are important because this fungal infection is a marker of AIDS in South-east asia.
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ranking = 1
keywords = malignancy
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2/25. Plantar hyperkeratosis due to fusarium verticillioides in a patient with malignancy.

    We report the case of an 82-year-old man with hyperkeratosis of the right sole caused by a fusarium verticillioides infection mimicking verrucous tuberculosis; the infection was confirmed by direct potassium hydroxide microscopy, biopsy and cultures. The biopsy specimen showed an unusually deep invasion of fungal elements into the epidermis. This is an uncommon presentation in a localized cutaneous infection by fusarium but in this case, repeated local injuries were the portal of entry initiating the process. Clinical patterns of cutaneous fusarium infections in general are also discussed.
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ranking = 4
keywords = malignancy
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3/25. Fungal pseudotumor masquerading as pancreatic cancer-a sequela of new technology?

    Fungal infection resulting in chronic pancreatitis is rare. We report a case of chronic pancreatitis due to fungal infection causing common bile duct obstruction and abdominal pain mimicking pancreatic cancer. Treatment included resection to cure the pain and rule out malignancy. Long-term effects of fungal infection may be seen more frequently as total parenteral nutrition, antibiotics, and foreign bodies (e.g., stents, drains, central venous catheters) are more often being used in the treatment of many diseases.
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ranking = 1
keywords = malignancy
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4/25. Localized oral fusarium infection in an AIDS patient with malignant lymphoma.

    We report here a case of localized oral fusarium infection in an AIDS patient who developed an ulceration in the soft palate. fusarium solani was identified by histopathology and culture. We believe this to be the second reported case of oral fusarium infection in a patient with haematological malignancy and the first reported association of oral fusarium infection with AIDS.
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ranking = 366.35457654438
keywords = haematological malignancy, malignancy
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5/25. splenic rupture in children with hematologic malignancies.

    BACKGROUND: splenic rupture is an uncommon but life-threatening complication of leukemias and lymphomas, and is reported mostly in adults. The authors investigated the frequency with which splenic rupture is diagnosed in pediatric patients with hematologic malignancies and reviewed its clinical profile and outcome. methods: The data base of St. Jude Children's research Hospital was searched for cases coded as splenic laceration or rupture, splenic infarction, or splenectomy in patients diagnosed with lymphoma or leukemia between January 1962 and December 1997. The medical records of patients with histopathologic or radiologic evidence of splenic rupture were reviewed. The time spanned by the study was divided into early (1962-1990) and recent (1991-1997) eras to reflect the availability of modern diagnostic imaging techniques. RESULTS: Seven children experienced splenic rupture. They were between ages 5-17 years. There were four males and three females. Primary diagnoses included acute myeloid leukemia (four patients), acute lymphoblastic leukemia (two patients), and Hodgkin lymphoma (one patient). Five patients were diagnosed in the recent era and two in the early era. Four patients had radiologic or bacteriologic evidence of fungal infection concomitant with the splenic event. Of five deaths, only two were related causally to splenic rupture; these occurred in the early era. All seven acute episodes of splenic rupture were managed conservatively without surgery. CONCLUSIONS: The overall frequency with which splenic rupture was detected in children with hematologic malignancy at the study institution was 0.18%. In the recent era, the frequency of detection was 9-fold higher (0.55%) than that of the early era (0.06%). Improved imaging techniques and increased utilization of imaging studies may account for the increased incidental detection of "preclinical" splenic rupture. adolescent age group, acute myeloid leukemia (especially acute promyelocytic leukemia), a high leukocyte count, thrombocytopenia, and coagulopathy may predispose children with leukemia to pathologic splenic rupture. Fungal infection frequently was associated with splenic rupture and may play a role in its pathogenesis.
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ranking = 1
keywords = malignancy
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6/25. Successful treatment of disseminated fusarium infection in an infant with leukemia.

    Disseminated fusarium infection in an immunocompromised host is intractable and results in high mortality. We provide the first full case report on successful treatment of a disseminated fusarium infection in an infant. The 6-month-old infant, whose family raised livestock, had infantile leukemia. During the neutropenic period after intensive chemotherapy, vomiting, diarrhea, fever, subcutaneous nodes, and coughing appeared. pneumonia was diagnosed, and fusarium moniliforme was isolated from blood culture. A central venous catheter was removed. granulocyte colony-stimulating factor (G-CSF) and amphotericin b (AMPH-B) (total dose, 65 mg/kg) were administered continuously for 8 weeks. The infection was resolved according to improvement of clinical and laboratory findings, and intensive chemotherapy was restarted for the leukemia. cord blood stem cell transplantation from an unrelated donor was performed. The fusarium infection did not recur, but after transplantation, leukemia relapsed. Treatment of neutrophils using G-CSF, AMPH-B, and local treatment induced resolution of the disseminated fusarium infection in this immunocompromised host with malignancy. We suggest caution for patients living in an environment conducive to the development of fusarium infection because of the particular risk of infection.
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ranking = 1
keywords = malignancy
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7/25. trichosporon asahii, a non-candida yeast that caused fatal septic shock in a patient without cancer or neutropenia.

    trichosporon asahii (formerly trichosporon beigelii) is an emerging fungal pathogen seen particularly in immunologically compromised patients. There are now approximately 100 reported cases of hematogenously disseminated infections with this life-threatening yeast, and no effective antifungal therapy is available. The present case is unusual because the patient did not have neutropenia or evidence of a malignancy.
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ranking = 1
keywords = malignancy
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8/25. Invasive fungal infections: evolving challenges for diagnosis and therapeutics.

    Invasive fungal infections (IFI) parallel the explosive increase in the immunocompromized patient population, and are characterized by diagnostic difficulties and extreme mortality. candidemia in a tertiary referral hospital in the middle east confirms the current epidemiologic shift in this common blood stream pathogen towards non-malignancy cases (38%) and antifungal prophylaxis failure (20%), high presentation sepsis scores and attributable mortality (32%). Invasive aspergillosis (IA) is also associated with high mortality. Use of non-invasive computerized tomographic (CT) radiologic scanning linked to early administration of high dose liposomal amphotericin b (LAB) is associated with a reduced mortality of 9.5% compared to historical experience of 28%.life threatening invasive aspergillosis also occurs in patients who are less obviously immunocompromized. Investigations may reveal subtle immune deficits which could place the patient at some risk for an invasive mycosis. Antifungal treatment used in combination with progenitor cell growth factors and gamma-interferon has proved successful in such situations of progressive fungal disease unresponsive to antifungal therapy alone.Pharmacologic remodeling of existing compounds by lipidisation reduces both the toxicity denominator and the efficacy numerator of the therapeutic index when compared to the parent drug. A comparative dose study of liposomal amphotericin b in aspergillosis has demonstrated equi-efficacy, generated debate over the ability of the controlled clinical trial to be capable of assessing antifungal efficacy, and illustrated that recovery from an invasive fungal infection may require maximum tolerated doses and immunomanipulation.Several new antifungal strategies are under clinical investigation. These include reformulating existing antifungals, exploitation of the growing knowledge of virulence factors to synthesize antagonists, immune reconstitution and immunoprotection. An interim analysis of an ongoing placebo controlled study of recombinant interleukin-11 to assess its efficacy in reducing sepsis in leukemia patients through prevention of chemotherapy induced gut epithelial cell apoptosis, has demonstrated a difference in the two study arms in sepsis rates and preservation of gastrointestinal epithelial cell integrity.The unique and special challenges presented by the dynamic epidemiologics of invasive fungal infections are demanding and attracting considerable responses, in the fields of diagnosis and therapeutics. Current strategies need considerable improvement, yet ongoing collaborative efforts will have a positive impact on our understanding of the fungus-host interaction and ultimately our ability to offer better care for our patients with invasive mycoses.
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ranking = 1
keywords = malignancy
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9/25. Invasive infections due to trichoderma species: report of 2 cases, findings of in vitro susceptibility testing, and review of the literature.

    trichoderma species are filamentous fungi that were previously considered to be culture contaminants. We report 2 well-documented cases of invasive trichoderma infections, and we comprehensively review the literature on this topic. trichoderma species are mainly responsible for continuous ambulatory peritoneal dialysis-associated peritonitis (7 cases) and invasive infections in immunocompromised patients (9 cases) with a hematologic malignancy or solid-organ transplant. Definitive diagnosis is difficult to achieve because of the lack of specific diagnosis tools. Species identification can benefit from a molecular approach. trichoderma longibrachiatum is the most common species involved in these infections. Regardless of the type of infection, the prognosis was poor, with 8 deaths among 18 cases. This may be partially because of the resistance of these organisms to the majority of available antifungal agents, including amphotericin b. trichoderma species now should be added to the growing list of emerging filamentous fungal pathogens.
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ranking = 1
keywords = malignancy
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10/25. Actinomycotic tubo-ovarian abscess mimicking pelvic malignancy.

    A 39-year-old multipara was admitted to hospital with lower abdominal pain. She had used an intrauterine device (IUD) for 10 years. Three years ago, her tubes were ligated. Ultrasound examination revealed a 9.5 x 6 cm multiloculated cystic mass in the right part of her lower abdomen. CA-125 was also found to be increased. Since ovarian malignancy was suspected, laparotomy was performed. Pathologically, an actinomycotic tubo-ovarian abscess with sulfur granules was disclosed.
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ranking = 5
keywords = malignancy
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