Cases reported "mycotoxicosis"

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1/3. Acute aflatoxicosis: case report.

    The objective of this presentation is to document the salient clinical findings in a case of aflatoxicosis and to review the literature on the same so as to increase the index of suspicion, enhance early diagnosis and improve management. The case was a 17-year-old schoolboy presenting with vomiting, features of infection and gastrointestinal tract symptoms. Examination revealed a very ill looking pale patient with abdominal distension, tenderness and rectal bleeding and easy bruisability. Investigations showed abnormal liver function tests, pancytopenia and elevated serum levels of aflatoxins. Management consisted of supportive care including antibiotics and antifungal therapy, transfusion of red blood cells and fresh frozen plasma. His recovery was uneventful. The literature on human aflatoxicosis shows that the presentation may be acute, subacute and chronic. The degree of emanating clinical events also conforms to status of the aflatoxicosis. overall, the features are protean and may masquerade many other forms of toxaemias. In conclusion, the diagnosis of aflatoxicosis takes cognisance of geographical location, past events, staple diet and clinical features to exclude other infections. Also required are high index of suspicion and importantly serum levels of aflatoxin. Treatment strategies involved use of antimicrobials and supporting the damaged multi-organs. ( info)

2/3. Sporadic clinical human mycotoxicosis. A widespread new unitarian pathology?

    Over hundreds of years, huge losses of human life have resulted from the ingestion of plant mycotoxins. These virulent toxins are manufactured at times by certain fungi which speedily infest cereals stored at moisture levels of more than 15%, a situation that is very common in subsistence farming. As these toxins can withstand both boiling, and gastric acid and they can pass the placental barrier, it is fair to say that huge numbers of humans are exposed to them from intra-uterine life to the very grave. It would be strange thus were they not responsible for wide-spread sporadic (non-epidemic) disease, either as a sole agent or one that conditions humans to the ill effects of other agents, especially when compared with effects upon animals. This paper sets out the bases for these suggestions, and reviews clinical patterns and details results of investigations upon hospitalised patients. ( info)

3/3. Pulmonary mycotoxicosis: a clinicopathologic study of three cases.

    Pulmonary mycotoxicosis (PM), also termed organic dust toxic syndrome or silo unloader's syndrome, is an acute illness resulting from massive inhalation of microbial toxins in organic dusts. It has not been well described histologically. Three cases of PM are presented in this report. Open lung biopsies were examined in each case. All of the patients were farmers with no prior lung disease. One had burning in his eyes, throat, and chest after exposure to moldy silage; chills, fever, dry cough, malaise, and weakness developed within 24 hours. Two patients presented with fever, progressive dyspnea, cough, and fatigue within 24 hours of emptying a corncrib, cleaning a chicken coop, and baling hay. Bilateral alveolar and interstitial infiltrates on chest roentgenograms and leukocytosis with neutrophilia were observed in all of the three patients. Two patients became hypoxemic and required mechanical ventilation. Histologic examination showed acute and organizing diffuse alveolar damage in two biopsy specimens and an acute bronchopneumonia in the third. One specimen had 1- to 10-microm ovoid organisms demonstrable with methenamine silver stains; cultures grew fusarium and penicillium species. The other two biopsy specimens had negative tissue cultures and special stains for organisms, although penicillium species were grown from a preoperative bronchoalveolar lavage in one case. The two patients on mechanical ventilation recovered completely with high-dose steroids. The third patient recovered without steroids. No patient had residual functional deficits or chest radiographic abnormalities. PM can be distinguished from allergic and infectious diseases common in individuals exposed to large amounts of organic dust by its clinicopathologic features. ( info)

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