1/15. Streptococcal toxic shock syndrome revealed by a peritonitis. Case report and review of the literature.Group A streptococcus (GAS) or streptococcus pyogenes cause a variety of life-threatening infectious complications including necrotizing fasciitis, purpura fulminans and streptococcal toxic shock syndrome (STSS). exotoxins that act as superantigens are felt to be responsible for STSS. These exotoxins are highly destructive to skin, muscle and soft tissue. This syndrome has a rapid and fulminant course with frequently fatal outcome. GAS remains sensitive to penicillin but in serious infection a combination of clindamycin and ceftriaxone or meropenemum is recommended. Several studies have shown that mortality was dramatically reduced in STSS patients treated with immunoglobulin g given intravenously (IVIG). Early recognition of this most rapidly progressive infection and prompt operative debridement are required for successful management. This report presents a female patient at two month post-partum with a peritonitis and multi-organ failure.- - - - - - - - - - ranking = 1keywords = antigen (Clic here for more details about this article) |
2/15. cytomegalovirus colitis following immunosuppressive therapy for lupus peritonitis and lupus nephritis.We report a woman with lupus nephritis complicated with lupus peritonitis and cytomegalovirus (CMV) colitis. diagnosis of lupus peritonitis was made by abdominal computed tomography scan, colonoscopy, and ascitic fluid analysis. Steroid and cyclophosphamide therapy resulted in the improvement of severe lupus nephritis and peritonitis. Thereafter, she developed multiple colonic ulcers as diagnosed by colonoscopy and positive CMV antigenemia assay. Treatment with ganciclovir resulted in the disappearance of colonic lesions. The low cluster of differentiation (CD)4 lymphocyte count (41/mm3) suggested that the cell-mediated immunity of this patient was comparable to that seen in patients with acquired immunodeficiency syndrome (AIDS).- - - - - - - - - - ranking = 1keywords = antigen (Clic here for more details about this article) |
3/15. diagnosis of aspergillus peritonitis in a renal dialysis patient by PCR and galactomannan detection.This report describes the use of the polymerase chain reaction (PCR) and galactomannan detection to detect aspergillus in the continuous ambulatory peritoneal dialysis (CAPD) fluid and blood of a patient with multiple myeloma on CAPD and immunosuppressive treatment. diagnosis of aspergillosis was initially made by conventional culture of CAPD fluid, but the PCR and galactomannan assays also detected aspergillus dna and antigen in the blood, respectively. This suggests that the PCR and galactomannan assays, previously suggested as useful in the management of invasive fungal infections in neutropenic haematological patients, may be suitable for application to a broad range of clinical situations and sample types.- - - - - - - - - - ranking = 1keywords = antigen (Clic here for more details about this article) |
4/15. immunohistochemistry for the differentiation of peritoneal disseminated carcinoma of unknown origin.We report a woman with ascites, hydrothorax, pancreatic tumor, left cystic ovarian tumor, and an elevated serum cancer antigen 125 level. Exploratory laparotomy was performed to determine peritoneal disseminated carcinoma of unknown origin. Immunohistochemical analysis demonstrated positive staining for carcinoembryonic antigen, trypsin, and progesterone receptor and nonspecific or negative reaction for calretinin, estrogen receptor, amylase, lipase, wilms tumor gene 1 protein, and inhibin or chromogranin a. These results together with the morphology of tubular structure suggested the pathological diagnosis of adenocarcinoma with pancreatic characteristics and contradicted ovarian cancer or mesothelioma. immunohistochemistry is an adjunct tool to differentiate the primary site of carcinomatous peritonitis.- - - - - - - - - - ranking = 2keywords = antigen (Clic here for more details about this article) |
5/15. Peritoneal eosinophilia associated with paecilomyces variotii infection in continuous ambulatory peritoneal dialysis.A 65-year-old woman maintained on continuous ambulatory peritoneal dialysis (CAPD) presented with a 5-month history of intermittent cloudy bags and sterile peritoneal and peripheral blood eosinophilia, which failed to clear despite conventional antibiotics. Impaired catheter inflow and delayed effluent drainage gradually occurred and intracatheter streptokinase, administered to rectify catheter dysfunction, dislodged a catheter cast composed of fungal hyphae of paecilomyces variotii. Fungal peritonitis and paecilomyces fungemia ensued, which were treated with amphotericin b and catheter removal. Peripheral eosinophilia rapidly resolved. paecilomyces is a saprophytic fungus found in soil and water that is capable of infecting prosthetic devices. eosinophils may have accumulated in this case in response to particulate fungal cell antigens being washed into the peritoneal cavity during dialysis. Chronic fungal catheter infection should be excluded in cases of late onset, persistant peritoneal eosinophilia on CAPD.- - - - - - - - - - ranking = 1keywords = antigen (Clic here for more details about this article) |
6/15. Disseminated coccidioidomycosis with peritonitis in a patient with acquired immunodeficiency syndrome. Prolonged survival associated with positive skin test reactivity to coccidioidin.coccidioidomycosis involving the lungs and the meninges occurred as the sole opportunistic infection in a patient with the acquired immunodeficiency syndrome (AIDS). skin test reactivity to coccidioidin was present, but antibody response to coccidioidal antigens was markedly distinguished. Treatment with amphotericin B, administered intravenously for 3 1/2 months and intrathecally for 13 months, resulted in a disease-free interval of one year. Subsequently, coccidioidal peritonitis developed, which responded to treatment with amphotericin b. However, 29 months after the initial diagnosis, the patient died of complications of hepatic encephalopathy resulting from alcoholic cirrhosis. To our knowledge, this patient represents the first reported case of coccidioidal peritonitis in AIDS and involves the most prolonged survival of a patient with coccidioidomycosis and AIDS. The presence of positive skin test reactivity to coccidioidin may have been a predictor of prolonged survival in this patient.- - - - - - - - - - ranking = 1keywords = antigen (Clic here for more details about this article) |
7/15. Cryptococcal peritonitis in patients on peritoneal dialysis.peritonitis is an unusual complication of infections caused by cryptococcus neoformans and has rarely been reported in patients with end-stage renal disease who are maintained on peritoneal dialysis. We report two patients on chronic peritoneal dialysis in whom the first known manifestation of cryptococcal infection was dialysate cultures positive for cryptococcus neoformans. One patient was on prednisone for systemic lupus erythematosis. The other patient was severely malnourished with type I diabetes mellitus. Both patients were found to have cryptococcal meningitis. Both patients were treated with intravenous (IV) amphotericin b and removal of the dialysis catheter. Evaluation and care of peritoneal dialysis patients with cryptococcal peritonitis include serial cryptococcal cultures and antigen titers, investigation for cryptococcal meningitis, removal of the peritoneal dialysis catheter, and IV amphotericin b.- - - - - - - - - - ranking = 1keywords = antigen (Clic here for more details about this article) |
8/15. toxoplasma peritonitis in a patient with acquired immunodeficiency syndrome.toxoplasma gondii was identified in a stained slide preparation of, and isolated from, peritoneal fluid specimens obtained from a patient with the acquired immunodeficiency syndrome (AIDS). At the time of admission to the hospital, the patient's serologic tests were positive for toxoplasma. toxoplasma was isolated from samples of the patient's blood by mouse inoculation. Findings of newly developed methods for diagnosis of the presence of T gondii in body fluids by assay for toxoplasma-specific antigen and by use of a dna probe were positive.- - - - - - - - - - ranking = 1keywords = antigen (Clic here for more details about this article) |
9/15. peritoneal dialysis complicated by aspergillus flavus peritonitis: a role for fungal antigen serodiagnosis.A patient is described with aspergillus peritonitis associated with peritoneal dialysis. Although the diagnosis was established by exploratory laparotomy, aspergillus antigenemia was detected retrospectively in sera obtained 15 days prior to the surgical procedure. An approach to the evaluation of a patient with culture negative peritonitis and the potential clinical usefulness of the detection of fungal antigen in serum and peritoneal fluid of patients undergoing peritoneal dialysis is discussed.- - - - - - - - - - ranking = 6keywords = antigen (Clic here for more details about this article) |
10/15. hepatitis b virus: a possible cause of serositis in hemodialysis patients.An epidemiologic survey in a maintenance hemodialysis population of 300 patients was undertaken to relate the appearance of acute serositis (pericarditis, pleuritis or ascites) to HBsAg antigenemia. A significant number of incidents of serositis occurred in patients acutely or chronically infected with hepatitis B surface antigen (HBsAg) suggesting an etiologic role for the virus in the serositis of uremia. In 2 patients with both end-stage renal disease and chronic HBsAg antigenemia, immunofluorescent studies of serosal tissues showed fluorescent clusters interpreted to be HBs antigen-antibody complexes. It is concluded that an immunologic response to viremia may be one of the causes of serositis in uremia.- - - - - - - - - - ranking = 4keywords = antigen (Clic here for more details about this article) |
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