1/4. rhodococcus equi and cytomegalovirus pneumonia in a renal transplant patient: diagnosis by fine-needle aspiration biopsy.rhodococcus equi is a common cause of pneumonia in animals. Human infection is rare. Increasing number of cases are being reported in immunosuppressed individuals mostly associated with hiv infection, but also in solid organ transplant recipients and leukemia/lymphoma patients. We report on an adult male who developed pneumonia and gastroenteritis 4 mo after receiving a renal transplant. CT scan of the lungs showed a dominant 2.5-cm upper lobe lung mass and smaller bilateral nodules. He underwent a diagnostic bronchoscopy with fine-needle aspiration biopsy of the largest lung nodule. Smears showed histiocytic granulomatous inflammation, foamy macrophages, and acute inflammatory exudate. Scattered foamy macrophages displayed intracellular coccobacilli identifiable on Diff-Quik stain. A few cells with changes suggestive of viral inclusions were identified. cytomegalovirus (CMV) immunostain was positive in the cell block sections. lung cultures grew R. equi. To the best of our knowledge, this is the first report of coinfection with R. equi and CMV.- - - - - - - - - - ranking = 1keywords = coinfection (Clic here for more details about this article) |
2/4. Fatal case of aspergillus coinfection in a renal transplant recipient suffering from cytomegalovirus pneumonitis.cytomegalovirus (CMV) disease is common in postrenal transplant recipients, and may predispose the patients to secondary bacterial or fungal infections. However, simultaneous coinfection is rare and often makes diagnosis difficult. We report a case of CMV pneumonitis in a renal transplant recipient presenting with elevated CMV pp65 antigen level and abnormal chest radiograph. Despite potent and broad-spectrum antimicrobial therapy, his condition deteriorated rapidly - he soon went into respiratory failure, septic shock and died several days later. Transbronchial biopsy and bronchoalveolar lavage obtained before the patient's death showed evidence of invasive pulmonary aspergillosis with concomitant CMV pneumonitis. High index of suspicion and early and empirical initiation of antifungal therapy may be necessary for successful management of fulminant pneumonia in solid organ transplant recipients.- - - - - - - - - - ranking = 5keywords = coinfection (Clic here for more details about this article) |
3/4. Respiratory syncytial virus infection: a cause of respiratory distress syndrome and pneumonia in adults.Respiratory syncytial virus (RSV) infection, an important and sometimes lethal disease of infants and children, generally causes a milder and self-limited syndrome of cough, nasal congestion and fever in adults. While some evidence suggests that RSV may be responsible for more serious respiratory illness in the elderly and chronically ill, it has not been shown to cause life-threatening respiratory tract disease in previously healthy adults. This report describes a previously healthy woman who experienced the acute onset of right lower lobe pneumonia which rapidly progressed to the adult respiratory distress syndrome (ARDS). Acute and convalescent serology showed RSV was the cause of the respiratory tract illness. michigan Department of public health records revealed six additional cases of adult bilateral pneumonia with diagnostic antibody titers to RSV, with or without coinfection with a second organism. These data suggest that RSV may be an under-recognized cause of lower respiratory tract disease in adults.- - - - - - - - - - ranking = 1keywords = coinfection (Clic here for more details about this article) |
4/4. Lymphocytic alveolitis after primary hiv infection with CMV coinfection.Herein is a report of an adult case of primary hiv infection with cytomegalovirus coinfection causing cough, fever, and lymphocytic alveolitis. Primary hiv infection has not been previously reported as a cause of lymphocytic alveolitis.- - - - - - - - - - ranking = 5keywords = coinfection (Clic here for more details about this article) |