1/22. porphyromonas gingivalis bacteremia and subhepatic abscess after renal transplantation: a case report.A uremic patient developed subhepatic abscess, porphyromonas gingivalis bacteremia and cytomegalovirus viremia after a renal transplantation in mainland china. P. gingivalis infection has been reported to cause gingivitis and periodontitis. bacteremia due to P. gingivalis, however, has not been reported in the literature. We report herein a case of subhepatic abscess and bacteremia due to P. gingivalis in a renal transplant recepient who was treated successfully with the well functioning renal graft.- - - - - - - - - - ranking = 1keywords = cytomegalovirus (Clic here for more details about this article) |
2/22. Disseminated fatal human cytomegalovirus disease after severe trauma.OBJECTIVE: Disseminated human cytomegalovirus (HCMV) disease is considered to be uncommon in critically ill but otherwise not immunosuppressed patients. We describe the case of a trauma victim who developed fatal HCMV disease that initially presented as pseudomembranous colitis and resulted in sudden cardiac death. DESIGN: Case report of fatal HCMV disease in a previously healthy patient after multiple trauma. SETTING: Surgical intensive care unit (ICU). PATIENT: A 63-yr-old male patient with multiple injuries. INTERVENTIONS AND MEASUREMENTS: Under ICU treatment, symptoms of HCMV reactivation presenting as pseudomembranous colitis appeared 32 days after trauma. Detailed laboratory examinations for HCMV infection were performed, including complement fixation titer, immunoglobulin g and M, polymerase chain reaction, and virus isolation. RESULTS: The intravital detection of HCMV dna in serum, leukocytes, and a colonic biopsy specimen indicated HCMV reactivation. Postmortem examination findings, including positive viral cultures, showed severe disseminated HCMV disease with involvement of the colon and myocardium. CONCLUSIONS: The lack of specific clinical symptoms of HCMV disease and the delay until viral culture results are available make an exact and timely diagnosis of HCMV disease difficult. Its prevalence in critically ill but otherwise not immunosuppressed patients is currently unknown and possibly underestimated. Because severe illness or trauma can cause immunodysfunction and, thus, may contribute to an increased rate of HCMV disease, detailed studies are warranted to evaluate the real risk in the ICU setting.- - - - - - - - - - ranking = 5keywords = cytomegalovirus (Clic here for more details about this article) |
3/22. Quantitative monitoring of circulating Epstein-Barr virus dna for predicting the development of posttransplantation lymphoproliferative disease.Epstein-Barr virus (EBV)-dna was quantitatively measured to assess posttransplantation virus reactivation by real-time polymerase chain reaction (PCR). In the first retrospective analysis of a 7-year-old boy with lymphoproliferative disease (LPD) after an unrelated cord blood transplantation, serum EBV-dna progressively increased to 4 x 10(5) copies/mL. EBV load was then prospectively monitored in peripheral blood from posttransplantation patients. The second case was an 8 year-old boy with aplastic anemia who received a CD34 cell transplantation. This patient died of LPD with the progression of pulmonary nodules. EBV-dna increased to 4 x 10(4) copies/mL after the control of cytomegalovirus reactivation. On the other hand, EBV-dna was undetectable (<200 copies/mL) in the series of all 58 samples from 10 patients who did not develop LPD after hematopoietic stem cell transplantation. Sequential monitoring of circulating EBV-dna by quantitative PCR may be a useful indicator for predicting the development of posttransplantation LPD.- - - - - - - - - - ranking = 1keywords = cytomegalovirus (Clic here for more details about this article) |
4/22. T-gamma gene rearrangement and CMV mononucleosis.A clonal T-gamma rearrangement was found in peripheral blood and bone marrow in a 57-year-old female who presented with 6-week history of fevers, night sweats, and weight loss. splenomegaly, hemolytic anemia, atypical lymphocytosis, a marrow lymphoid aggregate, and elevated LDH had suggested lymphoproliferative disease. However, IgM serology for cytomegalovirus (CMV) was positive. With observation alone, her clinical features improved over 4 weeks with normalization of the blood count and disappearance of CMV viremia and the aberrant T-gamma clone. Acute CMV infection may mimic lymphoproliferative disease. T-gamma gene rearrangement may be part of the immune response to CMV infection and is not specific to lymphoid neoplasia.- - - - - - - - - - ranking = 1keywords = cytomegalovirus (Clic here for more details about this article) |
5/22. pharmacokinetics of ganciclovir in renal transplant children.Three cytomegalovirus (CMV)-seronegative children received renal transplants from CMV-seropositive donors and developed clinical symptoms of CMV infection between days 20 and 34 post transplantation. ganciclovir (DHPG) was administered in a 1-h infusion, and the doses and dose intervals were adapted to the degree of renal insufficiency, according to the manufacturer's recommendations for adults. Individual pharmacokinetic parameters of DHPG were determined and were markedly altered. plasma clearances were 0.4, 1.1 and 2.2 ml/min per kg and were related to individual creatinine clearances (20, 45 and 60 ml/min per 1.73 m2); the corresponding elimination half-lives were 23.7, 9.9 and 3.9 h. In two patients, the doses had to be further reduced in order to maintain plasma levels within the recommended values for peak and trough plasma concentrations. Therefore, monitoring of DHPG appears essential in adjusting dosage for optimal efficacy and minimal toxicity.- - - - - - - - - - ranking = 1keywords = cytomegalovirus (Clic here for more details about this article) |
6/22. Increase in severity of graft versus host disease by cytomegalovirus.An allogeneic transplant recipient developed severe graft versus host disease (GvHD) 48 days after transplantation that was concomitant with a cytomegalovirus (CMV) viraemia, from which she subsequently died. CMV infection was detected in blood by the polymerase chain reaction and later in tissue by immunohistochemical techniques. CMV should be considered in patients in whom GvHD does not respond to appropriate treatment, and this case suggests that herpes viruses may increase the severity of GvHD by synergistically enhancing the graft versus host reaction.- - - - - - - - - - ranking = 5keywords = cytomegalovirus (Clic here for more details about this article) |
7/22. Chronic intestinal pseudoobstruction in a patient with heart-lung transplant. Therapeutic effect of leuprolide acetate.After orthotopic heart-lung transplantation and immunosuppression, a patient developed intractable nausea and vomiting in association with chronic cytomegalovirus infection. Chronic intestinal pseudoobstruction was documented by antroduodenal manometric study. The patient was treated with leuprolide acetate with resolution of symptoms and improvement of intestinal motility abnormality. This case demonstrates an association of chronic viral infection with acquired intestinal motor disorders. Gastrointestinal complications that are common after organ transplantation might be due to acquired neuromuscular disease. The potential efficacy of leuprolide in such neuromuscular disorders provides a rationale for diagnostic motility studies in patients with "functional" gastrointestinal disorders.- - - - - - - - - - ranking = 1keywords = cytomegalovirus (Clic here for more details about this article) |
8/22. Alemtuzumab induced complete remission of autoimmune hemolytic anemia refractory to corticosteroids, splenectomy and rituximab.A 58-year-old man with warm-antibody-mediated autoimmune hemolytic anemia (AIHA) refractory to prednisolone, azathioprine, splenectomy, rituximab and combination chemotherapy, and with unacceptably high transfusion requirement, was treated with alemtuzumab. After a cumulative dose of 883 mg of alemtuzumab, the AIHA remitted completely, with normalization of hemoglobin and transfusion-independence. The major side effect was reactivation of cytomegalovirus, which was controlled with intravenous and oral ganciclovir. This case showed that alemtuzumab might be of use in therapy-refractory AIHA.- - - - - - - - - - ranking = 1keywords = cytomegalovirus (Clic here for more details about this article) |
9/22. multiple organ failure during primary hiv infection.The appearance of primary hiv infection ranges from an asymptomatic presentation to a symptomatic illness resembling infectious mononucleosis. Severe unusual presentations include acute myopericarditis, renal failure, and opportunistic infections such as esophageal candidiasis, cytomegalovirus infection, and pneumocystis jirovecii pneumonia. We report a case of multiple organ failure during primary hiv infection.- - - - - - - - - - ranking = 1keywords = cytomegalovirus (Clic here for more details about this article) |
10/22. Ultrastructural observations on the cytomegalic inclusion cell in peripheral blood.A 31-year-old woman with adult T-cell leukemia developed interstitial pneumonitis. Large abnormal cells different from those of adult T-cell leukemia appeared in the peripheral blood. hematoxylin-eosin staining of the buffy coat of peripheral blood revealed these cells to be cytomegalic inclusion cells. Electron microscopy disclosed cytomegalovirus particles in these inclusion cells. Virus particles were seen in both the nuclei and cytoplasm. Dense bodies characteristic of cytomegalovirus infection were also seen in the cytoplasm. This is the first report of cytomegalovirus particles found in the peripheral blood mononuclear cells.- - - - - - - - - - ranking = 3keywords = cytomegalovirus (Clic here for more details about this article) |
| | Next -> |