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Fungal infection and pancreas

Thomas Schachtner, Marina Zaks, Natalie M Otto, Andreas Kahl, Petra Reinke
BACKGROUND: As immunosuppressive therapy has improved in simultaneous pancreas/kidney transplant recipients (SPKTRs), infection has become the major limitation of disease-free survival. METHODS: We studied all SPKTRs and deceased-donor kidney transplant recipients (KTRs) between 2003 and 2015. Thirty-six of 134 SPKTRs (26.9%) were diagnosed with sepsis among which 13/36 SPKTRs (36.1%) developed severe sepsis/septic shock. A control group of 98 SPKTRs without sepsis and 61/538 KTRs (11...
April 2018: Transplant Infectious Disease: An Official Journal of the Transplantation Society
Naomi Chou, Rebecca Burbridge, Sarah Karram
Fungal infections of the pancreas have been shown to occur most commonly in the setting of necrotizing pancreatitis, pancreatic cysts, or pancreatic abscesses. Pancreatic fungal infections are rare without these predisposing factors, and may present similarly to pancreatic neoplasm. We report the case of a 48-year-old man who presented with epigastric abdominal pain, nausea, vomiting, and weight loss, with a potential mass in the head of the pancreas. The mass was resected via the Whipple procedure and was found to be a fungal collection with inflammatory cells and no malignancy...
2017: ACG Case Reports Journal
K Erles, A Mugford, D Barfield, T Leeb, P H Kook
An 11-month-old Border collie presented collapsed and continued to deteriorate rapidly despite supportive treatment. The dog had a history of failure to thrive and recurring respiratory infection. Laboratory abnormalities included neutrophilic leucocytosis, Heinz body anaemia, hyperammonaemia, hyperbilirubinaemia, proteinuria and hypocobalaminaemia. Post-mortem examination revealed multi-focal necrosis within the heart, kidneys, pancreas, liver, meninges and cerebral cortex. Fungal hyphae in lesions were identified as Scedosporium prolificans following culture...
April 8, 2017: Journal of Small Animal Practice
Paula E R Bitencourt, Lariane O Cargnelutti, Carolina S Stein, Raquel Lautenchleger, Luana M Ferreira, Manuela Sangoi, Laura Denardi, Raphaela M Borges, Aline Boligon, Rafael N Moresco, Letícia Cruz, Régis A Zanette, Sydney H Alves, Maria Beatriz Moretto
CONTEXT: Syzygium cumini (L.) Skeels (Myrtaceae) is a medicinal plant widely used in folk medicine for the treatment of diabetes mellitus (DM). However, studies on the use of this plant and of nanoparticle formulations against DM-related fungal infections are scarce. OBJECTIVE: To evaluate the effect of the treatments with aqueous seed extract of S. cumini (ASc) and ASc-loaded polymeric nanoparticles (NPASc) on biochemical parameters in Candida albicans-infected diabetic rats...
December 2017: Pharmaceutical Biology
Xiang-Wang Zhao, Lei Yan, Dan Xu, Yu-Hui Cui, Chun-Hui Yang, Yan-Jun Zhou, Jian-Guo Tang
BACKGROUND: Opportunistic infection of Candida albicans (C. albicans) has become a serious problem in immunocompromised patients. The study aimed to explore the mechanism of enterogenous infection of C. albicans in immunocompromised rats under severe acute pancreatitis (SAP). METHODS: Sprague Dawley (SD) rats (n=100) were randomly assigned into 5 groups as the following: blank group, cyclophosphamide+ceftriaxone+SAP group, cyclophosphamide+ceftriaxone group, cyclophosphamide+SAP group, and cyclophosphamide group...
2016: World Journal of Emergency Medicine
Hugo Bonatti, Costi D Sifri, Clara Larcher, Stefan Schneeberger, Camille Kotton, Christian Geltner
BACKGROUND: Solid organ transplantation (SOT) frequently is complicated by cytomegalovirus (CMV) infections. Cidofovir (CDV) is active against CMV, including many ganciclovir (GCV)-resistant mutants, but often is considered to be too nephrotoxic for use after organ transplantation. PATIENTS AND METHODS: Seven males and two females (median age 50.1 years), including two kidney/pancreas, four lung, one small bowel, and two hand recipients, received CDV for refractory CMV disease...
February 2017: Surgical Infections
L F A Guimarães, M Halpern, A S de Lemos, E F de Gouvêa, R T Gonçalves, M A A da Rosa Santos, M Nucci, G Santoro-Lopes
INTRODUCTION: Invasive fungal disease (IFD) is an important complication after solid organ transplantation (SOT). A marked geographic variation in the epidemiology of IFD after kidney transplantation (KT) has been suggested by the results of previous studies. Nevertheless, data from Latin American centers are scarce. OBJECTIVE: This study sought to describe the epidemiology of IFD at a Brazilian KT center. METHODS: This study was a retrospective single-center cohort study that included patients who underwent KT between 1998 and 2009 and were followed up until July 2015...
September 2016: Transplantation Proceedings
Thilo Hackert, Markus Wolfgang Büchler
The management of acute necrotizing pancreatitis (ANP) has undergone a change of paradigms during the last 2 decades with a decreasing impact of surgical interventions. Modern ANP management is done conservatively as long as possible and therapeutic approaches aim at volume resuscitation, pain management and early enteral nutrition. The diagnostic gold standard of contrast-enhanced CT scan helps to evaluate the extent of necrosis of the pancreas, which correlates with the risk of tissue infection. The crucial point for decision making is the proven existence of infected pancreatic necrosis...
2016: Digestive Diseases
Rafael Zaragoza, José María Aguado, Ricard Ferrer, Alejandro H Rodríguez, Emilio Maseda, Pedro Llinares, Santiago Grau, Patricia Muñoz, Jesús Fortún, Mercedes Bouzada, Juan Carlos Del Pozo, Rafael León
BACKGROUND: Although over the past decade the management of invasive fungal infection has improved, considerable controversy persists regarding antifungal prophylaxis in solid organ transplant recipients. AIMS: To identify the key clinical knowledge and make by consensus the high level recommendations required for antifungal prophylaxis in solid organ transplant recipients. METHODS: Spanish prospective questionnaire, which measures consensus through the Delphi technique, was conducted anonymously and by e-mail with 30 national multidisciplinary experts, specialists in invasive fungal infections from six national scientific societies, including intensivists, anesthetists, microbiologists, pharmacologists and specialists in infectious diseases that responded to 12 questions prepared by the coordination group, after an exhaustive review of the literature in the last few years...
October 2016: Revista Iberoamericana de Micología
T Grochowiecki, Z Gałązka, K Madej, S Frunze, S Nazarewski, T Jakimowicz, L Pączek, M Durlik, J Szmidt
OBJECTIVE: Simultaneous pancreas and kidney transplantation (SPKTx) is the most often performed multiorgan transplantation. The main source of complication is transplanted pancreas; as a result, early complications related to kidney transplant are rarely assessed. The aim of this study was to evaluate prevalence, types, and severity of postoperative complications due to kidney graft among the simultaneous pancreas and kidney recipients. METHODS: Complications related to transplanted kidney among 112 SPKTx recipients were analyzed...
October 2014: Transplantation Proceedings
D Kawecki, A Kwiatkowski, A Sawicka-Grzelak, M Durlik, G Mlynarczyk, A Chmura
OBJECTIVE: This study aims to evaluate the frequency of microbial isolates and their susceptibility profiles cultured from clinical samples obtained from 26 simultaneous pancreas-kidney transplant (SPK) recipients suspected of infections during the early post-transplantation period. PATIENTS AND METHODS: Data on microbiologic culture of 26 adult patients undergoing SPK were collected prospectively from 2001 to the end of 2006. Isolation and identification of cultured micro-organisms were performed according to standard microbiological procedures and commercially available tests...
October 2014: Transplantation Proceedings
Enrique de-Madaria
Acute pancreatitis (AP) is a common disease that is associated with significant morbidity and considerable mortality. In this article, developments relating to this disease that were presented in DDW 2014 are reviewed. Pancreatic steatosis could be a cause of recurrent AP. Patients with DM have an increased incidence of AP and pancreatic cancer. The use of anti-TNF drugs in inflammatory bowel disease may protect against the occurrence of AP. The presence of pancreas divisum protects against acute biliary pancreatitis...
September 2014: Gastroenterología y Hepatología
J M Miro, F Agüero, J-C Duclos-Vallée, N J Mueller, P Grossi, A Moreno
Solid organ transplantation (SOT) is an appropriate therapeutic option for HIV-infected patients with end-stage organ disease. Recent experience in North America and Europe indicates that 3- to 5-year survival in HIV/HCV-coinfected liver recipients is lower than that of HCV-monoinfected recipients. Conversely, 3- to 5-year survival of non-HCV-coinfected transplant patients (liver, kidney and heart) was similar to that of non-HIV-infected patients. Preliminary experience with lung transplantation and combined kidney and pancreas transplantation is also satisfactory...
September 2014: Clinical Microbiology and Infection
Fiona M Keane, Tsun-Wen Yao, Stefanie Seelk, Margaret G Gall, Sumaiya Chowdhury, Sarah E Poplawski, Jack H Lai, Youhua Li, Wengen Wu, Penny Farrell, Ana Julia Vieira de Ribeiro, Brenna Osborne, Denise M T Yu, Devanshi Seth, Khairunnessa Rahman, Paul Haber, A Kemal Topaloglu, Chuanmin Wang, Sally Thomson, Annemarie Hennessy, John Prins, Stephen M Twigg, Susan V McLennan, Geoffrey W McCaughan, William W Bachovchin, Mark D Gorrell
The protease fibroblast activation protein (FAP) is a specific marker of activated mesenchymal cells in tumour stroma and fibrotic liver. A specific, reliable FAP enzyme assay has been lacking. FAP's unique and restricted cleavage of the post proline bond was exploited to generate a new specific substrate to quantify FAP enzyme activity. This sensitive assay detected no FAP activity in any tissue or fluid of FAP gene knockout mice, thus confirming assay specificity. Circulating FAP activity was ∼20- and 1...
2013: FEBS Open Bio
Sam Zaid, Ahmed Mahmoud, Maged Barry, Robert Yavrouian
BACKGROUND: The lung is the most common site of coccidioidomycosis, with extrapulmonary sites of infection being described rarely. To date, the pancreas has not been reported as an isolated site of coccidioidomycosis. METHODS: Case report and literature review. CASE REPORT: Computed tomography (CT)-guided biopsy and gram staining of the pancreatic lesion of an immunocompetent patient without known risk factors revealed coccidioidomycosis of the head of the pancreas without malignant neoplasm or atypia...
December 2013: Surgical Infections
S Irtan, M Lamerain, F Lesage, V Verkarre, M-E Bougnoux, F Lanternier, J R Zahar, N Salvi, C Talbotec, O Lortholary, F Lacaille, C Chardot
Mucormycosis, an emerging fungal infection in solid organ transplant patients, is mostly located in rhino-orbito-cerebral, pulmonary, and cutaneous areas, or disseminated with poor prognosis. A 4-year-old girl with chronic intestinal pseudo-obstruction syndrome underwent a modified multivisceral transplantation, including half of the stomach, the duodeno-pancreas, the small bowel, and the right colon. On postoperative day 5, a digestive perforation was suspected. Surgical exploration found a small necrotic area on the native stomach, which was externally drained...
December 2013: Transplant Infectious Disease: An Official Journal of the Transplantation Society
Anna Poradzka, Mariusz Jasik, Waldemar Karnafel, Piotr Fiedor
Diabetes mellitus is one of the main risk factors of fungal infections of oral cavity, lower part of gastrointestinal tract, skin, foot, urogenital system and blood. Mycosis is a serious diagnostic and therapeutic problem and cause of mortality in diabetes. Fungal infections are also an important problem among hemodialysis patients with diabetes or diabetic patients after pancreas or kidney transplantation This work briefly describes the etiology, symptoms, diagnosis and ways of prophylaxis and treatment of mycosis in diabetic population...
July 2013: Acta Poloniae Pharmaceutica
Chelsea Guymer, Sanjeev Khurana, Ram Suppiah, Iain Hennessey, Celia Cooper
Mucormycosis is a rare angioinvasive fungal infection, more commonly seen in immunosuppressed patients, with reported mortality rates of 95% in disseminated disease. We present a case report of a patient with T-cell acute lymphoblastic leukaemia who developed disseminated infection with mucormycosis (involving the pancreas, left occipital lobe, right lower lobe of lung, appendix and right kidney) after having completed induction and consolidation chemotherapy. Growth of Lichtheimia corymbifera was initially isolated following a right pleural tap with fungal elements identified repeatedly on subsequent pathology specimens...
July 31, 2013: BMJ Case Reports
J M Herrero-Martínez, C Lumbreras, A Manrique, R San-Juan, A García-Reyne, F López-Medrano, M Lizasoain, B de Dios, A Andrés, C Jiménez, E Gutiérrez, E Moreno, J M Aguado
Limited information exists about epidemiology and risk factors of infection following pancreas-kidney transplantation and its impact on long-term pancreatic graft function. A retrospective chart review of episodes of severe infection in consecutive pancreas-kidney transplantations in a single institution was performed to assess the epidemiology, risk factors for infection and their impact on the development of pancreatic graft dysfunction. Ninety-four (81%) of 116 recipients (median follow-up of 1492 days; mean 1594) developed 248 episodes of severe infection...
December 2013: Clinical Microbiology and Infection
Michele Bartoletti, Carlos Cervera, Irma Hoyo, Laura Linares, Gemma Sanclemente, Jordi Bosch, Francesc Marco, Federico Cofán, María José Ricart, Miquel Navasa, Asunción Moreno
Candida peritonitis is a potentially life-threatening infection after abdominal transplantation, although there is scant information regarding its incidence and outcome. We analysed the incidence rate and outcome of Candida peritonitis in 717 liver or pancreas transplant recipients. Five cases of Candida peritonitis were diagnosed, representing the second most frequent cause of invasive fungal infection in the cohort. The incidence rate of Candida peritonitis during the first 30 days after transplantation was 6...
March 2013: Mycoses
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