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Diagnosis fungal infections

Maria Pia Bondioni, Vassilios Lougaris, Giuseppe Di Gaetano, Tiziana Lorenzini, Annarosa Soresina, Francesco Laffranchi, Diego Gatta, Alessandro Plebani
PURPOSE: The purpose of this study is to evaluate the possibility of early detection of pulmonary fungal infections by lung CT scan in chronic granulomatous disease (CGD). METHODS: A retrospective study on 14 patients affected with CGD for a total of 18 infectious episodes was performed. Revision of clinical data and CT scan analysis before and after treatment was performed. RESULTS: The presence of lung nodules <30 mm was evaluated in 18 infectious episodes in 14 patients...
October 21, 2016: Journal of Clinical Immunology
Abolghasem Allahyari, Seyed-Mehdi Hashemi, Fahimeh Nazemian, Mohammad Karimi, Mohammad-Reza Kazemi, Masoud Sadeghi
BACKGROUND: Acute lymphoblastic leukemia (ALL) is aggressive cancer, especially in adults as only 20-40% is cured with current treatment regimens. OBJECTIVES: The aim of this study is to evaluate prognostic factors and their effects on survival in ALL patients in the Northeast of Iran. METHODS: In a descriptive and retrospective study from 2009 to 2015, 48 ALL patients referred to hematology-oncology clinic. Age, sex, fever, blood group, type of ALL and consumption of amphotericin B, forms of cytogenetic, survival in the patients, WBC, hemoglobin, and platelet were checked in the first referral for every patient...
August 2016: Iranian Journal of Cancer Prevention
Prasan K Panda, Siddharth Jain, Rita Sood, Rajni Yadav, Naval K Vikram
Histoplasmosis is caused by a dimorphic fungus Histoplasma capsulatum in endemic areas, mainly America, Africa, and Asia. In India, it is being reported from most states; however, it is endemic along the Ganges belt. We report a case of an apparently immunocompetent male who presented with 3-month history of fever, cough, and weight loss with recent onset odynophagia and had hepatosplenomegaly and mucocutaneous lesions over the face. The differential diagnosis of leishmaniasis, tuberculosis, leprosy, fungal infection, lymphoproliferative malignancy, and other granulomatous disorders was considered, but he succumbed to his illness...
2016: Case Reports in Infectious Diseases
Yun Long, Yinxin Zhang, Yanping Gong, Ruixue Sun, Longxiang Su, Xin Lin, Ao Shen, Jiali Zhou, Zhuoma Caiji, Xinying Wang, Dongfang Li, Honglong Wu, Hongdong Tan
BACKGROUND AND AIMS: Bacteremia is a common serious manifestation of disease in the intensive care unit (ICU), which requires quick and accurate determinations of pathogens to select the appropriate antibiotic treatment. To overcome the shortcomings of traditional bacterial culture (BC), we have adapted next-generation sequencing (NGS) technology to identify pathogens from cell-free plasma DNA. METHODS: In this study, 78 plasma samples from ICU patients were analyzed by both NGS and BC methods and verified by PCR amplification/Sanger sequencing and ten plasma samples from healthy volunteers were analyzed by NGS as negative controls to define or calibrate the threshold of the NGS methodology...
July 2016: Archives of Medical Research
Philippe Montravers, Pierre-François Perrigault, Jean-François Timsit, Jean-Paul Mira, Olivier Lortholary, Olivier Leroy, Jean-Pierre Gangneux, Didier Guillemot, Caroline Bensoussan, Sébastien Bailly, Elie Azoulay, Jean-Michel Constantin, Hervé Dupont
OBJECTIVE: To compare the clinical characteristics and prognosis of patients treated for Candida peritonitis (CP), according to the type of systemic anti-fungal therapy (SAT), empiric (EAF) or targeted (TAF) therapies, and the final diagnosis of infection. METHODS: ICU patients treated for CP were selected among the AmarCAND2 cohort, to compare patients receiving EAF for not confirmed suspicion of CP (EAF/nonCP), to those with suspected secondarily confirmed CP (EAF/CP), or with primarily proven CP receiving TAF...
October 13, 2016: Clinical Microbiology and Infection
Andrej Spec, Christopher R Barrios, Usama Ahmad, Laurie A Proia
Severe pulmonary or disseminated histoplasmosis often necessitates presumptive antifungal treatment while awaiting definitive diagnosis. Histoplasma antigen assays have improved sensitivity but results may lag up to 7 days. In order to increase diagnostic certainty, "soft clues" may be looked for in laboratory and radiologic data, such as elevated alkaline phosphatase or ferritin levels and findings of mediastinal adenopathy or hepatosplenomegaly. To determine if elevated aspartate aminotransferase (AST) to alanine aminotransferase (ALT) ratio is specific to histoplasmosis or a non-specific marker for disseminated fungal infection or sepsis in general, we retrospectively examined records of all patients diagnosed with an endemic fungal infection (EFI) at Rush University Medical Center from January of 1997 to October of 2012, and a cohort of septic patients with elevated liver enzymes...
October 14, 2016: Medical Mycology: Official Publication of the International Society for Human and Animal Mycology
Eric M Melnychuk, David P Sole
BACKGROUND: Fungal nervous system infection can be a difficult diagnosis to make, due to the fact that there are no specific manifestations of the disease and laboratory confirmation is difficult to confirm. CASE REPORT: We report a young male who presented to our emergency department with a variety of unilateral visual field complaints. While he initially denied recent IV drug abuse, his physical examination was highly suggestive of a fungal infection known to result from brown heroin use...
October 8, 2016: Journal of Emergency Medicine
Mary K Klassen-Fischer, Ronald C Neafie
Surgical pathology results can play a crucial role in the management of immunocompromised patients. Here we highlight factors that differ between immunocompromised and immunocompetent hosts, such as variation in inflammatory response. Conditions that are covered include drug reactions, disease within solid organ allografts, immune reconstitution inflammatory syndrome, specific immunodeficiency syndromes, neoplasms related to viral infections, and viral, bacterial, fungal, and parasitic infections. Special techniques including immunohistochemistry, in situ hybridization and molecular detection of pathogen nucleic acid from formalin-fixed, paraffin-embedded tissue are discussed...
August 2016: Microbiology Spectrum
Winai Chaidaroon, Sumet Supalaset, Napaporn Tananuvat, Nongnuch Vanittanakom
PURPOSE: To report a rare case of keratitis infected by Bipolaris hawaiiensis. METHODS: A patient who was diagnosed as fungal keratitis caused by B. hawaiiensis was retrospectively reviewed for history, clinical characteristics, risk factors, laboratory findings, treatments, and outcomes. RESULTS: A 63-year-old man with a history of trauma and saw dust in the left eye presented with a corneal ulcer. Eye examination revealed whitish infiltration with a feathery edge and small brownish deposits in the anterior stroma of the left cornea...
May 2016: Case Reports in Ophthalmology
Marc Pihet, Yohann Le Govic
Dermatophytoses include a wide variety of diseases involving glabrous skin, nails and hair. These superficial infections are a common cause of consultation in dermatology. In many cases, their diagnosis is not clinically obvious, and mycological analysis therefore is required. Direct microscopic examination of the samples using clearing agents provides a quick response to the clinician and is usually combined with cultures on specific media, which must be used to overcome the growth of contaminating moulds that may hamper the recovery of dermatophytes...
October 7, 2016: Mycopathologia
Maurizio Bernasconi, Alessio Casutt, Angela Koutsokera, Igor Letovanec, Frédéric Tissot, Laurent P Nicod, Alban Lovis
The role of radial-endobronchial ultrasound (R-EBUS) assisted transbronchial biopsy (TBB) for the diagnosis of peripheral pulmonary lesions is well established. However, no study has addressed its safety and value in hemato-oncological patients presenting with non-resolving infiltrates during persistent febrile neutropenia. To assess safety and feasibility of R-EBUS assisted TBB in severe thrombocytopenic and neutropenic patients. Over a period of 18 months, eight patients were assessed with R-EBUS assisted TBB after adequate platelet transfusion...
October 4, 2016: Lung
Nancy F Crum-Cianflone
Background.  Invasive aspergillosis may occur in the setting of severe influenza infections due to viral-induced respiratory epithelium disruption and impaired immune effects, but data are limited. Methods.  A retrospective study was conducted among severe influenza cases requiring medical intensive care unit (ICU) admission at an academic center during the 2015-2016 season. Data collected included respiratory cultures, medical conditions and immunosuppressants, laboratory and radiographic data, and outcomes...
September 2016: Open Forum Infectious Diseases
Alina Tanase, Anca Colita, Gabriel Ianosi, Daniela Neagoe, Daciana Elena Branisteanu, Daniela Calina, Anca Oana Docea, Aristidis Tsatsakis, Simona Laura Ianosi
Fusarium infection is a severe fungal infection caused by fungi of the genus Fusarium. It most commonly occurs in immunocompromised patients with malignant hematological comorbidities or secondary to hematopoietic stem cell transplant. The classical route of contamination is through inhalation but infection may also occur through contiguity with a skin lesion. This report describes the case of a 24-year-old woman who developed graft-vs.-host disease (GVHD) at 220 days after receiving an allogeneic stem cell transplant from a sibling donor for Hodgkin disease...
October 2016: Experimental and Therapeutic Medicine
Anurag Garg, Alastair Stuart, Mark Fajgenbaum, David Alistair Laidlaw, Miles Stanford
: An 85-year-old man developed chronic postoperative endophthalmitis after complicated cataract surgery. Visual acuity in the affected eye was hand movements. Slitlamp biomicroscopy showed a hypopyon, superonasal iris nodule, and marked vitritis. An anterior chamber washout, iris biopsy, and intravitreal amphotericin injection were performed. Panfungal polymerase chain reaction of anterior chamber and vitreous samples were positive for Penicillium citrinum. The iris biopsy showed hyphae on Grocott staining...
September 2016: Journal of Cataract and Refractive Surgery
Yutaro Hino, Noriko Doki, Yasushi Senoo, Noritaka Sekiya, S Kurosawa, Satoshi Tsuboi, Kazuteru Ohashi
Nocardiosis is a rare bacterial infection occurring mainly in patients with deficient cell-mediated immunity. Although disseminated nocardiosis after allogeneic hematopoietic stem cell transplantation (allo-HSCT) is a rare complication, it is associated with high mortality. Moreover, after allo-HSCT, nocardiosis may be mistaken for other bacterial or fungal infections because clinical and radiographic findings of pulmonary, cerebral, and cutaneous nocardiosis lesions are non-specific. Here, we report a case of disseminated nocardiosis (caused by Nocardia abscessus) with skin, pulmonary, liver, lymph node, and multiple brain abscesses in a patient after allo-HSCT...
October 1, 2016: Transplant Infectious Disease: An Official Journal of the Transplantation Society
Yael Gernez, Angela Tsuang, Tukisa D Smith, Khurram Shahjehan, Yiqun Hui, Paul J Maglione, Charlotte Cunningham-Rundles
Recurrent pneumonia with cavitation leading to pneumatoceles, secondary fungal infections, and hemoptysis are major causes of mortality and morbidity in patients with hyper-IgE syndrome. Prevention and aggressive treatment of pneumonia in these patients are essential to prevent further lung damage, but treatment may be delayed because the classic signs/symptoms of infection such as fever, chills, or rigors may be lacking. Early imaging to identify infection is essential for diagnosis and treatment. The mainstay of therapy is continuous, full-dose daily trimethoprim-sulfamethoxazole and commonly fungal coverage...
September 29, 2016: Journal of Allergy and Clinical Immunology in Practice
Tahereh Malakoutian, Maliheh Yarmohamadi, Ronak Mohammadi, Mojgan Asgari, Reyhaneh Mahmoodian
Splenic abscess is one of the rare and potentially life-threatening complications after kidney transplantation. Splenic abscess generally occurs in patients who have immunodeficiency state. It becomes more important with the increased use of immunosuppressed drugs and organ transplantation. The clinical presentation of splenic abscess is insidious, often with constitutional symptoms. Left upper quadrant tenderness is an uncommon sign. Therefore, its diagnosis is difficult and requires a high degree of clinical suspicion...
2016: Journal of Renal Injury Prevention
Roumi Ghosh, Pranshu Mishra, Sumit Sen, Prasanta Kumar Maiti, Govinda Chatterjee
We report two cases of chronic progressive disseminated histoplasmosis with unusual and rare clinical picture in a patient with no underlying risk factor. One 50-year-old male, presented with hoarseness of voice, chronic cough, with a history of nonresponding anti-tubercular therapy, revealed mucocutaneous lesions on examination. Fungating vocal cord lesions were visualized on bronchoscopy, raised suspicion of carcinoma. The second case, a 22-year-old female, referred to hospital with suspected vasculitis, with complaints of "off and on" fever with decreased oral intake, arthralgia, who later developed generalized nodular skin eruptions...
September 2016: Indian Journal of Dermatology
Zoi-Dorothea Pana, Katerina Vikelouda, Emmanuel Roilides
The optimal management of invasive fungal infections (IFIs) in children requires prompt and precise diagnosis that enables timely implementation of appropriate antifungal therapy and decreased use of unnecessary toxic antifungals. Areas covered: Traditional approaches such as culture, microscopy and histopathology remain the gold standard but are often not sufficiently sensitive and specific. These limitations have led to the development of alternative non-invasive diagnostic methods that in most cases detect fungal components, such as antigens or nucleic acids...
October 11, 2016: Expert Review of Anti-infective Therapy
Clara Valero, María José Buitrago, Maud Gits-Muselli, Marion Benazra, Aude Sturny-Leclère, Samia Hamane, Nicolas Guigue, Stéphane Bretagne, Alexandre Alanio
Pneumocystis jirovecii is an unculturable fungus and the causative agent of Pneumocystis pneumonia, a life-threatening opportunistic infection. Although molecular diagnosis is often based on the detection of mtLSU rRNA mitochondrial gene, the number of copies of mitochondrial genes had not been investigated. We developed and optimized six real-time PCR assays in order to determine the copy number of four mitochondrial genes (mtSSU rRNA, mtLSU rRNA, NAD1, and CYTB) in comparison to nuclear genome (DHPS and HSP70) and tested 84 bronchoalveolar fluids of patients at different stages of the infection...
2016: Frontiers in Microbiology
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