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Immunocompromised surgery

Bret H Clough, Eoin P McNeill, Daniel Palmer, Ulf Krause, Thomas J Bartosh, Christopher D Chaput, Carl A Gregory
BACKGROUND CONTEXT: Spine pain and the disability associated with it are epidemic in the United States. According to the National Center for Health Statistics, >650,000 spinal fusion surgeries are performed annually in the US and yet there is a failure rate of 15-40% when standard methods employing current commercial bone substitutes are utilized. Autologous bone graft is the gold standard in terms of fusion success, but the morbidity associated with the procedure and limitations in the availability of sufficient material has limited its use in the majority of cases...
October 17, 2016: Spine Journal: Official Journal of the North American Spine Society
Haruki Funao, Khaled M Kebaish, Norihiro Isogai, Takahiro Koyanagi, Morio Matsumoto, Ken Ishii
BACKGROUND: Spondylodiscitis still remains a serious problem especially in immunocompromised patients. Surgery is necessary when non-surgical treatment is unsuccessful. Although minimally invasive spine stabilization (MISt) with percutaneous pedicle screws is less invasive, percutaneous sacropelvic fixation techniques are not common practice. Here, we describe two cases in which spondylodiscitis in the lumbosacral spine was treated with a percutaneous stabilization using S2 alar-iliac (S2AI) screw technique...
October 15, 2016: World Neurosurgery
Vipul M Patel, Bhavin Kapadiya, Viral Shah
Phaeohyphomycosis is a term used to describe infections caused by dematiaceous fungi, i.e. fungi which contain melanin in their cell wall. Cladophialophora bantiana has been implicated to cause brain abscess in immunocompromised patients. Infection caused by Cladophialophora bantiana in an immunocompetent host is relatively rare. Surgical site infection at abdominal subcutaneous tissue caused by Cladophialophora bantiana was noted in this case, which was rarely reported.
May 2016: Journal of the Association of Physicians of India
Aaron Smith, Vikrum Thimmappa, Brandon Shepherd, Meredith Ray, Anthony Sheyn, Jerome Thompson
BACKGROUND: Invasive fungal sinusitis (IFS) represents an often fatal condition within the pediatric population. In an effort to characterize demographics, treatment modalities, and prognostic factors, we performed a systematic review. METHODS: We systematically reviewed EMBASE, Medline, TRIPdatabase, SCOPUS and the Cochrane database for invasive fungal nasal and sinus infections limited to individuals <18 years of age. Case series including 3 or more patients were included...
November 2016: International Journal of Pediatric Otorhinolaryngology
Sali Priyanka Akhilesh, Yadav Kamal Sunder, Pande Prasad, George Mary Asha, Agarwal Mohan, Mehta Hitesh
Appendiceal mucormycosis is a rare life-threatening infection seen in immunocompromised patients. It is usually seen in chemotherapy induced neutropenia in patients with hematological malignancies. Clinically, the symptoms and signs may be masked due to ongoing corticosteroids. The condition may mimic bacterial appendicitis and the less serious condition, typhlitis. The disease demands prompt surgical debulking and aggressive antifungal treatment. However, surgery is delayed due to the poor performance status and severe neutropenia...
2016: Case Reports in Surgery
Els Hermans, Schalk W Van der Merwe, Jeroen Depreeuw, Jeroen Dekervel, Enrico Radaelli, Tania Roskams, Jos van Pelt Jos, Baki Topal, Chris Verslype, Hans Prenen, Werner Van Steenbergen, Frederik Nevens, Diether Lambrechts, Frédéric Amant
Background and study aim: Typically, pancreatic patient-derived tumor xenografts (PDXs) are established by transplanting large tumor biopsies obtained through invasive surgery approaches into immunocompromised mice. We aimed to develop pancreatic PDXs by transplanting tumor tissue acquired by endoscopic ultrasound (EUS)-guided fine needle biopsies (FNB), assess take rates compared to surgery-derived PDXs, and demonstrate the histological and genetic resemblance to the original tumor. Patients and methods: Biopsies of untreated pancreatic carcinoma were collected at surgery and during EUS and processed to generate PDXs...
September 14, 2016: Endoscopy
Maria N Gamaletsou, Blandine Rammaert, Marimelle A Bueno, Nikolaos V Sipsas, Brad Moriyama, Dimitrios P Kontoyiannis, Emmanuel Roilides, Valerie Zeller, Saad J Taj-Aldeen, Michael Henry, Vidmantas Petraitis, David W Denning, Olivier Lortholary, Thomas J Walsh
Aspergillus arthritis is a debilitating form of invasive aspergillosis. Little is known about its epidemiology, clinical manifestations, laboratory features, treatment, and prognosis. Cases of Aspergillus arthritis were reviewed in the English literature from 1967 through 2015 for variables of arthritis with Aspergillus spp. recovered from joint and/or adjacent bone, underlying conditions, symptoms, signs, inflammatory biomarkers, diagnostic imaging, management, and outcome. Among 31 evaluable cases, 87% were males and 13% pediatric...
September 8, 2016: Medical Mycology: Official Publication of the International Society for Human and Animal Mycology
Julie Galea, Katherine M Burnand, Fiona L Dawson, Chandrasen K Sinha, Dean Rex, Bruce O Okoye
Aim Pneumatosis intestinalis (PI) is a condition in which multiple gas-filled cysts form within the wall of the gastrointestinal tract in either the subserosa or submucosa. The presence of pneumoperitoneum in the presence of PI can present a therapeutic dilemma. The aim of our study was to review our experience and management of this condition. Methods A single-center retrospective study of consecutive children (> 1 year) presenting with a pneumoperitoneum and evidence of PI (2009-2015). Demographics, case notes, microbiology, and imaging were reviewed...
September 5, 2016: European Journal of Pediatric Surgery
Yusuke Takanashi, Takamitsu Hayakawa, Hiroshi Neyatani, Kazuhito Funai
Descending necrotizing mediastinitis (DNM) is a potentially lethal disease that originates from a deep neck infection (DNI); it is often associated with an immunocompromised state. Hyperimmunoglobulin E syndrome (HIES) is an extremely rare complex immune deficiency characterized by recurrent abscesses of staphylococcal etiology. A rare case of a 34-year-old woman wherein HIES putatively promoted the development of DNI into DNM is described. She presented with cervical purulent lymphadenitis and retropharyngeal abscess...
July 2016: Respirology Case Reports
Süheyla Kömür, Ayşe Seza İnal, Behice Kurtaran, Aslıhan Ulu, Aysun Uğuz, Hasan Salih Zeki Aksu, Yeşim Taşova
BACKGROUND/AIM: Mucormycosis is a rare invasive fungal infection most commonly encountered in the immunocompromised host. We analyzed 51 adult patients treated for mucormycosis between 2003 and 2013 and recorded at a tertiary university hospital in Turkey. MATERIALS AND METHODS: We examined the following data for all patients: age, sex, predisposing disease, symptoms, treatment, surgical procedure, concomitant infections, intensive care requirement, and outcomes...
2016: Turkish Journal of Medical Sciences
S W Park, T Eade, L Pang, A Wignall, D Veivers
OBJECTIVE: To investigate the rate of occult neck disease in patients with metastatic squamous cell carcinoma to the parotid gland following parotidectomy and neck dissection. METHODS: A consecutive series of patients treated between 2000 and 2014 for metastatic squamous cell carcinoma to the parotid were analysed. Patients were included if they had no clinical or radiological evidence of neck disease. Pathology of parotidectomy and neck dissection specimens was reviewed...
July 2016: Journal of Laryngology and Otology
Carmen Martín Salas, Igberto J Tordoya Titichoca, Carmen Ezpeleta Baquedano
The environmental microbiological control is necessary to prevent infections associated with certain procedures that are performed at the hospital. In this review the procedures for control of water and dialysis fluids, and air in operating rooms and immunocompromised units are addressed. The dialysis quality management guidelines define the highest levels of chemical, microbiological and endotoxin in purified water and dialysis fluids based on the recommendations of scientific societies. The microbiological control of water and dialysis fluids should include detection of microorganisms and endotoxin levels...
July 2016: Enfermedades Infecciosas y Microbiología Clínica
Katie Tharshana Yoganathan, Andrew Roger Morgan, Kathir G Yoganathan
Cytomegalovirus (CMV) infection is the most common viral opportunistic infection in immunocompromised patients and is a rare cause of bowel perforation. It invariably requires surgical intervention and is often fatal. We report a 50-year-old Caucasian man with AIDS, presented 3 weeks after developing abdominal pain and distension. He was treated for CMV retinitis in the past. His adherence to antiretroviral therapy was poor. Examination revealed a recurrence of active CMV retinitis. His abdomen was tender and distended...
2016: BMJ Case Reports
Katie Young, Faraz Khan Luni, Youngsook Yoon
Streptococcal toxic shock syndrome is a rapidly fatal disease causing hypotension with multi organ dysfunction (MODS) early in the course of infection, which by definition is caused by Group A streptococcus (GAS). We describe a case of Toxic Shock like Syndrome (TSLS) in which the causative organism was not a GAS. A 71-year-old woman with hepatitis C and primary biliary cirrhosis had sudden onset of slurred speech and left arm and facial numbness. She had bilateral erythematous macular rash present on the flanks and legs...
July 2016: American Journal of the Medical Sciences
Eran Millet, Josef Haik, Elad Ofir, Yael Mardor, Eyal Winkler, Moti Harats, Ariel Tessone
BACKGROUND: Although fat grafting is a common technique to repair defects after breast cancer reconstruction surgery and has a low complication rate, the relation between fat grafting and the risk of breast cancer is unknown. Clinical trials to investigate this connection can elucidate the benefits and potential risks of fat grafting in oncology patients. OBJECTIVES: To establish an efficient experimental model, using magnetic resonance imaging (MRI) scans, for comparing different breast tumor study groups post-fat grafting...
May 2016: Israel Medical Association Journal: IMAJ
Khaled Al-Tarrah, Mahmoud Abdelaty, Ahmad Behbahani, Eman Mokaddas, Helmy Soliman, Ahdi Albader
BACKGROUND: Mucormycosis is a rare, aggressive, and life-threatening infection that is caused by organisms belonging to the order Mucorales. It is usually acquired through direct means and virtually always affects immunocompromised patients with the port of entry reflecting the site of infection, in this case, cutaneous. Unlike other mucormycoses, patients affected by Apophysomyces elegans (A elegans) are known to be immunocompetent. This locally aggressive disease penetrates through different tissue plains invading adjacent muscles, fascia, and even bone causing extensive morbidity and may prove fatal if treated inadequately...
July 2016: Medicine (Baltimore)
José Moreira, Andrea Varon, Maria Clara Galhardo, Fabio Santos, Marcelo Lyra, Rodolfo Castro, Raquel Oliveira, Cristiane C Lamas
OBJECTIVES: Mucormycosis is an invasive fungal infection afflicting immunocompromised patients, causing a significant degree of morbidity and mortality. The purpose of the study was to provide a comprehensive analysis describing the epidemiology and outcome of mucormycosis in the scenario of HIV infection. METHODS: We systematically searched PubMed for reports about mucormycosis associated with HIV. Eligible studies describe the predisposing factor, clinical form, treatment, and survival outcome...
September 2016: Journal of Infection
M Mohan, S C Shalin, A Kothari, J C C Rico, K Caradine, M Burgess
Lasiodiplodia species are environmental fungi that have been reported as a cause of infection in both immunocompetent and immunocompromised patients. We present a case of fungal osteomyelitis caused by Lasiodiplodia species in a patient with multiple myeloma after autologous stem cell transplant. The patient was successfully treated with a combination of surgery and oral voriconzole. To the best of our knowledge, this is the first reported case of fungal osteomyelitis caused by Lasiodiplodia species This article is protected by copyright...
July 8, 2016: Transplant Infectious Disease: An Official Journal of the Transplantation Society
Elisabetta Schiaroli, Maria Bruna Pasticci, Elena De Carolis, Enrica Mello, Carlo Pallotto, Christian Leli, Giuseppe Vittorio De Socio, Franco Baldelli, Maurizio Sanguinetti, Antonella Mencacci
Infections by Nocardia spp. are generally regarded as opportunistic diseases in immunocompromised patients, but can also affect immunocompetent subjects. Such infections represent an important diagnostic challenge for clinicians and microbiologists, and diagnosis is frequently delayed or even conducted post mortem. A 54-year-old man was admitted to our hospital because of ventriculitis and relapsing brain abscess. Five months prior, this patient had undergone external ventricular drain and surgery for a cerebellar abscess...
June 1, 2016: Le Infezioni in Medicina
Amol Raheja, Aleksandra Sowder, Cheryl Palmer, Fausto J Rodriguez, William T Couldwell
Epstein-Barr virus (EBV)-associated smooth muscle tumors (SMTs) have recently been associated with primary and secondary immunodeficiencies. They are broadly divided into 3 subgroups: HIV-related, posttransplant, and congenital immunodeficiency. Subsequent to organ transplantation and acquired immunosuppression, a few cases of EBV-associated SMTs have been described in the liver, respiratory tract, and gastrointestinal system. To the authors' knowledge, intracranial involvement after peripheral blood stem cell transplantation has never been reported previously...
June 24, 2016: Journal of Neurosurgery
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