scholarly journals IL-7 Immunotherapy in a Non-Immunocompromised Patient with Intractable Fungal Wound Sepsis

2021 ◽  
Author(s):  
Isaiah R Turnbull ◽  
Monty B Mazer ◽  
Mark H Hoofnagle ◽  
John P Kirby ◽  
Jennifer M Leonard ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Cell Function ◽  
Fungal Infections ◽  
Immunocompromised Patient ◽  
Host Immunity ◽  
Wound Sepsis ◽  
Trichosporon Asahii ◽  
Life Threatening ◽  
Aggressive Debridement ◽  
Anti Fungal

Abstract A non-immunocompromised patient developed life-threatening soft-tissue infection with Trichosporon asahii, Fusarium, and Saksenaea that progressed despite maximum anti-fungal therapies and aggressive debridement. IL-7 immunotherapy resulted in clinical improvement, fungal clearance, reversal of lymphopenia, and improved T-cell function. Immunoadjuvant therapies to boost host immunity may be efficacious in life-threatening fungal infections.

Rashes associated with transplantations

2020 ◽  
pp. 535-538
Keyword(s):  
Fungal Infections ◽  
Solid Organ Transplantation ◽  
Organ Transplant ◽  
Solid Organ Transplant ◽  
Host Immunity ◽  
Solid Organ ◽  
Graft Versus Host ◽  
Gingival Hypertrophy ◽  
Life Threatening ◽  
Transplant Complications

Dermatological manifestations following transplantation are common but important to recognize and diagnose since they may be severe and life-threatening if not adequately and promptly treated. This chapter provides a systematic overview of the types of skin disease that may be encountered in children that have received a haematological or solid organ transplant. Complications relating to immunosuppression include an increased susceptibility to bacterial, viral, and fungal infections which may be significantly more virulent and hazardous in the context of reduced host immunity. Immune suppressant drugs may also cause drug rashes and aesthetic complications such as acne, hypertrichosis, or gingival hypertrophy, as well as longer-term risks from the development of malignancy. It is also important to recognize the range of mucocutaneous signs of acute and chronic graft versus host disease following bone marrow and solid organ transplantation which, again, may be severe and associated with significant morbidity and mortality.

Fungal arthritis

2013 ◽  
Author(s):  
Carol A. Kemper ◽  
Stanley C. Deresinski
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Therapeutic Agent ◽  
Fungal Infections ◽  
Immunocompromised Patient ◽  
Central Nervous System Disease ◽  
Coccidioides Immitis ◽  
System Disease ◽  
Fungal Arthritis ◽  
Life Threatening

Fungal infections of the musculoskeletal system are uncommon and diagnosis is often delayed. Infection is more common in the immunocompromised patient. The most important infections are due to candida species, Histoplasmosis capsulatum, Blastomycosis dermatiditis, and Coccidioides immitis. Amphotericin B remains the initial therapeutic agent of choice for many serious fungal infections, especially for those who are severely immunosuppressed, have life-threatening or central nervous system disease, or who have failed azole therapy.

Emerging Virulence, Drug Resistance and Future Anti-fungal Drugs for Candida Pathogens

2018 ◽  
Vol 18 (9) ◽  
pp. 759-778 ◽  
Author(s):  
Vartika Srivastava ◽  
Rajeev Kumar Singla ◽  
Ashok Kumar Dubey
Keyword(s):  
Fungal Infections ◽  
Age Groups ◽  
Human Pathogens ◽  
Candida Spp ◽  
Candida Sp ◽  
Invasive Infections ◽  
Life Threatening ◽  
Pros And Cons ◽  
Superficial Type ◽  
Anti Fungal

Increased incidences of Candida infection have augmented morbidity and mortality in human population, particularly among severely immunocompromised patients and those having a long stay in hospitals (nosocomial infections). Many virulence factors and fitness attributes are reported to be associated with the pathogenicity of Candida sp. It can cause infections ranging from easily treatable superficial type to life-threatening invasive infections. Additionally, it has the capability to infect humans of all age groups. Indeed, overutilization of broad-spectrum antibiotics has further complicated the scenario by leading the emergence of less sensitive Candida strains especially non-albicans. Despite our developed armamentarium, the diagnosis and treatment of human fungal infections remain a challenge. This review focuses on the prevalence of Candida spp. as human pathogens with emerging resistance to existing anti-fungal drugs. Furthermore, factors and mechanisms contributing to the pathogenicity of Candida spp. and the challenges being faced in combating the devastating infections associated with these pathogens have been discussed. Moreover, pros and cons of the current and future anti-mycotic drugs have been analyzed.

scholarly journals A rare case of multi-focal non-contiguous necrotizing soft tissue infections and literature review

2019 ◽  
Vol 2019 (11) ◽  
Author(s):  
Yaying Eileen Xu ◽  
Vinay Gounder
Keyword(s):  
Soft Tissue ◽  
Exploratory Laparotomy ◽  
Immunocompromised Patients ◽  
Soft Tissue Infections ◽  
Colonic Malignancy ◽  
Left Lower Limb ◽  
Necrotizing Soft Tissue Infections ◽  
Life Threatening ◽  
Aggressive Debridement ◽  
Repeat Assessment

Abstract Necrotising soft tissue infection (NSTI) is a rare yet life-threatening surgical emergency, characterized by rapidly spreading infection below the epidermis to the soft tissue layers of the dermis, subcutaneous layers, fascia and sometimes muscle. Multi-focal NSTIs have been rarely described in the literature, with reported cases predominantly involving immunocompromised patients. We report a case of an immunocompromised 70-year-old woman who initially presented with concern of a perforated colonic malignancy requiring exploratory laparotomy and within 24 hours while on inotropes, developed rapidly progressing necrotizing fasciitis (NF) of the left thigh with renal failure secondary to sepsis. Despite aggressive debridement, a progress computed tomography later showed multi-focal non-contiguous necrotising myositis of the whole left lower limb and right gluteal regions. Early diagnosis of multi-focal NF especially in immunocompromised patients, repeat assessment, aggressive surgical debridement and prompt antibiotics usage are the key to treatment.

scholarly journals Role for IL-1 Family Cytokines in Fungal Infections

2021 ◽  
Vol 12 ◽  
Author(s):  
James S. Griffiths ◽  
Giorgio Camilli ◽  
Natalia K. Kotowicz ◽  
Jemima Ho ◽  
Jonathan P. Richardson ◽  
...  
Keyword(s):  
Fungal Pathogens ◽  
Fungal Infections ◽  
Systemic Disease ◽  
Severe Disease ◽  
Life Threatening ◽  
Current Therapies ◽  
Immunotherapy Target ◽  
Systemic Infections ◽  
Fungal Immunity ◽  
Anti Fungal

Fungal pathogens kill approximately 1.5 million individuals per year and represent a severe disease burden worldwide. It is estimated over 150 million people have serious fungal disease such as recurrent mucosal infections or life-threatening systemic infections. Disease can ensue from commensal fungi or new infection and involves different fungal morphologies and the expression of virulence factors. Therefore, anti-fungal immunity is complex and requires coordination between multiple facets of the immune system. IL-1 family cytokines are associated with acute and chronic inflammation and are essential for the innate response to infection. Recent research indicates IL-1 cytokines play a key role mediating immunity against different fungal infections. During mucosal disease, IL-1R and IL-36R are required for neutrophil recruitment and protective Th17 responses, but function through different mechanisms. During systemic disease, IL-18 drives protective Th1 responses, while IL-33 promotes Th2 and suppresses Th1 immunity. The IL-1 family represents an attractive anti-fungal immunotherapy target. There is a need for novel anti-fungal therapeutics, as current therapies are ineffective, toxic and encounter resistance, and no anti-fungal vaccine exists. Furthering our understanding of the IL-1 family cytokines and their complex role during fungal infection may aid the development of novel therapies. As such, this review will discuss the role for IL-1 family cytokines in fungal infections.

scholarly journals Case Series of Opportunistic Deep Seated Fungal Infections in Surgical Practice in an Agrarian Society

2021 ◽  
Vol 3 (1) ◽  
pp. 30-33
Author(s):  
Jeevan Ruban Kumar ◽  
Nikitha Moorthy ◽  
R. Arihanth ◽  
Rekha Arcot
Keyword(s):  
Fungal Infections ◽  
Case Series ◽  
Diabetic Patients ◽  
Surgical Practice ◽  
Agrarian Society ◽  
Co Morbidity ◽  
History Of ◽  
Atypical Presentations ◽  
Aggressive Debridement ◽  
Anti Fungal

This article is to highlight the atypical presentations of fungal infections which may be encountered in surgical practice and to help surgeons to recognise these cases early and provide appropriate management. Three cases of skin and soft tissue fungal infections with atypical presentations have been discussed. All the patients are aged above 45 years and farmers by occupation with type 2 diabetes mellitus as a common co-morbidity. These cases showed aggressive progression of the disease and were started on anti-fungal agents along with serial aggressive debridement. Two patients deteriorated rapidly, as they succumbed to their illness. Fungal agents being commonly present in the environment, are likely to cause infection in immunocompromised states like diabetic patients, especially in those with a preceding history of trauma.

scholarly journals Isolated Invasive Cerebral Mucormycosis in a Diabetic Female Patient: A Case Report With Rising Concerns

2019 ◽  
Author(s):  
Farzad Ferdosian ◽  
Marzie Vaghefi ◽  
Ehsan Sanaei
Keyword(s):  
Parietal Lobe ◽  
Fungal Infections ◽  
Laboratory Data ◽  
Invasive Infection ◽  
Immunocompromised Patients ◽  
Upper And Lower Extremities ◽  
Life Threatening ◽  
Cerebral Infection ◽  
The Right ◽  
Anti Fungal

Isolated cerebral mucormycosis can be life-threatening in immunocompromised patients. Sinus and lung were the most involved organs, while cerebral infection by mucormycosis is more fetal. This infection needs proper debridement and antifungal therapy. We report a 12-year-old diabetic girl with manifestations of fever, headache, and weakness in the right upper and lower extremities without any involvement of sinuses and lung. The patient had approximately normal routine laboratory data, and its CSF was not diagnostic. Because of its features in brain CT and MRI that suggested a necrotic lesion in the left parietal lobe, she was undergone craniotomy and received broad-spectrum antibiotics along with anti-fungal and anti-tuberculosis drugs. Histopathological findings of the mass, which was excised in craniotomy, confirmed the diagnosis of mucormycosis. Unfortunately, the patient died because of this invasive infection. The fatality of fungal infections, especially cerebral types, warn us to be aware of them in immunocompromised patients and perform the proper treatment to reduce its mortality

scholarly journals Management of Open Injuries of the Foot: Current Concepts

2016 ◽  
Vol 3 (1) ◽  
pp. 28-40
Author(s):  
Navjot Singh ◽  
Avtar Singh ◽  
Rajeev Vohra ◽  
Kanwar K Singh ◽  
Inderdeep Singh
Keyword(s):  
Soft Tissue ◽  
Soft Tissue Injuries ◽  
Asia Pacific ◽  
Wound Management ◽  
Vascular Surgeon ◽  
Appropriate Treatment ◽  
Life Threatening ◽  
Traumatic Wound ◽  
Open Injuries ◽  
Aggressive Debridement

ABSTRACT Open fractures of the foot are rare, and a few surgeons see the whole spectrum of these injuries. When confronted with open injuries of the foot, the decision to salvage the foot needs to be taken after thorough assessment of bony and soft tissue injuries and the associated life-threatening injuries. Foot and ankle surgeon, plastic surgeon, and vascular surgeon must work as a team to provide a pain-free functional and plantigrade foot that fits into a conventional shoe or a brace. Aggressive debridement and wound management remains the cornerstone of modern surgical treatment. If debridement and wound management can convert a contaminated traumatic wound into a clean surgical wound, which can be adequately covered within 7 to 10 days, then definitive skeletal fixation is advised. In the presence of severe soft tissue and bony injuries, the reconstruction needs to be staged and planned to match the unique personality of the patient and injury. Amputation can be a positive step toward decreasing the overall morbidity in the presence of severe injury and poor host biology. Despite appropriate treatment, the prognosis of the patient with severe open foot injuries remains guarded. How to cite this article Vohra R, Singh A, Singh KK, Singh I, Singh N, Bansal A. Management of Open Injuries of the Foot: Current Concepts. J Foot Ankle Surg (Asia-Pacific) 2016;3(1): 28-40.

A Unique Case of Cutaneous Cunninghamella infection in an Immunocompromised Patient (Preprint)

2020 ◽  
Author(s):  
Mauricio Portillo ◽  
Shyam Allamaneni ◽  
Richard Goodman
Keyword(s):  
Fungal Infections ◽  
Immunocompromised Patient ◽  
Lymphocytic Leukemia ◽  
Peripherally Inserted Central Catheter ◽  
Central Catheter ◽  
Unique Case ◽  
Systemic Complications ◽  
Prompt Treatment ◽  
Mode Of Transmission ◽  
And Control

UNSTRUCTURED Cunninghamella species are an extremely rare cause of fungal infections. The usual mode of transmission is through inhalation however rare cases of cutaneous spread have been reported. The objective of this clinical case report is to highlight the uniqueness of which the patient acquired the infection, the progression, and control of it. A 57-year-old male with chronic lymphocytic leukemia was found to have an abscess next to his peripherally inserted central catheter (PICC) line. The abscess culture grew back Cunninghamella and was debrided and treated with a novel antifungal. The fungal infection was controlled and the total timeframe took 28 days. Rapid recognition and prompt treatment demonstrate the prevention of rapidly progressive angioinvasian and further systemic complications. This case also proves that a novel antifungal may be appropriate in controlling the spread of Cunninghamella species.

scholarly journals Reinforcing the Immunocompromised Host Defense against Fungi: Progress beyond the Current State of the Art

2021 ◽  
Vol 7 (6) ◽  
pp. 451
Author(s):  
Georgios Karavalakis ◽  
Evangelia Yannaki ◽  
Anastasia Papadopoulou
Keyword(s):  
Host Defense ◽  
Hematopoietic Cell Transplantation ◽  
State Of The Art ◽  
Fungal Infections ◽  
Solid Organ Transplantation ◽  
Immunocompromised Host ◽  
Antifungal Drugs ◽  
Solid Organ ◽  
Cell Immunotherapy ◽  
Life Threatening

Despite the availability of a variety of antifungal drugs, opportunistic fungal infections still remain life-threatening for immunocompromised patients, such as those undergoing allogeneic hematopoietic cell transplantation or solid organ transplantation. Suboptimal efficacy, toxicity, development of resistant variants and recurrent episodes are limitations associated with current antifungal drug therapy. Adjunctive immunotherapies reinforcing the host defense against fungi and aiding in clearance of opportunistic pathogens are continuously gaining ground in this battle. Here, we review alternative approaches for the management of fungal infections going beyond the state of the art and placing an emphasis on fungus-specific T cell immunotherapy. Harnessing the power of T cells in the form of adoptive immunotherapy represents the strenuous protagonist of the current immunotherapeutic approaches towards combating invasive fungal infections. The progress that has been made over the last years in this field and remaining challenges as well, will be discussed.

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