scholarly journals Intrathecal Administration of High-Titer Cytomegalovirus Immunoglobulin for Cytomegalovirus Meningitis

2014 ◽  
Vol 2014 ◽  
pp. 1-3 ◽  
Author(s):  
Shin-ichiro Fujiwara ◽  
Kazuo Muroi ◽  
Raine Tatara ◽  
Ken Ohmine ◽  
Tomohiro Matsuyama ◽  
...  
Keyword(s):  
Graft Failure ◽  
High Titer ◽  
Central Nervous System Disease ◽  
Intrathecal Administration ◽  
Intravenous Ganciclovir ◽  
Hematopoietic Stem ◽  
System Disease ◽  
Cord Blood Transplant ◽  
Life Threatening ◽  
Life Threatening Complication

Cytomegalovirus (CMV) central nervous system disease after hematopoietic stem cell transplantation (HSCT) is a rare but life-threatening complication. Here, we report a patient who developed CMV meningitis after HSCT and was treated with the combination therapy of intrathecal high-titer CMV immunoglobulin and antiviral drugs. A 38-year-old man with myelodysplastic syndrome received a cord blood transplant after graft failure. On day 147, he was diagnosed with CMV meningitis based on pleocytosis and CMV DNA in the cerebrospinal fluid (CSF). Intravenous ganciclovir, foscarnet, and immunoglobulin were administered; however, CMV DNA in the CSF was continuously detected. The addition of intrathecal high-titer CMV immunoglobulin resulted in CMV DNA in the CSF becoming undetectable. On day 241, CMV DNA in the CSF was detected again, but both intrathecal immunoglobulin and intravenous ganciclovir led to its disappearance. No adverse effects related to intrathecal administration were observed. The intrathecal administration of immunoglobulin may be safe and effective for CMV meningitis.

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.

Fungal arthritis

2013 ◽  
pp. 808-814
Author(s):  
Carol A. Kemper ◽  
Stanley C. Deresinski
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Musculoskeletal System ◽  
Fungal Infections ◽  
Central Nervous System Disease ◽  
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.

scholarly journals Efficacy of Recombinant Human Thrombopoietin for the Treatment of Secondary Failure of Platelet Recovery After Allogeneic HSCT

2022 ◽  
Vol 28 ◽  
pp. 107602962110680
Author(s):  
Yigeng Cao ◽  
Mingyang Wang ◽  
Biao Shen ◽  
Fei Zhao ◽  
Rongli Zhang ◽  
...  
Keyword(s):  
Clinical Intervention ◽  
Complete Response ◽  
Hematopoietic Stem ◽  
Platelet Recovery ◽  
Allogeneic Hsct ◽  
Overall Response ◽  
Secondary Failure ◽  
Life Threatening ◽  
Life Threatening Complication ◽  
Recombinant Human Thrombopoietin

Secondary failure of platelet recovery (SFPR) is a life-threatening complication that may affect up to 20% of patients after allogeneic hematopoietic stem cell transplantation (HSCT). In this study, to evaluate the efficacy of recombinant human thrombopoietin (rhTPO), we retrospectively analyzed 29 patients who received continuous rhTPO for the treatment of SFPR. Overall response and complete response were observed in 24 (82.8%) patients and 10 (34.5%) patients, at a median time of 21.5 days (range, 3-41 days) and 39.5 days (range, 7-53 days) after initiation of rhTPO treatment, respectively. Among the responders, the probability of keeping overall response and complete response at 1 year after response was 77.3% and 80.0%, respectively. In multivariate analysis, higher CD34+ cells (≥3 × 106/kg) infused during HSCT (HR: 7.22, 95% CI: 1.53-34.04, P = 0.01) and decreased ferritin after rhTPO treatment (HR: 6.16, 95% CI: 1.18-32.15, P = 0.03) were indicated to associate with complete response to rhTPO. Importantly, rhTPO was well tolerated in all patients without side effects urging withdrawal and clinical intervention. The results of this study suggest that rhTPO may be a safe and effective treatment for SFPR.

Fungal arthritis

2013 ◽  
pp. 808-814
Author(s):  
Carol A. Kemper ◽  
Stanley C. Deresinski
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Musculoskeletal System ◽  
Fungal Infections ◽  
Central Nervous System Disease ◽  
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.

Vergleich von MRT- und SPECT-Befunden bei Patienten mit zerebraler Mikroangiopathie

1991 ◽  
Vol 30 (05) ◽  
pp. 161-169 ◽  
Author(s):  
C. Weiller ◽  
R. Weigmann ◽  
H.-J. Kaiser ◽  
U. Büll ◽  
R. Schneider ◽  
...  
Keyword(s):  
White Matter Lesions ◽  
Central Nervous System Disease ◽  
Deep White Matter ◽  
Cranial Ct ◽  
System Disease ◽  
Ct Findings ◽  
Hmpao Spect ◽  
Significant Difference ◽  
Cerebral Microangiopathy ◽  
99Mtc Hmpao

Lacunar infarctions and periventricular hypodensity are assumed to be typical CT patterns of cerebral microangiopathy (MA). In 17 patients with such findings and in 6 controls without any signs of central nervous system disease cranial CT, MRT and 99mTc-HMPAO-SPECT were employed. In 7 patients with CT findings of minor MA demonstrated in comparison to controls no significant difference. In 10 cases with CT findings of pronounced MA periventricular rCBF was significantly reduced compared to controls. rCBF of temporal and parietal cortex were not diminished compared to controls. In 14 patients studied with MRT deep white matter lesions were found which appeared solitary, multiple or confluent. Employing 99mTc-HMPAO-SPECT, cerebral MA revealed rCBF reduction in periventricular brain tissue by cerebellar standardization.

Presentation of Gall Stone Ileus as Gut Obstruction

JMS SKIMS ◽  
2019 ◽  
Vol 21 (2) ◽  
pp. 117-119
Author(s):  
Munir Ahmad Wani ◽  
Mubarak Ahmad Shan ◽  
Syed Muzamil Andrabi ◽  
Ajaz Ahmad Malik
Keyword(s):  
Abdominal Pain ◽  
Case Report ◽  
Ct Scan ◽  
Bowel Obstruction ◽  
Emergency Surgery ◽  
Gallstone Ileus ◽  
Gall Stone ◽  
Life Threatening ◽  
Life Threatening Complication ◽  
Gall Stone Ileus

Gallstone ileus is an uncommon and often life-threatening complication of cholelithiasis. In this case report, we discuss a difficult diagnostic case of gallstone ileus presenting as small gut obstruction with ischemia. A 56-year-old female presented with abdominal pain and vomiting. A CT scan was performed and showed an evolving bowel obstruction with features of gut ischemia with pneumobilia although no frank hyper density suggestive of a gallstone was noted. The patient underwent emergency surgery and a 60 mm obstructing calculus was removed from the patient's jejunum, with a formal tube cholecystostomy. JMS 2018: 21 (2):117-119

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