scholarly journals Aspergillus flavus as a surprise space occupying lesion in an immunocompetent pediatric patient

2021 ◽  
Vol 36 (1) ◽  
Author(s):  
Mir Ibrahim Sajid ◽  
Noor Malik ◽  
Samira S. Balouch ◽  
Ehsan Bari
Keyword(s):  
Aspergillus Flavus ◽  
Fungal Infections ◽  
Granulomatous Inflammation ◽  
Immunocompromised Host ◽  
Rapid Onset ◽  
The Body ◽  
University Hospital ◽  
Left Frontal Lobe ◽  
Onset Condition ◽  
Space Occupying Lesion

Abstract Background Fungal infections of the CNS are almost always a clinical surprise. Aspergillus species although ubiquitous are more frequently observed in immuno-compromised individuals upon inhalation of conidia. Most of the fungal infections which happen in humans are opportunistic, mostly due to immunocompromised host. Case description We present the case of a 14-year-old boy who presented to the Emergency Department of Aga Khan University Hospital, Karachi, with complaints of right-sided weakness of the body. This was a rapid-onset condition which was associated with gait disturbances and multiple episodes of vomiting. MRI head showed encapsulated Space Occupying Lesion with puss in the left frontal lobe with surrounding edema. The patient was planned for a craniotomy to remove an intracerebral abscess. Histopathology report revealed the presence of chronic granulomatous inflammation with necrosis and numerous septate hyphae. A fungus culture was run which confirmed the presence of heavy colonies of Aspergillus flavus. Conclusion Fungal infections of the central nervous system are almost always a clinical surprise, have a subtle presentation and mistaken often as meningitis, brain abscess, or tumor. Any suspected lesion once removed should be sent for biopsy to rule out the presence of any fungal infection.

scholarly journals Aspergillus Flavus as a Surprise CNS Space Occupying Lesion in an Immunocompetent Pediatric Patient

2020 ◽  
Author(s):  
Mir Ibrahim Sajid ◽  
Noor Malik ◽  
Samira Shabbir Balouch ◽  
Ehsan Bari
Keyword(s):  
Fungal Infection ◽  
Aspergillus Flavus ◽  
Fungal Infections ◽  
Granulomatous Inflammation ◽  
Immunocompromised Host ◽  
Rapid Onset ◽  
Primary Concern ◽  
Left Frontal Lobe ◽  
Onset Condition ◽  
Space Occupying Lesion

Abstract Background: Fungal infections of the CNS are almost always a clinical surprise. Aspergillus species although ubiquitous are more frequently observed in immuno-compromised individuals, upon inhalation of conidia. Most of the fungal infections which happen in humans are opportunistic- in an immunocompromised host. However, we report the case of CNS fungal infection in a healthy child, without any co-morbidities, trauma, or medico-surgical intervention- which could have been the nidus of infection. Case Presentation: We present the case of a 14 year old boy who presented to our institute’s emergency department with primary concern of right sided body hemiparesis since twenty-four hours. This was a rapid-onset condition which was associated with gait disturbances and multiple episodes of vomiting. An MRI of the head showed encapsulated Space Occupying Lesion in the left frontal lobe with surrounding edema. The patient was planned for craniotomy to remove the intracerebral abscess. Histopathology report revealed presence of chronic granulomatous inflammation with necrosis and numerous septate hyphae. A fungus culture was run which confirmed presence of heavy colonies of Aspergillus Flavus. Post-operatively the patient was kept on Voricoazole and anti-inflammatory medications. Conclusion: Fungal infections of the central nervous system are almost always a clinical surprise, and have subtle presentation. Any suspected lesion once removed should be sent for biopsy to rule out the presence of any fungal infection.

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.

scholarly journals The p47phox mouse knock-out model of chronic granulomatous disease.

1995 ◽  
Vol 182 (3) ◽  
pp. 751-758 ◽  
Author(s):  
S H Jackson ◽  
J I Gallin ◽  
S M Holland
Keyword(s):  
Nadph Oxidase ◽  
Chronic Granulomatous Disease ◽  
Fungal Infections ◽  
Critical Role ◽  
Granulomatous Inflammation ◽  
Mammalian Host ◽  
Granulomatous Disease ◽  
Knock Out ◽  
Phagocyte Nadph Oxidase ◽  
Life Threatening

Chronic granulomatous disease (CGD) is caused by a congenital defect in phagocyte reduced nicotinamide dinucleotide phosphate (NADPH) oxidase production of superoxide and related species. It is characterized by recurrent life-threatening bacterial and fungal infections and tissue granuloma formation. We have created a mouse model of CGD by targeted disruption of p47phox, one of the genes in which mutations cause human CGD. Identical to the case in human CGD, leukocytes from p47phox-/- mice produced no superoxide and killed staphylococci ineffectively. p47phox-/- mice developed lethal infections and granulomatous inflammation similar to those encountered in human CGD patients. This model mirrors human CGD and confirms a critical role for the phagocyte NADPH oxidase in mammalian host defense.

scholarly journals Masses of the Lacrimal Gland: Evaluation and Treatment

2021 ◽  
Vol 82 (01) ◽  
pp. 100-106 ◽  
Author(s):  
Jane S. Kim ◽  
Jason Liss
Keyword(s):  
Lacrimal Gland ◽  
Malignant Disease ◽  
Systemic Disease ◽  
Granulomatous Inflammation ◽  
Disease Recurrence ◽  
Rapid Onset ◽  
Lymphoproliferative Disorders ◽  
Orbital Imaging ◽  
Malignant Neoplasia

AbstractLacrimal gland lesions account for approximately 9 to 10% of all biopsied orbital masses. Potential causes include nongranulomatous and granulomatous inflammation, autoimmune disease, lymphoproliferative disorders, benign epithelial proliferation, malignant neoplasia, and metastatic disease. Inflammatory lesions and lymphoproliferative disorders are the most common and may be unilateral or bilateral; they may also be localized to the orbit or associated with systemic disease. Both benign and malignant epithelial lacrimal gland masses tend to be unilateral and involve the orbital lobe, but a more rapid onset of symptoms and periorbital pain strongly suggest malignant disease. On orbital imaging, both inflammatory and lymphoproliferative lesions conform to the globe and surrounding structures, without changes in adjacent bone, whereas epithelial lacrimal gland masses often show scalloping of the lacrimal gland fossa. Malignant epithelial lacrimal gland tumors can also have radiographic evidence of bony invasion and destruction. Masses of the lacrimal gland may be due to a broad range of pathologies, and a good working knowledge of common clinical characteristics and radiographic imaging findings is essential for diagnosis and treatment. All patients with inflammatory, lymphoproliferative, and epithelial neoplastic lesions involving the lacrimal gland require long-term surveillance for disease recurrence and progression.

scholarly journals A New Radiographic Method for Estimating Tibial Malrotation

2020 ◽  
Vol 7 (3) ◽  
pp. 121-128
Author(s):  
Hamidreza Yazdi ◽  
◽  
Mohammad Taher Ghaderi ◽  
Alireza Yousof Gomrokchi ◽  
Parham Pezeshk ◽  
...  
Keyword(s):  
Lower Limb ◽  
Evaluation Method ◽  
Bone Fractures ◽  
Distal Tibia ◽  
Bone Diseases ◽  
The Body ◽  
University Hospital ◽  
Radiographic Evaluation ◽  
Minor Trauma ◽  
Lower Limb Injury

Background: Diaphyseal tibial fractures are the most frequent bone fractures in the body and are usually treated with intramedullary nailing method. However, this approach is responsible for 41% of the rotational deviation.  Objectives: This study aimed to provide a radiographic evaluation method to determine tibial malrotation in closed fixation of tibia bone fractures during or after the operation. Methods: This study was conducted in a university hospital from May 2015 to March 2016. All patients referring to the hospital with the complaints of minor trauma around the ankle and knee requiring radiographic evaluation of both joints were enrolled in the study. The inclusion criteria included being 20 and 50 years old; having normal axial, sagittal, and coronal lower limb alignment; lacking previous lower limb injury (such as fractures of the tibia or fibula), ankle or knee sprain; not having previous lower limb surgery, metabolic or congenital bone diseases, or malignancy. In all cases, a standard Anteroposterior (AP) radiograph of the knee was taken, and then, without changing the limb position or image setting, an AP radiograph of the ankle was obtained. The overlap between the distal tibia and fibula was measured in the PACS program environment.   Results: Fifty cases were included in this study. The Mean±SD ages of males and females were 29.08±2.49 years and 31.46±2.04 years, respectively. The range of distal tibia-fibula overlap one centimeter above the tibiotalar joint line was 7.81 to 9.09 mm (confidence interval of 95%), and its percentage to the fibula shaft width at the same level was 49.43% to 54.35%. Conclusion: According to the results, distal tibia-fibula overlap when the knee is in the true AP position, regardless of the side and gender, is 7.81 to 9.09 mm or 49.43% to 54.35%.

scholarly journals Effect of Nursing Guidelines on Coping of Infertile Couples Undergoing In Vitro Fertilization

2020 ◽  
Vol 2 (2) ◽  
pp. 11
Author(s):  
Gehan S. Abdelgelel ◽  
Shadia H. Muhsib ◽  
Mona H. Abdelaal ◽  
Randa M. Ibrahim
Keyword(s):  
In Vitro Fertilization ◽  
Coping Strategies ◽  
Unprotected Sex ◽  
The Body ◽  
University Hospital ◽  
Vitro Fertilization ◽  
Significant Difference ◽  
Infertile Couples ◽  
Nursing Guidelines

Context: Infertility is defined as not being able to conceive after one year of unprotected sex. In vitro fertilization (IVF) is a process of fertilization where an ovum is combined with sperm outside the body, in vitro. In vitro fertilization (IVF) is psychologically and emotionally stressful. Coping strategies are needed to master, tolerate, reduce, or minimize stressful events. Aim: This study aimed to evaluate the effect of nursing guidelines on coping of infertile couples' undergoing In Vitro Fertilization. Methods: A quasi-experimental research design was utilized to achieve the aim of this study. This study conducted at the assisted reproductive technology unit of Ain shams Maternity University Hospital on a convenient sample of 98 couples undergoing fertility treatments. Two tools were used for data collection; the first tool was a structured interviewing questionnaire to assess the couple's socio-demographic data, obstetric history, the couple's knowledge regarding in vitro fertilization. The second tool was ways of coping scale (WQS) to assess coping strategies among the infertile couple. Results: There is no statistically significant difference between couples in both groups according to their knowledge and their coping strategies to IVF before the implementation of nursing guidelines (p> 0.05). In contrast, there is a highly statistically significant improvement in knowledge and coping strategies of couples on the study group compared to control group couples after implementation of nursing guidelines(p<0.001). Conclusion: The finding of the current study supported the hypothesis, which stated that the infertile couples who will expose to the nursing guidelines, will exhibit improved coping strategies to IVF compared to the controls. The study recommended the application of nursing guidelines at the IVF unit of Ain Shams Maternity University Hospital and other settings for IVF treatment as routine care to improve infertile couples' coping strategies.

scholarly journals Unusual Site for a White Nodule on the Palatine Tonsil: Presentation, Differential Diagnosis, and Discussion

2021 ◽  
Vol 2021 ◽  
pp. 1-4
Author(s):  
Ashwag Yagoub Aloyouny
Keyword(s):  
Differential Diagnosis ◽  
Clinical Presentation ◽  
Surgical Intervention ◽  
Fungal Infections ◽  
The Body ◽  
Palatine Tonsil ◽  
Unusual Site ◽  
Case Presentation ◽  
Lymphoepithelial Cysts ◽  
Malignant Lesions

Introduction. Palatine tonsils are part of the mucosa-associated lymphoid tissue, located in the oropharyngeal region. Although these tissues protect the body from foreign intruders, they are more prone to infections due to their anatomical structure and location. For instance, the differential diagnosis of a white lesion on the palatine tonsil can range from benign to malignant lesions. Oral lymphoepithelial cysts commonly arise as painless, yellowish nodules on the floor of the mouth and the ventral or lateral surface of the tongue. Case Presentation. This paper presents a rare case of an unusual site of a lymphoepithelial cyst (LEC) in the oral cavity. The lesion was located in the tonsil of a 20-year-old woman with a chief complaint of a painless, white lump in the back of the mouth for nine months. Discussion. The differential diagnosis of a white lesion on the palatine tonsil is caused by several factors, such as bacterial, viral, and fungal infections; trauma; stones; cysts; abscess; or cancer. In this case, both the clinical presentation and extra- and intraoral examinations were highly associated with LEC. Oral LEC etiopathogenesis is uncertain, and several theories have been proposed to discuss the causes of LEC. In addition, oral LEC could be monitored without surgical intervention if the nodule is asymptomatic. Conclusion. We emphasize the importance of a thorough clinical examination of oral and oropharyngeal lesions, which are usually neglected.

scholarly journals Safety of using the preparation “Licopid®” in opinion of experts in various specialities

2019 ◽  
Vol 36 (2) ◽  
pp. 81-92 ◽  
Author(s):  
A. E. Krasheninnikov ◽  
A. V. Matveev ◽  
T. M. Andronova ◽  
S. V. Guryanova ◽  
N. V. Shilova ◽  
...  
Keyword(s):  
Fungal Infections ◽  
The Body ◽  
Occurrence Rate ◽  
Synthetic Analogue ◽  
Structural Fragment ◽  
Bacterial Cells ◽  
Adjuvant Effect ◽  
Chi Square ◽  
Medical Speciality ◽  
Region Of Residence

Aim. To study the safety of the preparation “Licopid®” using the data, obtained with the method of questioning of doctors of various specialities. The reactant of “Licopid®” tablets is glucoseminylmuramildipeptide – a synthetic analogue of the structural fragment of bacterial cells membrane (peptidoglycan), which is an activator of congenital and acquired immunity;it strengthens the defense of the body from viral, bacterial and fungal infections; it has an adjuvant effect in development of immunological reactions. Materials and methods. The object of this study were the answers of 2315 specialists to the questions of surveys regarding the safety of using immunomodulator“Licopid®” in their practical activity. The regions, involved into the survey were the following cities: Moscow, Kazan, Krasnodar, Ekaterinburg, St. Petersburg, Chelyabinsk, Novosibirsk, Perm, Samara and Voronezh as well as Krasnodar Krai. Processing of the results was fulfilled with the methods of descriptive statistics; the obtained data were compared with the method based on calculation of chi-square criterion. Results. The analyzed results showed that 962 respondents (41.5 %) indicated the fact of revealing undesirable reactions (UR) of the preparation “Licopid®” in their own practice. It was noted by them that all undesirable reactions were not severe and predicted, i.e. they were indicated in the instruction for medical use of “Licopid®” 1 mg and 10 mg. Conclusions. While conducting questioning, the authors revealed statistically significant differences in the structure of respondents’ answers depending on the region of residence and medical speciality. At the same time, for all UR, indicated in instruction, subjectively estimated occurrence rate of reactions coincided with that, declared upon registration, except myalgias and arthralgias, which were noted by doctors much rarely.

scholarly journals VENTILATORY AND METABOLIC RESPONSES DURING FIELD TESTS AND CPX IN OBESE ADULTS

2017 ◽  
Vol 25 (1) ◽  
pp. 168
Author(s):  
Nicole Oliver ◽  
Renata Carlos ◽  
Tatiana Onofre ◽  
Joceline Cássia Ferezini De Sá ◽  
Eliane Pereira Da Silva ◽  
...  
Keyword(s):  
Field Tests ◽  
Carbon Dioxide Production ◽  
Cross Sectional Study ◽  
Peak Oxygen Uptake ◽  
Cardiopulmonary Exercise Test ◽  
Rehabilitation Program ◽  
The Body ◽  
University Hospital ◽  
Functional Evaluation ◽  
Cross Sectional

The 6 minute walk test (6MWT) and the incremental shuttle walking test (ISWT) have been used as an alternative to the Cardiopulmonary Exercise Test (CPX) for functional evaluation as well after rehabilitation programs. The objective was to analysis the cardiorespiratory and metabolic demands among the ISWT, 6MWT and CPX in the obese and the contribution of adiposity markers on this response. An observational and cross-sectional study was conducted with fifteen obese (10 women; 39.4+10.1years), performing CPX, 6MWT and ISWT. The subjects were as initial part of a rehabilitation program and bariatric surgery at the University Hospital. Metabolic and ventilatory variables were recorded by a telemetry system during all tests. Peak oxygen uptake-VO2peak was similar between CPX (18.6±4.0ml/kg/min) and ISWT (15.4±2.9ml/kg/min) and different from 6MWT (13.2±2.5ml/kg/min). There was agreement (3.2ml/kg/min; 95%; IC-3.0-9.4) between VO2peak of CPX and ISWT. CPX duration (R2=0.61;p=0.001) was best-fit by waist circumference (WC) and the body adiposity index(BAI) that reduced 4.7% and 3.2% CPX duration respectively. Forced vital capacity-FVC and WC predicts increasing of carbon dioxide production (VCO2) on CPX (R2=0.95;p=0.001) and ISWT (R2=0.67;p=0.001). In conclusion the obese individuals perform the ISWT and CPX test with similar physiological responses. It is suggested that, ISWT could be an alternative to CPX and that metabolic monitoring of ISWT by telemetry can be useful for the clinical assessment of the functional capacity of the obese.

scholarly journals Estado nutricional e desfechos clínicos em pacientes críticos internados em hospital universitário

2020 ◽  
Vol 34 (4) ◽  
pp. 361-366
Author(s):  
Edcleide Oliveira dos Santos Olinto ◽  
Gina Araújo Martins Feitosa ◽  
Izaura Odir Lima Gomes da Costa ◽  
Janine Maciel Barbosa ◽  
Ericka Vilar Bôtto Targino ◽  
...  
Keyword(s):  
Body Mass ◽  
Statistical Significance ◽  
Strong Relationship ◽  
The Body ◽  
University Hospital ◽  
Nutritional Risk ◽  
World Health ◽  
P Value ◽  
Chi Square ◽  
Length Of Hospitalization

Introduction: There is a strong relationship between malnutrition and increased length of hospitalization and morbidity and mortality. Studies have shown that malnourished patients can have up to twenty times more complications than eutrophic ones. In critically ill patients, there is a tendency to catabolism, resulting in the loss of lean body mass, which when it reaches 40% is usually lethal. Methods: A quantitative, descriptive study was conducted on adults from both genders, admitted to the intensive care unit (ICU) of a university hospital, from March to December 2018. The following variables were collected from the evaluation and nutritional records: length of hospitalization in the ICU, date of discharge or death, nutritional risk through specific screening, height, weight and arm circumference (AC). For the screening, the Nutric score was used. For the nutritional evaluation, the body mass index (BMI) and AC indicators and the classifications recommended by the World Health Organization (2004) and Blackburn and Thornton (1979) were used. After collecting the data, they were analyzed in the Statistical Package for Social Sciences (SPSS) 13.0 and for the association of the variables the Chi-square test was used, considering statistical difference when the p value <0.05. Results: The sample consisted of 116 patients, mostly female (53.4%) whose median age was 46 years (interquartile range IQR 31-53). Regarding the frequency of nutritional risk, most patients (61.5%) had a low score. There was an important frequency of malnutrition, according to the AC indicator (73%), although BMI (43.5%) showed eutrophy. Even though most patients had low nutritional risk, those with high nutritional risk (38.5%) had a higher tendency to mortality, however, not statistically confirmed (p> 0.05). There was also a tendency of association between death and malnutrition, although no statistical significance was shown(p> 0.05). Conclusion: Patients at nutritional risk and/or malnutrition appear to be vulnerable to worse clinical outcomes.

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