A Case Series of Pulmonary Mucormycosis Caused by Rhizopus Microsporus

Mucormycosis is a relatively uncommon but intractable fungal infectious disease. The mortality is very high when it occurs. In this study, we reported a continuous cases of pulmonary mucormycosis in three patients who suffered from chronic kidney disease, history of renal transplantation and multiple myeloma in April 2017, respectively. Cultures were obtained from several specimens (pathological tissue, bronchoalveolar lavage fluid and sputum) and all identified as Rhizopus microsporus by Matrix-Assisted Laser Desorption Ionization Time- Of-Flight (MALDI-TOF) mass spectrometry and ITS DNA sequencing methods. In addition, they all showed susceptibility to amphotericin B and posaconazole. Unfortunately, even through the three patients all treated with amphotericin B and posaconazole, one man still died eventually. Clinicians should keep an eye on patients who are at high risk of acquiring this fatal disease and make early intervention strategies to reduce terrible outcomes.

Download Full-text

Case Report: Metagenomics Next-Generation Sequencing Can Be Performed for the Diagnosis of Disseminated Mucormycosis

Frontiers in Medicine ◽

10.3389/fmed.2021.675030 ◽

2021 ◽

Vol 8 ◽

Author(s):

Yi Sun ◽

HuiLing Li ◽

JiaJun Chen ◽

ZhongHui Ma ◽

Pin Han ◽

...

Keyword(s):

Next Generation Sequencing ◽

Lavage Fluid ◽

Next Generation ◽

Rhizopus Microsporus ◽

History Of ◽

Post Traumatic ◽

Disseminated Mucormycosis ◽

Underlying Diseases ◽

Very High ◽

Generation Sequencing

Mucormycosis is an infection caused by a group of filamentous molds with in the order Mucorales. In developing countries, most cases of mucormycosis occur in persons with poorly controlled diabetes mellitus or subjects with normal post-traumatic immune function. Mucormycosis exhibits a marked propensity for invading blood vessels. The mortality rate of invasive mucormycosis is very high (>30–50%), and 90% of mortality is related to disseminated diseases. We report a 62-year-old man with underlying diseases, such as diabetes and psoriatic arthritis, with a history of trauma before admission. Chest CT showed multiple cavities. Based on the suspected clinical manifestation of mucormycosis infection, the patient received a microbiological culture of bronchoalveolar lavage fluid, and metagenomics next generation sequencing (mNGS) was performed. The results suggested Klebsiella pneumoniae infection. However, Rhizopus microsporus strains were shown by the mNGS of transpulmonary puncture tissue. Therefore, we report a case in which rare pathogens are identified by mNGS.

Download Full-text

A Useful Diagnostic Method for Drug-induced Pneumonitis

The American Journal of Chinese Medicine ◽

10.1142/s0192415x94000395 ◽

1994 ◽

Vol 22 (03n04) ◽

pp. 329-336 ◽

Cited By ~ 19

Author(s):

Akira Kawasaki ◽

Yutaka Mizushima ◽

Hitoshi Kunitani ◽

Masanobu Kitagawa ◽

Masashi Kobayashi

Keyword(s):

Bronchoalveolar Lavage Fluid ◽

Challenge Test ◽

Lavage Fluid ◽

Peripheral Blood Lymphocytes ◽

Lymphocyte Stimulation Test ◽

Drug Induced ◽

Chief Complaints ◽

History Of ◽

Chest X Ray

A 51 year-old male was admitted to our hospital with chief complaints of fever, dry cough and dyspnea. Chest X -ray films and his history of taking Chinese medicine for liver dysfunction were suggestive of drug-induced pneumonitis. Lymphocyte stimulation test (LST) to causative Chinese medical drugs of Sho-saiko-to and Dai-saiko-to was negative with peripheral blood lymphocytes (PBL), but was positive with Iymphocytes from bronchoalveolar lavage fluid (BALF). In vivo challenge test for Sho-saiko-to was positive. The LST with BALF-lymphocytes proved to be very useful in making a diagnosis of drug-induced pneumonitis.

Download Full-text

Actinomyces graevenitziiPulmonary Abscess Mimicking Tuberculosis in a Healthy Young Man

Canadian Respiratory Journal ◽

10.1155/2014/841480 ◽

2014 ◽

Vol 21 (6) ◽

pp. e75-e77 ◽

Cited By ~ 7

Author(s):

Smaranda Gliga ◽

Mathilde Devaux ◽

Marine Gosset Woimant ◽

Dominique Mompoint ◽

Christian Perronne ◽

...

Keyword(s):

Computed Tomography ◽

Lung Cancer ◽

Bronchoalveolar Lavage Fluid ◽

Lavage Fluid ◽

Clinical Samples ◽

High Dose ◽

Pulmonary Actinomycosis ◽

History Of ◽

Right Lobe

Pulmonary actinomycosis is a rare disease that is often misdiag-nosed as tuberculosis or lung cancer.Actinomyces graevenitziiis a relatively new recognizedActinomycesspecies isolated from various clinical samples. The authors report a case of pulmonary actinomycosis caused byA graevenitzii. A computed tomography examination revealed an excavated consolidation in the middle right lobe of a previously healthy young man who presented with a long history of moderate cough. Cultures of the bronchoalveolar lavage fluid confirmed the diagnosis of pulmonary abscess caused byA gravenitzii. At the three-month follow-up consultation and, after six weeks of high-dose amoxicillin, the pulmonary lesion had completely disappeared.

Download Full-text

Chronic cough and cystic lung disease caused byBordetella bronchisepticain a patient with AIDS

BMJ Case Reports ◽

10.1136/bcr-2018-228741 ◽

2019 ◽

Vol 12 (4) ◽

pp. e228741

Author(s):

Muhammad Sameed ◽

Scott Sullivan ◽

Ellen T Marciniak ◽

Janaki Deepak

Keyword(s):

Bronchoalveolar Lavage Fluid ◽

Lower Lobe ◽

B Cell Lymphoma ◽

Lavage Fluid ◽

Hiv Viral Load ◽

Cystic Lung ◽

Breath Sounds ◽

Combined Antiretroviral Therapy ◽

History Of ◽

Fluid Culture

A 24-year-old man with a history of HIV and large B cell lymphoma (currently in remission) presented with fever, dry cough and dizziness. His CD4+ count was undetectable, and the HIV viral load was 109 295 cop/mL. Physical examination revealed fever, hypotension and tachycardia with coarse breath sounds in the middle and lower chest zones bilaterally. Chest imaging showed diffuse abnormal micronodular and patchy infiltrates, without focal consolidation. A cavitary lesion was noted measuring 5×2 cm in axial dimensions within the left lower lobe and multiple small cystic lesions in the background. Bronchoalveolar lavage fluid culture grewBordetella bronchiseptica. The patient was empirically treated with vancomycin and piperacillin–tazobactam for multifocal pneumonia with concerns for sepsis and was started on combined antiretroviral therapy (cART) with abacavir/dolutegravir/lamivudine. Symptoms improved after day 3 of therapy, and the patient was discharged home on 2 weeks of moxifloxacin, in addition to the cART and appropriate chemoprophylaxis.

Download Full-text

Ramatroban, an orally bioavailable immunomodulator and antithrombotic agent for treatment of COVID-19 disease: A Case Report

10.21203/rs.3.rs-474882/v1 ◽

2021 ◽

Author(s):

MS MBBS Ashutosh Agarwal ◽

Kate Chander Chiang ◽

MS MBBS Aditya Agarwal

Keyword(s):

Bronchoalveolar Lavage Fluid ◽

Lavage Fluid ◽

Lipid Mediators ◽

Ambulatory Setting ◽

Potential Treatment ◽

Prothrombotic State ◽

Rapid Improvement ◽

Antithrombotic Agent ◽

Orally Bioavailable ◽

Very High

Abstract SARS-CoV-2 pneumonia and COVID-19 disease are characterized by a maladaptive immune response and prothrombotic state. The Spike protein of SARS-CoV-2 virus unleashes a storm of lipid mediators with very high levels of thromboxane B2 and prostaglandin D2 in the bronchoalveolar lavage fluid. DPr2 receptors for prostaglandin D2 and TPr receptors for thromboxane A2 have been proposed as therapeutic targets in COVID-19 in order to decrease viral load and inhibit platelet dependent thrombosis, respectively. Ramatroban is an oral, dual receptor antagonist of the DPr2 and TPr receptors with established safety profile, having been used in Japan for the treatment of allergic rhinitis for over 20 years. We report two patients, an 88-year-old woman and a 31-year-old man, both with COVID-19 pneumonia who were successfully treated in ambulatory setting with oral ramatroban, leading to rapid improvement in oxygen saturation from about 80–82% to about 90–95% over 24–48 hours followed by gradual recovery from the disease. The mechanism of action of ramatroban and its efficacy reported here supports clinical trials on this drug as a potential treatment for COVID-19.

Download Full-text

Cangrelor ameliorates CLP-induced pulmonary injury in sepsis by inhibiting GPR17

10.21203/rs.3.rs-30944/v1 ◽

2020 ◽

Author(s):

Qiancheng Luo ◽

Rui Liu ◽

Guorong Liu ◽

Min Hang ◽

Guo Chen ◽

...

Keyword(s):

Inflammatory Response ◽

Bronchoalveolar Lavage Fluid ◽

Lavage Fluid ◽

Surface Expression ◽

Pulmonary Injury ◽

Protective Mechanisms ◽

Tnf Α ◽

G Protein Coupled ◽

Very High ◽

Masson Staining

Abstract BackgroundSepsis is a common complication of severe wound injury and infection, with a very high mortality rate. The P2Y12 receptor inhibitor, cangrelor, is an antagonist antiplatelet drug.MethodsIn our study, we investigated the protective mechanisms of cangrelor in CLP-induced pulmonary injury in sepsis, using mouse models.ResultsTdT-mediated dUTP Nick-End Labeling (TUNEL) and Masson staining showed that apoptosis and fibrosis in lungs were alleviated by cangrelor treatment. Cangrelor significantly promoted surface expression of CD40L on platelets and inhibited CLP-induced neutrophils in Bronchoalveolar lavage fluid (BALF). We also found that cangrelor decreased the inflammatory response in the CLP mouse model and inhibited the expression of inflammatory cytokines, IL-1β, IL-6, and TNF-α. Western blotting and RT-PCR showed that cangrelor inhibited the increased levels of G-protein-coupled receptor 17 ༈GPR17༉induced by CLP. Conclusion: Our study indicated that cangrelor repressed the levels of GPR17, followed by a decrease in the inflammatory response and a rise of neutrophils in BALF, potentially reversing CLP-mediated pulmonary injury during sepsis.

Download Full-text

Rhino Orbital Cerebral Mucormycosis in settings of Covid-19 infection: A Case Series of Thirteen Patients

10.21203/rs.3.rs-1240669/v1 ◽

2022 ◽

Author(s):

Rajesh Verma ◽

Rajarshi Chakraborty ◽

Keerthiraj DB ◽

Kingzang Wangda ◽

Veerendra Verma ◽

...

Keyword(s):

Amphotericin B ◽

Public Awareness ◽

Tertiary Care ◽

Case Series ◽

Care Hospital ◽

Imaging Features ◽

Initial State ◽

Northern India ◽

History Of

Abstract Background Rhino-Orbital-Cerebral Mucormycosis (ROCM) is an important infectious disease encountered in huge number in this recent post-covid 19 era. An alteration in defence immune system during covid-19 illness, in the presence of uncontrolled hyperglycaemia has led to the new epidemic of ROCM especially in developing nations like India. Method This case series of thirteen patients illustrates the various clinical presentation, laboratorical parameters, imaging features and outcome of patients of ROCM admitted in a tertiary care hospital in Northern India. Result In our case series, a total of 13 newly diagnosed cases of Rhino-Orbital-Cerebral Mucormycosis were studied. History of covid-19 illness was observed in 7 cases (53.8%), use of steroid during Covid-19 illness was seen in 5 cases (38.5%), oxygen therapy was given in 4 cases (30.8%). Co-morbid state in the form of diabetes mellitus was present in 12 cases (92.3%) with mean duration 16.69 months with an important finding of 6 cases (46.2%) having new-onset diabetes; hypertension in present in 3 cases (23.1%). Magnetic resonance imaging of paranasal sinuses showed involvement of multiple sinuses in all the 13 cases(100%), including maxillary and ethmoidal sinuses, with frontal in 12 cases (92.3%), sphenoidal in 11 cases (84.6%), symmetric in 9 cases (69.2%), mastoiditis in 4 cases (30.8%), maxillary space involvement in 4 cases (30.8%), palatal involvement in 1 case (7.7%). Multi-speciality approach treatment was given in the liposomal amphotericin B therapy in all the patients along with thorough endo-nasal debridement done in all cases, transcutaneous retrobulbar amphotericin B in 6 cases (46.2%) with exenteration done in 7 patients (53.9%). At 3 months of follow-up, there was substantial clinical improvement in all the cases. Conclusion There should be definite emphasis on high suspicion of mucor clinically for early diagnosis and aggressive management at initial state of diagnosis for better outcome. The need for sustained proper glycemic control during covid 19 era along with judicious use of steroid and public awareness for early symptoms and manifestations of mucor can curb the magnitude of such potentially opportunistic epidemic to a substantial rate. The longer the infection remains undetected, the greater the devastation ROCM can impose, of which blindness is an important hazard.

Download Full-text

Expression of selected miRNA, RARβ and FHIT genes in BALf of squamous cell lung cancer (squamous-cell carcinoma, SCC) patients: a pilot study

Molecular Biology Reports ◽

10.1007/s11033-019-05057-2 ◽

2019 ◽

Vol 46 (6) ◽

pp. 6593-6597

Author(s):

Agata Dutkowska ◽

Adam Antczak ◽

Daria Domańska-Senderowska ◽

Ewa Brzeziańska-Lasota

Keyword(s):

Squamous Cell ◽

Bronchoalveolar Lavage Fluid ◽

Retinoic Acid Receptor ◽

Lavage Fluid ◽

Lung Carcinogenesis ◽

Diagnostic Potential ◽

Healthy Donors ◽

History Of ◽

Fhit Protein ◽

The Relationship

Abstract Two suppressor genes which often undergo epigenetic silencing during the early stages of lung carcinogenesis are those encoding retinoic acid receptor-β (RARβ) and Fhit protein (FHIT). RARβ expression is regulated by miRNA-34a and miRNA-141, and FHIT expression by miRNA-143 and miRNA-217. The aim of the study was to assess how selected miRNAs regulate the expression of their targeted genes in bronchoalveolar lavage fluid (BALf), obtained from patients with SCC of the lung. It also examines the relationship between the genetic findings and the clinical and pathomorphological features of the tumor. A total of 50 BALf samples were taken: 25 from patients with SCC and 25 from healthy donors. The expression (RQ) of the selected genes was analyzed by qPCR, as well as the miRNA level, with a particular emphasis on the relationship between the expression of the genes themselves and their corresponding miRNAs; in addition, the expression of the genes and miRNAs were compared with the pathomorphological features of the tumor and the clinical features of patients. Analysis of the RQ values showed downregulation of RARß, FHIT and miRNA-34a and increased expression of miRNA-141, miRNA-143 and miRNA-217 in all BALf samples (P > 0.05). No correlation was found between the expression of the selected genes and corresponding miRNAs, history of smoking, cancer stage, age and sex of the patients. The presence of the selected genes and miRNAs in BALf material does not seem to have diagnostic potential in patients with SCC; however, the results should be verified on a larger group of patients.

Download Full-text

Pulmonary Mucormycosis in Chronic Lymphocytic Leukemia and Neutropenia

Case Reports in Infectious Diseases ◽

10.1155/2018/2658083 ◽

2018 ◽

Vol 2018 ◽

pp. 1-4

Author(s):

Izza Mir ◽

Sijan Basnet ◽

David Ellsworth ◽

Elan Mohanty

Keyword(s):

Chronic Lymphocytic Leukemia ◽

Fungal Infection ◽

Amphotericin B ◽

Thoracoscopic Surgery ◽

Left Lung ◽

Lymphocytic Leukemia ◽

Pulmonary Mucormycosis ◽

Life Threatening ◽

History Of ◽

Video Assisted Thoracoscopic Surgery

Pulmonary mucormycosis is a rare life-threatening fungal infection associated with high mortality. We present the case of a 61-year-old man with history of chronic lymphocytic leukemia who presented with fever and cough, eventually diagnosed with pulmonary mucormycosis after right lung video-assisted thoracoscopic surgery. The patient was successfully treated with amphotericin B and right lung pneumonectomy; however, he later died from left lung pneumonia.

Download Full-text

Oral Formulation of Angiotensin-(1-7) Promotes Therapeutic Actions in a Model of Eosinophilic and Neutrophilic Asthma

Frontiers in Pharmacology ◽

10.3389/fphar.2021.557962 ◽

2021 ◽

Vol 12 ◽

Author(s):

Giselle Santos Magalhães ◽

Juliana Fabiana Gregório ◽

Arthur Tonani Pereira Cançado Ribeiro ◽

Isis Felippe Baroni ◽

Ana Victoria de Oliveira Vasconcellos ◽

...

Keyword(s):

Lung Function ◽

Bronchoalveolar Lavage Fluid ◽

Pulmonary Inflammation ◽

Lavage Fluid ◽

Oral Formulation ◽

Standards Of Care ◽

Disease Symptoms ◽

Asthmatic Patients ◽

History Of ◽

Severity Of The Disease

The presence of eosinophils and neutrophils in the lungs of asthmatic patients is associated with the severity of the disease and resistance to corticosteroids. Thus, defective resolution of eosinophilic and neutrophilic inflammation is importantly related to exacerbation of asthma. In this study, we investigated a therapeutic action of angiotensin-(1-7) (Ang-(1-7)) in a model of asthma induced by ovalbumin (OVA) and lipopolysaccharide (LPS). Balb-c mice were sensitized and challenged with OVA. Twenty-three hours after the last OVA challenge, experimental groups received LPS, and 1 h and 7 h later, mice were treated with oral formulation of Ang-(1-7). On the next day, 45 h after the last challenge with OVA, mice were subjected to a test of motor and exploratory behavior; 3 h later, lung function was evaluated, and bronchoalveolar lavage fluid (BALF) and lungs were collected. Motor and exploratory activities were lower in OVA + LPS-challenged mice. Treatment with Ang-(1-7) improved these behaviors, normalized lung function, and reduced eosinophil, neutrophil, myeloperoxidase (MPO), eosinophilic peroxidase (EPO), and ERK1/2 phosphorylation (p-ERK1/2) in the lungs. In addition, Ang-(1-7) decreased the deposition of mucus and extracellular matrix in the airways. These results extended those of previous studies by demonstrating that oral administration of Ang-(1-7) at the peak of pulmonary inflammation can be valuable for the treatment of neutrophil- and eosinophil-mediated asthma. Therefore, these findings potentially provide a new drug to reverse the natural history of the disease, unlike the current standards of care that manage the disease symptoms at best.

Download Full-text