scholarly journals Case Report: Tropheryma whipplei Hide in an AIDS Patient With Pneumocystis Pneumonia

2021 ◽  
Vol 9 ◽  
Author(s):  
Jun Yan ◽  
Binhai Zhang ◽  
Zhongdong Zhang ◽  
Jinchuan Shi ◽  
Shourong Liu ◽  
...  
Keyword(s):  
Case Report ◽  
Bronchoalveolar Lavage ◽  
Clinical Improvement ◽  
Opportunistic Infections ◽  
Pneumocystis Pneumonia ◽  
Tropheryma Whipplei ◽  
Pneumocystis Jirovecii ◽  
Aids Patients ◽  
Case Presentation ◽  
Timely Diagnosis

Introduction:Pneumocystis pneumonia (PCP) is one of the most common opportunistic infections in HIV-infected patients. However, coinfection with Tropheryma whipplei is infrequent in AIDS patients with PCP.Case Presentation: We report a 28-year-old male AIDS patient coinfected with T. whipplei and Pneumocystis jirovecii diagnosed in the bronchoalveolar lavage. After sulfamethoxazole–trimethoprim and meropenem treatment, the patient showed clinical improvement in 2 weeks.Conclusion: Clinicians need to be alert to the occurrence of T. whipplei infection in AIDS patients with PCP and timely diagnosis and antibacterial treatments are essential. This case may help clinicians for timely diagnosis of the coinfection of T. whipplei and P. jirovecii in AIDS patients.

scholarly journals Frequency of Pneumocystis jirovecii in sputum from HIV and TB patients in Namibia

2014 ◽  
Vol 8 (03) ◽  
pp. 349-357 ◽  
Author(s):  
Vincent Nowaseb ◽  
Esegiel Gaeb ◽  
Marcin G Fraczek ◽  
Malcolm D Richardson ◽  
David W Denning
Keyword(s):  
Pneumocystis Pneumonia ◽  
Sub Saharan Africa ◽  
Pneumocystis Jirovecii ◽  
Aids Patients ◽  
Limited Region ◽  
Minimum Frequency ◽  
Resource Limited ◽  
Smear Negative ◽  
Sub Saharan ◽  
Hiv Aids

Introduction: The opportunistic fungus Pneumocystis jirovecii causes Pneumocystis pneumonia (PcP), which is a life-threatening infection in HIV/AIDS patients. The seemingly low prevalence of P. jirovecii pneumonia in sub-Saharan Africa has been a matter of great debate because many HIV/AIDS patients reside in this region. The lack of suitable diagnostic practices in this resource limited-region has been added to the uncertainty of PcP prevalence. Only a few studies have evaluated the utility of easily obtainable samples such as expectorated sputum for diagnosis of PcP. Thus, the aim of the current study was to evaluate the effectiveness of expectorated sputum for the routine diagnosis of PcP in a resource-limited sub-Saharan African setting. Methodology: Randomly collected sputum samples were analysed by microscopy after Grocott’s methenamine silver (GMS) stain staining and by qPCR to determine the minimum frequency of detectable P. jirovecii. Results: A total of 475 samples were analysed. Twenty five (5.3%) samples were positive for P. jirovecii, i.e., 17 (3.6%) using both qPCR and GMS staining and eight (1.7%) using qPCR only. P. jirovecii was present in 8/150 (5.3%) HIV-positive and tuberculosis (TB) smear-negative patients, and in 12/227 (5.3%) TB smear-negative patients with an unknown HIV status. The minimum frequency of PcP was 3.6% in Namibian HIV and TB patients, while the actual frequency is likely to be 5.3%. Conclusion: This study demonstrated that expectorated sputum can be used routinely for the diagnosis of PcP by GMS, although qPCR is more sensitive, and it requires less time and skill.

scholarly journals Diagnostic Performance of Bronchoalveolar Lavage (1,3)-β-d-Glucan Assay for Pneumocystis jirovecii Pneumonia

2020 ◽  
Vol 6 (4) ◽  
pp. 200
Author(s):  
Shiwei Zhou ◽  
Kathleen A. Linder ◽  
Carol A. Kauffman ◽  
Blair J. Richards ◽  
Steve Kleiboeker ◽  
...  
Keyword(s):  
Bronchoalveolar Lavage ◽  
Test Performance ◽  
Predictive Value ◽  
Operating Characteristic ◽  
Area Under The Curve ◽  
Lavage Fluid ◽  
Pneumocystis Pneumonia ◽  
Pneumocystis Jirovecii ◽  
Pneumocystis Jirovecii Pneumonia ◽  
Characteristic Area

We evaluated the performance of the (1,3)-β-d-glucan (BDG) assay on bronchoalveolar lavage fluid (BALF) as a possible aid to the diagnosis of Pneumocystis jirovecii pneumonia. BALF samples from 18 patients with well-characterized proven, probable, and possible Pneumocystis pneumonia and 18 well-matched controls were tested. We found that the best test performance was observed with a cut-off value of 128 pg/mL; receiver operating characteristic/area under the curve (ROC/AUC) was 0.70 (95% CI 0.52–0.87). Sensitivity and specificity were 78% and 56%, respectively; positive predictive value was 64%, and negative predictive value was 71%. The low specificity that we noted limits the utility of BALF BDG as a diagnostic tool for Pneumocystis pneumonia.

scholarly journals A case report of serious brain and lung injury caused by mistakenly taking Mosquito repellent liquid contains Meperfluthrin

2020 ◽  
Author(s):  
Qing Lou ◽  
Shengxin Zhang ◽  
Shengkun Zheng ◽  
Huaying Liu ◽  
Yi Lu ◽  
...  
Keyword(s):  
Mechanical Ventilation ◽  
Case Report ◽  
Lung Injury ◽  
Bronchoalveolar Lavage ◽  
Daily Life ◽  
Mosquito Repellent ◽  
Case Presentation ◽  
Toxic Damage ◽  
Xiamen City ◽  
Clinical Cases

Abstract Background Mosquito repellent liquid containing Meperfluthrin is widely used in the daily life. Among all clinical cases that children take mosquito repellent by mistake, only a fewwere recorded with serious brain and lung damages caused by Meperfluthrin. Case presentation: This case report presents a 16-month-old child in Xiamen City of China with severe brain and lung injury caused by mistakenly taking mosquito repellent that contains 0.8% Meperfluthrin. The child was treated with mechanical ventilation, fiberoptic bronchoalveolar lavage, anti-infection, 20% mannitol for dehydration, ganglioside and neurologic rehabilitation. The child recovered after 2 months. Conclusion This case shows that the improper administration of Meperfluthrin may cause serious toxic damage to brain and lung. Clinicians and parents should pay attention to prevention and targeting treatment promptly after intoxication.

scholarly journals Rare Presentation of Pulmonary Embolism Associated with PCP in a 28-Year-Old Man who was not known to be infected with HIV Before

2020 ◽  
Vol 5 (7) ◽  
pp. 66-72
Author(s):  
Nasser Al-Shekaili ◽  
Ahmed Nada ◽  
Yousif A. Hamad
Keyword(s):  
Pulmonary Embolism ◽  
Opportunistic Infections ◽  
Pneumocystis Pneumonia ◽  
Hiv Positive ◽  
Rare Presentation ◽  
Case Presentation ◽  
Pulmonary Angiogram ◽  
Human Immunodeficiency Viruses ◽  
History Of ◽  
Suspected Pneumonia

Introduction Human Immunodeficiency Viruses (HIV) commonly presented with acute seroconversion symptoms or opportunistic infections from immunosuppression, but first presentation of HIV with pulmonary embolism associated with active Pneumocystis pneumonia (PCP) is very rare. Case presentation A 28-year-old man presented with history of fever and cough associated with dyspnoea over 8 weeks and gradually worsen till maximised 2 week prior to admission. he did not improved inspite of antibiotics for suspected pneumonia. Found to be HIV positive with opportunistic infection. Computed Tomography Pulmonary Angiogram (CTPA) confirmed the presence of pulmonary embolism. He was treated successfully with anticoagulants, steroids, and antibiotics . discharged on base of clinical and radiological improvement. Conclusion Pulmonary embolism can be the first presentation of a newly diagnosed with HIV patient. The similar features of both viral pneumonia and subacute pulmonary embolism can lead to delay diagnosis, especially in the era of covid-19 pandemic infection

scholarly journals SARS-CoV-2 Translocate from Nasopharyngeal to Bronchoalveolar Site: A Case Presentation

Reports ◽  
2020 ◽  
Vol 3 (3) ◽  
pp. 23
Author(s):  
Filippo Luciani ◽  
Erika Cione ◽  
Maria Cristina Caroleo ◽  
Manuela Colosimo ◽  
Alfredo Zanolini ◽  
...  
Keyword(s):  
Case Report ◽  
Bronchoalveolar Lavage ◽  
Antiviral Therapy ◽  
Clinical Condition ◽  
Nasopharyngeal Swab ◽  
Present Case Report ◽  
Case Presentation ◽  
Severe Impairment ◽  
Negative Detection

The nasopharyngeal swab is commonly used for the diagnosis of SARS-CoV-2 infection. Since the swab is performed in this site, of course, it cannot detect the presence of the virus in other tissue districts such as the lung, brain, or bowel. In the present case report, the nasopharyngeal swab was negative twice. From this, the patient discontinued antiviral therapy. Nasopharyngeal swabs were maintained negative until five days later, when we recorded a severe impairment of the patient’s clinical condition. At this time, the bronchoalveolar lavage was positive for SARS-CoV-2. The purpose of the case herein described is to suggest paying attention to the nasopharyngeal swab result. A negative detection in nasopharyngeal swab could not be indicative of COVID-19 recovery.

An Obscure Colon Dilatation and its Underlying Cause: Case Report and Literature Review

2020 ◽  
pp. 1-5
Author(s):  
Anton Stift ◽  
Kerstin Wimmer ◽  
Felix Harpain ◽  
Katharina Wöran ◽  
Thomas Mang ◽  
...  
Keyword(s):  
Case Report ◽  
Sigmoid Colon ◽  
Immunohistochemical Staining ◽  
Late Onset ◽  
Hirschsprung Disease ◽  
Endoscopic Examination ◽  
Case Presentation ◽  
Idiopathic Megacolon ◽  
History Of ◽  
Cells Of Cajal

Introduction: Congenital as well as acquired diseases may be responsible for the development of a megacolon. In adult patients, Clostridium difficile associated infection as well as late-onset of Morbus Hirschsprung disease are known to cause a megacolon. In addition, malignant as well as benign colorectal strictures may lead to intestinal dilatation. In case of an idiopathic megacolon, the underlying cause remains unclear. Case Presentation: We describe the case of a 44-year-old male patient suffering from a long history of chronic constipation. He presented himself with an obscurely dilated large intestine with bowel loops up to 17 centimeters in diameter. Radiological as well as endoscopic examination gave evidence of a spastic process in the sigmoid colon. The patient was treated with a subtotal colectomy and the intraoperative findings revealed a stenotic stricture in the sigmoid colon. Since the histological examination did not find a conclusive reason for the functional stenosis, an immunohistochemical staining was advised. This showed a decrease in interstitial cells of Cajal (ICC) in the stenotic part of the sigmoid colon. Discussion: This case report describes a patient with an idiopathic megacolon, where the underlying cause remained unclear until an immunohistochemical staining of the stenotic colon showed a substantial decrease of ICCs. Various pathologies leading to a megacolon are reviewed and discussed.

Descending Cervical-Sacral Pain after the Administration of Antivenom to the Scorpion Sting Poisoning: A Case Report

2020 ◽  
Vol 2 (2) ◽  
pp. 93-96
Author(s):  
Josué Saúl Almaraz Lira ◽  
Alfredo Luis Chávez Haro ◽  
Cristian Alfredo López López ◽  
Remedios del Pilar González Jiménez
Keyword(s):  
Blood Pressure ◽  
Type 2 Diabetes ◽  
Case Report ◽  
Signs And Symptoms ◽  
Cervical Region ◽  
Scorpion Sting ◽  
Case Presentation ◽  
Sacral Region ◽  
Scorpion Stings

Introduction. Scorpion stings occur mainly in spring and summer, with an estimate of 1.2 million cases per year worldwide. About 300,000 poisonings occur within a year, primarily affecting children and adults older than 65 years. In 2019, Guanajuato (Mexico) ranked third in poisoning by scorpion sting with a total of 43,913 cases. The intoxication grades are three where the signs and symptoms are varied. There are two types of antivenom in the Mexican market, and we use Alacramyn® in our case. Case presentation. A 70-year-old female —with grade 1 scorpion sting poisoning, 30 minutes of evolution, with type 2 diabetes and high blood pressure— received two vials of antivenom according to current regulations. She presented transient vagal reaction and subsequent transient pain in the cervical region that radiates to the sacral region. At discharge, there are no data compatible with scorpion sting poisoning. Conclusions. Transient pain in the cervical region to the sacral region may be secondary to an anxiety crisis, hypersensitivity to IgG, or secondary reaction to administration in less time than recommended by the provider. The benefit was greater than the reactions that occurred.

CLINICAL CHALLENGES FOR ANESTHESIOLOGIST FACING PATIENT WITH ACROMEGALY. CASE REPORT

2020 ◽  
Vol 30 (3) ◽  
pp. 56-59
Author(s):  
Jūratė Gudaitytė ◽  
Justina Jermolajevaitė ◽  
Martynas Judickas
Keyword(s):  
Atrial Fibrillation ◽  
Case Report ◽  
General Population ◽  
Metabolic Disorders ◽  
Upper Airway ◽  
Cardiovascular Complications ◽  
Case Presentation ◽  
Increased Risk ◽  
Fluid Regulation ◽  
Class Iv

Background and objectives: Acromegaly is endocri­nal disorder which results in changes involving ge­neral appearance as well as upper airway abnorma­lities, cardiovascular and metabolic disorders which can aggravate the anesthesia and can lead to compli­cations. We aim to discuss the challenges for anesthe­siologist that occurs facing patient with acromegaly and are necessary to investigate before performing any kind of intervention. Case Presentation: 79 years old male patient presen­ted the hospital with recently diagnosed acromegaly for rectal prolapse surgery. From anamnesis he had NYHAIII with cardiomyopathy, atrial fibrillation and arterial hypertension, also multiple old compressive fractures Th10 – L5. He was graded with Mallam­pati score IV and ASA class IV. The complemen­tary examinations were made to assess the possible complications. In induction of general anesthesia the intubation was performed using fibro- bronchoscope and anesthesia went without complications except hypotension which was managed. After surgery the patient was leaded to the postoperative room for furt­her monitoring. Discussion and Conclusion: Acromegalic patients have an increased risk of difficulty during anesthe­sia compared to general population due to difficult intubation, cardiovascular complications , OSA , alte­ration in intraoperative glucose intolerance and fluid regulation. Therefore profound investigation and as­sessment are necessary to predict and prepare for possible difficulties in the surgery room.

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