scholarly journals First Report of an Invasive Infection by Cephalotrichum gorgonifer in a Neutropenic Patient with Hematological Malignancy under Chemotherapy

2021 ◽  
Vol 7 (12) ◽  
pp. 1089
Author(s):  
Ana Álvarez-Uría ◽  
Pilar Escribano ◽  
Verónica Parra-Blanco ◽  
José Francisco Cano-Lira ◽  
Alberto Miguel Stchigel ◽  
...  
Keyword(s):  
Hematological Malignancy ◽  
Fungal Infections ◽  
Neutropenic Patient ◽  
Acute Angle ◽  
Invasive Infection ◽  
Morphological Examination ◽  
First Case ◽  
Mantle Cell ◽  
Etiological Agents ◽  
The Right

The etiological agents of infrequent invasive fungal infections (IFI) are difficult to identify on the species level using classic morphological examination. We describe the first case of an IFI caused by Cephalotrichum gorgonifer in a neutropenic patient with a hematological malignancy and put it on the map as a new causative agent of IFI. Case report, microbiological findings and description of the etiological agent. A 60-year-old man was diagnosed with mantle cell lymphoma. A CT scan confirmed the presence of lung infiltrates located at the right upper lobe. Histological examination of one of the nodules showed a large number of narrow septate hyphae with acute-angle branching and irregular round cell morphology; vessels walls appeared infiltrated, proving an angioinvasive pulmonary IFI. Sample culture resulted positive and molecular identification proved the presence of Cephalotrichum gorgonifer. Voriconazole was used for 12 months and the patient did not report any complications or side effects. Complete remission of lymphoma was achieved later by the time chemotherapy, radiotherapy, and radioimmunotherapy consolidation were completed. We recommend the inclusion of Cephalotrichum gorgonifer in the list of opportunistic pathogens causing mycoses in neutropenic hematological patients with suspected mould-related IFI.

scholarly journals Saprochaete capitata oropharyngeal infection in a neutropenic patient: unusual presentation

2020 ◽  
Vol 26 (2) ◽  
pp. 21
Author(s):  
Mourad Belaouni ◽  
Rabii Elbahraouy ◽  
Elhoucine Malki ◽  
Lhoussain Louzi ◽  
Mohammed Er-rami
Keyword(s):  
Fungal Infections ◽  
Neutropenic Patient ◽  
Hematologic Malignancy ◽  
Oral Candidiasis ◽  
Etiologic Agent ◽  
Morbidity And Mortality ◽  
Severe Neutropenia ◽  
Invasive Infection ◽  
Starting Point ◽  
Oropharyngeal Infection

Introduction: Saprochete capitata is unusual etiologic agent in immunocompromised patients, particularly in those with hematologic malignancy and severe neutropenia. Most often, infections of the oral cavity are manifested clinically as oral candidiasis. Invasive forms are rarely described. Observation: a 63-year-old man consulted for pseudomembranous lesions associated with ulcero perforating lesion of the tongue and palatal region ulcerations. All evolving in a context of profound physical deterioration and severe neutropenia. Mycological examination showed Saprochaete capitata. The evolution was favorable with oral voriconazole. Comment: Saprochaete capitata invasive fungal infections have become an important cause of morbidity and mortality, particularly in hematology-oncology patients. Invasive or non-invasive, oropharyngeal involvement with this pathogen should not be underestimated in the neutropenic patient. They are the main starting point for fongemia of this pathogen, which is often fatal. Conclusion: Saprochete capitata is now recognized emerging etiologic agent in patients with hematological malignancy and severe neutropenia. Early detection and diagnosis of these fungal infections could lead to reduced morbidity and mortality, particularly in locally invasive infection.

scholarly journals Neck subcutaneous nodule as first metastasis from broad ligament leiomyosarcoma: a case report and review of literature

BMC Surgery ◽  
2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Fiorella Cazzato ◽  
Angela D’Ercole ◽  
Graziano De Luca ◽  
Francesca B. Aiello ◽  
Adelchi Croce
Keyword(s):  
Broad Ligament ◽  
Neck Region ◽  
Neck Mass ◽  
High Recurrence Rate ◽  
Low Grade ◽  
Morphological Examination ◽  
First Case ◽  
One Year ◽  
The Right ◽  
Primary Leiomyosarcoma

Abstract Background Leiomyosarcoma usually develops in the myometrium and is characterized by a high recurrence rate, frequent hematogenous dissemination, and poor prognosis. Metastasis is usually to lungs, liver, and bone, and occasionally to the brain, but seldom to the head and neck region. Primary leiomyosarcoma very rarely arises in the broad ligament. Case presentation A 54-year old woman presented to the otolaryngology department with a mass in the right posterior region of the neck 4 years after surgery for a primary leiomyosarcoma of the right broad ligament. The neck mass was removed and found to be a metastatic leiomyosarcoma. Leiomyosarcoma localizations in lungs and liver were absent. Morphological examination showed both the primary and the secondary leiomyosarcomas to have features of low-grade tumors. One year after excision of the neck mass, the patient presented with tachycardia. Echocardiography detected two intracardiac nodules suggestive of metastatic tumors. Chemotherapy was administered; the disease has been stable since then. Conclusions We report the first case of broad ligament leiomyosarcoma with the neck subcutaneous region being the first site of secondary involvement. We speculate that the Batson venous plexus might have been the pathway of dissemination.

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

Adult-to-Adult Living-Donor Liver Transplantation

Swiss Surgery ◽  
2003 ◽  
Vol 9 (5) ◽  
pp. 227-236 ◽  
Author(s):  
Majno ◽  
Mentha ◽  
Berney ◽  
Bühler ◽  
Giostra ◽  
...  
Keyword(s):  
Liver Transplantation ◽  
Living Donor ◽  
Living Donor Liver Transplantation ◽  
Therapeutic Option ◽  
Donor Liver ◽  
Donor Liver Transplantation ◽  
Multidisciplinary Program ◽  
First Case ◽  
Living Donor Transplantation ◽  
The Right

Living donor liver transplantation is a relatively new procedure in which the right side of the liver is harvested in a healthy donor and transplanted into a recipient. After the first case in 1994, over 3000 cases have been done worldwide. This review summarizes the reasons why the procedure is needed, describes its main technical aspects, highlights the boundaries in which it can be done safely, summarizes the current experience worldwide and describes the main points of the program in our unit. We argue that living-donor transplantation is a viable alternative to a long time on the waiting list for several patients, and it can be performed safely and successfully provided that all precautions are undertaken to minimize the risks in the donor and to increase the chances of a good outcome in the recipients. If these prerequisites are met, and within the framework of a structured multidisciplinary program, we believe that living-donor liver transplantation should be funded by health insurances as a recognized therapeutic option.

RARE CASE OF NODULAR LYMPHOID HYPERPLASIA OF LEFT LUNG IN THE PATIENT WITH PREVIOUS PULMONARY TUBERCULOSIS

2018 ◽  
Vol 40 (4) ◽  
pp. 332-335
Author(s):  
P V Kuzyk ◽  
M A Savchyna ◽  
S G Gychka
Keyword(s):  
Pulmonary Tuberculosis ◽  
Lymphoproliferative Disorder ◽  
Clinical Laboratory ◽  
Left Lung ◽  
Lymphoid Hyperplasia ◽  
Morphological Examination ◽  
Nodular Lymphoid Hyperplasia ◽  
Lymph Nodes Dissection ◽  
The Right ◽  
Immunohistochemical Studies

Aim: To describe the case of rare benign lymphoproliferative disorder — pulmonary nodular lymphoid hyperplasia in the patient with previous pulmonary tuberculosis. Materials and Methods: In the case of pulmonary nodular lymphoid hyperplasia clinical, laboratory, instrumental and morphological examination was performed. Results: 44-year-old woman in 7 years after successfully treated infiltrative drug-susceptible tuberculosis of the right lung, was hospitalized with a suspected tumor of the left lung root. The patient underwent left-sided pneumonectomy with lymph nodes dissection. The results of histopathological and immunohistochemical studies evidenced on nodular lymphoid hyperplasia of the left lung. Conclusion: Pulmonary nodular lymphoid hyperplasia is a rare lymphoproliferative disorder of the lung with favorable prognosis. For the purpose of differential diagnosis, it is necessary to apply immunohistochemistry.

The Importance of Fluconazole in Treatment of Endogenous Endophtalmitis in Patients Prior Treated Using Negative Pressure Therapy for Wound Closure Contaminated with Meticillin-resistant Staphylococcus aureus

2017 ◽  
Vol 68 (7) ◽  
pp. 1598-1601 ◽  
Author(s):  
Anisia Iuliana Alexa ◽  
Roxana Ciuntu ◽  
Alina Cantemir ◽  
Nicoleta Anton ◽  
Ciprian Danielescu ◽  
...  
Keyword(s):  
Antifungal Agents ◽  
Fungal Infections ◽  
Prolonged Treatment ◽  
Endogenous Endophthalmitis ◽  
Pressure Therapy ◽  
First Case ◽  
Severe Infections ◽  
Pars Plana ◽  
Delay In Treatment ◽  
Vitreous Biopsy

Severe infections with C. albicans should be treated promptly with antifungal agents, any delay in treatment increases the risk of endophthalmitis. The systemic Amphotericin B therapy is the gold standard in the treatment of endophthalmitis, but in the case of fungal infections it has not yet been determined. Numerous studies have shown that the use of Fluconazole is effective in the treatment of fungal endophthalmitis. In this paper, we report two cases (3 eyes) that have been presented for the same accusations of significant decrease of AV (visual acuity), ocular pain and blepharospasm suddenly installed, both of which required urgent antibiotic and intravenous antifungal treatment. Both are diagnosed with endogenous endophthalmitis and vitreous biopsy + VPP (pars plana vitrectomy) are performed, with a negative result of the vitreous culture. In both situations the treatment was with antibiotic and systemic antifungals. Postoperatively, evolution was favorable in the first case and less favorable in the second one. The prognosis depends on the virulence of the microorganisms and the time elapsed until initiation of the treatment. Also, the presence of risk factors such as diabetes, sepsis, recent abdominal surgery (C. Albicans is part of the comesary flora of the digestive tract) have influenced the prognosis decisively. Severe infections with C. albicans should be promptly treated with antifungal agents, any delay in treatment increases the risk of endophthalmitis. Even when prolonged treatment of candidemia is instituted, 3% of patients can develop endogenous endophthalmitis, so ocular evaluation is particularly important for patients immobilized in anesthesia and intensive care units.

scholarly journals Primary Gastrointestinal Stromal Tumor of the Liver with Cystic Changes

2019 ◽  
Vol 13 (1) ◽  
pp. 58-65
Author(s):  
Takashi Tashiro ◽  
Fumihiro Uwamori ◽  
Yukiomi Nakade ◽  
Tadahisa Inoue ◽  
Yuji Kobayashi ◽  
...  
Keyword(s):  
Liver Tumors ◽  
Past History ◽  
Brain Infarction ◽  
Arterial Phase ◽  
First Case ◽  
Positron Emission ◽  
Cystic Changes ◽  
Multiple Bone Metastases ◽  
The Right ◽  
Cells Of Cajal

Gastrointestinal stromal tumors (GISTs) are known to originate specifically from the intestinal cells of Cajal located in the gastrointestinal mesenchyme. GISTs developing outside of the digestive tract have barely been reported. We encountered a first case of large primary GISTs in the liver with cystic changes. A 63-year-old man with a past history of brain infarction visited our hospital. The computed tomography (CT) revealed a 6-cm and a 10-cm mass in the right and the caudal lobe of the liver, respectively. These tumors have marginal enhancement in the arterial phase; however, they presented as hypodense in the internal tumor sites. Both liver tumors had cystic changes. Gastrointestinal examinations using endoscopy revealed no other gastrointestinal tumors, and [18F]-fluoro-2-deoxy-D-glucose positron emission tomography/CT revealed multiple bone metastases in addition to the liver tumors. The liver tumor specimens were composed of spindle cells, and the immunohistochemical staining for c-Kit and for DOG1, as discovered on GIST, was positive. The patient was diagnosed with primary hepatic GIST with cystic changes.

scholarly journals Emphysematous pyelonephritis with air bubble in the inferior vena cava

2020 ◽  
Vol 26 (1) ◽  
Author(s):  
Tiffany A. Perkins ◽  
Alberic Rogman ◽  
Murali K. Ankem
Keyword(s):  
Septic Shock ◽  
Inferior Vena Cava ◽  
Inferior Vena ◽  
Vena Cava ◽  
Rare Presentation ◽  
Emphysematous Pyelonephritis ◽  
Case Presentation ◽  
Air Bubble ◽  
First Case ◽  
The Right

Abstract Background Emphysematous pyelonephritis (EPN) with gas in the inferior vena cava (IVC) is a rare presentation and to our knowledge, this is the first case report in the urologic literature. Case presentation A 35-Year-old obese diabetic Hispanic female presented to the emergency room with a clinical picture of septic shock. Prompt computerized tomography scan revealed EPN with gas throughout the right renal parenchyma and extending to the right renal vein, IVC, and pulmonary artery. She died before surgical intervention Conclusion This case demonstrates that patients presenting with severe EPN have a high mortality risk and providers should acknowledge that septic shock, endogenous air emboli, or a combination of both could result in cardiovascular collapse and sudden death.

scholarly journals Bittersweet: infective complications of drug-induced glycosuria in patients with diabetes mellitus on SGLT2-inhibitors: two case reports

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Caroline Bartolo ◽  
Victoria Hall ◽  
N. Deborah Friedman ◽  
Chloe Lanyon ◽  
Andrew Fuller ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Fungal Infections ◽  
Case Reports ◽  
Sglt2 Inhibitor ◽  
Sglt2 Inhibitors ◽  
Urogenital Tract ◽  
Hypoglycemic Agents ◽  
Drug Induced ◽  
First Case ◽  
Increased Risk

Abstract Background Sodium-glucose co-transporter 2 (SGLT2) inhibitors are novel hypoglycemic agents which reduce reabsorption of glucose at the renal proximal tubule, resulting in significant glycosuria and increased risk of genital mycotic infections (GMI). These infections are typically not severe as reported in large systematic reviews and meta-analyses of the medications. These reviews have also demonstrated significant cardiovascular benefits through other mechanisms of action, making them attractive options for the management of Type 2 diabetes mellitus (T2DM). We present two cases with underlying abnormalities of the urogenital tract in which the GMI were complicated and necessitated cessation of the SGLT2 inhibitor. Case presentations Both cases are patients with T2DM on empagliflozin, an SGLT2 inhibitor. The first case is a 64 year old man with Candida albicans balanitis and candidemia who was found to have an obstructing renal calculus and prostatic abscess requiring operative management. The second case describes a 72 year old man with Candida glabrata candidemia who was found to have prostatomegaly, balanitis xerotica obliterans with significant urethral stricture and bladder diverticulae. His treatment was more complex due to fluconazole resistance and concerns about urinary tract penetration of other antifungals. Both patients recovered following prolonged courses of antifungal therapy and in both cases the SGLT2 inhibitor was ceased. Conclusions Despite their cardiovascular benefits, SGLT2 inhibitors can be associated with complicated fungal infections including candidemia and patients with anatomical abnormalities of the urogenital tract may be more susceptible to these infections as demonstrated in these cases. Clinicians should be aware of their mechanism of action and associated risk of infection and prior to prescription, assessment of urogenital anatomical abnormalities should be performed to identify patients who may be at risk of complicated infection.

scholarly journals A First Case Report of Orbital Extra-Adrenal Paraganglioma in Cat

2021 ◽  
Vol 8 (5) ◽  
pp. 86
Author(s):  
Leonardo Leonardi ◽  
Raluca Ioana Rizac ◽  
Ilaria Pettinari ◽  
Luca Mechelli ◽  
Carlo De Feo
Keyword(s):  
Parasympathetic Nervous System ◽  
Neuron Specific Enolase ◽  
Final Diagnosis ◽  
Neuroendocrine Cells ◽  
Neuroendocrine Neoplasm ◽  
Glial Fibrillary Acid Protein ◽  
Veterinary Clinic ◽  
First Case ◽  
The Right ◽  
Extra Adrenal Paraganglioma

Paraganglioma is a rare neuroendocrine neoplasm originating from paraganglia and consisting of neuroendocrine cells of the sympathetic and parasympathetic nervous system. Extra-adrenal paraganglioma occurs with a low incidence in both humans and animals. This report presents the first case of paraganglioma in a cat with orbital primary location. An 18-year-old spayed female European domestic shorthair cat of 3.60 kg body weight was evaluated in a private veterinary clinic in Perugia, Italy, for a pronounced exophthalmos of the right eye. The cat underwent surgery for the enucleation of the right eye and of the mass. The biopsy samples of the removed tissue were fixed in 10% buffered neutral formalin for histological and immunohistochemical evaluations. Therefore, specific markers were used for immunohistochemical investigations, such as anti-neuron specific enolase (NSE), anti-synaptophysin, anti-glial fibrillary acid protein, anti-cytokeratin and anti-chromogranin. The results of these investigations allowed establishing the final diagnosis of ocular extra-adrenal paraganglioma of the cat.

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