scholarly journals Aspergillus aortitis in an immunocompetent patient presenting with acute endophthalmitis

2018 ◽  
Vol 10 (2) ◽  
Author(s):  
Joseph M. Rocco ◽  
Maggie K. Benson
Keyword(s):  
Cardiac Surgery ◽  
Early Recognition ◽  
Disease Process ◽  
Infectious Agent ◽  
Immunocompetent Patient ◽  
Endogenous Endophthalmitis ◽  
Laboratory Studies ◽  
Aortic Pseudoaneurysm ◽  
First Case ◽  
Ascending Aortic Pseudoaneurysm

Aspergillus is a common environmental mold most often recognized as an infectious agent in patients with severe immune compromise. We present a case of an immunocompetent patient presenting with endogenous endophthalmitis in the absence of other infectious symptoms. The search for a systemic source revealed an ascending aortic pseudoaneurysm. Surgical resection and pathology revealed angioinvasive aspergillus aortitis. Recent cardiac surgery has been noted to be a risk factor for angioinvasive aspergillosis. Diagnosis is difficult as symptoms are mild and laboratory studies are often normal. To our knowledge this is the first case of aspergillus aortitis presenting as endogenous endophthalmitis without systemic signs of inflammation. These patients have a high mortality rate therefore early recognition is essential. It is important to consider angioinvasive aspergillus infections in patients with prior cardiac surgery presenting with occult embolic phenomena. Only with early diagnosis and prompt treatment can we improve outcomes of this disease process.

Ascending aortic pseudoaneurysm, a ticking bomb after cardiac surgery

2011 ◽  
Vol 12 (3) ◽  
pp. 177-180 ◽  
Author(s):  
Leenhapong Navaravong ◽  
Fadi Saab ◽  
James R. Cook ◽  
Mark Peterman ◽  
Joseph Flack
Keyword(s):  
Cardiac Surgery ◽  
Aortic Pseudoaneurysm ◽  
Ascending Aortic Pseudoaneurysm

scholarly journals Ascending aorta pseudoaneurysm simulating mediastinal lymphoma in computed tomography, a possible diagnostic error: a case report

2020 ◽  
Vol 14 (1) ◽  
Author(s):  
Marcello Chiocchi ◽  
Luigi Spiritigliozzi ◽  
Federica Di Tosto ◽  
Leonardo Benelli ◽  
Francesca D’Errico ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Cardiac Surgery ◽  
Case Report ◽  
Rare Complication ◽  
Laboratory Data ◽  
Aortic Pseudoaneurysm ◽  
Computed Tomographic ◽  
Imaging Results ◽  
Mediastinal Lymphoma ◽  
Ascending Aortic Pseudoaneurysm

Abstract Background An ascending aortic pseudoaneurysm is a severe and rare complication following cardiothoracic surgery. This case report demonstrates its possible misinterpretation and the consequent importance of multidisciplinary evaluation. Case presentation We present a case of an 18-year-old Caucasian man with Marfan syndrome who developed an ascending aortic pseudoaneurysm about 1 year after undergoing cardiac surgery with the Bentall procedure. Computed tomographic examination of the thoracic aorta and positron emission tomography–computed tomography initially suggested a lymphomatous pathology. However, these imaging results were in contrast to the transesophageal echocardiogram and the laboratory data that showed negative results for hematological pathology. A second computed tomographic scan redirected the diagnosis toward a pseudoaneurysm. Conclusion This case demonstrates the utility of close communication and interdisciplinary consultation between cardiovascular radiologists and the cardiac surgery team, which are mandatory in order to maximize their diagnostic skills in identifying postoperative complications.

scholarly journals Transcatheter Intervention for Complex Ascending Aortic Pseudoaneurysm After Cardiac Surgery

2014 ◽  
Vol 78 (9) ◽  
pp. 2215-2218 ◽  
Author(s):  
Wei-Hsian Yin ◽  
Jeng Wei ◽  
Shen Kou Tsai ◽  
Ming C. Hsiung ◽  
Yung-Tsai Lee ◽  
...  
Keyword(s):  
Cardiac Surgery ◽  
Transcatheter Intervention ◽  
Aortic Pseudoaneurysm ◽  
Ascending Aortic Pseudoaneurysm

Novel percutaneous femoral arterial-transthoracic approach for closure of ascending aortic pseudoaneurysm with a septal occluder device in a child

2013 ◽  
Vol 24 (4) ◽  
pp. 752-755 ◽  
Author(s):  
Samer I. Masri ◽  
Marianne N. Majdalani ◽  
Fadi F. Bitar
Keyword(s):  
Transcatheter Closure ◽  
Rare Complication ◽  
High Morbidity ◽  
Transthoracic Approach ◽  
Aortic Pseudoaneurysm ◽  
First Case ◽  
Alternative Approach ◽  
Septal Occluder Device ◽  
Occluder Device ◽  
Ascending Aortic Pseudoaneurysm

AbstractAscending aortic pseudoaneurysms are a rare complication following cardiac surgery. Their traditional surgical management carries high morbidity and mortality, especially in patients with multiple comorbidities. Transcatheter closure of these pseudoaneurysms using a septal occluder device has been previously reported in adults as an alternative approach with fewer complications. We report the first case of a novel percutaneous femoral arterial-transthoracic approach for exclusion of an ascending aortic pseudoaneurysm with an Amplatzer atrial septal occluder device in a 9-year-old child with Takayasu's arteritis.

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 Do Animals Play a Role in the Transmission of Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2)? A Commentary

Animals ◽  
2020 ◽  
Vol 11 (1) ◽  
pp. 16
Author(s):  
Anna Costagliola ◽  
Giovanna Liguori ◽  
Danila d’Angelo ◽  
Caterina Costa ◽  
Francesca Ciani ◽  
...  
Keyword(s):  
Severe Acute Respiratory Syndrome ◽  
Neutralizing Antibodies ◽  
Experimental Studies ◽  
Infectious Agent ◽  
Human Infection ◽  
Farm Animals ◽  
Partial Protection ◽  
Management Measures ◽  
First Case ◽  
And Behavior

Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) belongs to the Beta-coronavirus genus. It is 96.2% homologous to bat CoV RaTG13 and 88% homologous to two bat SARS-like coronaviruses. SARS-CoV-2 is the infectious agent responsible for the coronavirus disease (COVID-19), which was first reported in the Hubei province of Wuhan, China, at the beginning of December 2019. Human transmission from COVID-19 patients or incubation carriers occurs via coughing, sneezing, speaking, discharge from the nose, or fecal contamination. Various strains of the virus have been reported around the world, with different virulence and behavior. In addition, SARS-CoV-2 shares certain epitopes with some taxonomically related viruses, with tropism for the most common synanthropic animals. By elucidating the immunological properties of the circulating SARS-CoV-2, a partial protection due to human–animal interactions could be supposed in some situations. In addition, differential epitopes could be used for the differential diagnosis of SARS-CoV-2 infection. There have been cases of transmission from people with COVID-19 to pets such as cats and dogs. In addition, wild felines were infected. All These animals were either asymptomatic or mildly symptomatic and recovered spontaneously. Experimental studies showed cats and ferrets to be more susceptible to COVID-19. COVID-19 positive dogs and felines do not transmit the infection to humans. In contrast, minks at farms were severely infected from people with COVID-19. A SARS-Cov-2 variant in the Danish farmed mink that had been previously infected by COVID-19 positive workers, spread to mink workers causing the first case of animal-to-human infection transmission that causes a moderate decreased sensitivity to neutralizing antibodies. Thus, more investigations are necessary. It remains important to understand the risk that people with COVID-19 pose to their pets, as well as wild or farm animals so effective recommendations and risk management measures against COVID-19 can be made. A One Health unit that facilitates collaboration between public health and veterinary services is recommended.

Neonatal Toxic Shock Syndrome–Like Exanthematous Disease in North America

2019 ◽  
Author(s):  
Megan Culler Freeman ◽  
Stephanie Mitchell ◽  
John Ibrahim ◽  
John V Williams
Keyword(s):  
North America ◽  
Diagnostic Criteria ◽  
Skin Rash ◽  
Toxic Shock Syndrome ◽  
Disease Process ◽  
Toxic Shock ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
First Case

Abstract Neonatal toxic shock syndrome (TSS)-like exanthematous disease (NTED) is a syndrome first reported in Japan. Neonates develop systemic exanthema, thrombocytopenia, and fever usually during the first week of life. The disease is distinguished from frank TSS because affected infants are not severely ill and do not meet TSS criteria. Most infants are confirmed to be colonized with TSST-1 producing strains of S. aureus. Suggested diagnostic criteria for NTED include a skin rash with generalized macular erythema and one of the following symptoms: fever >38.0°C, thrombocytopenia <150 x103uL, or low positive C-reactive protein (1-5 mg/dL) in the absence of another known disease process. NTED is common in Japanese NICUs, but outside Japan, only one case has been reported in France. We describe the first case of NTED reported in North America.

scholarly journals Fungal Endogenous Endophthalmitis Secondary to Magnusiomyces capitatus

2019 ◽  
Vol 10 (2) ◽  
pp. 292-298
Author(s):  
Nestore Rota ◽  
Carla Danese ◽  
Francesca Menchini ◽  
Silvia Pignatto ◽  
Maddalena Peghin ◽  
...  
Keyword(s):  
Single Case ◽  
Immunocompetent Patient ◽  
Ascending Aorta ◽  
Endogenous Endophthalmitis ◽  
Coronary Angiogram ◽  
Literature Research ◽  
Normal Human

We report the case of a 68-year-old immunocompetent patient with a dilatation of the ascending aorta, intraluminal vegetations, and pseudoaneurysmatic bulging who presented with unilateral fungal endogenous endophthalmitis 8 days after coronary angiogram. The isolated pathogen resulted to be Magnusiomyces capitatus, a filamentous, yeast-like fungus that can be commonly found in normal human microflora, with an immunosuppression-related pathogenicity. A literature research revealed a single case of ophthalmic infection – a keratitis – caused by this pathogen. Furthermore, we add a review of mycotic endophthalmitis related to aortic infection.

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