Opportunistic Fungal Infections in Small Animals

2018 ◽  
Vol 54 (6) ◽  
pp. 327-337 ◽  
Author(s):  
Andrea Dedeaux ◽  
Amy Grooters ◽  
Nobuko Wakamatsu-Utsuki ◽  
Joseph Taboada
Keyword(s):  
Clinical Presentation ◽  
Fungal Infections ◽  
Small Animal ◽  
Small Animals ◽  
Clinical Presentations ◽  
Number Of Patients ◽  
Causes Of Disease ◽  
Immunosuppressed Patients ◽  
Opportunistic Mycoses ◽  
Hyphal Diameter

ABSTRACT Opportunistic fungal infections have long been recognized as rare causes of disease in immunocompetent dogs and cats. Recently, the escalating use of multiagent immunosuppression protocols (especially those that include cyclosporine) has resulted in an increased number of patients with opportunistic fungal infection encountered by small animal practitioners and has altered the typical case phenotype. Based on histologic and cytologic features such as pigmentation, hyphal diameter, and distribution in tissue, these opportunistic mycoses can be placed into categories such as phaeohyphomycosis, hyalohyphomycosis, and eumycotic mycetoma. This review aims to summarize the clinical presentations, methods for diagnosis, treatment recommendations, and prognosis for both immunocompetent and immunosuppressed patients with opportunistic fungal infections. An example case description is included to illustrate the most common current clinical presentation.

scholarly journals Clinical Presentation, Outcomes, and Treatment of Membranous Nephropathy after Transplantation

2018 ◽  
Vol 2018 ◽  
pp. 1-6 ◽  
Author(s):  
Artur Q. B. da Silva ◽  
Taina V. de Sandes-Freitas ◽  
Juliana B. Mansur ◽  
Jose Osmar Medicina-Pestana ◽  
Gianna Mastroianni-Kirsztajn
Keyword(s):  
Membranous Nephropathy ◽  
Clinical Presentation ◽  
Patient Survival ◽  
De Novo ◽  
Immunosuppressive Regimen ◽  
Graft Dysfunction ◽  
Class V ◽  
Clinical Presentations ◽  
Number Of Patients ◽  
Standard Strategy

There are scarce data about clinical presentation and outcomes of posttransplant membranous nephropathy (MN), and few reports include a large number of patients. This was a retrospective cohort including adult patients with posttransplant MN transplanted between 1983 and 2015 in a single center (n=41). Only patients with histological diagnosis of MN in kidney grafts were included. Clinical and laboratory presentation, histological findings, treatment, and outcomes were detailed. Patients were predominantly male (58.5%), with a mean age of 49.4 ± 13.2 years; 15 were considered as recurrent primary MN; 3 were class V lupus nephritis; 14 were considered as de novo cases, 7 secondary and 7 primary MN; and 9 cases were considered primary but it was not possible to distinguish between de novo MN and recurrence. Main clinical presentations were proteinuria (75.6%) and graft dysfunction (34.1%). Most patients with primary recurrent and de novo primary MN were submitted to changes in maintenance immunosuppressive regimen, but no standard strategy was identified; 31 patients presented partial or complete remission, and glomerulopathy appeared not to impact graft and patient survival.

Fungal bone and joint infections

2017 ◽  
Author(s):  
Damien Mack ◽  
Simon Warren ◽  
Shara Palanivel ◽  
Christopher P. Conlon
Keyword(s):  
Fungal Infections ◽  
Vertebral Osteomyelitis ◽  
Invasive Fungal Disease ◽  
Clinical Suspicion ◽  
Dimorphic Fungi ◽  
Joint Infections ◽  
Clinical Presentations ◽  
Direct Inoculation ◽  
Immunosuppressed Patients ◽  
Haematogenous Spread

Although fungal infections of bones and joints are rare, the increasing incidence of invasive fungal disease, along with an increased population of immunosuppressed patients and individuals with multiple comorbidities, means that these infections are also increasing. The most common organisms are Candida and Aspergillus species, although the endemic dimorphic fungi are responsible for significant numbers of cases in some parts of the world. Most infections occur following haematogenous spread, but invasion from contiguous infection occurs, as does direct inoculation after trauma or surgery. Clinical presentations differ somewhat between children and adults, with the latter more likely to have vertebral osteomyelitis. Clinical presentations may be subtle, often without fever or raised inflammatory markers, and diagnosis may be delayed as a consequence. Diagnosis rests on clinical suspicion coupled with the need to obtain tissue for culture and for histology. Appropriate antifungal therapy usually needs to be prolonged and combined with surgical debridement.

scholarly journals Anticapsular and Antifungal Activity of α-Cyperone

Antibiotics ◽  
2021 ◽  
Vol 10 (1) ◽  
pp. 51
Author(s):  
Connor Horn ◽  
Govindsamy Vediyappan
Keyword(s):  
Antifungal Activity ◽  
Fungal Pathogens ◽  
Fungal Infections ◽  
Antifungal Drugs ◽  
Cyperus Rotundus ◽  
Drug Resistant ◽  
Fungal Virulence ◽  
Medical Needs ◽  
Number Of Patients ◽  
Immunosuppressed Patients

Fungal infections affect 300 million people and cause 1.5 million deaths globally per year. With the number of immunosuppressed patients increasing steadily, there is an increasing number of patients infected with opportunistic fungal infections such as infections caused by the species of Candida and Cryptococcus. In fact, the drug-resistant Can. krusei and the emerging pan-antifungal resistant Can. auris pose a serious threat to human health as the existing limited antifungals are futile. To further complicate therapy, fungi produce capsules and spores that are resistant to most antifungal drugs/host defenses. Novel antifungal drugs are urgently needed to fill unmet medical needs. From screening a collection of medicinal plant sources for antifungal activity, we have identified an active fraction from the rhizome of Cyperus rotundus, the nut grass plant. The fraction contained α-Cyperone, an essential oil that showed fungicidal activity against different species of Candida. Interestingly, the minimal inhibitory concentration of α-Cyperone was reduced 8-fold when combined with a clinical antifungal drug, fluconazole, indicating its antifungal synergistic potential and could be useful for combination therapy. Furthermore, α-Cyperone affected the synthesis of the capsule in Cryp. neoformans, a causative agent of fungal meningitis in humans. Further work on mechanistic understanding of α-Cyperone against fungal virulence could help develop a novel antifungal agent for drug-resistant fungal pathogens.

Histoplasmosis Infection Presenting as an Isolated Subcutaneous Periarticular Upper Limb Swelling in the Immunosuppressed Patient

2005 ◽  
Vol 30 (2) ◽  
pp. 229-232 ◽  
Author(s):  
G. D. SMITH ◽  
R. A. D. SHATFORD
Keyword(s):  
Acute Phase ◽  
Upper Limb ◽  
Functional Capacity ◽  
Host Response ◽  
Clinical Presentation ◽  
Fungal Infections ◽  
Immunosuppressed Patient ◽  
Tissue Cultures ◽  
Delay In Diagnosis ◽  
Immunosuppressed Patients

Atypical mycobacterial and fungal infections may occur in immunosuppressed patients. The impaired host response can make the clinical presentation atypical. Blood and tissue cultures may be negative in the acute phase of the illness, which can lead to a delay in diagnosis. In those patients with AIDS or other underlying immunosuppressive conditions, histoplasmosis cannot always be eradicated, but treatment that achieves chronic suppression may be adequate to maintain functional capacity. This report describes two immunosuppressed patients who presented with isolated subcutaneous histoplasmosis infection around the wrist.

scholarly journals Variation in the clinical presentation of takotsubo cardiomyopathy in a non-referral hospital

2016 ◽  
Vol 5 ◽  
Author(s):  
Stefan Peters
Keyword(s):  
Takotsubo Cardiomyopathy ◽  
Clinical Presentation ◽  
Neurological Diseases ◽  
Case Reports ◽  
Referral Hospital ◽  
Cardiac Diseases ◽  
Clinical Presentations ◽  
Number Of Patients ◽  
The World ◽  
Varied Distribution

The spectrum of clinical presentations of takotsubo cardiomyopathy is larger than once suspected. There are several pulmonary and neurological diseases that can aggravate leading to atypical takotsubo cardiomyopathy documented in a large collective of case reports from all all over the world. This varied distribution of patients’ presentations is illustrated by several cases.  The spectrum of takotsubo cardiomyopathy can be enlarged in non-acute and non-cardiac diseases leading to an increase of this diagnosis in a large number of patients.

Recommendations for Intensive Care Management in Small Animals Following Anaesthesia

1992 ◽  
Vol 05 (02) ◽  
pp. 66-70
Author(s):  
Karol Mathews ◽  
Doris Dyson
Keyword(s):  
Intensive Care ◽  
Care Management ◽  
Small Animal ◽  
Small Animals ◽  
Monitoring Equipment ◽  
Intensive Care Management ◽  
Good Communication

Intensive care management can be provided in a small animal facility by centralisation of emergency and monitoring equipment. Good communication between all personnel involved in the case ensures that staff are prepared for complications that could arise related to recovery from anaesthesia.

Computer-Aided Diagnosis in Jaundice: Comparison of Knowledge-based and Probabilistic Approaches

1996 ◽  
Vol 35 (01) ◽  
pp. 41-51 ◽  
Author(s):  
F. Molino ◽  
D. Furia ◽  
F. Bar ◽  
S. Battista ◽  
N. Cappello ◽  
...  
Keyword(s):  
Clinical Presentation ◽  
Clinical Information ◽  
Diagnostic Value ◽  
Clinical Findings ◽  
Clinical Documentation ◽  
Data Set ◽  
Knowledge Based ◽  
Number Of Patients ◽  
Support Tools ◽  
Aided Diagnosis

AbstractThe study reported in this paper is aimed at evaluating the effectiveness of a knowledge-based expert system (ICTERUS) in diagnosing jaundiced patients, compared with a statistical system based on probabilistic concepts (TRIAL). The performances of both systems have been evaluated using the same set of data in the same number of patients. Both systems are spin-off products of the European project Euricterus, an EC-COMACBME Project designed to document the occurrence and diagnostic value of clinical findings in the clinical presentation of jaundice in Europe, and have been developed as decision-making tools for the identification of the cause of jaundice based only on clinical information and routine investigations. Two groups of jaundiced patients were studied, including 500 (retrospective sample) and 100 (prospective sample) subjects, respectively. All patients were independently submitted to both decision-support tools. The input of both systems was the data set agreed within the Euricterus Project. The performances of both systems were evaluated with respect to the reference diagnoses provided by experts on the basis of the full clinical documentation. Results indicate that both systems are clinically reliable, although the diagnostic prediction provided by the knowledge-based approach is slightly better.

scholarly journals COVID-19—Importance for Patients on the Waiting List and after Kidney Transplantation—A Single Center Evaluation in 2020–2021

Pathogens ◽  
2021 ◽  
Vol 10 (4) ◽  
pp. 429
Author(s):  
Simone C. Boedecker ◽  
Pascal Klimpke ◽  
Daniel Kraus ◽  
Stefan Runkel ◽  
Peter R. Galle ◽  
...  
Keyword(s):  
Kidney Transplantation ◽  
Waiting List ◽  
Smoking History ◽  
Immunocompromised Patients ◽  
Dialysis Patients ◽  
Vaccination Programs ◽  
Mild Disease ◽  
Probability Of Survival ◽  
Number Of Patients ◽  
Immunosuppressed Patients

(1) Background: Dialysis patients and recipients of a kidney allograft are at high risk for infection with SARS-CoV-2. It has been shown that the development of potent neutralizing humoral immunity against SARS CoV-2 leads to an increased probability of survival. However, the question of whether immunocompromised patients develop antibodies has not yet been sufficiently investigated; (2) Methods: SARS-CoV-2 antibodies were examined in hemodialysis patients on the waiting list for kidney transplantation as well as patients after kidney transplantation. Patients were interviewed about symptoms and comorbidities, BMI, and smoking history; (3) Results: SARS-CoV-2 antibodies were found in 16 out of 259 patients (6%). The trend of infections here reflects the general course of infection in Germany with a peak in November/December of 2020. Remarkably, patients on the waiting list experienced only mild disease. In contrast, transplanted patients had to be hospitalized but recovered rapidly from COVID-19. Most interesting is that all immunosuppressed patients developed antibodies against SARS-CoV-2 after infection; (4) Conclusions: Even with extensive hygiene concepts, an above-average number of patients were infected with SARS-CoV-2 during the second wave of infections in Germany. Because SARS-CoV-2 infection triggered the formation of antibodies even in these immunocompromised patients, we expect vaccination to be effective in this group of patients. Thus, dialysis patients and patients after kidney transplantation should be given high priority in vaccination programs.

1001 Intra-Articular Distal Radius Fracture Surgical Intervention Threshold Origins and Development

2021 ◽  
Vol 108 (Supplement_2) ◽  
Author(s):  
G Esworthy ◽  
N Johnson ◽  
J Dias ◽  
P Divall
Keyword(s):  
Distal Radius ◽  
Clinical Presentation ◽  
Surgical Intervention ◽  
Threshold Value ◽  
British Society ◽  
Relevant Today ◽  
Clinical Presentations ◽  
Post Traumatic ◽  
Current Guidance ◽  
Traumatic Arthritis

Abstract Background Treatment of intra-articular distal radius fractures is guided by the displacement of the articular fragments. Symptomatic post-traumatic arthritis is expected to occur if step displacement is > 2mm; this value is often used as an indication for surgery if closed reduction is not possible. Method A systematic review was performed to establish the origin and adaptations of the threshold, with papers screened and relevant citations reviewed. Orthopaedic textbooks were reviewed to ensure no earlier mention of the threshold was present. Results Knirk and Jupiter, 1986, are the first to quantify a threshold, with all their patients developing arthritis with >2mm displacement. Some papers have discussed using 1mm, although 2mm is most widely reported. Current guidance from the British Society for Surgery of the Hand supports 2mm. Although this paper is still widely cited, the authors published a re-examination of the data showing methodological flaws which is not as widely reported. They claim their conclusions are still relevant today; however, the radiological arthritis does not correlate with the clinical presentation. Conclusions Knirk and Jupiter originated the threshold value of 2mm. The lack of correlation between the radiological and clinical presentations warrants further investigation. The principle of treatment remains restoration of normal anatomical position.

scholarly journals Case series on variable presentations of tuberculosis of the breast

2020 ◽  
Vol 13 (12) ◽  
pp. e236019
Author(s):  
Tharun Ganapathy Chitrambalam ◽  
Jeyakumar Sundaraj ◽  
Pradeep Joshua Christopher ◽  
Ramyasree Paladugu
Keyword(s):  
Clinical Presentation ◽  
Case Series ◽  
Common Type ◽  
Breast Abscess ◽  
Breast Lump ◽  
Clinical Presentations ◽  
Malignant Lesions

Tuberculosis (TB) of the breast is extremely rare and is often mistaken for benign or malignant lesions of the breast. They are rare even in countries which are endemic for TB, like India. The most common type of clinical presentation is a vague lump in the breast, but there are even other types of presentations which are documented. In olden days, there was a lot of dilemma and challenge in diagnosing TB of the breast, but thanks to improved pathological knowledge and the advent of investigations such as QuantiFERON-TB gold and GeneXpert, TB can be diagnosed early nowadays and treated accordingly. In this study series, we report 10 cases of TB of the breast with variable clinical presentations as fibroadenosis, breast abscess, duct ectasia and breast lump on evaluation, and the challenges encountered in establishing the diagnosis.

Sign in / Sign up

Export Citation Format

Share Document