Pharmacokinetics of Voriconazole in the Cerebrospinal Fluid of an Immunocompromised Patient with a Brain Abscess Due to Aspergillus fumigatus

2004 ◽  
Vol 39 (4) ◽  
pp. 603-604 ◽  
Author(s):  
E. Denes ◽  
N. Pichon ◽  
M. Debette-Gratien ◽  
B. Bouteille ◽  
J. M. Gaulier
Keyword(s):  
Cerebrospinal Fluid ◽  
Aspergillus Fumigatus ◽  
Brain Abscess ◽  
Immunocompromised Patient

scholarly journals Calcineurin Controls Growth, Morphology, and Pathogenicity in Aspergillus fumigatus

2006 ◽  
Vol 5 (7) ◽  
pp. 1091-1103 ◽  
Author(s):  
William J. Steinbach ◽  
Robert A. Cramer ◽  
B. Zachary Perfect ◽  
Yohannes G. Asfaw ◽  
Theodor C. Sauer ◽  
...  
Keyword(s):  
Aspergillus Fumigatus ◽  
Clinical Observation ◽  
Immunocompromised Patient ◽  
Fungal Growth ◽  
Pathogenic Fungi ◽  
Wild Type ◽  
Therapeutic Approaches ◽  
Growth Morphology ◽  
Different Types ◽  
Hyphal Morphology

ABSTRACT Calcineurin is implicated in a myriad of human diseases as well as homeostasis and virulence in several major human pathogenic microorganisms. The fungus Aspergillus fumigatus is a leading cause of infectious death in the rapidly expanding immunocompromised patient population. Current antifungal treatments for invasive aspergillosis are often ineffective, and novel therapeutic approaches are urgently needed. We demonstrate that a mutant of A. fumigatus lacking the calcineurin A (cnaA) catalytic subunit exhibited defective hyphal morphology related to apical extension and polarized growth, which resulted in drastically decreased filamentation. The ΔcnaA mutant lacked the extensive lattice of invading hyphae seen with the wild-type and complemented strains. Sporulation was also affected in the ΔcnaA mutant, including morphological conidial defects with the absence of surface rodlets and the added presence of disjunctors creating long conidial chains. Infection with the ΔcnaA mutant in several distinct animal models with different types of immunosuppression and inoculum delivery led to a profound attenuation of pathogenicity compared to infection with the wild-type and complemented strains. Lung tissue from animals infected with the ΔcnaA mutant showed a complete absence of hyphae, in contrast to tissue from animals infected with the wild-type and complemented strains. Quantitative fungal burden and pulmonary infarct scoring confirmed these findings. Our results support the clinical observation that substantially decreasing fungal growth can prevent disease establishment and decrease mortality. Our findings reveal that calcineurin appears to play a globally conserved role in the virulence of several pathogenic fungi and yet plays specialized roles in each and can be an excellent target for therapeutic intervention.

Primary aspergillosis of the larynx causing acute airway distress

2021 ◽  
Vol 14 (4) ◽  
pp. e240434
Author(s):  
David Ranford ◽  
Chong Kang ◽  
Mairead Kelly ◽  
Luigi Volpini
Keyword(s):  
Acute Myeloid Leukaemia ◽  
Invasive Aspergillosis ◽  
Aspergillus Fumigatus ◽  
Immunocompromised Patient ◽  
Secondary Infection ◽  
Tracheobronchial Tree ◽  
Emergency Intervention ◽  
Recent Diagnosis ◽  
Cord Lesion ◽  
Acute Myeloid

Laryngeal aspergillosis is most commonly seen as a secondary infection that spreads from the lungs and tracheobronchial tree. Primary invasive aspergillosis of the larynx is rare and most likely seen in an immunocompromised patient. We present a case of a 59-year-old woman who presented with progressive dysphonia and subsequently acute stridor. She is a non-smoker with a recent diagnosis of acute myeloid leukaemia. Fibreoptic nasendoscopy revealed a left sided vocal cord lesion ball valving into the glottic space. Histology taken during emergency debulking confirmed Aspergillus fumigatus and the patient was successfully treated with intravenous antifungals. Although there are cases of primary laryngeal aspergillosis discussed in the literature, to the best of our knowledge this is the first reported case to have caused acute airway distress requiring emergency intervention.

scholarly journals Cerebral aspergillosis due to Aspergillus fumigatus in AIDS patient: first culture - proven case reported in Brazil

2005 ◽  
Vol 47 (3) ◽  
pp. 161-165 ◽  
Author(s):  
José E. Vidal ◽  
Rafi F. Dauar ◽  
Marcia S.C. Melhem ◽  
Walderez Szeszs ◽  
Sandra R.B.S. Pukinskas ◽  
...  
Keyword(s):  
Aspergillus Fumigatus ◽  
Amphotericin B ◽  
Brain Abscess ◽  
Brain Biopsy ◽  
Mass Effect ◽  
Aids Patients ◽  
History Of ◽  
Proven Case ◽  
Mycological Examination ◽  
The Brain

Cerebral aspergillosis is a rare cause of brain expansive lesion in AIDS patients. We report the first culture-proven case of brain abscess due to Aspergillus fumigatus in a Brazilian AIDS patient. The patient, a 26 year-old male with human immunodeficiency virus (HIV) infection and history of pulmonary tuberculosis and cerebral toxoplasmosis, had fever, cough, dyspnea, and two episodes of seizures. The brain computerized tomography (CT) showed a bi-parietal and parasagittal hypodense lesion with peripheral enhancement, and significant mass effect. There was started anti-Toxoplasma treatment. Three weeks later, the patient presented mental confusion, and a new brain CT evidenced increase in the lesion. He underwent brain biopsy, draining 10 mL of purulent material. The direct mycological examination revealed septated and hyaline hyphae. There was started amphotericin B deoxycholate. The culture of the material demonstrated presence of the Aspergillus fumigatus. The following two months, the patient was submitted to three surgeries, with insertion of drainage catheter and administration of amphotericin B intralesional. Three months after hospital admission, his neurological condition suffered discrete changes. However, he died due to intrahospital pneumonia. Brain abscess caused by Aspergillus fumigatus must be considered in the differential diagnosis of the brain expansive lesions in AIDS patients in Brazil.

scholarly journals Nocardia thailandica Brain Abscess in an Immunocompromised Patient

2021 ◽  
Vol 2021 ◽  
pp. 1-4
Author(s):  
Muhammad Effendi ◽  
Samad Tirmizi ◽  
Dayna McManus ◽  
Anita J. Huttner ◽  
David R. Peaper ◽  
...  
Keyword(s):  
Brain Abscess ◽  
Successful Treatment ◽  
Medical Literature ◽  
Immunocompromised Patient ◽  
Treatment Success ◽  
Cns Infection ◽  
16S Rdna Sequencing ◽  
Rdna Sequencing ◽  
Cns Penetration ◽  
Initiation Of Therapy

Objectives. Successful treatment for Nocardia thailandica is not well elucidated in the literature. To the best of our knowledge, N. thailandica has not yet been described in the medical literature to cause central nervous system (CNS) infection from brain abscess. We report the case of an immunocompromised patient who underwent successful treatment to treat his brain abscess caused by N. thailandica. Methods. After failing medical therapy, the patient underwent a craniotomy, and tissue was sent for culture. Upon identification by 16S rDNA sequencing, the organism causing infection was identified to be N. thailandica. Results. Based on susceptibilities, the patient was treated with IV ceftriaxone 2 grams daily for five months. The patient demonstrated clinical and radiological improvement which persisted to 7 months after initiation of therapy. Conclusions. To the best of our knowledge, this is the first documented case of a brain abscess due to N. thailandica which was successfully treated. Due to the location of the infection, ceftriaxone was chosen because of optimal CNS penetration. Ceftriaxone monotherapy demonstrated clinical and radiographic treatment success resulting in the successful treatment of this infection.

scholarly journals Isolation of Abiotrophia adiacens from a Brain Abscess Which Developed in a Patient after Neurosurgery

1999 ◽  
Vol 37 (3) ◽  
pp. 769-771 ◽  
Author(s):  
C. Biermann ◽  
G. Fries ◽  
P. Jehnichen ◽  
S. Bhakdi ◽  
M. Husmann
Keyword(s):  
Cerebrospinal Fluid ◽  
Brain Abscess ◽  
Ribosomal Dna ◽  
Dna Analysis ◽  
Abscess Drainage ◽  
16S Ribosomal Dna ◽  
Specific Pcr ◽  
Microbiological Methods ◽  
Large Brain ◽  
Pcr Products

We report the case of a patient who developed a large brain abscess after neurosurgery. Cerebrospinal fluid from the abscess drainage yielded Abiotrophia adiacens-specific PCR products and microorganisms that were identified by conventional microbiological methods and by 16S ribosomal DNA analysis as Abiotrophia adiacens, which was formerly classified as a member of nutritionally variant streptococci.

scholarly journals Primary Nocardia farcinica Brain Abscess With Secondary Relapsing Meningitis in an Immunocompromised Patient

2015 ◽  
Vol 6 (7) ◽  
pp. 304-306
Author(s):  
Eleni Mylona ◽  
Styliani Golfinopoulou ◽  
Anthi Tragousti ◽  
Athanasios Skoutelis
Keyword(s):  
Brain Abscess ◽  
Immunocompromised Patient ◽  
Nocardia Farcinica

Late Aspergillus fumigatus endomyocarditis with brain abscess as a lethal complication after heart transplantation

2002 ◽  
Vol 21 (11) ◽  
pp. 1242-1245 ◽  
Author(s):  
Florian Rueter ◽  
Hans H Hirsch ◽  
Franziska Kunz ◽  
Peter Buser ◽  
James M Habicht ◽  
...  
Keyword(s):  
Heart Transplantation ◽  
Aspergillus Fumigatus ◽  
Brain Abscess

scholarly journals Suppurative intracranial processes in 15 domestic ruminants

2014 ◽  
Vol 34 (5) ◽  
pp. 421-426 ◽  
Author(s):  
Antônio Carlos Lopes Câmara ◽  
André Menezes do Vale ◽  
Jael Soares Batista ◽  
Francisco Marlon C. Feijó ◽  
Benito Soto-Blanco
Keyword(s):  
Escherichia Coli ◽  
Central Nervous System ◽  
Cerebrospinal Fluid ◽  
Nervous System ◽  
Brain Abscess ◽  
Preventive Measures ◽  
Light Yellow ◽  
Domestic Ruminants ◽  
Yellow Coloration ◽  
Arcanobacterium Pyogenes

In addition to listeriosis which is relatively common in ruminants, there are three other uncommon suppurative intracranial processes (SIP) identifiable in adult ungulates as brain abscess, basilar empyema and suppurative meningitis. The present paper reports the epidemiological, clinical, laboratorial, pathological and microbiological findings of 15 domestic ruminants with SIP. A total of 15 animals were selected (eight sheep, four cattle and three goats); with the definitive diagnoses of basilar empyema (n=3), brain abscess (n=1), listeriosis (n=5) and suppurative meningitis (n=6). Hematology revealed leukocytosis with inversion of the lymphocyte/ neutrophil ratio in 4 cases. In the majority of animals, cerebrospinal fluid (CSF) presented light yellow coloration and cloudy aspect due to neutrophilic pleocytosis (15 - 997 leukocytes/µL). Microbiological culture of CSF or central nervous system (CNS) fragments resulted on isolation of Trueperella (Arcanobacterium) pyogenes,Listeria monocytogenes,Escherichia coli and Stenotrophomonas sp. In a goat with thalamic abscess, microbiological assay was not performed, but Gram positive bacilli type bacteria were observed in histology. The diagnosis of these outbreaks was based on the association of epidemiological, clinical, pathological and bacteriological findings; reiterating that the infectious component remains an important cause of CNS disease in domestic ruminants and also shows the need for dissemination of information about the most effective preventive measures for the ranchers.

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