scholarly journals Primary Cutaneous Cryptococcosis: An Unusual Injection Site Infection

2020 ◽  
Vol 12 (2) ◽  
pp. 138-143
Author(s):  
Guy Shalom ◽  
Amir Horev
Keyword(s):  
Patient Education ◽  
Injection Site ◽  
Alternative Treatment ◽  
Clinical Setting ◽  
Subcutaneous Injection ◽  
Unusual Case ◽  
Immunocompromised Patient ◽  
Site Infection ◽  
Risks And Benefits ◽  
Cutaneous Cryptococcosis

Primary cutaneous cryptococcosis (PCC) is an uncommonly reported entity. We describe an unusual case of PCC in an injection site of an immunocompromised patient. The specific case demonstrates a challenging treating dilemma with different alternative treatment choices. In the presented clinical setting, each choice concealed its risks and benefits. We highlight the importance of patient education for taking the appropriate measures for the disinfection of subcutaneous injection sites.

scholarly journals Predictors of Subcutaneous Injection Site Reactions to Sustained-Release Buprenorphine in Rhesus Macaques (Macaca mulatta)

2021 ◽  
Author(s):  
Andrew J Haertel ◽  
Matthew A Schultz ◽  
Lois M Colgin ◽  
Amanda L Johnson
Keyword(s):  
Sustained Release ◽  
Injection Site ◽  
Macaca Mulatta ◽  
Subcutaneous Injection ◽  
Rhesus Macaques ◽  
Single Case ◽  
Subcutaneous Tissue ◽  
Injection Site Reaction ◽  
Reaction Rates ◽  
Injection Site Reactions

Subcutaneous injection site reactions to sustained-release buprenorphine hydrochloride (Buprenorphine SR) in macaqueshave been reported in only a single case report. In the current study, we evaluated the incidence rate and predictors ofbuprenorphine SR reactions in the subcutaneous tissue of rhesus macaques (Macaca mulatta) based on retrospective reviewof macaque buprenorphine SR injection records. Potentially predictive variables were identified with logistic regressionmodeling and were evaluated using model selection based on Akaike information criterion. Record review revealed subcutaneoustissue reactions occurred in 52 (3%) of 1559 injections and were noted between 4 and 311 d after injection. Modelselection showed that body weight and MHC allele Mamu-B*29 were the best predictors of subcutaneous reactions. Basedon these results, we recommend consideration of potential risk factors prior to the administration of buprenorphine SR toa rhesus macaque. In addition, the authors advise that using the highest concentration of buprenorphine SR available mayreduce injection site reaction rates due to the injection of less copolymer.

scholarly journals An unusual case of Hyalohyphomycosis due to Purpureocillium lilacinum in a patient with Myasthenia gravis

2018 ◽  
Vol 4 (2) ◽  
Author(s):  
Ramya Raghavan ◽  
Gomathi Chithra ◽  
Sanal Fernandez ◽  
Bettadpura Shamana Suryanarayana ◽  
Rakesh Singh
Keyword(s):  
Myasthenia Gravis ◽  
Unusual Case ◽  
Immunocompromised Patient ◽  
Fungal Growth ◽  
Surgical Excision ◽  
Lower Limbs ◽  
Unusual Site ◽  
Purpureocillium Lilacinum ◽  
Uncontrolled Diabetes ◽  
Alternative Treatment Option

Background and Purpose: Purpureocillium lilacinum (previously known as Paecilomyces lilacinus) and Paecilomyces variotii cause hyalohyphomycosis.Case report: In this study, we present a case of multiple subcutaneous abscesses of the lower limbs due to Purpureocillium lilacinum in a patient with myasthenia gravis and uncontrolled diabetes. Subcutaneous involvement of the lower limbs with this fungus is an unusual presentation. Pus aspirate collected on multiple occasions revealed hyaline septate hyphae under microscopic examination and Purpureocillium lilacinum grew on Sabouraud Dextrose Agar. The patient was initially treated by surgical excision and itraconazole therapy. Swelling regressed but discharge was noticed from the excision site after three months of itraconazole therapy. Culture from the discharge material yielded the same fungal growth. Treatment was changed to ketoconazole and he responded. Conclusion: This case report emphasizes the importance of identifying Purpureocillium lilacinum at an unusual site like the lower limbs in an immunocompromised patient. Ketoconazole may be used as an alternative treatment option for hyalohyphomycosis caused by Purpureocillium lilacinum. Keywords: Hyalohyphomycosis, Immunocompromised patient, Myasthenia gravis, Purpureocillium lilacinum, Purpureocillium lilacinum  

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