scholarly journals Candida glabrata spondylodiscitis: A case report

2018 ◽  
Vol 12 (02.1) ◽  
pp. 32S
Author(s):  
Christina El Khoury ◽  
Philippe Younes ◽  
Rabih Hallit ◽  
Nabil Okais ◽  
Matta Antoun Matta
Keyword(s):  
Candida Glabrata ◽  
Fungal Infections ◽  
Rare Condition ◽  
Intervertebral Disc Space ◽  
Disc Space ◽  
Surgical Biopsy ◽  
Surgical Fusion ◽  
Immunosuppressed Patients ◽  
Open Surgical Biopsy ◽  
Disease Free

Introduction: Spondylodiscitis is an infection in the intervertebral disc space and adjacent end plates. It can be attributed to bacteria, mycobacteria or fungi. As the number of immunosuppressed patients continues to grow, the incidence of developing fungal infections has become more frequent. Methodology: We report the case of a 53-year-old immunocompetent female patient with a fungal spondylodiscitis infection caused by Candida glabrata diagnosed by open surgical biopsy, one-month posturosepsis. Results: Our patient with Candida glabrata was disease free in 6 months after being treated through surgical fusion at the level of C4-C5 and the use of intravenous micafungin followed by oral voriconazole for a total of 6 months. Discussion: Fungal spondylodiscitis, especially due to Candida glabrata, remains a rare condition, usually suspected in immunocompromised and elderly patients. Without appropriate diagnosis and tailored surgical and medical treatment, the infection can be progressive and yield to deleterious complications such as vertebral destruction. Surgical debridement of the disc alongside fusion and antifungal therapy for a minimum of 3 months are highly recommended.

Intervertebral disc space cyst simulating a recurrent herniated nucleus pulposus

1988 ◽  
Vol 69 (1) ◽  
pp. 137-139 ◽  
Author(s):  
Jordan C. Grabel ◽  
Raphael Davis ◽  
Rosario Zappulla
Keyword(s):  
Intervertebral Disc ◽  
Preoperative Diagnosis ◽  
Relevant Literature ◽  
Radicular Pain ◽  
Lumbar Region ◽  
Intervertebral Disc Space ◽  
Disc Space ◽  
Content Type ◽  
Herniated Nucleus Pulposus ◽  
Fine Print

✓ The case presented is of a patient with an intervertebral disc space cyst producing recurrent radicular pain following microdiscectomy in the lumbar region. Difficulties with the preoperative diagnosis of this and other recurrent radicular syndromes are discussed, and a review of the relevant literature is presented.

Results of alemtuzumab-based reduced-intensity allogeneic transplantation for chronic lymphocytic leukemia: a British Society of Blood and Marrow Transplantation Study

Blood ◽  
2006 ◽  
Vol 107 (4) ◽  
pp. 1724-1730 ◽  
Author(s):  
Julio Delgado ◽  
Kirsty Thomson ◽  
Nigel Russell ◽  
Joanne Ewing ◽  
Wendy Stewart ◽  
...  
Keyword(s):  
Chronic Lymphocytic Leukemia ◽  
Hematopoietic Cell Transplantation ◽  
Fungal Infections ◽  
Allogeneic Transplantation ◽  
Lymphocytic Leukemia ◽  
British Society ◽  
Graft Versus Host ◽  
Blood And Marrow Transplantation ◽  
Immunosuppressed Patients ◽  
Related Mortality

We report results in 41 consecutive patients with chronic lymphocytic leukemia (CLL) who underwent allogeneic hematopoietic cell transplantation (HCT) after fludarabine, melphalan, and alemtuzumab conditioning. Donors were 24 HLA-matched siblings and 17 unrelated volunteers, 4 of them mismatched with recipients. All but 3 patients had initial hematologic recovery, but 5 more patients had secondary graft failure. Median intervals to neutrophil (greater than 0.5 × 109/L) and platelet (greater than 20 × 109/L) recovery were 14 days (range, 9-30 days) and 11 days (range, 8-45 days), respectively. Eleven (27%) patients had relapses and received escalated donor lymphocyte infusions, but only 3 of them had sustained responses. Acute and chronic graft-versus-host disease (GVHD) was observed in 17 (41%) and 13 (33%) patients, respectively. Seventeen (41%) patients have died, 5 of progressive disease. The 2-year overall survival and transplantation-related mortality (TRM) rates were 51% (95% confidence interval [CI], 33%-69%) and 26% (95% CI, 14%-46%), respectively. The alemtuzumabbased regimen was feasible and effective in patients with CLL with a relatively low rate of GVHD. However, TRM remains relatively high as a result of a variety of viral and fungal infections. Studies are ongoing to address the efficacy of reduced doses of alemtuzumab in this group of immunosuppressed patients.

scholarly journals Primary umbilical endometriosis – A rare presentation of cutaneous endometriosis

2021 ◽  
Vol 6 (3) ◽  
pp. 226-230
Author(s):  
Girija C ◽  
Muhammed Aslam K K
Keyword(s):  
Rare Condition ◽  
Surgical Excision ◽  
Rare Presentation ◽  
Surgical Biopsy ◽  
Diagnostic Dilemma ◽  
Child Bearing ◽  
Surgical Speciality ◽  
Cutaneous Endometriosis ◽  
Clinical Differential Diagnosis ◽  
Umbilical Endometriosis

Primary umbilical endometriosis is a rare condition with an overall incidence of around 0.5% to 1% among all the endometriosis cases, but at times it poses a diagnostic dilemma. In our institution we encountered a case of primary umbilical endometriosis presented to multiple surgical speciality departments. A prompt clinical examination with surgical biopsy was the key tool which lead to the diagnosis and providing a complete cure for the patient. Pelvic endometriosis affects 5-10% of women in the child bearing age group. The most pronounced symptoms are dyspareunia, pelvic pain, and infertility. Clinical presentations of umbilical endometriosis are as a nodule with or without associated umbilical pain and bleeding. This patient was given primary hormonal therapy and later underwent a biopsy which paved way for an accurate diagnosis of primary umbilical endometriosis. In this case of umbilical swelling, conditions like a benign nevus, lipoma, abscess, cyst, hernia, as well as metastatic deposit from a systemic malignancy were considered in the clinical differential diagnosis. However surgical excision helped us arrive at a definitive diagnosis and cure for the patient.

scholarly journals Pulmonary Interleukin-17-Positive Lymphocytes Increase during Pneumocystis murina Infection but Are Not Required for Clearance of Pneumocystis

2017 ◽  
Vol 85 (7) ◽  
Author(s):  
Chiara Ripamonti ◽  
Lisa R. Bishop ◽  
Joseph A. Kovacs
Keyword(s):  
T Cells ◽  
Fungal Infections ◽  
Intracellular Cytokine Staining ◽  
Γδ T Cells ◽  
Interleukin 17 ◽  
Content Type ◽  
Immunosuppressed Patients ◽  
Ifn Γ ◽  
Immunocompetent Mice ◽  
Deficient Mice

ABSTRACT Pneumocystis remains an important pathogen of immunosuppressed patients, causing a potentially life-threatening pneumonia. Despite its medical importance, the immune responses required to control infection, including the role of interleukin-17 (IL-17), which is important in controlling other fungal infections, have not been clearly defined. Using flow cytometry and intracellular cytokine staining after stimulation with phorbol myristate acetate and ionomycin, we examined gamma interferon (IFN-γ), IL-4, IL-5, and IL-17 production by lung lymphocytes in immunocompetent C57BL/6 mice over time following infection with Pneumocystis murina. We also examined the clearance of Pneumocystis infection in IL-17A-deficient mice. The production of both IFN-γ and IL-17 by pulmonary lymphocytes increased during infection, with maximum production at approximately days 35 to 40, coinciding with peak Pneumocystis levels in the lungs, while minimal changes were seen in IL-4- and IL-5-positive cells. The proportion of cells producing IFN-γ was consistently higher than for cells producing IL-17, with peak levels of ∼25 to 30% of CD3+ T cells for the former compared to ∼15% for the latter. Both CD4+ T cells and γδ T cells produced IL-17. Administration of anti-IFN-γ antibody led to a decrease in IFN-γ-positive cells, and an increase in IL-5-positive cells, but did not impact clearance of Pneumocystis infection. Despite the increases in IL-17 production during infection, IL-17A-deficient mice cleared Pneumocystis infection with kinetics similar to C57BL/6 mice. Thus, while IL-17 production in the lungs is increased during Pneumocystis infection in immunocompetent mice, IL-17A is not required for control of Pneumocystis infection.

Albert Dereymaeker and Joseph Cyriel Mulier’s description of anterior cervical discectomy with fusion in 1955

2018 ◽  
Vol 28 (4) ◽  
pp. 395-400 ◽  
Author(s):  
Ronald H. M. A. Bartels ◽  
Jan Goffin
Keyword(s):  
French Literature ◽  
Case Series ◽  
Anterior Cervical Discectomy ◽  
Subsequent Paper ◽  
Intervertebral Disc Space ◽  
Disc Space ◽  
Iliac Crest Graft ◽  
Cervical Discectomy ◽  
Time Period

Anterior cervical discectomy with fusion (ACDF) is a very well-known and often-performed procedure in the practice of spine surgeons. The earliest descriptions of the technique have always been attributed to Cloward, Smith, and Robinson. However, in the French literature, this procedure was also described by others during the exact same time period (in the 1950s).At a meeting in Paris in 1955, Belgians Albert Dereymaeker and Joseph Cyriel Mulier, a neurosurgeon and an orthopedic surgeon, respectively, described the technique that involved an anterior cervical discectomy and the placement of an iliac crest graft in the intervertebral disc space. In 1956, a summary of their oral presentation was published, and a subsequent paper—an illustrated description of the technique and the details of a larger case series with a 3.5-year follow-up period—followed in 1958.The list of authors who first described ACDF should be completed by adding Dereymaeker’s and Mulier’s names. They made an important contribution to the practice of spinal surgery that was not generally known because they published in French.

Diagnosis and treatment of Candida glabrata proventriculitis in an eclectus parrot (Eclectus roratus)

2021 ◽  
pp. 1-8
Author(s):  
Kyra J. Berg ◽  
David Sanchez-Migallon Guzman ◽  
Joanne Paul-Murphy ◽  
Michelle G. Hawkins ◽  
Barbara A. Byrne
Keyword(s):  
Candida Glabrata ◽  
Fungal Infections ◽  
Clinical Signs ◽  
Antifungal Treatment ◽  
Coelomic Fluid ◽  
Fecal Culture ◽  
Cytologic Examination ◽  
Contrast Enhanced Ct ◽  
History Of ◽  
Upper Gastrointestinal

Abstract CASE DESCRIPTION An 8-year-old sexually intact female eclectus parrot (Eclectus roratus) with a 4-day history of hyporexia and lethargy and a 1-day history of tenesmus was examined. CLINICAL FINDINGS Severe leukocytosis characterized by severe heterophilia and moderate monocytosis was present. Marked dilation of the proventriculus and ventriculus and ascites were identified by means of radiography, coelomic ultrasonography, and contrast-enhanced CT, with no clinically relevant motility noted on ultrasonography. Results of coelomic fluid analysis were consistent with pyogranulomatous effusion. Endoscopy of the upper gastrointestinal tract following proventricular and ventricular lavage showed a thick caseous plaque occupying 30% of the caudal proventricular mucosa. Abundant yeast organisms were evident during cytologic examination of a proventricular and ventricular wash sample, and fecal culture yielded Candida glabrata. TREATMENT AND OUTCOME The bird was treated with SC fluids, assisted feedings, nystatin, fluconazole, amoxicillin–clavulanic acid, enrofloxacin, gastroprotectants, maropitant, and analgesics and slowly improved during hospitalization. A marked decrease in proventricular dilation was evident on serial radiographs obtained over a 12-month period. One year after diagnosis, the bird was presented with a 1-week history of hyporexia and lethargy, and fecal culture grew C glabrata. Antifungal treatment was resumed for 3 months. The bird had no clinical signs of infection 16 months after this recurrence, and subsequent fecal cultures were negative for fungal growth. CLINICAL RELEVANCE Findings illustrate the importance of upper gastrointestinal endoscopy in diagnosing proventricular and ventricular dilation in birds and emphasize the need for long-term antifungal treatment and monitoring in birds with fungal infections.

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