ABSTRACT
Objective To provide reference for establishing diagnosis and differential diagnosis methods of rare yeast-like fungal bloodstream infection for clinical microbiology laboratory.Methods Trichosporon asahii (T.asa-hii)and Geotrichum capitatum (G.capitatum)bloodstream infection was diagnosed and differentially diagnosed through clinical data analysis,morphological examination,biochemical reactions,and molecular biology technology. Results Two types of yeast-like fungal bloodstream infections in case 1 and case 2 both occurred in leukemia agranulocytosis phase after chemotherapy,such infections were serious and highly similar.The cultivated colonies on blood agar plates of case 1 and case 2 were performed gram stain and microscopic examination.Hyphae,arthro-spores and microconidia were visible in the former,thickness of hyphae branches and length of arthrospores were different,most presented rectangular and barrel shape;the latter can be seen hyphae with transparent septum bro-ken up into arthrospores,presented rectangular shape,did not produce blastoconidia.Identification with API 20C AUX showed that they were T.asahii and G.capitatum.The PCR product sequences were compared with NCBI, suggesting that T.asahii and G.capitatum were at sexual stage.Conclusion Comprehensive application of a varie-ty of technical methods is helpful for improving the diagnosis accuracy of bloodstream infection with yeast-like fungi, identifying Trichosporon and Geotrichum to the species level may help physicians to understand such rare fungal in-fection,choose antifungal agents rationally,and improve clinical prognosis.
ABSTRACT
Objective To evaluate the treatment of interapleural talc on the patients with malignant pleural effusion.Method There were 44 patients with malignant pleural effusion in the study.Every cases was inserted a chest drain to release the effusion with the rate of 200 ml per 2 hours.When there was no evidence of fluid in the pleural space as assessed by plain chest roentgenography,the talc slurry containing 4 g talc、40 ml of saline solution (0.9%) and 5 ml of 2% lidocaine was injected via the intercostal drain into the pleural space.An additional 20 ml of saline solution was used to flush the drain.Then,the drain was clamped,and the patient was asked to change position to allow adequate distribution of talc.After 2 hours,the drain was opened again.When the drainage decreased to less than 150 ml per 24 hours,the chest drain was removed.Result complete success was observed in 36 cases (81.8%),partial success in 6 cases (13.7%),and ineffective success in 2 cases (4.5%).There were 21 (47.7%) and 24 (54.4%) cases experienced pleuritic pain and fever after talc pleurodesis respectively,1 cases suffered from respiratory insufficiency which controled by using glucocorticoid later.Conclusion The talc pleurodesis is an effective treatment for the patients with malignant pleural effusion.It is safe and easily performed,and should be used extensively in clinic.