ABSTRACT
Cerebral aspergillosis accounts for about 10% of all the cases of invasive aspergillosis. The brain is the only infected site in less than 10% of cases. The patients at high risk for of aspergillosis are immunocompromised patients such as those in a neutropenic state after chemotherapy, AIDS and etc. We experienced a case of cerebral aspergillosis in a patient with acute leukemia that was in complete remission. The patient visited our hospital's ER due to nasal bleeding, and then he was quickly diagnosed as having acute promyelocytic leukemia. After the first induction chemotherapy, he achieved a complete remission. Loss of consciousness developed on day 31 after chemotherapy. High signal intensity in the right temporooccipital lobe and multiple nodular lesions in both cerebral hemispheres were observed on the brain MRI. Stereotaxic biopsy showed septate aspergillus hyphae in the brain specimen. Despite of the use of amphotericin B deoxycholate, the patient died of recurrent grand mal seizure and multiple organ failure.
Subject(s)
Humans , Amphotericin B , Aspergillosis , Aspergillus , Biopsy , Brain , Brain Infarction , Cerebrum , Deoxycholic Acid , Drug Therapy , Epistaxis , Hyphae , Immunocompromised Host , Induction Chemotherapy , Leukemia , Leukemia, Promyelocytic, Acute , Magnetic Resonance Imaging , Multiple Organ Failure , Seizures , UnconsciousnessABSTRACT
We experienced a case of infective endocarditis, which unusual has symptoms and microcytic hypochromic anemia. Anemia associated with infective endocarditis is a common manifestation, but is generally normocytic nor-mochromic. However, microcytic hypochromic anemia is an uncommon manifestation of infective endo-carditis, and has only been noted in a few previous reports. We systematically evaluated anemia, and diagnosed fatal underlying diseases, such as infective endocarditis.
Subject(s)
Anemia , Anemia, Hypochromic , EndocarditisABSTRACT
Cryptococcus neoformans commonly causes opportunistic infection in other immunocompromised patients as well as in AIDS. Among cryptococcosis, cryptococcal meningitis is a relatively frequent manifestation and causes serious morbidity and mortality. It needs urgent diagnosis and effective antifungal therapy. We experienced cryptococcal meningitis in a 25-year-old female patient with autoimmune hemolytic anemia. She was admitted because of autoimmune hemolytic crisis. Her anemic symptoms were controlled by steroid and red cell transfusions. However, she was suddenly readmitted with decreased mentality. Seven days later, she was diagnosed as cryptococcal meningitis and cryptococcemia resulting from culture studies of CSF and blood. Since treated with amphotericin B and flucytosine and maintained with prudent fluconazole therapy, her symptoms and general conditions were improved. We report an unusual case of cryptococcal meningitis developed in a patient with autoimmune hemolytic anemia in spite of short-term steroid therapy.
Subject(s)
Adult , Female , Humans , Amphotericin B , Anemia , Anemia, Hemolytic, Autoimmune , Cryptococcosis , Cryptococcus neoformans , Diagnosis , Fluconazole , Flucytosine , Immunocompromised Host , Meningitis , Meningitis, Cryptococcal , Mortality , Opportunistic Infections , SteroidsABSTRACT
Tracheobronchial aspergillosis is an uncommon clinical form of invasive aspergillosis, particularly found in patients with AIDS and in lung transplant recipients than in other immunocompromised patients. The rapidity of the disease progression can result in fatal airway obstruction in a short period of time that the patient may need emergency tracheostomy without knowing the cause of the obstruction. We describe a case of fatal tracheobronchial aspergillosis which developed in a 43- year-old female patient with acute lymphoblastic leukemia. Dyspnea and stridor developed on the 20th day after 2nd consolidation chemotherapy, which was during the prolonged neutropenic period. Airway narrowing was observed on the computed tomograph scan of neck and emergency tracheostomy was performed. Infiltration with aspergillus hyphae was found in the tracheal ring and bronchial mucosa. Despite the use of amphotericin B, the patient died of bleeding and airway obstruction.
Subject(s)
Female , Humans , Airway Obstruction , Amphotericin B , Aspergillosis , Aspergillus , Bronchi , Consolidation Chemotherapy , Disease Progression , Dyspnea , Emergencies , Hemorrhage , Hyphae , Immunocompromised Host , Lung , Mucous Membrane , Neck , Neutropenia , Precursor Cell Lymphoblastic Leukemia-Lymphoma , Respiratory Sounds , Trachea , Tracheostomy , TransplantationABSTRACT
Tracheobronchial aspergillosis is an uncommon clinical form of invasive aspergillosis, particularly found in patients with AIDS and in lung transplant recipients than in other immunocompromised patients. The rapidity of the disease progression can result in fatal airway obstruction in a short period of time that the patient may need emergency tracheostomy without knowing the cause of the obstruction. We describe a case of fatal tracheobronchial aspergillosis which developed in a 43- year-old female patient with acute lymphoblastic leukemia. Dyspnea and stridor developed on the 20th day after 2nd consolidation chemotherapy, which was during the prolonged neutropenic period. Airway narrowing was observed on the computed tomograph scan of neck and emergency tracheostomy was performed. Infiltration with aspergillus hyphae was found in the tracheal ring and bronchial mucosa. Despite the use of amphotericin B, the patient died of bleeding and airway obstruction.