Huge Candida albicans normal native tricuspid valve endocarditis

Fungal endocarditis has become an important infection associated with medical progress and the modern lifestyle. In particular, Candida spp. is a rare but important cause of infective endocarditis. We report the case of a 28-year-old woman­quadriplegic and bedridden from birth­who died after repeated episodes of pneumonia treated with different regimens of intravenous antibiotics. A medico legal autopsy was performed, which diagnosed severe Candida native valve infective endocarditis (CIE). This case report illustrates the prolonged use of antibiotic treatment as a possible risk factor for the development of CIE. We also considered how the bedridden condition and the presence of a central venous catheter may be additional risk factors for the development of this entity. Finally, we examined the absence of peripheral embolization in the setting of endocarditis of the right side of the heart.

Micosis superficiales en adultos mayores residentes de la unidad geriátrica “Monseñor Dr. Rafael Arias Blanco” De Juan Griego Estado Nueva Esparta-Venezuela / Superficial mycoses in old people residents of the geriatrical unit “Monseñor Dr. Rafael Arias Blanco” Juan Griego Nueva Esparta state Venezuela

Se evaluó la frecuencia de micosis superficiales en una población de 71 adultos mayores entre 62 y 98 años, de sexo masculino y femenino, residentes de la Unidad Geriátrica, durante el periodo octubre 2005-Febrero 2006, de los cuales 49 presentaron diagnóstico sugestivo. A las muestras obtenidas, se les practicó examen directo con KOH al 10%, se cultivaron en agar Fungobiotic y se incubaron durante 15 días a temperatura ambiente. Las colonias filamentosas se identificaron a través de las características macro y microscópicas, mientras que las levaduras del género Candida por el sistema de identificación API 20 C AUX®. Los resultados obtenidos fueron analizados a través del método de análisis porcentual (%) y la prueba de Chi-cuadrado (c²). Resultaron positivos 40 (81,63%) casos, de los cuales el 82,50% fueron para candidosis cutáneas, siendo la candidosis ungueal la más frecuente, seguido de la tinea unguium (12,50%) y las onicomicosis por hongos no dermatofitos (5,00%). No se detectó ningún caso de pitiriasis versicolor. C. albicans fue el hongo más frecuentemente aislado (64,81%), sobre todo en uñas de pies, seguido de C. parapsilosis (12,96%) y Trichophyton mentagrophytes (5,56%). En la vejez, se observa una alta incidencia de candidosis cutáneas, la cual es favorecida por las condiciones físicas propias del adulto mayor, enfermedades concomitantes, déficit en la inmunidad celular y ciertos factores predisponentes como el ritmo de vida, el uso de calzados cerrados, el clima cálido y la humedad de la región donde se reside.

Prevalence of oral hairy leukoplakia and epithelial infection by Epstein-Barr virus in pregnant women and diabetes mellitus patients: cytopathologic and molecular study

Oral hairy leukoplakia (OHL) is generally reported in patients with severe immunosuppression, except for a few cases in individuals with moderate degree of immunodeficiency. It is a white lesion that appears mainly in the lateral border of the tongue, caused by Epstein-Barr virus (EBV). The nuclear changes caused by EBV (Cowdry A inclusion, ground glass and nuclear beading), observed in cytopathology, are specific and enough for the definitive diagnosis of OHL, independent of the identification of the virus. Here we investigated the prevalence of OHL and the presence of EBV-DNA in the lateral borders of the tongue from 90 pregnant women, 90 diabetes mellitus (DM) patients, 30 healthy individuals (negative group) and 30 HIV+ with OHL (positive group). Smears were analyzed by cytopathology and polymerase chain reaction (PCR). A case of subclinical OHL and candidiasis was identificated in a DM patient by cytopathologic analysis. PCR results demonstrated EBV-DNA in 65 percent of the pregnant women, in 35 percent of DM patients, and in 20 percent of the healthy individuals. We concluded that DM patients can develop OHL with a low prevalence. Furthermore, the prevalence of the EBV in lateral border of the tongue is larger in pregnant women than in healthy individuals.

Disseminated intra-cerebral microabscesses: a clinico-pathologic study.

In this retrospective study, clinical and neuropathological features were analysed in eight patients with disseminated intracerebral microabscesses. All the patients presented with clinical features, suggestive of an encephalopathic process of an acute onset. Neuroradiological and laboratory investigations were not helpful in establishing the diagnosis in any patient during their hospital stay. All the eight patients died in the hospital and at autopsy disseminated intracerebral microabscesses were the most striking feature. In two patients hyphae of Candida albicans were demonstrated within the microabscesses. Gram negative bacilli in two patients and gram positive and gram positive cocci in one patient were demonstrated in the microabscesses. Disseminated intra-cerebral microabscesses are usually an unrecognised manifestation of central nervous system infections and should be considered in the differential diagnosis of patients with encephalopathy of unknown aetiology.

Radiologic and endoscopic studies of gatric ulcers associated with candida infection

The radiologic and endoscopic studies in 30 lesions of 30 gastric peptic ulcers associated with candida infection diagnosed histologically and the follow-up studies in 23 lesions of 23 patients over period of 6 months to 12 years were performed. 1. The ratio of male to female was 5:1, 43 per cents were found over 7th decade and 33 per cents with systemic diseases. 2. Although the ulcers showed no characteristic endoscopic and radiologic features, half of themn were il in depth (54 per cents), with unclear border (60 per cents). 3. The curability of gastric ulcers was low with 30 per cents cured in 6 months or more of follow-up period. 4. The continuity of candida infection, bleeding or perforation from the ulcer, candidemia or fatal accident were not encountered without antimycotic treatment

Atividade de derivados imidazólicos contra espécies de candida isoladas de pacientes com câncer / Imidazole antibiotics activities against Candida species recovered from cancer patients

Foram avaliadas as atividades fungicida e fungistática de quatro derivados imidazólicos contra espécies de Candida, isoladas de pacientes com câncer e submetidos à quimioterapia ou à radioterapia. Embora a atividade antifúngica desses antibióticos tenha variado conforme a espécie estudada, a µg/ml o cetoconazol foi agente inibidor mais efetivo, agindo sobre 90,3 (por cento) das leveduras, enquanto o clotrimazol foi o menos efetivo, agindo sobre 26,4 (por cento). O nitrato de econazol e o nitrato de miconazol foram fungistáticos para, praticamente, a mesma percentagem de leveduras (63,8 e 63,4 (por cento) respectivamente), porém, assim como os outros imidazóicos, foram icapazes de exercer açäo fungicida contra a maioria delas (au)