Histomorphologic study of experimental fungal infection with immune modulation.

Background and objectives: To study the histomorphological changes in various organs of mice receiving C.albicans inoculation with and without prior corticosteroid injections. Method: The study consisted of 5 groups. Group I animals received C.albicans intraperitoneally. Group II received corticosteroids prior to intraperitoneal C.albicans inoculation. Group III animals received intravenous injections of C.albicans. Group IV animals received corticosteroids prior to intravenous C.albicans injection. Group V, the control group received normal saline. Results: Group I animals showed microabscesses on liver, spleen and in omentum. Healing of lesions occurred spontaneously. Group II animals noted increased mortality with more widespread lesions. Involvement of lung and kidney was also noted. In Group III, mortality occurred in all animals within 72hrs. Lesions were also noted in kidneys, heart, and brain. Conclusion: Corticosteroid administration induces immunosupression resulting in disseminated infections.

A Premature Infant Case on the Treatment of Candidemia, Candidal Meningitis and Multiple Brain Microabscesses with Amphotericin B and Fluconazole

Identified risk factors for neonatal candidemia are low-birth weight, use of a central venous catheter, parenteral nutrition, and broad spectrum antibiotics. Candidemia is also the source of considerable morbidity endophthalmitis, meningitis, brain abscess, endocarditis, and renalare all examples of the potential consequences of candidemia abscess. In this study, we report a premature infant case whose candidemia involving candidal meningitis and multiple brain microabscesses was completely remedied through antifungal therapy without any onset of neurodevelopmental disability.

Granulomatous(Lobular) Mastitis in a Pregnant Woman: A case report

Granulomatous(lobular) mastitis is a distinct disease entity of unknown etiology which is characterized by noncaseating granulomatous lobulocentric inflammation. We describe a rare case of granulomatous(lobular) mastitis of a 36 year-old pregnant woman a review of the literature. The mass which was discovered in the third month of her pregnancy, began as a localized, nontender mass on the left breast and persisted during her entire pregnancy. It decreased slightly in size when she began taking post-partum bromocriptine. Clinically and mammographically, the mass was highly suspected as a carcinoma with axillary lymph node metastasis. Fine needle aspiration smears revealed numerous aggregates of granulomas composed of epithelioid histiocytes admixed with multinucleated giant cells of Langhans' and foreign body type, and collections of polymorphonuclear leukocytes. Ziehl-Neelsen, silver methenamine and PAS stain were negative for acid-fast bacilli, fungus, and bacilli on the smear respectively. Histologically, granulomatous inflammation was centered on the breast lobules. Caseation necrosis was absent, instead, numerous microabscesses were formed in the center of the granulomas. Cultures of the fresh tissue for the AFB, aerobic and anaerobic bacteria, and fungus were all negative. Excision of the mass was performed without further treatment and there was no recurrence of the mass 6 months postoperatively. An autoimmune mechanism, infection, and some association with oral contraceptives have been suggested as etiologic factors in the literature.

Placetnal Findings of Septic Abortion Caused by Listeria Monocytogenes: A case report

Since human listeriosis was firstly described by Nyfeldt in 1929, Listeria monocytogenes as a cause of septic abortion has been well known. It primarily affects pregnant woman and neonates, the elderly, and persons with immune-system dysfunction due to immunosuppressive drugs, malignant tumors or AIDS. Although several large epidemic listeriosis have been reported in the English literatures, it is still an underdiagnosed and underreported cause of congenital sepsis and septic abortion, because it is not always easy to isolate the organism in culture. There are 17 cases reports of Listeria monocytogenes infection in Korea, however, most of which were described about the bascteriologically proven cases. We describe placental findings of a septic abortion caused by Listeria monocytogenes at 15 weeks gestation in a 23-year-old primigravida woman. Placental examination showed characteristic and relatively specific patterns of granulomatous microabscesses composed of necrotic nuclear debris in the center and surrounding epithelioid histocytes enmeshed in fibrin between the acutely inflamed villi. There were numerous gram positive bacilli on Brown-Brenn stain.