RESUMO
Infective endocarditis usually involves cardiac valves and perivalvular tissue. Sometimes it can penetrate through the free wall of myocardium and form burrowing abscess, usually in patients with congenital heart diseases, such as ventricular septal defect. We experienced a case of mural endocarditis of right atrium in a patient without underlying cardiac diseases. A 55-year old man was admitted due to chest tightness, fever and dyspnea. Streptococcus intermedius grew in 3 pairs of blood culture tests and transesopha- phageal echocardiography revealed a 2 cm-sized vege-tation in the right atrial auricle. Lung ventilation and perfusion scans were checked due to aggravation of dyspnea, which showed pulmonary embolism with high probability. The vegetation penetrated through the free wall of the right atrial auricle and formed a mural abscess, which was removed by surgery and its wall defect repaired with bovine patch.
Assuntos
Humanos , Pessoa de Meia-Idade , Abscesso , Dispneia , Ecocardiografia , Endocardite , Febre , Átrios do Coração , Cardiopatias , Comunicação Interventricular , Valvas Cardíacas , Pulmão , Miocárdio , Perfusão , Embolia Pulmonar , Streptococcus intermedius , Tórax , VentilaçãoRESUMO
Tuberculosis is a significant opportunistic infection in transplant recipients under the immunosuppressed condition, though not common and also known to have higher incidence among transplant recipients than in general population. The most common form of tuberculosis among transplant recipients is pulmonary, gastrointestinal, bone and genital tract in decreasing order. However tuberculous infection of the transplanted graft is rare and usually associated with disseminated tuberculosis with high mortality. We experienced M.. tuberculosis infection of the renal allograft after chronic rejection. A 28-year-old female received living-related renal transplantation, required high-dose steroid therapy for two episodes of acute rejection (8 and 20 months later). However, she eventually became renal failure due to chronic rejection and immunosuppression therapy was discontinued. Patient was refered back to our institute for the hemodialysis (post-transplant 40 months) when the patient was found to have pulomary tuberculosis of miliary type. Antituberculosis medication (INH, RFP, EMB & PZA) was immediately started on the basis of positive cultures from lung and bone marrow specimen for M. tuberculosis. In spite of full medication, high fever was sustained and subsequently pyonephritis of grafted kidney was detected and infected graft was removed to confirm the tuberculosis is very serious disease among immunosuppressed transplant patient and therefore more aggressive approach is needed including the search for the hidden infection even at the failed graft with cessated function
Assuntos
Adulto , Feminino , Humanos , Abscesso , Aloenxertos , Medula Óssea , Febre , Terapia de Imunossupressão , Incidência , Rim , Transplante de Rim , Pulmão , Mortalidade , Infecções Oportunistas , Diálise Renal , Insuficiência Renal , Transplante , Transplantes , TuberculoseRESUMO
The survival rate after liver transplantation has greatly improved. However, complications such as infection and rejection remain major causes of mortality and morbidity. The fungal infections are associated with high mortality rates, despite having a relatively lower incidence, compared with bacterial and viral infections. Difficulty in establishing an early diagnosis, lack of effective therapy, difficult management of certain antifungal agent, limited data for antifungal prophylaxis presents remaining problems.3) We report our experience with one case of syatemic candidemia after orthotopic liver transplantation.
Assuntos
Candidemia , Diagnóstico Precoce , Incidência , Transplante de Fígado , Fígado , Mortalidade , Taxa de SobrevidaRESUMO
The survival rate after liver transplantation has greatly improved. However, complications such as infection and rejection remain major causes of mortality and morbidity. The fungal infections are associated with high mortality rates, despite having a relatively lower incidence, compared with bacterial and viral infections. Difficulty in establishing an early diagnosis, lack of effective therapy, difficult management of certain antifungal agent, limited data for antifungal prophylaxis presents remaining problems.3) We report our experience with one case of syatemic candidemia after orthotopic liver transplantation.
Assuntos
Candidemia , Diagnóstico Precoce , Incidência , Transplante de Fígado , Fígado , Mortalidade , Taxa de SobrevidaRESUMO
No abstract available.