RESUMO
No abstract available.
Assuntos
Humanos , Masculino , Pessoa de Meia-Idade , Infecções por Citomegalovirus/diagnóstico , Rejeição de Enxerto/diagnóstico , Transplante de Rim/efeitos adversos , Nefrite Intersticial/diagnóstico , Obstrução Ureteral/diagnósticoRESUMO
Coccidioidomycosis, a fungal infection caused by the fungus known as Coccidioides immitis, can affect many species of mammals and some reptiles. The fungus is endemic in the soil of the southwestern United States, Mexico, and parts of Central and South America. Most infections in humans are relatively mild or asymptomatic, but severe or fatal illness can also occur, especially in the elderly or immunocompromised. We report on a patient with disseminated coccidioidomycosis whose lymph nodes, skin, and especially brain were infected at diagnosis; however, the lung parenchyme was not infected. Because the brain infection could have been a fatal complication in this peculiar case, we recommended life-long fluconazole treatment for the patient. After 2 months of high doses of fluconazole, the patient's clinical signs were greatly improved with respect to fever, headache, skin lesions, and mediastinal widening on the chest X-ray.
Assuntos
Idoso , Humanos , Encéfalo , Coccidioides , Coccidioidomicose , Febre , Fluconazol , Fungos , Cefaleia , Pulmão , Linfonodos , Mamíferos , México , Répteis , Pele , Solo , América do Sul , Sudoeste dos Estados Unidos , TóraxRESUMO
Coccidioidomycosis, a fungal infection caused by the fungus known as Coccidioides immitis, can affect many species of mammals and some reptiles. The fungus is endemic in the soil of the southwestern United States, Mexico, and parts of Central and South America. Most infections in humans are relatively mild or asymptomatic, but severe or fatal illness can also occur, especially in the elderly or immunocompromised. We report on a patient with disseminated coccidioidomycosis whose lymph nodes, skin, and especially brain were infected at diagnosis; however, the lung parenchyme was not infected. Because the brain infection could have been a fatal complication in this peculiar case, we recommended life-long fluconazole treatment for the patient. After 2 months of high doses of fluconazole, the patient's clinical signs were greatly improved with respect to fever, headache, skin lesions, and mediastinal widening on the chest X-ray.
Assuntos
Idoso , Humanos , Encéfalo , Coccidioides , Coccidioidomicose , Febre , Fluconazol , Fungos , Cefaleia , Pulmão , Linfonodos , Mamíferos , México , Répteis , Pele , Solo , América do Sul , Sudoeste dos Estados Unidos , TóraxRESUMO
We report a case of necrotizing fasciitis and severe sepsis complicated by emphysematous gastritis. The patient initially presented with sepsis due to extensive necrotizing fasciitis. Although he recovered from severe sepsis after intensive treatment including amputation of involved lesion, fatal emphysematous gastritis developed later during long-term hospitalization. To the best of our knowledge, this is the first report on emphysematous gastritis associated with necrotizing fasciitis and sepsis.
Assuntos
Humanos , Amputação Cirúrgica , Fasciite Necrosante , Gastrite , Hospitalização , SepseRESUMO
Citrobacter species is a gram-negative bacilli that can cause opportunistic infections in immunocompromised hosts. Citrobacter braakii refers to the genomospecies 6 of the Citrobacter freundii complex. There are no detailed studies on infections caused by this newly identified specific genetic species in Korea. We herein report a case of a patient with hepatocellular carcinoma who, after undergoing transcatheter arterial chemoembolization, developed biloma which later progressed to C.braakii sepsis and did not respond to treatment. To our knowledge, this is the first reported case in Korea on C. braakii infection resulting in septic shock in a patient with malignancy in Korea.
Assuntos
Humanos , Carcinoma Hepatocelular , Citrobacter , Citrobacter freundii , Hospedeiro Imunocomprometido , Coreia (Geográfico) , Infecções Oportunistas , Sepse , Choque SépticoRESUMO
BACKGROUND/AIMS: Kidney transplantations at our center rely mainly on living donors. The purpose of this study was to suggest future donor supply directions by reviewing changing trends in donor type. METHODS: During the past 40 years, 1,690 kidney transplantations were performed at our center. We divided the follow-up period into four decades and the donor population into three groups: living related, living unrelated, and deceased. We analyzed changing trends in donors from each group for each decade. Patients receiving overseas transplantation were also included. RESULTS: The proportion of living related donors decreased from 84% (54/64) in the 1970s to 61% (281/458) in the 2000s. Living unrelated donors showed a sustained proportion of around 20% after 1990. However, among living unrelated donors, the proportion of spouse donors increased from 4.6% (17/369) in the 1980s to 8.5% (39/458) in the 2000s. Transplants from deceased donors were only 3.3% (12/369) in the 1980s. However the proportion of deceased donors increased gradually, reaching 13.2% (105/799) in the 1990s and 19.9% (91/458) after 2000. Overseas transplantations increased after 2000 and reached 20% of all cases treated in our center during the 2000s. Such transplantations peaked in 2006 and decreased markedly thereafter. CONCLUSIONS: The proportion of each donor type has continuously changed, and the changes were associated with changes in the social structure and system. We expect that this study could be an important reference for other countries to estimate future changes of donor type.