Subject(s)
Cerebral Veins/pathology , Sinus Thrombosis, Intracranial/diagnostic imaging , Adult , Aged , Anticoagulants/therapeutic use , Female , Hemorrhage/diagnostic imaging , Hemorrhage/etiology , Humans , Lung/pathology , Magnetic Resonance Angiography , Male , Middle Aged , Sinus Thrombosis, Intracranial/drug therapy , Thrombolytic Therapy , Tomography, X-Ray ComputedABSTRACT
An 83-year-old man had an influenza-like upper respiratory infection that progressed to pneumonia and respiratory insufficiency during a period two weeks. After admission, anti-influenza A antibody increased 32-fold and antibiotic treatment had little effect on the pneumonia. Aspergillus antigen was detected from his serum and pleural effusion, however, culture of sputum was negative for aspergillus. Administration of amphotericin B reduced the serum level of aspergillus antigen, however he died due to the progression of respiratory insufficiency and bloody sputum. Aspergillus infection is generally thought to occur in immunocompromised hosts, but this patient had no apparent immunosuppressive conditions except for his age before the influenza A infection. His WBC and lymphocyte count temporally decreased to 2,000 x 10(6)/L (lymphocytes 160 x 10(6)/L) followed by aspergillus infection. This temporally reduction of lymphocytes is thought to have been responsible for the aspergillus infection. Complications of influenza infection are sometimes fatal and vaccination against influenza seems necessary in high risk individuals such as elderly people.
Subject(s)
Aspergillosis/etiology , Influenza A virus , Influenza, Human/complications , Lung Diseases, Fungal/etiology , Aged , Aged, 80 and over , Humans , MaleABSTRACT
A 69-year-old man with chronic alcoholism was admitted to our hospital due to disturbance of consciousness and oliguria. Emergency laboratory examination revealed metabolic acidosis, hypoglycemia, hyponatremia, mild liver dysfunction, acute renal failure and rhabdomyolysis. After administration of fluids and nutrients and continuous hemodiafiltration, he recovered from all signs and symptoms except for disturbance of consciousness after 7 days. Since severe hypophosphatemia persisted, we administered adequate phosphates, and then his level of consciousness normalized. We discuss the relationships among alcohol abuse, hypophosphatemia and disturbance of consciousness, and recommend that hypophosphatemia be considered a potential cause of disturbance of consciousness in alcoholic patients.
Subject(s)
Alcoholism/complications , Consciousness Disorders/etiology , Hypophosphatemia/complications , Acidosis/blood , Acidosis/complications , Acidosis/therapy , Acute Kidney Injury/blood , Acute Kidney Injury/complications , Acute Kidney Injury/therapy , Aged , Alcoholism/blood , Consciousness Disorders/blood , Creatinine/blood , Follow-Up Studies , Hemodiafiltration , Humans , Hypoglycemia/blood , Hypoglycemia/complications , Hypoglycemia/therapy , Hyponatremia/blood , Hyponatremia/complications , Hyponatremia/therapy , Hypophosphatemia/blood , Hypophosphatemia/drug therapy , Male , Myoglobin/blood , Phosphates/blood , Phosphates/therapeutic use , Phosphorus/blood , Phosphorus/therapeutic use , Rhabdomyolysis/blood , Rhabdomyolysis/complications , Rhabdomyolysis/therapyABSTRACT
Baker's yeast reduction of methyl and ethyl (2-oxocyclohexyl) acetates proceeded with enantio- and diastereo-selectivity, affording the corresponding (2S)-trans-alcohols (major), (2S)-cis-alcohols (minor), and the unaltered (1S)-ketones with high optical purity.
