Subject(s)
Bacteremia/microbiology , Catheter-Related Infections/microbiology , Central Venous Catheters/adverse effects , Cross Infection/microbiology , Gram-Negative Bacterial Infections/microbiology , Hodgkin Disease/complications , Methylobacterium/isolation & purification , Adult , Antineoplastic Combined Chemotherapy Protocols/administration & dosage , Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Bacteremia/etiology , Biofilms , Bleomycin/administration & dosage , Carmustine/administration & dosage , Catheter-Related Infections/epidemiology , Catheter-Related Infections/etiology , Cisplatin/administration & dosage , Cross Infection/epidemiology , Cross Infection/etiology , Cytarabine/administration & dosage , Dacarbazine/administration & dosage , Deoxycytidine/administration & dosage , Deoxycytidine/analogs & derivatives , Doxorubicin/administration & dosage , Drug Resistance, Multiple, Bacterial , Equipment Contamination , Etoposide/administration & dosage , Female , Gram-Negative Bacterial Infections/epidemiology , Gram-Negative Bacterial Infections/etiology , Hodgkin Disease/drug therapy , Humans , Immunocompromised Host , Melphalan/administration & dosage , Methylobacterium/drug effects , Methylobacterium/genetics , Methylobacterium/growth & development , Prednisone/administration & dosage , Ribotyping , Spain/epidemiology , Vinblastine/administration & dosage , GemcitabineABSTRACT
Introducción. La infección intraabdominal granulomatosa por hongos es una entidad de difícil diagnóstico y escasa incidencia. La histopatología usualmente muestra tejido inflamatorio con células gigantes multinucleadas y levaduras, hifas o conidios. Material y métodos. Presentamos el caso de una mujer de 51 años con antecedentes de adenocarcinoma endometrial y múltiples intervenciones quirúrgicas en la cavidad abdominal asociados con sepsis intraabdominal, la cual fue tratada con varias combinaciones de antimicrobianos y antifúngicos. Resultados. Durante la última intervención quirúrgica se detectan múltiples formaciones nodulares que se envían al Laboratorio de Patología y se informan como granulomas necrotizante. Las técnicas de PAS demostraron la presencia de formas fúngicas y el estudio microbiológico por PCR realizado en material embebido en parafina de la biopsia detectó Cladosporium cladosporioides. Conclusiones. La infección intraabdominal formando granulomas por C. cladosporioides no ha sido previamente publicada. Se discute el diagnóstico diferencial con otras causas de granulomatosis intraabdominal(AU)
Introduction. Intra-abdominal granulomatosis caused by fungal infection is infrequent and difficult to diagnose. The histopathology usually reveals a chronic inflammatory reaction with multinucleated giant cells, yeast, hyphae and/or conidia. Material and methods. We report a case of a 51-year-old woman with a previous history of endometrial adenocarcinoma and repeated abdominal surgery associated with intrabdominal infection, which was treated with various antibiotics and antifungals. Results. The most recent surgical intervention revealed multiple nodules which were seen on microscopy to have necrotizing granulomatous inflammation. Histochemistry with PAS confirmed a fungal infection and the microbiological study with PCR in formalin-fixed paraffin-embedded tissue identified the pathogen as Cladosporium cladosporioides. Conclusions. To our knowledge, this is the first report of intraabdominal infection due to C. cladosporioides with granuloma formation. The differential diagnosis with other intraabdominal granulomatous is discussed(AU)
