ABSTRACT
BACKGROUND: Ochroconis gallopava is a neurotropic dematiaceous mold that causes respiratory and central nervous system (CNS) infection in domestic poultry and in immunocompromised patients. We recently treated 3 solid organ transplant (SOT) recipients for pulmonary Ochroconis infections with successful outcome, prompting us to review the literature on this unique pathogen. METHODS: We reviewed all published cases of O. gallopava infections in SOT recipients and analyzed the impact of CNS infection on the outcome. RESULTS: In addition to the 3 new cases reported here, 9 published cases of Ochroconis infection were analyzed. The disease involved the lungs only in 5/12 (42%) of patients, brain in 6/12 (50%) patients, and lung and skin in 1 patient. Survival was significantly reduced with brain infection (33% vs. 100%; P<0.03; Fisher's exact test). CONCLUSIONS: O. gallopava may infect SOT recipients with a particular tropism for the CNS. Early recognition of O. gallopava pulmonary infection is important, as the prognosis is excellent before dissemination to the brain.
Subject(s)
Ascomycota/isolation & purification , Brain Diseases/etiology , Central Nervous System Fungal Infections/etiology , Mycoses/etiology , Organ Transplantation/adverse effects , Pneumonia/etiology , Adolescent , Adult , Aged , Antifungal Agents/pharmacology , Ascomycota/drug effects , Brain Diseases/diagnostic imaging , Brain Diseases/epidemiology , Brain Diseases/microbiology , Central Nervous System Fungal Infections/diagnostic imaging , Central Nervous System Fungal Infections/epidemiology , Central Nervous System Fungal Infections/microbiology , China/epidemiology , Dermatomycoses/diagnosis , Dermatomycoses/epidemiology , Dermatomycoses/etiology , Dermatomycoses/microbiology , Female , Humans , Male , Microbial Sensitivity Tests , Middle Aged , Mycoses/diagnostic imaging , Mycoses/epidemiology , Mycoses/microbiology , Pneumonia/diagnostic imaging , Pneumonia/epidemiology , Pneumonia/microbiology , Radiography , United States/epidemiology , Young AdultABSTRACT
Qualitative and quantitative measurement of the carbon dioxide (CO2) concentration in respiratory gases is readily available with current technology. End-tidal CO2 (PetCO2) monitoring, whether by qualitative colorimetric methods or by solid-state spectrophotometric techniques, is becoming increasingly valuable in the Emergency Department (ED). These techniques offer a practical adjunct to the ED management of critical interventions including endotracheal intubation, conscious sedation, and cardiopulmonary resuscitation.
