Assuntos
Hematologia , Piomiosite , DNA Ribossômico , Humanos , Reação em Cadeia da Polimerase , Estudos ProspectivosRESUMO
Enterocytozoon bieneusi microsporidiosis is an emerging disease in immunocompromised patients. We report 2 cases of this disease in allogeneic hematopoietic stem cell transplant patients successfully treated with fumagillin. Thrombocytopenia occurred but without major adverse events. Modifications of immunosuppression could be avoided when E. bieneusi is rapidly identified and fumagillin therapy is started promptly.
Assuntos
Antifúngicos/administração & dosagem , Cicloexanos/administração & dosagem , Enterocytozoon/efeitos dos fármacos , Ácidos Graxos Insaturados/administração & dosagem , Transplante de Células-Tronco Hematopoéticas , Leucemia Mieloide/imunologia , Microsporidiose/tratamento farmacológico , Adulto , Antifúngicos/efeitos adversos , Cicloexanos/efeitos adversos , Enterocytozoon/patogenicidade , Enterocytozoon/fisiologia , Ácidos Graxos Insaturados/efeitos adversos , Feminino , Humanos , Imunossupressores/uso terapêutico , Leucemia Mieloide/patologia , Leucemia Mieloide/terapia , Masculino , Microsporidiose/diagnóstico , Microsporidiose/microbiologia , Pessoa de Meia-Idade , Ácido Micofenólico/uso terapêutico , Contagem de Plaquetas , Prednisona/uso terapêutico , Sesquiterpenos/administração & dosagem , Sesquiterpenos/efeitos adversos , Trombocitopenia/induzido quimicamente , Resultado do TratamentoRESUMO
We report two cases of endocarditis due to Moraxella osloensis. Only one previous case of such infection has been described. These infections occurred in immunocompromised patients (B-cell chronic lymphocytic leukaemia and kidney graft associated with Hodgkin's disease) and both patients had a favourable outcome with a complete cure of their infectious endocarditis. This bacterium could be an emerging pathogen revealed by MALDI-TOF. Indeed, its characterisation within the Moraxella group by use of biochemistry-based methods is difficult. Moreover, this strain could be particularly involved in immunocompromised patients.
Assuntos
Endocardite Bacteriana/microbiologia , Hospedeiro Imunocomprometido , Moraxella , Infecções por Moraxellaceae/microbiologia , Idoso , Endocardite Bacteriana/imunologia , Humanos , Masculino , Pessoa de Meia-Idade , Infecções por Moraxellaceae/imunologiaRESUMO
A 72-year-old man consulted in November 2012 for abdominal pain in the right upper quadrant. The patient had a history of suspected hepatic amebiasis treated in Senegal in 1985 and has not traveled to endemic areas since 1990. Abdominal CT scan revealed a liver abscess. At first, no parasitological tests were performed and the patient was treated with broad-spectrum antibiotics. Only after failure of this therapy, serology and PCR performed after liver abscess puncture established the diagnosis of hepatic amebiasis. The patient was treated with metronidazole and tiliquinol-tilbroquinol. Amebic liver abscess is the most frequent extra-intestinal manifestation. Hepatic amebiasis 22 years after the last visit to an endemic area is exceptional and raises questions on the mechanisms of latency and recurrence of these intestinal protozoan parasites.
