Fungal infection in single and bilateral lung transplantation: report of 17 cases in 42 consecutive recipients

We reviewed the frequency and type of fungal infections in patients undergoing lung transplantation at Pavilhäo Pereira Filho Hospital between may 1989 and january 1995. Among the 42 lung transplant recipients studies, 17 ( 40 por cento ) had histologic diagnosis of fungal infection: aspergillosis 8 casos, candidosis 6 cases, and aspergillosis combined with candidosis 3 cases. Among all fungal infections, 47 por cento ( 8 of 17 cases ) occurred in the first month after transplantation, and 82 por cento occurred within the first six months after the transplant. The diagnosis was done during life in candidosis in 77 por cento of patients by transbronchial biopsy. However, aspergillosis was revealed in autopsy material in 82 por cento of cases. Most of the patients with candidosis had a local infection in the transplanted lung. On the contrary, in aspergillosis patients 88 por cento had the mycosis in the native lung

Pulmonary Aspergillus niger intracavitary colonization. Report of 23 cases and a review of the literature.

In this study we have compared clinical data obtained from 40 reported cases of pulmonary Aspergillus niger intracavitary colonization in the literature and those of our series 23 cases. Additionaly six of our cases have been summarized. Our findings revealed a similar occurrence of male sex, active tuberculosis, diabetes mellitus, systemic oxalosis, and lethal outcome in both groups. In conclusion, A. niger is not the most frequent causative agent of saprophytic aspergillosis neither is the most pathogenic species of Aspergillus. Despite that, when pulmonary A. niger intracavitary colonization is associated with diabetes the prognosis is generaly poor, probably due to acute oxalosis.

Pulmonary Aspergillus intracavitary colonization (PAIC).

We have attempted to elucidate the natural history of pulmonary aspergillus intracavitary colonization (PAIC) based on more than 350 cases of the disease observed in the last 11 years and on data collected from the literature. The data indicate that PAIC is a dynamic process consequent to the continual growth and death of fungal elements and also with their relationships to the anatomic features of the cavity (valvular mechanisms, vascular alteration). The clinical presentations reflect immunological changes in the host. Metabolites produced by the species of Aspergillus involved affect the clinical presentation of the syndrome.

[Pituitary adenomas: immunohistochemical study of 167 cases]. / Adenomas da hipófise: estudo imuno-histoquímico de 167 casos.

One hundred and sixty seven cases of pituitary adenoma were analysed using the immunocytochemical method of the Avidin-Biotin Complex (ABC), described by Hsu et al. (1981). Six pituitary anti-hormones were utilized: anti-prolactin (aPRL) at a 1:1,500 dilution; anti-growth hormone (aHGH) at a 1:4,000 dilution: anti-adrenocorticotrophic hormone (aACTH) at a 1:3,000 dilution; anti-thyrothrophic hormone (aTSH) at a 1:3,000 dilution; anti-luteinizing hormone (aLH) at a 1:1,000 dilution; and a anti-follicle-stimulating hormone (aFSH) at a 1:300 dilution. Incubation period was 14 to 16 hours at 4 degrees C. The survey of clinical, laboratory and radiological data of cases of pituitary adenomas was performed after reading the stained slides using the immunocytochemical method. Of the 167 cases of pituitary adenomas, 136 (81.4%) disclosed a positive immunoreaction to one or more anti-hormones, and the positivity index of neoplastic cells varied from 1 to 90%. The immunoreaction was positive exclusively to one anti-hormone in 80 cases (58.8%) and to two or more anti-hormones in 56 cases, and the association most frequently found was between both aPRL and aHGH. The positivity to the immunoreaction was distributed as follows: -100 cases were positive for aPRL, exclusively in 4 cases; -65 cases were positive for aHGH, exclusively in 22 cases; -31 cases were positive for aACTH, exclusively in 8 cases; -5 cases were positive for aTSH, exclusively in one case; -one patient presented an adenoma positive to aLH and another patient to aFSH.

Adenomas da hipófise: estudo imuno-histoquímico de 167 casos / Pituitary adenomas: immunohistochemical study of 167 cases

Foram analisados 167 casos de adenomas da hipófise pelo método imuno-histoquímico utilizando o Complexo da Avidina Biotina (ABC) descrito por HSU e col. (1981). Foram usados 6 anti-hormônios hipofisários: anti-prolactina (aPRL), na diluiçäo de 1:1.500, anti-hormônio do crescimento (aHGH), na diluiçäo de 1:4.000, anti-hormônio adrenocorticotrófico (aACTH), na diluiçäo de 1:3.000, anti-hormônio tireotrófico (aTSH), na diluiçäo de trófico (aACTH), na diluiçäo de 1:3.000, anti-hormônio tireotrófico (aTSH), na diluiçäo de 1:3.000, anti-hormônio luteinizante (aLH), na diluiçäo de 1:1.000, anti-hormônio folículo estimulante (a(FSH), na diluiçäo de 1;3.000. O período de incubaçäo foi de 14 a 16 horas a 4-C. Foi realizada também a coloraçäo pelo Orange G-PAS. O levantamento dos dados clínicos, laboratoriais, e radiológicos dos casos de adenomas de hipófise foi realizado após leitura das lâminas pelo método imuno-histoquímico. Dos 167 casos de adenomas da hipófise, 136 (81,4%) mostraram imuno-reaçäo positiva a um ou mais anti-hormônios, variando o índice de positividade entre 1 e 90% das células neoplásicas. A imuno-reaçäo foi positiva exclusivamente a um anti-hormônio em 80 casos (58,8%) e para dois ou mais anti-hormônios nos 56 casos restantes (41,2%), sendo a associaçäo mais freqüentemente encontrada aquela em que a positividade ocorreu para o aPRL e o aHGH. A positividade a reaçäo imuno-histoquímica distribuiu-se da seguinte forma: 100 casos foram positivos para o aPRL, em 49 pacientes de forma isolada; 65 casos foram positivos para o aHGH, em 22 pacientes de forma isolada; 31 casos foram positivos para o aACTH, em 8 pacientes de forma isolada; 5 casos foram positivos ao aTSH, em um paciente de forma isolada; um paciente apresentou adenoma positivo ao aLH; um caso foi positivo ao aFSH

Adiaspiromycosis treated successfully with ketoconazole.

We describe a case of adiaspiromycosis in a 37-year-old male Caucasian. This is the first reported case with diffuse involvement of both lungs in a severely ill patient treated successfully with antifungal chemotherapy.

Invasive aspergillosis in an alpaca (Lama pacos).

An invasive form of aspergillosis in an alpaca (Lama pacos) is described, with dissemination causing small abscesses and multifocal areas of necrosis in the lung, heart, spleen and kidneys. Histological sections showed hyphae morphologically compatible with an Aspergillus species. Direct immunofluorescent testing confirmed the diagnosis of aspergillosis.

Multiple paracoccidioidomas simulating Wegener's granulomatosis.

Five cases of paracoccidioidomas are reviewed. One case with multiple coin-lesions simulating Wegener's granulomatosis is described.

Oxalosis associated with an aspergillus niger fungus ball. Report of a case.

During a seventeen day period an A. niger fungus ball evolved within a healed tuberculous cavity of a patient. Symptoms were a cough with a chocolate brown expectoration and dyspnea. The patient died and necropsy was performed. Crystals of calcium oxalate were deposited in the cavity lining and in the adjacent tissue of the lung. Fibrosis, mononuclear infiltration and intraalveolar purulent exudate were seen in these tissues. Some small vessels presented recent thrombosis and deposition of calcium oxalate. The bronchus connected with the cavity presented a disrupted epithelial layer, edema, polymorphonuclear infiltration and birefringent crystals. Scattered areas of tubular atrophy, glomerular sclerosis and lymphoid infiltration were seen in the cortex of the kidney. Oxalate crystals were also seen within the renal tubuli.

Acute pulmonary paracoccidioidomycosis in an immunosuppressed patient.

A case of an acute pulmonary paracoccidioidomycosis following the use of immunosuppressive therapy in a solid cancer patient is reported.

The primary pulmonary lymph node complex in paracoccidioidomycosis

A case of primary pulmonary lymph node complex in paracoccidioidomycosis is reported.