Coxsackievirus B1 peritonitis in a patient treated with continuous ambulatory peritoneal dialysis: a case report and brief review of the literature.

We report a case of viral peritonitis caused by coxsackievirus B1 in a 79-year-old male undergoing continuous ambulatory peritoneal dialysis (CAPD), and review the English language literature. Clinicians should be aware of viral peritonitis in patients on CAPD presenting with a viral syndrome and mononuclear peritoneal dialysis effluent. Currently, viral diagnostic tests are available to confirm the diagnosis and avoid unnecessary treatment with antibiotics.

Acute kidney injury after use of oral Fleet Phospho Soda as bowel preparation for colonoscopy.

We present a case of a 64-year old woman who developed acute kidney injury (AKI) finally resulting in stage 4 chronic kidney disease after ingestion of a high phosphate containing solution (oral Fleet Phospho Soda) as bowel cleansing for colonoscopy.

Isolated zygomycosis in a bought living unrelated kidney transplant.

We report the first case of zygomycosis by Absidia corymbifera, only localized in an unrelated living donor kidney was bought and transplanted in India. Zygomycosis was diagnosed 2.5 months post-transplantation, in the clinical setting of rapid transplant failure, following an episode of cytomegalovirus (CMV) colitis, CMV nephritis, and acute rejection. Treatment consisted of transplantectomy. One year later, the patient is doing well, without clinical or serological evidence of persistent mycotic or virological infections. We speculate that this isolated mycotic infection originated with the donor or was due to the poor hygienic conditions in the operating theater or surgical ward. Another possibility is that this isolated renal involvement resulted from a subclinical pulmonary infection with hematogenous dissemination to the kidney in a manner comparable to renal tuberculosis. The patient received no amphotericin and was cured with transplantectomy alone.

Corticosteroid-induced myopathy involving respiratory muscles in patients with chronic obstructive pulmonary disease or asthma.

We made observations on two patients with asthma and one with COPD who developed steroid-induced myopathy during prolonged treatment with high doses of corticosteroids. On admission, quadriceps force was on the average reduced to 31% of predicted (range 16 to 46% of predicted, nondominant leg), and urinary excretion of creatine in 24 h averaged 687 mg (range 275 to 1,045 mg/24 hr). Respiratory muscle involvement was evidenced by reductions in PImax and PEmax, being 38% (range 36 to 39) and 48% of predicted (range 36 to 68), respectively. Tapering of treatment with corticosteroids resulted in important recovery of quadriceps force and respiratory muscle force. In all three patients, a correlation between muscle forces and steroid dose was present during reduction of the dose. After 6 months quadriceps force averaged 62% of predicted (range 31 to 85), and PImax and PEmax reached 74% (range 52 to 92) and 92% of predicted (range 80 to 106), respectively, after 3 months. Consequently, respiratory muscle force appeared to recover faster than quadriceps force. The implications of these observations for patients treated with the usual doses of corticosteroids for shorter periods require further investigation.