• Title/Summary/Keyword: Immunocompetent Host

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A Case of Isolated Pulmonary Mucormycosis in an Immunocompetent Host

  • Lee, Jung Su;Kim, Ho Cheol;Park, Sang Woo;So, Hoon Sub;Woo, Chang Yun;Choi, Jong Han;Kim, Sang Hyung;Kim, Se Jin;Oh, Yeon-Mok
    • Tuberculosis and Respiratory Diseases
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    • v.74 no.6
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    • pp.269-273
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    • 2013
  • Mucormycosis is a rare fungal disease that holds a fatal opportunistic fungal infection in diabetes mellitus, hematological malignancy, and immunocompromised host. Isolated pulmonary mucormycosis is extremely rare. Optimal therapy is a combined medical-surgical approach and a management of the patient's underlying disease. Herein, we report a case-study of isolated pulmonary mucormycosis which was being presented as multiple lung nodules in a patient with no underlying risk factors. Considering that the patient had poor pulmonary functions, we treated him with only antifungal agent rather than a combined medical-surgical approach. After treatment with antifungal agent for six months, the nodules of pulmonary mucormycosis were improved with the prominent reductions of size on the computed tomography.

A review of Gymnophalloides seoi (Digenea: Gymnophallidae) and human infections in the Republic of Korea

  • Lee, Soon-Hyung;Chai, Jong-Yil
    • Parasites, Hosts and Diseases
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    • v.39 no.2
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    • pp.85-118
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    • 2001
  • Studies on Gymnophalloides seoi (Digenea: Gymnophallidae) and human infections are briefly reviewed. This minute intestinal fluke was first discovered from a Korean woman suffering from acute pancreatitis and gastrointestinal troubles. It was described as a new species by Lee, Chai and Hong in 1993. The southwestern coastal village where the patient resided was found to be a highly endemic area, and additional endemic areas have been identified. The parasite is very small, 0.33-0.50 mm long and 0.23-0.33 mm wide. and characterized by the presence of a ventral pit. The first intermediate host remains unknown, but the second intermediate host has been found to be the oyster Crassostrea gigas. Man and the Palearctic oystercatcher Haematopus ostralegus have been shown to be natural definitive hosts , and wading birds including the Dentish plover Charadrius alexandrinus are highly susceptible to experimental infection. Gerbils, hamsters, cats, and several strains of mice were also susceptible laboratory hosts. In experimentally infected mice, the parasites inhabit the small intestine, pinching and sucking the root of villi with their large oral suckers, but they did not invade beyond the mucosa in immunocompetent mice. However, they were found to invade the submucosa in immunosuppressed mice. Human G. seoi infections have been found in at least 25 localities; 23 islands on the Yellow Sea or the South Sea, and 2 western coastal villages. The highest Prevalence was found in a village on Aphaedo. Shinan-fun (49% e99 Positive rate) : other areas showed 0.8-25.3% prevalence. Infected people complained of variable degrees of gastrointestinal troubles and indigestion. The infection can be diagnosed by recovery of eggs in the feces; however, an expert is needed to identify the eggs. Praziquantel, 10mg/kg in single dose, is effective for treatment of human infections. Eating raw oysters in endemic areas should be avoided.

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Localized Pulmonary Cryptococcosis Diagnosed by Fine Needle Aspiration Cytology - Report of a Case - (세침흡인도말로 진단된 국한성 폐장효모균증)

  • Park, Chan-Kum;Lyu, Geun-Shin;Kim, Wan-Sup;Jeon, Seok-Chol;Lee, Jung-Dal
    • The Korean Journal of Cytopathology
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    • v.8 no.1
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    • pp.103-107
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    • 1997
  • Initial rapid diagnosis of primary pulmonary cryptococcosis(PPC) occurring in a immunocompetent host was made by transthoracic fine needle aspiration cytology of a solitary subpleural nodule. Numerous refractile spherical organisms surrounded by a clear halo were demonstrated with haematoxylin-eosin and Papanicolaou stains. The organisms, $5{\sim}15{\mu}m$ in diameter, were easily demonstrated with Gomori methenamine-silver stain. Many of the organisms showed narrow-base budding. Carminophilic cell walls were well demonstrated with mucicarmine stain.

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Multidrug-Resistant Tuberculosis Presenting as Miliary Tuberculosis without Immune Suppression: A Case Diagnosed Rapidly with the Genotypic Line Probe Assay Method

  • Ko, Yousang;Lee, Ho Young;Lee, Young Seok;Song, Junwhi;Kim, Mi-Yeong;Lee, Hyun-Kyung;Shin, Jeong Hwan;Choi, Seok Jin;Lee, Young-Min
    • Tuberculosis and Respiratory Diseases
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    • v.76 no.5
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    • pp.245-248
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    • 2014
  • Miliary tuberculosis (TB) is a rare extrapulmonary form of TB, and there have been only two reports of miliary TB associated with infection with multidrug-resistant (MDR)-TB pathogen in an immunocompetent host. A 32-year-old woman was referred to our hospital because of abnormal findings on chest X-ray. The patient was diagnosed with MDR-TB by a line probe assay and was administered proper antituberculous drugs. After eight weeks, a solid-media drug sensitivity test revealed that the pathogen was resistant to ethambutol and streptomycin in addition to isoniazid and rifampicin. The patient was then treated with effective antituberculous drugs without delay after diagnosis of MDR-TB. To the best of our knowledge, this is the first case of miliary TB caused by MDR-TB pathogen in Korea.

Spontaneous Splenic Rupture as a Paradoxical Reaction during Treatment for Splenic Tuberculosis

  • Yeo, Hye Ju;Lee, Soo Yong;Ahn, Eunyoung;Kim, Eun Jung;Rhu, Dae Gon;Choi, Kyoung Un;Lee, Seung Eun;Cho, Woo Hyun;Jeon, Doosoo;Kim, Yun Seong
    • Tuberculosis and Respiratory Diseases
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    • v.75 no.5
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    • pp.218-221
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    • 2013
  • This report describes a rare case of a patient with splenic tuberculosis (TB) who developed spontaneous splenic rupture after 10 weeks of antituberculous chemotherapy. The patient responded well to the antituberculous regimen prior to the spontaneous splenic rupture. We considered a paradoxical reaction as a cause of the splenic rupture. The patient underwent splenectomy and continuously received initial antituberculous drugs without change. To the best of our knowledge, this is the first report of spontaneous splenic rupture as a paradoxical reaction to antituberculous chemotherapy in an immunocompetent host with splenic TB.

Inhibition of Graft Versus Host Disease Using CD4+CD25+ T Cells Induced with Interleukin-2 in Mismatched Allogeneic Murine Hematopoietic Stem Cell Transplantation (주조직적합항원이 불일치하는 마우스 동종 조혈모세포이식에서 IL-2로 유도된 CD4+CD25+ T세포를 이용한 이식편대숙주병의 억제)

  • Hyun, Jae Ho;Jeong, Dae Chul;Chung, Nak Gyun;Park, Soo Jeong;Min, Woo Sung;Kim, Tai Gyu;Choi, Byung Ock;Kim, Won Il;Han, Chi Wha;Kim, Hack Ki
    • IMMUNE NETWORK
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    • v.3 no.4
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    • pp.287-294
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    • 2003
  • Background: In kidney transplantation, donor specific transfusion may induce tolerance as a result of some immune regulatory cells against the graft. In organ transplantation, the immune state arises from a relationship between the immunocompromised graft and the immunocompetent host. However, a reverse immunological situation exists between the graft and the host in hematopoietic stem cell transplantation (HSCT). In addition, early IL-2 injections after an allogeneic murine HSCT have been shown to prevent lethal graft versus host disease (GVHD) due to CD4+ cells. We investigated the induction of the regulatory CD4+CD25+ cells after a transfusion of irradiated recipient cells with IL-2 into a donor. Methods: The splenocytes (SP) were obtained from 6 week-old BALB/c mice ($H-2^d$) and irradiated as a single cell suspension. The donor mice (C3H/He, $H-2^k$) received $5{\times}10^6$ irradiated SP, and 5,000 IU IL-2 injected intraperitoneally on the day prior to HSCT. The CD4+CD25+ cell populations in SP treated C3H/He were analyzed. In order to determine the in vivo effect of CD4+CD25+ cells, the lethally irradiated BALB/c were transplanted with $1{\times}10^7$ donor BM and $5{\times}10^6$ CD4+CD25+ cells. The other recipient mice received either $1{\times}10^7$ donor BM with $5{\times}10^6$ CD4+ CD25- cells or the untreated SP. The survival and GVHD was assessed daily by a clinical scoring system. Results: In the MLR assay, BALB/c SP was used as a stimulator with C3H/He SP, as a responder, with or without treatment. The inhibition of proliferation was $30.0{\pm}13%$ compared to the control. In addition, the MLR with either the CD4+CD25+ or CD4+CD25- cells, which were isolated by MidiMacs, from the C3H/He SP treated with the recipient SP and IL-2 was evaluated. The donor SP treated with the recipient cells and IL-2 contained more CD4+CD25+ cells ($5.4{\pm}1.5%$) than the untreated mice SP ($1.4{\pm}0.3%$)(P<0.01). There was a profound inhibition in the CD4+CD25+ cells ($61.1{\pm}6.1%$), but a marked proliferation in the CD4+CD25- cells ($129.8{\pm}65.2%$). Mice in the CD4+CD25+ group showed low GVHD scores and a slow progression from the post-HSCT day 4 to day 9, but those in the control and CD4+CD25- groups had a high score and rapid progression (P<0.001). The probability of survival was 83.3% in the CD4+CD25+ group until post-HSC day 35 and all mice in the control and CD4+CD25- groups died on post-HSCT day 8 or 9 (P=0.0105). Conclusion: Donor graft engineering with irradiated recipient SP and IL-2 (recipient specific transfusion) can induce abundant regulatory CD4+CD25+ cells to prevent GVHD.