• 제목/요약/키워드: Immunocompromised Patient

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Lophomonas blattarum-like organism in bronchoalveolar lavage from a pneumonia patient: current diagnostic scheme and polymerase chain reaction can lead to false-positive results

  • Moses Lee;Sang Mee Hwang;Jong Sun Park;Jae Hyeon Park;Jeong Su Park
    • Parasites, Hosts and Diseases
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    • 제61권2호
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    • pp.202-209
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    • 2023
  • Lophomonas blattarum is an anaerobic protozoan living in the intestine of cockroaches and house dust mites, with ultramicroscopic characteristics such as the presence of a parabasal body, axial filament, and absence of mitochondria. More than 200 cases of Lophomonas infection of the respiratory tract have been reported worldwide. However, the current diagnosis of such infection depends only on light microscopic morphological findings from respiratory secretions. In this study, we attempted to provide more robust evidence of protozoal infection in an immunocompromised patient with atypical pneumonia, positive for Lophomonas-like protozoal cell forms. A direct search of bronchoalveolar lavage fluid via polymerase chain reaction (PCR), transmission electron microscopy (TEM), and metagenomic next-generation sequencing did not prove the presence of protozoal infection. PCR results were not validated with sufficient rigor, while de novo assembly and taxonomic classification results did not confirm the presence of an unidentified pathogen. The TEM results implied that such protozoal forms in light microscopy are actually non-detached ciliated epithelial cells. After ruling out infectious causes, the patient's final diagnosis was drug-induced pneumonitis. These findings underscore the lack of validation in the previously utilized diagnostic methods, and more evidence in the presence of L. blattarum is required to further prove its pathogenicity.

면역 기능이 정상인 소아에서의 대상포진 수막염 2례 (Two cases of varicella zoster meningitis in immunocompetent children)

  • 강지희;진용만;노의정;강소영;유지숙;정은희
    • Pediatric Infection and Vaccine
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    • 제14권2호
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    • pp.188-193
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    • 2007
  • 대상포진 수막염은 대상포진 후 발생할 수 있는 신경학적 합병증으로 주로 면역 기능이 저하된 상태의 환자에게서 발생한다. 저자들은 면역 기능이 정상인 환아에서 피부 병변 없이, 수두 백신 접종을 한 경우 드물게 발생하는 대상포진 수막염 2례를 경험하였기에 보고하는 바이다.

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익수 후 발생한 흡인성 폐렴에서 유발된 파종성 Scedosporium apiospermum 감염 1예 (Disseminated Scedosporium apiospermum Infection Induced from Aspiration Pneumonia after Near-Drowning)

  • 원호연;김형래;김동환;오재원;기정혜;한창훈;이선민;김정주
    • Tuberculosis and Respiratory Diseases
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    • 제69권4호
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    • pp.298-302
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    • 2010
  • Scedosporium apiospermum, the anamorph of Pseudallescheria boydii, is a ubiquitous saprophytic fungus. S. apiospermum can cause life-threatening infections usually in immunocompromised patients or after near-drowning incidents. Here, we report the first case of disseminated infection caused by S. apiospermum after near-drowning in Korea. A 44-year-old healthy man developed aspiration pneumonia, followed by multiple brain abscesses, and endopthalmitis, after a near-drowning incident in a septic tank. S. apiospermum infection was diagnosed on the 33rd day after the incident had occurred. The patient died from the progressive renal failure 255 days after incident, although he had been treated with voriconazole.

전이성 폐암으로 추정된 폐효모균증 (Pulmonary Cryptococcosis That Was Suspected to be Metastatic Lung Cancer)

  • 김종인;조성래;계여곤
    • Journal of Chest Surgery
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    • 제42권1호
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    • pp.123-126
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    • 2009
  • 효모균증은 비둘기의 배설물에 의해 오염된 먼지나 토양에 주로 존재하는 cryptococcus neoformans에 의한 아급성 또는 만성 감염이다. 폐의 효모균증은 건강한 사람에게는 잘 발생하지 않으며 면역이 저하된 환자 특히 후천성 면역결핍증 환자에게서 호발 한다. 일반적으로 증상이 없이 단순 흉부 X-선 검사에서 고립성 또는 다발성 폐 결절이 관찰되며, 이런 경우에는 대부분 절제된 조직의 병리학적 소견으로 진단된다. 본 증례는 갑상선 암으로 수술 받은 32세 여자환자에서 추적관찰 중에 발견된 좌하엽폐의 종괴가 전이성 폐암으로 추정되어 좌하엽폐 절제술을 시행한 후 폐 효모균증으로 확인되었다.

Impact of Upper Limb Joint Fluid Variation on Inflammatory Diseases Diagnosis

  • Hari, Krishnan G.;Ananda, Natarajan R.;Nanda, Anima
    • Journal of Electrical Engineering and Technology
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    • 제9권6호
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    • pp.2114-2117
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    • 2014
  • Joint pain is generally a common disorder not only for the old aged people but also for the immunocompromised patients. The present proposed study reveals the presence of inflammatory diseases in joint generally diagnosed by removing synovial fluid and changes in the volume and composition are examined for the presence of WBC and crystals. This study implement a non-invasive approach to identify the changes in joint fluid by measuring the changes in electrical property of the synovial tissue under the influence of electrical current signal with frequency range between 100 kHz to 300 kHz. The response of tissue for the current signal was measured in terms of potential drop across the tissue. The hardware system design consists of input and output sections. The input section which applies current signal to upper limb joint region is made of ICL8038 function generator IC with amplifier and voltage to current converter. The output section picks voltage variation using metal surface electrode, amplifier, ADC, PIC microcontroller and LCD interface. 100 patient inclusive of normal and disease affected patients where examined for upper limb synovial fluid variation and inflammatory diseases were identified.

Cryptococcal Brainstem Abscess Mimicking Brain Tumors in an Immunocompetent Patient

  • Hur, Jong Hee;Kim, Jang-Hee;Park, Seoung Woo;Cho, Kyung Gi
    • Journal of Korean Neurosurgical Society
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    • 제57권1호
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    • pp.50-53
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    • 2015
  • Usually fungal infections caused by opportunistic and pathogenic fungi had been an important cause of morbidity and mortality among immunocompromised patients. However clinical data and investigations for immunocompetent pathogenic fungal infections had been rare and neglected into clinical studies. Especially Cryptococcal brainstem abscess cases mimicking brain tumors were also much more rare. So we report this unusual case. This 47-year-old man presented with a history of progressively worsening headache and nausea for 1 month and several days of vomituritions before admission. Neurological and laboratory examinations performed demonstrated no abnormal findings. Previously he was healthy and did not have any significant medical illnesses. A CT and MRI scan revealed enhancing $1.8{\times}1.7{\times}2.0$ cm mass lesion in the left pons having central necrosis and peripheral edema compressing the fourth ventricle. And also positron emission tomogram scan demonstrated a hot uptake of fluoro-deoxy-glucose on the brainstem lesion without any evidences of systemic metastasis. Gross total mass resection was achieved with lateral suboccipital approach with neuronavigation system. Postoperatively he recovered without any neurological deficits. Pathologic report confirmed Cryptococcus neoformans and he was successively treated with antifungal medications. This is a previously unreported rare case of brainstem Cryptococcal abscess mimicking brain tumors in immunocompetent host without having any apparent typical meningeal symptoms and signs with resultant good neurosurgical recovery.

Occlusion of the Internal Carotid Artery due to Intracranial Fungal Infection

  • Kim, Joo-Pyung;Park, Bong-Jin;Lee, Mi-Suk;Lim, Young-Jin
    • Journal of Korean Neurosurgical Society
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    • 제49권3호
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    • pp.186-189
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    • 2011
  • In recent years the immunocompromised population has increased rapidly to include people with acquired immune deficiency syndrome (AIDS), drug abusers, and transplant patients. Accordingly, the incidence of intracranial fungal infection has increased. Our institution experienced 2 cases of internal carotid artery (ICA) occlusion due to invasion of the cavernous sinus by an intracranial fungal infection. The first case was a 60-year-old man who presented with headache, eye pain, conjunctival injection, right-sided diplopia, and blurred vision. Infected tissues within the frontal and ethmoid sinuses were removed via bifrontal craniotomy and endoscopic sinus surgery through the Caldwell Luc approach. The second case was a 63-year-old woman who developed right-sided facial pain after a tooth extraction. The infection was not controlled despite continuous use of antifungal agents, resulting in death from sepsis. We believe that when intracranial fungal infection is suspected in a patient with orbital symptoms and a focal neurologic deficit, immediate angiographic investigation of possible ICA occlusion is warranted. Aggressive treatment with antifungal agents is the only way to improve prognosis.

Aspergillus 기관-기관지염 1예 (A Case of Aspergillus Tracheobronchitis in Non-Immunocompromised Patient)

  • 정효영;김휘종;김수희;이종덕;황영실
    • Tuberculosis and Respiratory Diseases
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    • 제49권4호
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    • pp.508-513
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    • 2000
  • Aspergillus에 의한 기관-기관지염은 침습성 폐 국 균증의 한 분류로써 드문 질환이다. 저자들은 aspergillus에 의한 기관-기관지염증 aspergillus 기관-기관지염을 경험하고 성공적으로 치료하였기에 문헌고찰과 함께 보고하는 바이다.

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Gastric cancer and adenomatous colorectal polyp concomitant with pyogenic liver abscess and bacteremia

  • Kang, Min Kyu;Kwon, Hee Jung;Kim, Min Cheol
    • Journal of Yeungnam Medical Science
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    • 제37권3호
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    • pp.246-249
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    • 2020
  • Synchronous gastric cancer and adenomatous colorectal polyp in patients with Klebsiella pneumoniae-induced pyogenic liver abscess (KP-PLA) and bacteremia is a rare presentation. A 58-year-old man with a 6-month history of diabetes mellitus (DM) presented with febrile sensation and dull abdominal pain in the right upper quadrant of the abdomen. Subsequent to laboratory test results and abdominal computed tomography findings, KP-PLA with bacteremia was diagnosed. After intravenous antibiotic administration, his symptoms improved, and upper endoscopy and colonoscopy were performed to evaluate the cause of KP-PLA. Biopsy specimens of the prepyloric anterior wall revealed a moderately differentiated adenocarcinoma. Endoscopic mucosal resection of the colon revealed high-grade dysplasia. Early gastric cancer (EGC) and adenomatous colorectal polyps with high-grade dysplasia concomitant with KP-PLA and bacteremia were diagnosed in our patient who had DM. Intravenous antibiotic treatment for KP-PLA, subtotal gastrectomy for EGC, and colonoscopic mucosal resection for the colon polyp were performed. After 25 days of hospitalization, subtotal gastrectomy with adjacent lymph node dissection was performed. Follow-up ultrasound imaging showed resolution of the abscess 5 weeks post-antibiotic treatment, as well as no tumor metastasis. Upper gastrointestinal endoscopy and colonoscopy should be performed to evaluate gastric cancer in patients with PLA or bacteremia, accompanied with DM or an immunocompromised condition.

정상 면역을 지닌 환자에서 발견 된 고립된 뇌 아스페르질루스증: 증례 보고 (Isolated Aspergillosis of the Brain in an Immunocompetent Patient: A Case Report)

  • 임지혜;정태섭;김현기;안정용;서상현
    • Investigative Magnetic Resonance Imaging
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    • 제14권1호
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    • pp.64-68
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    • 2010
  • 뇌에 발생하는 아스페르질루스증은 최근 들어 급증하고 있다. 이 질병은 흔히 면역이 저하된 환자들에서 호발하며, 다른 원발 장기로부터 중추 신경계로의 혈행성 전파 또는 인접 구조물로부터의 직접 침입이 주요 발생 기전으로 알려져 있다. 본 증례는 특이 과거력 없는 29세 남환에서 발견된 고립된 뇌 병변에 대한 보고이며, 정위적 뇌 조직검사에 의한 병리 결과상 아스페르질루스균이 확인 되었다.