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At least 73 records · Page 4Linked to original sources
PubMed1999

Paracoccidioidomycosis.

Paracoccidioidomycosis is a systemic infection caused by the dimorphic fungus Paracoccidioides brasiliensis. It is commonly an endemic disease in Latin America, but several cases have been reported outside this area, particularly now in this time of world globalization. Primary pulmonary infection occurs commonly in the first and second decades of life and usually has a benign, self-limited respiratory infection course. The adult chronic manifestation of the disease is usually the result of reactivation of quiescent lesions with diffuse lung infiltrates, predominately of the interstitial pattern, with or without involvement of various other organs. The finding of this disease in a patient is an important step for the large differential diagnosis of the interstitial lung diseases group.

Adolescent↗
PubMedDate not supplied

Obstructive bronchial aspergillosis after heart transplantation.

Obstructive bronchial aspergillosis is a rarely observed consequence of Aspergillus infection. It occurs not only in patients with the acquired immunodeficiency syndrome (AIDS), but also after heart transplantation (HTx) if T cells are reduced markedly by the application of antithymocyte globulin (ATG) in addition to immunosuppression with corticosteroids. In contrast to invasive aspergillosis or Aspergillus tracheobronchitis, the course of this form of Aspergillus infection may not be accompanied by symptoms, because bronchial inflammation with pseudomembranes, ulcers or destruction of mucosa and intrapulmonary infiltrates are absent. To prevent invasive aspergillosis following HTx, intensive antifungal therapy is necessary in cases of bronchial obstructive aspergillosis, because this form of Aspergillus infection seems to represent a stage before recognizable invasive disease, as in other immunocompromised patients.

Aspergillosis↗
PubMed2000

Myelodysplastic syndrome with clonal eosinophilia accompanied by eosinophilic pulmonary interstitial infiltration.

We report a case of de novo myelodysplastic syndrome with clonal eosinophilia (MDS-Eo) and eosinophilic pulmonary interstitial infiltration, confirmed by autopsy. Cytogenetic study using Giemsa banding identified 47,XY,+1,der(1;7)(q10;p10),+8 in the marrow cells. Simple Giemsa staining revealed the same chromosomal aberration in metaphase spreads with eosinophilic granules, indicating the clonal proliferation of eosinophils. To our knowledge, our case is the 6th reported case of MDS-Eo with cytogenetically confirmed clonal eosinophilia, and the first autopsy of MDS-Eo. A review of the literature combined with our findings suggests that this type of chromosomal aberration might be involved in the as yet unknown pathogenesis of MDS-Eo.

Aged↗
PubMed1975

A computer-assisted instruction course in the diagnosis and treatment of respiratory diseases.

A computer-assisted simulation of the 'chart method' of teaching has been developed and was used to provide instruction in clinical decision-making in the diagonosis and treatment of pulmonary diseases. The course requires a student to reach and to defend a diagonisis and to provide appropriate treatment for each of 10 simulated cases. Evaluation of performance and immediate feedback and correction of errors of commission and ommission are an integral part of the course. The course provides a model for development of additional programs in other subject areas.

Curriculum↗
PubMedDate not supplied

Critical care perspective on immunotherapy in lung transplantation.

Lung transplantation is now a viable therapeutic option in the care of patients with advanced pulmonary parenchymal or pulmonary vascular disease. Lung transplantation, however, with chronic posttransplant immunosuppression, creates a uniquely vulnerable population of patients likely to experience significant life-threatening complications requiring intensive care. The introduction of several novel immunosuppressive agents, such as sirolimus and mycophenolate mofetil, in conjunction with more established agents such as cyclosporine and tacrolimus, has greatly increased treatment options for lung transplant recipients and likely contributed to improved short-term transplant outcomes. Modern transplant immunosuppression, however, is associated with a host of complications such as opportunistic infections, renal failure, and thrombotic thrombocytopenic purpura. The main focus of this review is to provide a comprehensive summary of modern immunotherapy in lung transplantation and to increase awareness of the serious and potentially life-threatening complications of these medications.

Animals↗
PubMed1995

Invasive aspergillosis: a life-threatening complication of short-term steroid treatment.

OBJECTIVE: To describe a patient with invasive pulmonary aspergillosis related to short-term steroid treatment. CASE SUMMARY: A 78-year-old man with chronic obstructive pulmonary disease (COPD) developed an invasive pulmonary aspergillosis after short-term (less than 1 week) intravenous steroid therapy. The diagnosis was established by recovering Aspergillus fumigatus from a bronchoalveolar lavage and was confirmed by autopsy, with the additional finding of an aspergilloma. DISCUSSION: This case is of interest for 3 reasons: (1) it illustrates that invasive aspergillosis may be followed by a rapidly progressive respiratory failure, even in the absence of a fever; (2) this patient had simultaneously an aspergilloma and an invasive aspergillosis; and (3) it confirms reports indicating that short-term steroid therapy for COPD represents a significant risk factor for opportunistic lung infections. CONCLUSIONS: In patients with COPD who receive even short-term steroid therapy and who have progressive respiratory failure caused by pneumonia, invasive aspergillosis should be suspected early and acted upon accordingly.

Aged↗
PubMed1992

Invasive Aspergillus niger with fatal pulmonary oxalosis in chronic obstructive pulmonary disease.

The ubiquitous Aspergillus fungus has numerous manifestations when associated with lung disease (primary Aspergillus pneumonia, aspergilloma, allergic bronchopulmonary aspergillosis, and invasive Aspergillus). This fungus also can colonize preexisting lung disease in an indolent manner and then acutely assume a more invasive nature. Although the species Aspergillus niger is infrequently encountered, the endobronchial visualization of black necrotic debris or a fungus ball or the finding of black acidic sputum or pleural fluid suggests the presence of A niger and the destructive by-product of its fermentation, oxalic acid.

Aspergillosis↗
PubMed1995

Desquamative interstitial pneumonitis and diffuse alveolar damage in textile workers. Potential role of mycotoxins.

Five of 88 workers at a textile plant developed interstitial lung disease. Biopsy specimens from the three initial cases demonstrated desquamative interstitial pneumonitis and diffuse alveolar damage. Two of these patients developed hypoxemic respiratory failure despite high-dose corticosteroid therapy. A survey of the remaining textile workers (questionnaires, chest radiographs, and pulmonary function tests) revealed one new case. This patient, and one other with a compatible presentation, improved clinically upon leaving the workplace and did not require therapy. A comprehensive assessment of the work environment was performed in search of potentially toxic respirable agents. We propose that these cases represent desquamative interstitial pneumonitis-like reactions, occupationally related to aflatoxin inhalation.

Adult↗