Adult ; Aspergillosis ; pathology ; Female ; Humans ; Laryngeal Diseases ; microbiology ; Male ; Middle Aged ; Vocal Cords ; microbiology

We report a case of Aspergillus terreus discitis which developed in a patient with acute lymphoblastic leukemia following induction chemotherapy. A. terreus was isolated from sputum, one month earlier, but the physician did not consider it significant at the time. Magnetic resonance imaging study showed the involvement of L3-4, L4-5 and L5-S1 intervertebral discs. Etiology was established by means of histology and culturing a surgical specimen of disc materials. Our patient survived after a surgical debridement and amphotericin B administration with a total dose of 2.0 g. Discitis caused by Aspergillus terreus is a very rare event. A. terreus is one of the invasive Aspergillus species. The pathogenetic mechanism is discussed and the literature is reviewed.
Aspergillosis/surgery ; Aspergillosis/pathology ; Aspergillosis/microbiology* ; Aspergillosis/drug therapy ; Aspergillosis/complications ; Aspergillus/isolation & purification ; Aspergillus/classification ; Journal Article ; Discitis/surgery ; Discitis/pathology ; Discitis/microbiology* ; Discitis/drug therapy ; Human ; Intervertebral Disk/surgery ; Intervertebral Disk/pathology ; Intervertebral Disk/microbiology* ; Leukemia, Lymphocytic, Acute/microbiology ; Leukemia, Lymphocytic, Acute/drug therapy ; Leukemia, Lymphocytic, Acute/complications* ; Lumbar Vertebrae/surgery ; Lumbar Vertebrae/pathology ; Lumbar Vertebrae/microbiology*

Pacemaker lead infection is a rare but a dangerous complication. Diagnosis can usually be established by the clinical picture and blood cultures. Transesophageal two dimensional echocardiography might be crucial in the diagnosis by visualizing pacing lead vegetations. Medical treatment alone is rarely successful, and several studies have suggested the infected pacemaker systems should be removed quickly for optimal management. We describe a case of Aspergillus infection in a permanent ventricular pacing lead, which appears to be the first reported case in Korea. A 30-yr-old man was evaluated for the symptoms and signs of congestive heart failure 3 yr after DDD pacemaker implantation. The transthoracic and transesophageal echocardiogram showed a large movable round shaggy mass attached to a ventricular lead in the right atrium. The atrial and ventricular leads were removed during cardiopulmonary bypass, and a new epicardial pacing system was implanted. The functional ventricular pacemaker lead was encased in a large organized thrombus. Histological findings were consistent with Aspergillus infection in a large thrombus attached to a pacemaker lead.
Adult ; Aspergillosis/diagnosis/*etiology/microbiology ; Echocardiography ; Echocardiography, Transesophageal ; Heart Atria/microbiology ; Humans ; Male ; Pacemaker, Artificial/*adverse effects/microbiology ; Thrombosis/diagnosis/*etiology/microbiology

OBJECTIVETo evaluate immunologic mechanisms underlying Aspergillus fumigatus pulmonary infections in immunocompetent Dark Agouti (DA) and Albino Oxford (AO) rats recognized as being susceptible to some inflammatory diseases in different manners.

METHODSLung fungal burden (quantitative colony forming units, CFU, assay), leukocyte infiltration (histology, cell composition) and their function (phagocytosis, oxidative activity, CD11b adhesion molecule expression) and cytokine interferon-γ (IFN-γ) and interleukin-17 and -4 (IL-17 and IL-4) lung content were evaluated following infection (intratracheally, 1x10(7) conidia).

RESULTSSlower reduction of fungal burden was observed in AO rats in comparison with that in DA rats, which was coincided with less intense histologically evident lung cell infiltration and leukocyte recovery as well as lower level of most of the their activities including intracellular myeloperoxidase activity, the capacity of nitroblue tetrazolium salt reduction and CD11b adhesion molecule expression (except for phagocytosis of conidia) in these rats. Differential patterns of changes in proinflammatory cytokine levels (unchanged levels of IFN-γ and transient increase of IL-17 in AO rats vs continuous increase of both cytokines in DA rats) and unchanged levels of IL-4 were observed.

CONCLUSIONGenetically-based differences in the pattern of antifungal lung leukocyte activities and cytokine milieu, associated with differential efficiency of fungal elimination might be useful in the future use of rat models in studies of pulmonary aspergillosis.

Animals ; Aspergillus fumigatus ; immunology ; Cytokines ; metabolism ; Lung ; immunology ; metabolism ; microbiology ; pathology ; Male ; Pulmonary Aspergillosis ; immunology ; Rats

Airway Obstruction ; diagnosis ; etiology ; Aspergillosis ; complications ; diagnosis ; Humans ; Laryngeal Diseases ; complications ; diagnosis ; microbiology ; Larynx

Child ; Guidelines as Topic ; Humans ; Invasive Pulmonary Aspergillosis ; diagnosis ; therapy ; Lung Diseases, Fungal ; diagnosis ; microbiology ; therapy

Aspergillosis ; complications ; Aspergillus ; Chemical and Drug Induced Liver Injury ; complications ; microbiology ; Humans

OBJECTIVETo investigate the mechanism of fungi invasion into the mucosal tissue, and to analyse the clinical-pathological relationship.

METHODSThe clinical data of 16 patients with invasive mycosis in the nose and paranasal sinus proved by pathologic examination between Apr, 1984 and Aug, 2002 were reviewed retrospectively. There were 7 males and 9 females with an average age of 48.6 years. The pathologic morphology of fungi found in these patients was investigated. Fourteen of 16 tissue samples from the paranasal sinuses obtained by endoscopic operation were cultivated for the fungi. One sample of invasive mycosis was observed under electron-microscope.

RESULTSFourteen cases were found to have following underlying conditions, including diabetes (n = 4), malignant tumor (n = 5). The infected sites were as follows: 7 cases presenting in unilateral maxillary sinus, 6 cases involving over two nasal sinuses, 8 cases invading the orbit. Of all 16 patients, 15 were positive (93.7%) for the culture. The positive rate of aspergillus was 62.5% and mucoraceae was 25.0%. The overall mortality rate was 50.0% after investigation from 6 months to 5 years. From 16 surgical specimens, hypha were proved in all cases for histopathologic methods. All of the 16 granulomatous and crumbley materials from the paranasal sinuses were found that inflammatory responses were predominantly neutrophilic leucocytes invasion (100%), suppurative granuloma formed in 15 cases (93.7%). Invasive diseases were characterized by prominent infarcts (27.8%), angio-invasion (100%), and surprisingly, prominent optic nervous invasion (16.7%) in biopsies.

CONCLUSIONSThe incidence of invasive mycosis is correlated with patients who suffered from diabetes, malignant tumor and other basic diseases causing depression of immunological function. The pathologic study shows that the fungi which invade the tissue are mostly aspergillus or mucoraceae, and the fungal vasculitis is the direct reason for tissue damage.

Adult ; Aged ; Aspergillosis ; pathology ; Aspergillus ; Female ; Humans ; Male ; Middle Aged ; Paranasal Sinuses ; microbiology ; pathology ; Retrospective Studies

Adult ; Aspergillosis ; pathology ; surgery ; Female ; Humans ; Laryngeal Diseases ; microbiology ; pathology ; surgery ; Middle Aged ; Vocal Cords ; pathology

The patient presented with dry cough, lending, fever and progressive dyspnea for two weeks. The patient had a prior respiratory infection history and the symptoms were not obvious, Early X-ray showed lung infection. Under the fibrolaryngoscope, the lingual surfaces of the epiglottis, epiglottic vallecula, and bilateral vocal cords were covered by yellow pseudomembrane. The motion of vocal cords was normal with poor glottic closure, and no ulcer was noted. Endotracheal mucosa was swelling and congested with an uneven surface, and purulent discharge and pseudomembrane was formed. Pathological examination revealed Aspergillus. The disease was diagnosed as Aspergillus laryngotracheobronchitis.
Adult ; Aspergillosis ; diagnosis ; physiopathology ; Aspergillus ; Bronchitis ; diagnosis ; microbiology ; physiopathology ; Humans ; Male