RESUMO
We report a case of disseminated aspergillosis in a hitherto healthy 24-year-old woman during her 24th week of pregnancy. Relevant findings at autopsy revealed innumerable septate, dichotomously branched (45 degrees ) hyphae compatible with Aspergillus in lung and liver tissues. Cerebral histology showed cerebral vessels occluded by hyphae causing cerebral infarction. There was no evidence of invasive aspergillosis in the placenta and fetal tissues. Aspergillus sp. was confirmed by amplification of a specific 357-base-pair amplicon from a paraffin block containing lung tissue. This case illustrates a previously uncharacterized spectrum of disseminated aspergillosis, indicating the need for a heightened awareness that Aspergillus species are opportunistic agents for invasive and disseminated infection in pregnancy.
Assuntos
Aspergilose/complicações , Aspergillus/isolamento & purificação , Infecções Oportunistas/complicações , Complicações Infecciosas na Gravidez/microbiologia , Adulto , Aspergilose/microbiologia , Aspergilose/patologia , Aspergillus/efeitos dos fármacos , Aspergillus/genética , Feminino , Humanos , Pneumopatias Fúngicas/complicações , GravidezRESUMO
Fungal infection of the thyroid is rare. Most reported cases have involved Aspergillus, Coccidioides, and Candida species in the setting of disseminated disease. Infection of the thyroid with Histoplasma capsulatum is rarely reported as part of disseminated disease, even in geographic areas where histoplasmosis is endemic. We report a 52-year-old woman with a previous Hashimoto's disease and non-Hodgkin's lymphoma in which a diffuse enlarged thyroid gland with a large nodule was the only apparent locus of histoplasmosis. Fine-needle aspiration of the thyroid was an important diagnostic tool in establishing the diagnosis of histoplasmosis of the thyroid. The patient was initially treated with itraconazole (400 mg/day) for the fungal infection and six cycles of chemotherapy for the lymphoma. At a 6-month follow-up examination, the patient was doing well on suppressive therapy of itraconazole (200 mg/day), with no symptoms and with regression of the thyroid nodule and cervical adenopathy.
Assuntos
Histoplasmose/patologia , Doenças da Glândula Tireoide/patologia , Glândula Tireoide/microbiologia , Antifúngicos/uso terapêutico , Feminino , Histoplasmose/complicações , Histoplasmose/tratamento farmacológico , Humanos , Itraconazol/uso terapêutico , Linfoma não Hodgkin/complicações , Linfoma não Hodgkin/tratamento farmacológico , Linfoma não Hodgkin/patologia , Macrófagos/microbiologia , Macrófagos/patologia , Pessoa de Meia-Idade , Doenças da Glândula Tireoide/complicações , Doenças da Glândula Tireoide/microbiologia , Glândula Tireoide/patologia , Tireoidite Autoimune/complicações , Resultado do TratamentoRESUMO
We report a further case of peritonitis due to Trichosporon inkin in a patient undergoing continuous ambulatory peritoneal dialysis. Peritonitis caused by Trichosporon species is reviewed.
Assuntos
Micoses/diagnóstico , Diálise Peritoneal Ambulatorial Contínua/efeitos adversos , Peritonite/microbiologia , Trichosporon , Humanos , Masculino , Pessoa de Meia-IdadeAssuntos
Síndrome da Imunodeficiência Adquirida/complicações , Antifúngicos/uso terapêutico , Cryptococcus neoformans/efeitos dos fármacos , Cryptococcus neoformans/isolamento & purificação , Fluconazol/uso terapêutico , Meningite Criptocócica/tratamento farmacológico , Adulto , Resistência Microbiana a Medicamentos , Humanos , Masculino , Meningite Criptocócica/complicações , Testes de Sensibilidade MicrobianaRESUMO
This paper reports a case of chronic necrotizing pulmonary aspergillosis in a patient without underlying disease. Aspergilluria was the starting point in the search for the origin of the pulmonary disease, later confirmed by an open lung biopsy.
Assuntos
Aspergilose/diagnóstico , Pneumopatias Fúngicas/diagnóstico , Aspergilose/urina , Biópsia , Brasil , Doença Crônica , Humanos , Pulmão/cirurgia , Pneumopatias Fúngicas/urina , Masculino , Pessoa de Meia-Idade , Necrose , Urina/microbiologiaRESUMO
We report a case of mixed intranasal infection caused by Fusarium solani and a zygomycete, with probable sinus and brain involvement. The patient had chronic myelogenous leukaemia and was treated with chemotherapy. Diagnosis of the infection was established by direct examination of the intranasal eschar and histopathological study of an excisional biopsy. Only F. solani was isolated from both specimens. Difficulties in diagnosis and treatment of these infections are discussed.
