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1.
Medicine (Baltimore) ; 99(9): e19391, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-32118790

RESUMO

RATIONALE: The emphysematous prostatic abscess is a rare but potentially life-threatening clinical condition. The early diagnosis is difficult due to nonspecific symptoms. PATIENT CONCERNS: A 72-year-old man with poorly controlled diabetes mellitus was admitted to hospital because of dysuria and acute urine retention. He had a refractory fever after admission. DIAGNOSES: The diagnosis of emphysematous prostatic abscess was confirmed by culture of catheterized urine and pelvic CT. INTERVENTIONS: We tried to give antimicrobial treatment and control of blood glucose at first, but the infection could not be controlled by antibiotic therapy and control of blood glucose. TRUS-guided aspiration was performed, but obviously not adequate for abscess drainage and the abscess progressed. TUR was then performed and the infection was gradually controlled. OUTCOMES: Pelvic CT scan 1 month after discharge showed complete resolution of the EPA. LESSONS: Given the poor conservative treatment effect of emphysematous prostatic abscesses, CT or TRUS should be performed in the patients with suspected diagnosis. Early and appropriate drainage with proper antibiotic therapy is important to achieve a favorable outcome.


Assuntos
Abscesso/etiologia , Candidíase/complicações , Próstata/anormalidades , Abscesso/cirurgia , Idoso , Antibacterianos/uso terapêutico , Candida tropicalis/efeitos dos fármacos , Candida tropicalis/patogenicidade , Candidíase/tratamento farmacológico , Disuria/etiologia , Humanos , Masculino , Próstata/fisiopatologia , Tomografia Computadorizada por Raios X/métodos , Retenção Urinária/etiologia
2.
Ghana Med J ; 53(2): 184-186, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31481816

RESUMO

Oesophageal intramural pseudodiverticulosis is an uncommon condition, characterized by multiple small rounded cavities seen in the oesophageal wall during oesophagogastroduodenoscopy. It is often associated with gastro-oesophageal reflux disease, achalasia, oesophageal candidiasis and diabetes mellitus. We report a 40 year old Nigerian man who presented with recurrent dysphagia and endoscopic findings typical of oesophageal intramural pseudodiverticulosis. The patient was managed medically with resolution of the dysphagia. This report highlights the occurrence of this rare and benign cause of dysphagia in Nigeria. Funding: None declared.


Assuntos
Candidíase/diagnóstico , Doenças do Esôfago/diagnóstico , Adulto , Antibacterianos/uso terapêutico , Antifúngicos/uso terapêutico , Candidíase/complicações , Candidíase/tratamento farmacológico , Transtornos de Deglutição/etiologia , Endoscopia do Sistema Digestório , Doenças do Esôfago/complicações , Doenças do Esôfago/tratamento farmacológico , Esofagite/complicações , Esofagite/diagnóstico , Esofagite/tratamento farmacológico , Fluconazol/uso terapêutico , Humanos , Masculino , Inibidores da Bomba de Prótons/uso terapêutico
5.
Mikrobiyol Bul ; 53(2): 192-203, 2019 Apr.
Artigo em Turco | MEDLINE | ID: mdl-31130123

RESUMO

Pathologic halitosis has been classified into 5 types: oral, airway, gastroesophageal, blood-borne and subjective, respectively. Type 1 (oral) halitosis mostly takes origin from anaerobic bacterial activities on oral surfaces. The role of anaerobic bacterial activities is clearly demonstrated, but despite the large number of anectodal claims, the role of Candida in patients with halitosis has not been adequately investigated. The aim of this study was to confirm the relationship between Candida and halitosis. A total of 136 subjects were enrolled and divided into two groups. The study group comprised of 69 patients with halitosis who had over 0.7 ppm H2S concentration in their oral cavity and the control group comprised of 67 healthly subjects. Self assesment scores for halitosis, Candida colony counts in saliva samples, oral NH3, SO2, H2S, H2 and volatile organic gas concentrations were recorded. H2S producing capacity of subjects was quantified by applying cysteine challenge test. Candida samples were taken from the mouths of the patients with and without halitosis, and Candida albicans isolates were inoculated into broth medium. After 3 days of incubation at 37oC, gas concentrations of the headspace of the flasks were read by a portable multigas detector. The rate of Candida positivity was 44.9% in the study group while it was 46.3% in the control group. There was no statistical significant difference between the groups according to the Candida growth (p= 0.561). The oral gas concentrations were comparable in both groups (p< 0.05). Oral H2S concentration increased 9.65 fold with 20 mM cysteine rinse in patients with halitosis while it was increased 5.8 fold in controls. Self assesment for halitosis were well correlated with clinical signs (p= 0.001, r= 0.8). Concentrations of hidrogen and organic gases were found to be increased in all Candida culture media. In this study, no relationship between the presence of Candida and oral halitosis was detected. As a result, there is no need for diets similar to Candida diet in the treatment of halitosis. On the other hand, cysteine challenge can be a useful diagnostic tool. In addition, portable gas detectors can be used as a convenient and practical halitometer to quantify halitosis.


Assuntos
Candida , Candidíase , Halitose , Candida/fisiologia , Candidíase/complicações , Candidíase/microbiologia , Halitose/complicações , Halitose/microbiologia , Humanos
6.
Medicine (Baltimore) ; 98(22): e15825, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-31145321

RESUMO

RATIONALE: Spontaneous gastric perforation in young children is rare, and gastric perforation caused by Candida albicans infection is even rarer. PATIENT CONCERNS: A 4-month-old infant presented with frequent retching. The results of X-rays showed obvious pneumoperitoneum but gastric vacuole was not seen. DIAGNOSIS: The infant was diagnosed as spontaneous gastric perforation caused by C albicans infection based on blood culture, peritoneal fluid culture, and postoperative histopathology. INTERVENTIONS: An emergency exploratory laparotomy was performed and a gastric perforation repair was done. The infant received antishock, antiinfection, and intravenous nutrition treatment. OUTCOMES: After operation and antiinfective symptomatic treatment, the infant recovered. LESSONS: This case emphasized the rare C albicans infection as a cause of the gastric perforation in infant. The C albicans infection should always be thought of as an etiology for the gastric perforation in infant, to reduce the significant mortality. The early detection is necessary to treat Candida infections.


Assuntos
Candidíase/complicações , Gastropatias/etiologia , Gastropatias/cirurgia , Candida albicans , Humanos , Lactente , Masculino , Pneumoperitônio
7.
BMJ Case Rep ; 12(5)2019 May 22.
Artigo em Inglês | MEDLINE | ID: mdl-31122953

RESUMO

A 42-year-old woman with a background of psoriatic arthritis presented with a 7-day medical history of fevers of unknown source; she had recently undergone elective shoulder arthroscopy, and her medications included anti-interleukin 17A (anti-IL-17A) drug, secukinumab.She went on to develop sepsis-induced cardiomyopathy, requiring veno-arterial extracorporeal membrane oxygenation (ECMO), from which she was successfully weaned after 12 days. However, she then went on to develop a candidaemia, with new intra-abdominal collections found incidentally on CT; despite appropriate anti-fungal therapy and attempts at drainage, she passed away.Both anti-IL-17A treatment and ECMO have been shown to be significant independent risk factors for Candida infection. The use of monoclonal antibody therapy in the management of autoimmune disease, and the use of ECMO in the intensive care setting are each becoming increasingly widespread. Fungal infection should be screened for early in this critically unwell group of patients, and treatment initiated as indicated.


Assuntos
Anticorpos Monoclonais Humanizados/efeitos adversos , Artrite Psoriásica/tratamento farmacológico , Candidíase/diagnóstico , Cardiomiopatias/diagnóstico , Sepse/diagnóstico , Adulto , Candida glabrata/isolamento & purificação , Candidíase/complicações , Cardiomiopatias/complicações , Oxigenação por Membrana Extracorpórea , Evolução Fatal , Feminino , Humanos , Sepse/complicações
9.
Intern Med ; 58(17): 2529-2533, 2019 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-31118395

RESUMO

Severe acute pancreatitis (SAP) is a risk factor for candidemia. We report a case of candida endophthalmitis in a 67-year-old man who was admitted to a hospital due to SAP with poorly controlled diabetes. After treatment for SAP, he was diagnosed with candidemia and candida endophthalmitis. We chose appropriate antifungal agents based on the results of a bacterial culture test. After treatment, the disappearance of Candida albicans (C. albicans) from the blood stream was confirmed in blood cultures. In addition, exudative plaques consistent with a fungal infection disappeared. After a diagnosis of candidemia is made, it is important to administer appropriate antifungal therapy and perform frequent ophthalmologic examinations.


Assuntos
Candidemia/diagnóstico , Candidíase/complicações , Endoftalmite/microbiologia , Infecções Oculares Fúngicas/diagnóstico , Pancreatite/complicações , Doença Aguda , Idoso , Antifúngicos/uso terapêutico , Hemocultura , Candida albicans , Candidemia/tratamento farmacológico , Candidíase/diagnóstico , Candidíase/tratamento farmacológico , Quimioterapia Combinada , Endoftalmite/diagnóstico , Endoftalmite/tratamento farmacológico , Infecções Oculares Fúngicas/tratamento farmacológico , Humanos , Masculino , Fatores de Risco
10.
Transplant Proc ; 51(3): 993-997, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-30979493

RESUMO

Recipients of organ transplants are immunosuppressed and at high risk of oral infection. Oral diseases are often neglected compared with infections of other organs that typically confer higher morbidity. However, severe local symptoms hinder oral intake, decrease quality of life, and are sometimes lethal. Here we describe a case of a 57-year-old woman who developed recurrent aphthous stomatitis after kidney transplantation; the cause of the infection was complex and included cytomegalovirus, herpes simplex virus, and Candida species. Since misdiagnosis of oral diseases impairs patient quality of life and increases morbidity, clinicians should be aware of possible etiologies of oral infections in renal transplant recipients.


Assuntos
Candida , Citomegalovirus , Transplante de Rim/efeitos adversos , Simplexvirus , Estomatite Aftosa/etiologia , Transplantados , Candidíase/complicações , Candidíase/microbiologia , Infecções por Citomegalovirus/complicações , Infecções por Citomegalovirus/virologia , Feminino , Herpes Simples/complicações , Herpes Simples/virologia , Humanos , Pessoa de Meia-Idade , Estomatite Aftosa/diagnóstico
11.
Int Immunopharmacol ; 72: 275-283, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31005037

RESUMO

Candida albicans infection-induced acute lung injury is one of the most prevalent diseases in immunosuppressive individual. Nevertheless, the mechanism by which Candida albicans induced acute lung injury remains unclear. The present study investigated the mechanism by which Candida albicans induced acute lung injury in mice. Mice were randomly divided into four groups and intratracheally injected with 60 µl Candida albicans (106 CFU) or normal saline. Half of the mice were sacrificed at 6 h after Candida albicans. The rest of the mice for survival test were observed until 7 d after Candida albicans. As expected, immunosuppression aggravated Candida albicans-induced acute lung injury and death in mice. Additionally, Candida albicans infection elevated mRNA levels of pro-inflammatory and chemokines in lungs and the levels of IL-6, IL-1ß and IL-17 in serum. Further study showed that Candida albicans promoted nuclear translocation of NF-κB p50 and p65 subunits in pulmonary epithelial cells and interstitial cells. Candida albicans induced pulmonary p38, ERK1/2 and Akt phosphorylation in normal and immunosuppressive mice. Moreover, Candida albicans infection activated pulmonary STAT3 signaling in normal and immunosuppressive mice. Overall, these results suggest that Candida albicans induced acute lung injury and death may be through activating several inflammatory signaling pathways.


Assuntos
Lesão Pulmonar Aguda/imunologia , Candidíase/imunologia , Imunossupressão , Lesão Pulmonar Aguda/etiologia , Animais , Candida albicans , Candidíase/complicações , Ciclofosfamida , Citocinas/sangue , Dexametasona , Inflamação/imunologia , Pulmão/imunologia , Masculino , Camundongos Endogâmicos BALB C , Proteínas Quinases Ativadas por Mitógeno/imunologia , NF-kappa B/imunologia , Proteínas Proto-Oncogênicas c-akt/imunologia , Fator de Transcrição STAT3/imunologia , Transdução de Sinais
13.
Intensive Care Med ; 45(6): 834-843, 2019 06.
Artigo em Inglês | MEDLINE | ID: mdl-31020361

RESUMO

INTRODUCTION: Respiratory tract Candida spp. colonization is associated with more frequent bacterial ventilator-associated pneumonia (VAP). However, this colonization could be causally related to VAP or simply reflect the immune paralysis associated with multiple organ failure. OBJECTIVE: To prospectively evaluate the relationship between Candida spp. colonization and bacterial VAP in mechanically ventilated patients with multiple organ failure. INCLUSION: Patients receiving mechanical ventilation for > 4 days and presenting multiple organ failure were included. Tracheal colonization with Candida spp. was evaluated at inclusion (day 0, D0) and every 4 days until extubation. Quantitative proximal and tracheal cultures were performed at each VAP episode. Monocyte human leukocyte antigen-DR isotype (mHLA-DR) expression and the ratio of polymononuclear leukocytes to lymphocytes were used to evaluate immunoparalysis at D0 and D7. The relationship between fungal colonization and VAP was modelled using cause-specific models for repeated events with adjustment for time-dependent confounders and immune factors. RESULTS: A total of 213 patients, with a median age of 64, simplified acute physiology score II (SAPS II) score 55 and sequential organ failure assessment (SOFA) score 10, mainly admitted for medical reasons (n = 197, 92%), were enrolled in 2012-2015. The median ICU stay was 24 days and the mortality rate was 32% (69 cases). Median mHLA-DR was 5916 Ab-bound/cell [3863-8934]; median lymphocyte count, 0.9Giga/L [0.6-1.3]; neutrophil-to-lymphocyte ratio, 10.9 [6.5-19.7]. Overall, 146 cases (68.5%) had tracheal colonization with Candida spp. An episode of VAP occurred (either for the first or only time) in 62 (29.1%) cases 5.5 days (median) after D0; a second episode occurred in 12 (5.6%) cases, 15.5 days (median) after D0. After adjustment, bronchial colonization with Candida was not associated with VAP [adjusted cause-specific hazard ratio = 0.98 (0.59-1.65), p = 0.95]. CONCLUSION: In patients with mechanical ventilation for more than 4 days and multiple organ failure, bronchial colonization with Candida spp. was not associated with VAP, even after adjustment for immune function.


Assuntos
Candidíase/complicações , Pneumonia Associada à Ventilação Mecânica/etiologia , Adulto , Brônquios/efeitos dos fármacos , Brônquios/microbiologia , Candida/efeitos dos fármacos , Candida/patogenicidade , Candidíase/epidemiologia , Candidíase/fisiopatologia , Estudos de Coortes , Feminino , França/epidemiologia , Humanos , Unidades de Terapia Intensiva/organização & administração , Unidades de Terapia Intensiva/estatística & dados numéricos , Masculino , Pessoa de Meia-Idade , Escores de Disfunção Orgânica , Pneumonia Associada à Ventilação Mecânica/epidemiologia , Pneumonia Associada à Ventilação Mecânica/fisiopatologia , Estudos Prospectivos , Fatores de Risco , Escala Psicológica Aguda Simplificada
17.
Eur J Clin Microbiol Infect Dis ; 38(6): 1071-1077, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-30739228

RESUMO

Cystic fibrosis (CF) patients become colonized by pathogenic bacteria as well as by Candida species. The interplay between different microorganisms may play a key role in the prognosis of CF. The aim of the study was to analyze the coexistence patterns of bacteria and Candida spp. in sputum samples of patients with CF and to compare these patterns with the results of patients with other respiratory disorders (ORD). Sputum samples from 130 patients with CF and 186 patients with ORD were cultured on six different agar plates promoting the growth of bacteria and yeasts. Bacterial and Candida species were identified with MALDI-TOF MS. Pathogenic bacteria were found in 69.2% of the sputum samples of the CF patients, and in 44.1% the patients with ORD. CF patients tended to have growth of Pseudomonas aeruginosa and Staphylococcus aureus in sputum more often than patients with ORD. Overall, there was no difference in the coexistence of pathogenic bacteria and Candida spp. in these patient groups. However, when analyzed at the species level, P. aeruginosa and S. aureus coexisted with Candida spp. more frequently in sputum samples of CF patients compared with patients with ORD. Also, when analyzed according to age, it was shown that the adult (≥ 18 years) CF patients had a higher rate of coexistence of any pathogenic bacteria and Candida spp. than the children with CF and the adult patients with ORD. The rate for colonization with Candida together with pathogenic bacteria is increased in adult patients with CF.


Assuntos
Bactérias/crescimento & desenvolvimento , Candida/crescimento & desenvolvimento , Fibrose Cística/microbiologia , Adolescente , Adulto , Fatores Etários , Bactérias/classificação , Candida/classificação , Candidíase/complicações , Candidíase/microbiologia , Criança , Coinfecção , Fibrose Cística/complicações , Feminino , Humanos , Masculino , Infecções por Pseudomonas/complicações , Infecções por Pseudomonas/microbiologia , Pseudomonas aeruginosa/crescimento & desenvolvimento , Pseudomonas aeruginosa/patogenicidade , Doenças Respiratórias/complicações , Doenças Respiratórias/microbiologia , Escarro/microbiologia , Infecções Estafilocócicas/complicações , Infecções Estafilocócicas/microbiologia , Staphylococcus aureus/crescimento & desenvolvimento , Staphylococcus aureus/patogenicidade
18.
Anticancer Res ; 39(2): 979-985, 2019 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-30711984

RESUMO

BACKGROUND/AIM: The aim of this study was to determine the association between post-esophagectomy pneumonia and the presence of pathogenic organisms in the sputum or pharynx and postoperative systemic inflammatory response syndrome (SIRS). MATERIALS AND METHODS: This retrospective study included 98 patients diagnosed with esophageal cancer who had undergone esophagectomy. RESULTS: Postoperative pneumonia was observed in 24 patients (24.5%). Of the total 98 patients, 45 (45.9%) were tested positive for pathogenic organisms preoperatively, and 16 of those (35.6%) developed postoperative pneumonia; postoperative pneumonia occurred at a higher rate in these patients compared to pathogenic organism-negative patients (p=0.019). Postoperative SIRS was observed in 62 patients (63.3%), and 21 of these (33.9%) developed postoperative pneumonia, a significantly higher rate compared to patients without SIRS (p=0.007). CONCLUSION: Postoperative pneumonia was significantly associated with the presence of pathogenic organisms in the sputum or pharynx and postoperative SIRS.


Assuntos
Neoplasias Esofágicas/complicações , Neoplasias Esofágicas/cirurgia , Esofagectomia/efeitos adversos , Pneumonia/etiologia , Síndrome de Resposta Inflamatória Sistêmica/etiologia , Idoso , Candida , Candidíase/complicações , Cuidados Críticos , Feminino , Humanos , Contagem de Linfócitos , Masculino , Pessoa de Meia-Idade , Neutrófilos/citologia , Complicações Pós-Operatórias , Período Pós-Operatório , Estudos Retrospectivos
19.
Wiad Lek ; 72(1): 68-71, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30796865

RESUMO

OBJECTIVE: Introduction: One of the pressing issues of modern dermatology is the prevalence of diseases of skin and mucous membranes caused by yeast-like fungi. The aim: To study specific features of the course of skin and mucous membranes superficial candidosis against the background of initial carbohydrate metabolism disorders or diabetes mellitus. PATIENTS AND METHODS: Materials and methods: We have examined 93 patients aged 18-75 suffering from superficial candidosis. Candidosis was diagnosed based on anamnesis data, results of clinical tests and laboratory studies. The study of carbohydrate metabolism included determining of the glucose level under fasting conditions to establish possible diabetes mellitus and glucose tolerance test (75 g glucose load), glycosylated hemoglobin (HbA1c) and fructosamine (FR). RESULTS: Results: In patients with mild and moderate candidosis we have detected an increased rates of НbA1с and fructosamine, as compared with the like indicators received in the control group, by 1.54 and 1.21 times respectively. In patients with severe candidosis and relapses the concentrations of НbA1с increased by 2.59 times, FR - by 2.26 times against the indicators received in the control group. Thus, increased levels of blood glycosylated protein indicate the pathogenetic importance of these processes in the development of candidosis. CONCLUSION: Conclusions: Consequently, increased levels of blood glycosylated protein indicates the pathogenetic importance of these processes in the development of candidal lesions. Tests for НbA1с and FR proved to be sensitive and allow reliable detection of individuals with diabetes mellitus and glucose intolerance among candidosis patients.


Assuntos
Candidíase/complicações , Erros Inatos do Metabolismo dos Carboidratos/complicações , Diabetes Mellitus/microbiologia , Adolescente , Adulto , Idoso , Glicemia/análise , Erros Inatos do Metabolismo dos Carboidratos/microbiologia , Frutosamina/sangue , Teste de Tolerância a Glucose , Hemoglobina A Glicada/análise , Humanos , Pessoa de Meia-Idade , Adulto Jovem
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