RESUMO
Pulmonary aspergillosis occurring in captive penguins living in zoos and aquariums is a fatal disease owing to its high mortality rate. On conducting computed tomography, two gentoo penguins (Pygoscelis papua) with respiratory clinical signs that were housed at an aquarium in Hokkaido, Japan were found to have a certain amount of fluid in their air sacs. This fluid was collected and cultured for bacteria and fungi, the results of which both came back negative. These results enabled us to rule out bacterial infection or aspergillosis and supported our decision not to administer antibacterial and antifungal drugs. Overall, the combination of computed tomography and air sac fluid examination was useful for ruling out bacterial infection or aspergillosis in penguins with respiratory clinical signs.
Assuntos
Aspergilose , Infecções Bacterianas , Spheniscidae , Animais , Sacos Aéreos , Aspergilose/diagnóstico por imagem , Aspergilose/veterinária , Tomografia Computadorizada por Raios X/veterinária , Infecções Bacterianas/veterináriaRESUMO
The global incidence of invasive fungal infections (IFIs) has increased over the past few decades, mainly in immunocompromised patients, and is associated with high mortality and morbidity. Aspergillus fumigatus is one of the most common and deadliest IFI pathogens. Major hurdles to treating fungal infections remain the lack of rapid and definitive diagnosis, including the frequent need for invasive procedures to provide microbiological confirmation, and the lack of specificity of structural imaging methods. To develop an Aspergillus-specific positron emission tomography (PET) imaging agent, we focused on fungal-specific sugar metabolism. We radiolabeled cellobiose, a disaccharide known to be metabolized by Aspergillus species, and synthesized 2-deoxy-2-[18F]fluorocellobiose ([18F]FCB) by enzymatic conversion of 2-deoxy-2-[18F]fluoroglucose ([18F]FDG) with a radiochemical yield of 60 to 70%, a radiochemical purity of >98%, and 1.5 hours of synthesis time. Two hours after [18F]FCB injection in A. fumigatus pneumonia as well as A. fumigatus, bacterial, and sterile inflammation myositis mouse models, retained radioactivity was only seen in foci with live A. fumigatus infection. In vitro testing confirmed production of ß-glucosidase enzyme by A. fumigatus and not by bacteria, resulting in hydrolysis of [18F]FCB into glucose and [18F]FDG, the latter being retained by the live fungus. The parent molecule was otherwise promptly excreted through the kidneys, resulting in low background radioactivity and high target-to-nontarget ratios at A. fumigatus infectious sites. We conclude that [18F]FCB is a promising and clinically translatable Aspergillus-specific PET tracer.
Assuntos
Aspergillus fumigatus , Celobiose , Tomografia por Emissão de Pósitrons , Animais , Tomografia por Emissão de Pósitrons/métodos , Celobiose/metabolismo , Aspergillus fumigatus/metabolismo , Camundongos , Aspergilose/diagnóstico por imagem , Fluordesoxiglucose F18/química , Aspergillus/metabolismo , Distribuição Tecidual , Compostos Radiofarmacêuticos/química , Compostos Radiofarmacêuticos/metabolismoRESUMO
The pathogenic fungus Aspergillus fumigatus utilizes a cyclic ferrioxamine E (FOXE) siderophore to acquire iron from the host. Biomimetic FOXE analogues were labeled with gallium-68 for molecular imaging with PET. [68Ga]Ga(III)-FOXE analogues were internalized in A. fumigatus cells via Sit1. Uptake of [68Ga]Ga(III)-FOX 2-5, the most structurally alike analogue to FOXE, was high by both A. fumigatus and bacterial Staphylococcus aureus. However, altering the ring size provoked species-specific uptake between these two microbes: ring size shortening by one methylene unit (FOX 2-4) increased uptake by A. fumigatus compared to that by S. aureus, whereas lengthening the ring (FOX 2-6 and 3-5) had the opposite effect. These results were consistent both in vitro and in vivo, including PET imaging in infection models. Overall, this study provided valuable structural insights into the specificity of siderophore uptake and, for the first time, opened up ways for selective targeting and imaging of microbial pathogens by siderophore derivatization.
Assuntos
Aspergilose , Aspergillus fumigatus , Radioisótopos de Gálio , Tomografia por Emissão de Pósitrons , Sideróforos , Staphylococcus aureus , Aspergillus fumigatus/metabolismo , Aspergillus fumigatus/química , Tomografia por Emissão de Pósitrons/métodos , Sideróforos/química , Sideróforos/metabolismo , Animais , Staphylococcus aureus/metabolismo , Aspergilose/diagnóstico por imagem , Aspergilose/microbiologia , Radioisótopos de Gálio/química , Especificidade da Espécie , Camundongos , Compostos Férricos/química , Materiais Biomiméticos/química , Materiais Biomiméticos/metabolismo , Desferroxamina/química , Peptídeos CíclicosRESUMO
ABSTRACT: We report a case of recurrent nasopharyngeal carcinoma postnasopharyngectomy, presenting with headaches. MRI revealed abnormal signals of the clivus with enhancement, and FDG PET/CT indicated intense uptake in the nasopharynx, clivus, and left neck lymph nodes. Bone SPECT/CT showed bony erosion and uptake in bilateral skull base areas. Biopsy confirmed aspergillosis. Despite the challenges in distinguishing tumor invasion from Aspergillus infection on MRI, bone SPECT/CT, and FDG PET/CT, the short postsurgery period and extensive uptake suggested skull base osteomyelitis.
Assuntos
Aspergilose , Carcinoma Nasofaríngeo , Neoplasias Nasofaríngeas , Base do Crânio , Humanos , Carcinoma Nasofaríngeo/diagnóstico por imagem , Carcinoma Nasofaríngeo/patologia , Neoplasias Nasofaríngeas/diagnóstico por imagem , Diagnóstico Diferencial , Base do Crânio/diagnóstico por imagem , Base do Crânio/patologia , Aspergilose/diagnóstico por imagem , Masculino , Recidiva Local de Neoplasia/diagnóstico por imagem , Tomografia por Emissão de Pósitrons combinada à Tomografia Computadorizada , Pessoa de Meia-Idade , Carcinoma/diagnóstico por imagem , Imageamento por Ressonância Magnética , RecidivaAssuntos
Aspergilose , Infecções por Herpesviridae , Influenza Humana , Leucemia Mieloide Aguda , Humanos , Influenza Humana/complicações , Influenza Humana/tratamento farmacológico , Aspergilose/complicações , Aspergilose/diagnóstico por imagem , Aspergilose/tratamento farmacológico , Leucemia Mieloide Aguda/complicações , Leucemia Mieloide Aguda/tratamento farmacológico , Infecções por Herpesviridae/tratamento farmacológico , Antifúngicos/uso terapêuticoRESUMO
Introduction: Aspergillosis is the second most frequent opportunistic fungal infection of the pa-ranasal sinuses. It primarily affects the maxillary sinus and occurs mainly in immunocompromi-sed individuals. Infection is caused by inhalation of spores or by an oro-sinusal communication. Aspergillosis is classified into an invasive and non-invasive form or Aspergilloma, which usually affects immunocompetent patients. Violaceous lesions, ulcers, necrosis and tissue destruction can be manifested clinically. Patients may experience pain, paresthesias, increases in the vo-lume of purulent or bloody nasal discharge and congestion. Case report: A 62-year-old female patient, immunocompetent, with a condition evolving for about six years. Condition began after a dental extraction, and consisted of absence of scarring and recurrent episodes of symptoma-tology suggestive of maxillary sinusitis with poor response to antibiotics. The patient was referred to the maxillofacial care unit, presenting an increase of volume in the right genial region, pain and paraesthesia of infraorbital region. The CT scan showed the presence of a radiopaque foreign body in the right maxillary sinus. A surgical procedure was carried out using the Caldwe-ll-Luc technique and biopsy; the case was diagnosed with Aspergillosis. The patient was treated without antifungal therapy because she had a good immune status. Conclusion: Aspergilloma is the most common form of Aspergillosis in immunocompetent individuals. It is usually diagnosed late, as its clinical picture is similar to bacterial sinusitis. In most cases, patients respond well to surgical treatment, and systemic antifungal therapy is not necessary.
Assuntos
Humanos , Feminino , Pessoa de Meia-Idade , Aspergilose/cirurgia , Aspergilose/diagnóstico por imagem , Tomografia Computadorizada por Raios X/métodos , Sinusite Maxilar/cirurgia , Hospedeiro ImunocomprometidoRESUMO
Background: Aspergillus osteomyelitis of the ribs is relatively uncommon. It is a debilitating and severe form of invasive aspergillosis. Case report: A 61year-old female presented with spontaneous chest pain on the right side of the rib cage and a palpable soft-tissue mass. FDG-PET/CT scan identified activity in the infected site. The lesion was punctured, and purulent material was sent to the laboratory. Aspergillus complex Flavi was isolated. An antifungal treatment with voriconazole was started. The lesion healed, and no recurrence was observed at 8-month follow-up. Molecular identification of the isolate was based on PCR amplification and sequencing of β-tubulin gene. Aspergillus flavus was identified. Conclusions: Our case highlights the relevance of microbiological studies in patients with osteomyelitis and the involvement of soft tissue. The FDG-PET/CT scan was found to be a useful tool for revealing the extent of the disease and evaluating the response to the antifungal therapy
Antecedentes: La osteomielitis en la parrilla costal por Aspergillus es una forma debilitante, grave y poco frecuente de aspergilosis invasora. Caso clínico: Mujer de 61 años que presentaba dolor en la parrilla costal derecha y una masa palpable en partes blandas. La FDG-PET/CT identificó actividad en el sitio infectado. Se obtuvo por punción material purulento y se envió al laboratorio. El aislamiento se identificó por cultivo como Aspergillus perteneciente al complejo Flavi. Se indicó tratamiento antifúngico con voriconazol durante 8 meses y la lesión curó sin recurrencia. Mediante la amplificación del gen de la ß-tubulina por PCR y su posterior secuenciación se identificó el aislamiento como Aspergillus flavus. Conclusiones: Destacamos la importancia del estudio microbiológico en pacientes con osteomielitis y con compromiso en los tejidos blandos. El estudio con FDG PET/CT es útil para revelar la extensión de la enfermedad y evaluar la respuesta a la terapia antimicótica
Assuntos
Humanos , Feminino , Pessoa de Meia-Idade , Aspergilose/complicações , Aspergillus flavus/isolamento & purificação , Osteomielite/microbiologia , Caixa Torácica/microbiologia , Antifúngicos/uso terapêutico , Aspergilose/diagnóstico por imagem , Aspergilose/tratamento farmacológico , Aspergillus flavus/genética , Osteomielite/diagnóstico por imagem , Osteomielite/tratamento farmacológico , Tomografia por Emissão de Pósitrons combinada à Tomografia Computadorizada , Tomografia Computadorizada por Raios X , Voriconazol/uso terapêuticoRESUMO
Aspergillus is a common cause of invasive mycosis, especially in immunocompromised individuals. We report the case of a 62-year-old male who was hospitalized after suffering severe physical injuries and died after few weeks of hospitalization. A medicolegal autopsy was conducted, and various organs were sent for histopathological examination of which heart, lungs, and kidneys showed extensive involvement by aspergillus. Thus, a diagnosis of disseminated invasive aspergillosis was made on autopsy, which itself is a rare entity. This case report illustrates a prolonged stay in the intensive care unit as a possible risk factor for the development of disseminated aspergillosis.
Assuntos
Humanos , Masculino , Pessoa de Meia-Idade , Aspergilose/patologia , Traumatismo Múltiplo , Aspergilose/diagnóstico por imagem , Autopsia , Causas de Morte , Unidades de Terapia Intensiva , Respiração ArtificialRESUMO
No disponible
Assuntos
Humanos , Feminino , Adulto , Mucocele/diagnóstico por imagem , Mucocele/microbiologia , Seio Esfenoidal/diagnóstico por imagem , Seio Esfenoidal/microbiologia , Aspergilose/diagnóstico por imagem , Doenças Raras , Imageamento por Ressonância Magnética , Angiografia por Tomografia ComputadorizadaRESUMO
No disponible
Assuntos
Humanos , Feminino , Idoso , Aspergilose/diagnóstico por imagem , Encefalopatias/microbiologia , Enteropatias/microbiologia , Evolução Fatal , Enteroscopia de Balão , Tomografia Computadorizada por Raios X , Encefalopatias/diagnóstico por imagem , Enteropatias/diagnóstico por imagem , Aspergilose Pulmonar/diagnóstico por imagemRESUMO
No disponible
Assuntos
Humanos , Feminino , Idoso , Aspergilose/diagnóstico por imagem , Nocardiose/complicações , Nocardiose/diagnóstico por imagem , Coinfecção/complicações , Coinfecção/diagnóstico por imagem , Esclerodermia Localizada/complicações , Lavagem Broncoalveolar , Nocardia/isolamento & purificação , Pulmão/diagnóstico por imagem , Pulmão/patologiaRESUMO
No disponible
Assuntos
Humanos , Masculino , Pessoa de Meia-Idade , Aspergilose/diagnóstico por imagem , Aspergilose/tratamento farmacológico , Voriconazol/uso terapêutico , Biópsia , Dermatopatias Vesiculobolhosas/diagnóstico , Antifúngicos/uso terapêutico , Aspergillus/citologia , Aspergillus/isolamento & purificaçãoRESUMO
Aspergillosis of the paranasal sinuses appears to be relatively rare in occurrence, but there is a growing incidence of it in accordance with the increasing use of antibiotics, steroid hormones, anticancer drugs, and radiation therapy. We have seen 15 cases of aspergillosis of the paranasal sinuses in which computed tomography (CT) was helpful for diagnosis. The characteristic feature of CT findings was the intermixture of high and low density areas in the affected paranasal sinuses, apparently caused by increased X-ray absorption due to calcification. These findings indicate that CT is useful in the preoperative diagnosis of aspergillosis of the paranasal sinuses.
Assuntos
Adulto , Feminino , Humanos , Masculino , Aspergilose/diagnóstico por imagem , Pessoa de Meia-Idade , Doenças dos Seios Paranasais/diagnóstico por imagem , Seios Paranasais/diagnóstico por imagem , Estudos Retrospectivos , Tomografia Computadorizada por Raios XRESUMO
Aspergillosis of the paranasal sinuses appears to be relatively rare in occurrence, but there is a growing incidence of it in accordance with the increasing use of antibiotics, steroid hormones, anticancer drugs, and radiation therapy. We have seen 15 cases of aspergillosis of the paranasal sinuses in which computed tomography (CT) was helpful for diagnosis. The characteristic feature of CT findings was the intermixture of high and low density areas in the affected paranasal sinuses, apparently caused by increased X-ray absorption due to calcification. These findings indicate that CT is useful in the preoperative diagnosis of aspergillosis of the paranasal sinuses.