amphotericin-b and Colonic-Diseases

Mucormycosis historically has caused substantial morbidity with high mortality in renal transplant patients with disseminated and/or rhinocerebral infection and in patients with gastrointestinal illness regardless of predisposing conditions. We report the first successful treatment of gastric mucormycosis in a renal transplant recipient and review presumed pathogenic mechanisms of mucormycosis in renal transplant recipients as well as historical data.

Topics: Amphotericin B; Antifungal Agents; Colonic Diseases; Combined Modality Therapy; Female; Gastrectomy; Humans; Kidney Transplantation; Middle Aged; Mucormycosis; Opportunistic Infections; Pancreatic Diseases; Peritonitis; Risk Factors; Stomach Diseases

We report three cases of colonic histoplasmosis observed in a non-endemic area in patients with AIDS. The patients presented with fever, abdominal pain and an abdominal mass in the right lower quadrant. Diagnosis was obtained using Gomori-Crocott staining of endoscopic or surgical biopsies. One patient died without specific treatment and two patients had a complete remission when treated with intravenous amphotericin B but suffered a relapse when given oral itraconazole. Thus, physicians in areas where intestinal histoplasmosis is not endemic should be aware of the condition. Diagnosis can easily be obtained using Gomori-Crocott staining of colonoscopic biopsies; this should avoid unnecessary laparotomies and allow specific treatment to be instituted rapidly.

Topics: Adult; AIDS-Related Opportunistic Infections; Amphotericin B; Antifungal Agents; Colonic Diseases; Female; France; Histoplasmosis; Humans; Male

Primary gastrointestinal infection is an uncommon manifestation of histoplasmosis. It is almost always associated with disseminated disease and/or an immunocompromised host. The ileum and cecum are the most common sites involved. We report two cases of primary gastrointestinal histoplasmosis in HIV-seropositive men who presented with annular constricting right colon lesions.

Topics: Adult; Amphotericin B; Biopsy; Colonic Diseases; Colonic Neoplasms; Diagnosis, Differential; Histoplasmosis; HIV Seropositivity; Humans; Male

To describe an unusual clinical presentation of visceral leishmaniasis affecting the colon.. We report the case of an HIV-positive patient with visceral leishmaniasis. We describe the clinical case, the procedures performed, the treatment provided and the patient's evolution. A comparative table of previously reported similar cases is shown.. Visceral leishmaniasis with intestinal involvement is an uncommon process. Nevertheless, this possibility should be taken into consideration in the differential diagnosis of immunosuppressed patients with symptoms of diarrhea, as a favorable prognosis depends on early diagnosis and appropriate treatment.

Topics: Amphotericin B; Antiprotozoal Agents; Colonic Diseases; HIV Infections; Humans; Leishmaniasis, Visceral; Male; Middle Aged

Invasive aspergillosis (IA), generally considered an opportunistic infection in immunocompromised hosts, is associated with high morbidity and mortality. IA commonly occurs in the respiratory tract with isolated reports of aspergillosis infection in the nasal sinuses, central nervous system, skin, liver, and urinary tract. Extra-pulmonary aspergillosis is usually observed in disseminated disease. To date, there are a few studies regarding primary and disseminated gastrointestinal (GI) aspergillosis in immunocompromised hosts. Only a few cases of primary GI aspergillosis in non-immunocompromised hosts have been reported; of these, almost all of them involved the upper GI tract. We describe a very rare case of IA involving the lower GI tract in the patient without classical risk factors that presented as multiple colon perforations and was successfully treated by surgery and antifungal treatment. We also review related literature and discuss the characteristics and risk factors of IA in the immunocompetent hosts without classical risk factors. This case that shows IA should be considered in critically ill patients, and that primary lower GI aspergillosis may also occur in the immunocompetent hosts without classical risk factors.

Topics: Amphotericin B; Antifungal Agents; Aspergillosis; Aspergillus; Colon; Colonic Diseases; Combined Modality Therapy; Humans; Immunocompetence; Laparotomy; Male; Middle Aged; Radiography; Treatment Outcome; Voriconazole

We present a case of a 59-year-old woman with Chagas disease who received a kidney transplant. At month 44 post-transplantation, the patient presented with diarrhea that had persisted for 2 months. Colonoscopy showed a colon ulcer and differential diagnoses included cytomegalovirus, bacteria, or parasite infection; drug-related diarrhea; Crohn's disease; celiac disease; and malignancy. The ulcer tissue was positive for Cryptococcus neoformans. Successful treatment consisted of amphotericin B for 8 days and oral fluconazole (800 mg daily) for 3 months. This case illustrates that a colonic ulcer, although rare, could be cryptococcosis.

Topics: Amphotericin B; Antifungal Agents; Colonic Diseases; Cryptococcosis; Cryptococcus neoformans; Diagnosis, Differential; Female; Fluconazole; Humans; Kidney Transplantation; Middle Aged; Ulcer

Topics: Amphotericin B; Antifungal Agents; Candidiasis; Coinfection; Colonic Diseases; Colonoscopy; Humans; Male; Middle Aged; Mucormycosis; Tomography, X-Ray Computed

Topics: Adolescent; Amphotericin B; Antiprotozoal Agents; Bone Marrow; Colon; Colonic Diseases; Hepatitis, Autoimmune; Hepatomegaly; Humans; Ileum; Immunocompromised Host; Immunosuppressive Agents; Leishmania infantum; Leishmaniasis, Visceral; Liver Transplantation; Male; Splenomegaly

Topics: Aged; Amphotericin B; Antibodies, Monoclonal; Antirheumatic Agents; Arthritis, Rheumatoid; Colonic Diseases; Colonoscopy; Female; Follow-Up Studies; Fungemia; Histoplasmosis; Humans; Immunocompromised Host; Infliximab; Risk Assessment; Ulcer

We experienced a rare case of colonic cryptococcosis in an apparently immunocompetent individual. A 27-year- old woman admitted our hospital for intermittent melena. Initial abdominal CT scan revealed a mass lesion obstructing most of the lumen in ascending colon. Colonoscopy showed huge ulcerofungating mass in proximal ascending colon. Colonoscopic biopsy was performed and pathologic diagnosis was made as colonic cryptococcosis with positive PAS stain. Laboratory test evaluating immune status and bone marrow examination was normal. The patient was treated with intravenous amphotericin B for four weeks and six months of oral fluconazole afterwards. Follow-up abdominal CT scan and colonoscopy were taken at four weeks and seven months after the beginning of treatment. On completion of intravenous amphotericin B treatment, the mass lesion was decreased in abdominal CT and colonoscopy. After seven months, abdominal CT and colonoscopy showed near-complete resolution of the colonic lesion so the treatment ended. Cryptococcosis in a healthy individual is a rare disease and there have been only several sporadic case reports on pulmonary or central nervous system involvement. Hence, we report a case of colonic cryptococcosis in an apparently immunocompetent individual.

Topics: Adult; Amphotericin B; Antifungal Agents; Colonic Diseases; Colonoscopy; Cryptococcosis; Cryptococcus neoformans; Female; Fluconazole; Humans; Injections, Intravenous; Tomography, X-Ray Computed

Topics: Adult; Amphotericin B; Colonic Diseases; Female; Histoplasmosis; Humans; Job Syndrome; Recurrence

Colonic histoplasmosis is a rare entity. There have been four previous reported cases within the population of patients with human immunodeficiency virus (HIV) infection. Because of the increasing incidence of HIV infection within regions where histoplasmosis is endemic, this condition may become more common. Gastrointestinal histoplasmosis has protean clinical manifestations, and symptoms are often nonspecific. Any patient with HIV infection who has unexplained GI symptoms should undergo evaluation for possible histoplasmosis. Aggressive long-term amphotericin B therapy has been effective in HIV patients with histoplasmosis. Resection or diversion of symptomatic colonic strictures caused by histoplasmosis may be necessary in addition to medical therapy.

Topics: Acquired Immunodeficiency Syndrome; Adult; Amphotericin B; Colonic Diseases; Histoplasmosis; Humans; Intestinal Obstruction; Male; Middle Aged

Topics: Amphotericin B; Colonic Diseases; Drug Therapy; Histoplasmosis; Humans; Rectum

Topics: Amphotericin B; Anti-Bacterial Agents; Colonic Diseases; Drug Therapy; Erythromycin; Gastrointestinal Tract; Humans; Intestines; Kanamycin; Neomycin; Nystatin; Preoperative Care; Staphylococcal Infections; Toxicology

Topics: Amphotericin B; Colonic Diseases; Histoplasmosis; Humans