amphotericin-b and Intestinal-Obstruction

We report a retroviral positive patient who presented to us with recurrent skin lesions along with intermittent, colicky periumbilical abdominal pain associated with non-projectile, postprandial vomiting. Contrast-enhanced CT (CECT) of abdomen and pelvis was suggestive of proximal jejunal obstruction. Double balloon enteroscopy done which showed extensive deep ulceration with surrounding nodular surface and friable mucosa at 60 cm from pylorus with luminal narrowing. The biopsy from this region as well as the skin lesion on the forehead grew

Topics: Adult; AIDS-Related Opportunistic Infections; Amphotericin B; Anti-Retroviral Agents; Antifungal Agents; Enteral Nutrition; Female; HIV Infections; HIV Seropositivity; Humans; Intestinal Obstruction; Itraconazole; Jejunostomy; Mycoses; Nutritional Status

A 59-year-old patient with multiple myeloma on maintenance chemotherapy presented with fever, weight loss, and night sweats. An F-18 fluorodeoxyglucose (FDG) positron emission tomography (PET) computed tomography (CT) showed intra-abdominal lymphadenopathy with a mesenteric mass that led to further workup and diagnosis of histoplamosis. The patient was treated with amphotericin B and subsequently switched to itraconazole. This exemplifies the usefulness of FDG PET CT in diagnosis of infectious complications.

Topics: Amphotericin B; Antifungal Agents; Antineoplastic Agents; beta-Glucans; Colonoscopy; Fever; Fluorodeoxyglucose F18; Gastrointestinal Diseases; Hematopoietic Stem Cell Transplantation; Histoplasma; Histoplasmosis; Humans; Ileum; Intestinal Obstruction; Itraconazole; Lymphadenopathy; Male; Middle Aged; Multiple Myeloma; Positron-Emission Tomography; Radiopharmaceuticals; Tomography, X-Ray Computed; Weight Loss

A 21-month-old male child presented with malnutrition and painless abdominal masses. The masses were provisionally diagnosed as being abdominal lymphoma. Pre-operative investigations did not establish any other cause. The diagnosis of primary gastrointestinal aspergilloma was obtained only post-operatively by histopathology and tissue culture. Following surgery, the tumour grew rapidly and massively despite intravenous amphotericin-B, in the recommended doses. The tumour caused recurrent intestinal obstruction which necessitated multiple extensive surgical excisions. The patient finally died due to sepsis and gastrointestinal bleeding. We believe this to be the first description of a primary gastrointestinal aspergilloma with aggressive local infiltration in a non-neutropenic child.

Topics: Amphotericin B; Antifungal Agents; Aspergillosis; Diagnosis, Differential; Fatal Outcome; Humans; Infant; Intestinal Diseases; Intestinal Obstruction; Male; Recurrence

We describe three severe clinic cases due to fungus balls of Candida albicans in hospitalized risky patients which presented a quickly clinical evolution. Because of their different local presentations medical and surgical management was needed. In the first case a intestinal fungus ball was found whereas in the other two cases were localized in the urinary tract. Here we present their clinical findings rather than their evolution after a medical and surgical management.

Topics: Adolescent; Amphotericin B; Candidiasis; Fluconazole; Humans; Infant; Infant, Newborn; Intestinal Obstruction; Jejunal Diseases; Kidney Diseases; Male; Ultrasonography; Ureteral Obstruction

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

Two infants recovered from endogenous Candida endophthalmitis. Case 1, to the best of my knowledge, is the first reported full term neonate with this entity. Free-floating vitreous opacitis ("ballon vitréen") were found in one infant and the second infant's lesions resolved in a more conventional manner.

Topics: Amphotericin B; Candidiasis; Ductus Arteriosus, Patent; Endophthalmitis; Female; Flucytosine; Humans; Infant; Infant, Newborn; Infant, Premature; Intestinal Obstruction; Intestine, Small; Male; Nystatin; Oxygen

Topics: Amphotericin B; Candida albicans; Candidiasis; Humans; Intestinal Obstruction; Intestine, Small; Male; Middle Aged; Postoperative Complications; Staining and Labeling

Topics: Amphotericin B; Animals; Intestinal Obstruction; Intussusception; Meat; Sheep; Sheep Diseases