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  • 1
    Electronic Resource
    Electronic Resource
    Aspergillus fumigatus, a rare cause of fatal coronary artery occlusion (1992)
    Springer
    Infection 20 (1992), S. 45-47 
    Details
    ISSN: 1439-0973
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung Bei abwehrgeschwächten Patienten kann eine Endokarditis durchAspergillus sp. auch ohne gefäßchirurgischen Eingriff auftreten, die allerdings extrem selten und schwer zu diagnostizieren ist. Wir berichten über einen 69 Jahre alten Patienten mit Haarzelleukämie, bei dem sich eine beidseitige Pneumonie entwickelte. Aus metastatischen subkutanen Knötchen wurdeA. fumigatus angezüchtet. Trotz Behandlung mit Amphotericin B in adäquater Dosierung (0,7 mg/kg/Tag i.v.) verstarb der Patient 18 Tage nach Therapiebeginn. Als Todesursache fanden sich eine Pilzendokarditis und ein Herzinfarkt infolge septisch- thrombotischen Verschlusses der linken Koronararterie, ausgelöst durchA. fumigatus. Trotz Behandlung mit Amphotericin B i.v. in einer Gesamtdosis von 756 mg konnteA. fumigatus noch aus autoptisch entnommenen Material aus der Aortenklappe kultiviert werden. Bei metastatischer Ausbreitung vonAspergillus spp. sollte eine Endokarditis vermutet werden.
    Notes: Summary Endocarditis byAspergillus species in patients without prior cardiovascular surgery is extremely rare and difficult to diagnose. We report and discuss a 69-year-old patient with hairy cell leukemia who developed severe bilateral pneumonia and metastatic subcutaneous nodules from whichA. fumigatus was cultured. He died after 18 days of treatment with an adequate dose (0.7 mg/kg/day) of amphotericin B intravenously. Fungal endocarditis and a myocardial infarction due to a septic thrombotic occlusion of the left coronary artery byA. fumigatus appeared to be the cause of death.A. fumigatus could still be cultured from the aortic valve postmortem despite a total dose of 756 mg amphotericin B. In case of metastatic spread ofAspergillus spp., endocarditis should be suspected.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01704896
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  • 2
    Electronic Resource
    Electronic Resource
    Pneumocystis carinii Pneumonia in HIV-negative patients with haematologic disease (1997)
    Springer
    Infection 25 (1997), S. 78-81 
    Details
    ISSN: 1439-0973
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Since 1990,Pneumocystis carinii pneumonia (PCP) was diagnosed in 15 adult HIV-negative haematologic patients in our hospital. None of them had received PCP prophylaxis. All except one had been treated with prednisone. Symptoms usually started after stopping or tapering. In six patients the diagnosis of PCP was delayed because of confounding bacterial isolates from blood, sputum or urine leading to unsuccessful antibiotic treatment. PCP was diagnosed by demonstrating pneumocysts in bronchoalveolar lavage fluid. In four patients additional fungal or viral pathogens were identified. The infections were not clustered. The patients were treated with co-trimoxazole and, in case of a pO2〈60 mmHg, with prednisone. Three patients died (20%); they all had a coinfection with cytomegalovirus and/or aspergillus. The others recovered completely. There were no relapses. Primary PCP prophylaxis should be considered in patients with lympho-proliferative disease and exposure to prednisone.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF02113579
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  • 3
    Electronic Resource
    Electronic Resource
    The serology and immunochemistry of HIV-induced platelet-bound immunoglobulin (1989)
    Springer
    Annals of hematology 59 (1989), S. 75-81 
    Details
    ISSN: 1432-0584
    Keywords: Thrombocytopenia ; HIV-infection ; platelet-bound immunoglobulins ; Classical immune thrombocytopenic purpura
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary A study was carried out on the presence of platelet-bound immunoglobulins, platelet-bound complement and serum immunoglobulin reactive with platelets in the blood of persons infected with HIV and those at risk of HIV infection. Platelet-bound immunoglobulins, predominantly IgG and IgM, but not complement, were demonstrated by immunofluorescence in 16 out of 16 patients with AIDS, in 5 out of 7 with AIDS-related complex/persistent generalized lymphadenopathy and in 7 out of 10 apparently healthy sexually active homosexual men, of whom 2 were anti-HIV1 seropositive. There was no correlation between the presence of platelet-bound immunoglobulins and either the platelet count or the level of circulating immune complexes. The specificity of the platelet-bound immunoglobulins and platelet-reactive immunoglobulins in the corresponding sera was studied. Platelet-bound immunoglobulins were eluted and then investigated for cross-reactivity with HIV. Both sera and eluates were tested for reactivity with cardiolipin and reactivity with the major target antigen in classical autoimmune thrombocytopenia, the GP IIb/IIIa complex. Of 17 eluates containing platelet-reactive immunoglobulins, 5 reacted with HIV-determinants but 2 out of 5 eluates that did not contain platelet-reactive immunoglobulins also reacted. Although anti-cardiolipin antibodies were detected in all sera, none of the 17 eluates reacted with cardiolipin. Moreover, sera and eluates, reactive with normal platelets, did not react with type-1-Glanzmann disease platelets. This indicates that the antibodies are directed against the glycoprotein IIb/IIIa complex of platelets. This could not be confirmed by immunoprecipitation or by immunoblotting, however. We conclude that the presence of platelet-bound immunoglobulins is common in HIV-infection but may also occur in persons at risk and that the nature of the auto-antibodies is not different from that of the auto-antibodies observed in classical ITP.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00320253
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  • 4
    Electronic Resource
    Electronic Resource
    FatalScedosporium prolificans infection in a leukemic patient (1997)
    Springer
    European journal of clinical microbiology & infectious diseases 16 (1997), S. 460-464 
    Details
    ISSN: 1435-4373
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The case is described of a 42-year-old patient with acute myeloid leukemia who received two courses of chemotherapy complicated by prolonged bone marrow depression. He was admitted to hospital with fever, hepatosplenomegaly and bilateral nodular pulmonary infiltrates. After admission diffuse cutaneous skin nodules, and hypodense lesions in the hemispheres and cerebellum developed. Cultures of cerebrospinal fluid, bronchoalveolar lavage fluid, skin biopsy specimens and blood revealedScedosporium prolificans, indicative of disseminated mycosis. Treatment with amphotericin B and fluconazole was unsuccessful and the patient died within five days after admission. Features that may enhance early recognition ofScedosporium prolificans infection by both clinicians and microbiologists, as well as options in the treatment of infection with this fungal agent are discussed.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF02471912
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  • 5
    Electronic Resource
    Electronic Resource
    Evaluation of penicillin G in the prevention of streptococcal septicaemia in patients with acute myeloid leukaemia undergoing cytotoxic chemotherapy (1993)
    Springer
    European journal of clinical microbiology & infectious diseases 12 (1993), S. 750-755 
    Details
    ISSN: 1435-4373
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The efficacy of penicillin G was evaluated in the prevention of infections caused by streptococci in patients receiving remission induction or intensive consolidation treatment for acute myeloid leukaemia. Between 1980 and 1988, 29 episodes of streptococcal septicaemia occurred in 139 treatment events. All patients received as prophylaxis regimen ciprofloxacin (n=38) or a combination of polymyxin B with nalidixic acid (n=42) or neomycin (n=59). Six patients died of streptococcal septicaemia despite adequate antibiotic treatment. The high incidence of streptococcal septicaemia lead to the administration of penicillin G in addition to ciprofloxacin as prophylaxis regimen during the 14 days immediately following cytotoxic chemotherapy. Only two episodes of streptococcal septicaemia were documented after addition of penicillin G to the prophylaxis regimen (n=76, p〈0.001). Both patients had an uneventful recovery after treatment with vancomycin. Patients receiving penicillin G prophylaxis experienced fever during 17 % of the time and received antimicrobial therapy during 20 % of the time per treatment event compared with 27 % and 32 % respectively of this time in patients receiving no streptococcal prophylaxis (p〈0.001). Penicillin G prophylaxis was associated with an increased incidence of fever of unknown origin and more frequent isolation of aerobic gram-negative bacteria in surveillance cultures. Penicillin G in combination with ciprofloxacin proved to be highly successful in preventing infections caused by streptococci and in reducing infection-related mortality and morbidity.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF02098462
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  • 6
    Electronic Resource
    Electronic Resource
    Acute lymphoblastic leukaemia in puberty and adolescence (2000)
    Springer
    Annals of oncology 11 (2000), S. 1375-1379 
    Details
    ISSN: 1569-8041
    Keywords: acute lymphoblastic leukaemia ; chromosome aberration ; drugmetabolism ; gene fusion ; gene rearrangement ; immunophenotype ; Philadelphia chromosome ; T cell
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1023/A:1026538713236
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