A 7-y-old boy with relapsed acute lymphatic leukaemia developed fungaemia due to Acremonium strictum, a fungus belonging to the group of the hyaline hyphomycetes. Initially, the fungus ras misdiagnosed as Candida sp, ...
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A 7-y-old boy with relapsed acute lymphatic leukaemia developed fungaemia due to Acremonium strictum, a fungus belonging to the group of the hyaline hyphomycetes. Initially, the fungus ras misdiagnosed as Candida sp, due to the presence of abundant adventitious forms. At the time of diagnosis the patient was neutropenic and had a central venous catheter (CVC) in situ, The formation of an occlusive thrombotic mass in the v. subclavia dextra complicated the infection. Treatment consisted of amphotericin B, fluconazole, granulocyte colony-stimulating factor (C-CSF) and removal of the CVC. However the patient responded clinically only. after the intravascular thrombus had been removed surgically. Ampbotericin B, voriconazole and terbinafine showed high activity in vitro against the Acremonium isolate. A literature review revealed 5 other immunocompromised paediatric patients with a systemic or localized infection due to Acremonium spp.
Focuses on a medical case of a white man diagnosed with acute lymphocytic leukemia. Results of a dermatological examination; Clinical hypothesis of septic emboli; Need for Fusarium solani to be added to list of opport...
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Focuses on a medical case of a white man diagnosed with acute lymphocytic leukemia. Results of a dermatological examination; Clinical hypothesis of septic emboli; Need for Fusarium solani to be added to list of opportunistic pathogens in the immunocompromised host.
BACKGROUND:The purpose of this study was to determine the prevalence of GB virus type C (GBV-C) infection in subjects treated for childhood acute lymphoblastic leukemia (ALL) or non-Hodgkin's lymphoma. STUDY DESIG...
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BACKGROUND:The purpose of this study was to determine the prevalence of GB virus type C (GBV-C) infection in subjects treated for childhood acute lymphoblastic leukemia (ALL) or non-Hodgkin's lymphoma. STUDY DESIGN AND METHODS: One hundred forty patients (82 males) aged 4 to 27 years (median, 11) diagnosed with ALL between 1976 and 1993, were prospectively followed for a median of 5 years (range, 0.1-17) after completion of therapy. Stored sera were tested for antibody to hepatitis C virus (HCV), HCV RNA, antibody to GBV-C E2 (anti-E2), and GBV-C RNA. RESULTS: Thirty-eight patients (27%) were exposed to GBV-C:30 were positive for GBV-C RNA (mostly type 2) and 8 were positive for anti-E2. Anti-E2 and GBV-C RNA were mutually exclusive: 61 patients (43%) were positive for HCV RNA, 16 (11%)were coinfected with GBV-C and HCV. Alanine aminotransferase (ALT) levels were increased (>35 mU/mL) in 32 (23%) of 137:3 of 20 who were positive for GBV-C and negative for HCV, 7 of 15 who were positive for GBV-C and HCV, 15 of 44 who were negative for GBV-C and positive for HCV, and 7 of 58 who were negative for GBV-C and HCV (p<0.001). Median ALT values were significantly higher in patients positive for GBV-C and HCV than in those who were positive for GBV-C and negative for HCV (35 vs. 13 mU/mL, p = 0.003). Thirty-one of 38 patients with GBV-C markers were retested: GBV-C RNA was lost in 16 of 30 tested, but 7 were still GBV-C RNA positive up to 50 months later, 3 tested positive for anti-E2 up to 27 months later, and 1 was positive for GBV-C RNA and anti-E2 26 months later, while 20 tested negative for both. CONCLUSION: GBV-C did not behave as a liver pathogen, because ALT alterations were unrelated to GBV-C status, but, rather, were related to HCV infection or coinfection. GBV-C RNA was frequently lost over a relatively short period, though in some cases, it was retained for a longer time. Anti-E2 rarely coexisted with GBV-C RNA and might be short-term.
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