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Query: UMLS:C0019158 (hepatitis)
 30,205 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

We determined the incidence and outcome of aplastic anemia among 56 patients who underwent liver transplantation for fulminant liver failure at the University of Nebraska Medical Center between July 1985 and December 1993. Aplastic anemia developed in 6 of 18 (33%) children and 1 of 19 (5%) adults who had fulminant non-A, non-B hepatitis; no cases of aplastic anemia occurred among patients with other causes of fulminant liver failure. None of these patients had evidence of a preexisting hematological disorder or infection with hepatitis C virus (as determined with a second-generation ELISA). Aplastic anemia was diagnosed at a median of 4 wk after the onset of hepatitis, with five cases seen before transplantation. Six patients received antithymocyte globulin to promote remission of aplastic anemia. Three children died (fungal infection in two, intracranial hemorrhage in one)--one at 43, one at 108 and one at 119 days after transplantation--without remission of aplastic anemia. Among the four surviving patients, with median follow-up of 25 mo, complete and partial remission of aplastic anemia have occurred in three and one, respectively. Liver allograft function is stable in all surviving patients. The data demonstrate that aplastic anemia is a common complication among children who undergo liver transplantation for fulminant non-A, non-B hepatitis. It is associated with a high rate of mortality, although most survivors appear to have full hematological recovery.
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PMID:Aplastic anemia after liver transplantation for fulminant liver failure. 765 71

To investigate husbandry-disease associations in farmed crocodiles 7 farms in Queensland and the Northern Territory were visited and details of past and present farm design and husbandry practices were recorded. In addition pathological examination of 300 (mostly young) crocodiles was carried out (85 necropsied, one biopsied and 214 examined retrospectively). Mortality rate and occurrence of disease, especially opportunistic infections with bacteria and fungi, were highest during winter months and in farms located at greater latitudes. A difference in the presence and prevalence of disease between the initial establishment phase of Northern Territory crocodile farms (1984-87) and currently (1988-91) was apparent; parasitic infections are now relatively infrequent and bacterial septicaemias and mycoses less common as a result of some provision of artificial heating for juveniles. Gross and microscopic changes observed in visceral and periarticular gout, bacterial hepatitis/septicaemia, deep and superficial mycosis, pentastomiasis and other parasitic infections are described.
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PMID:Disease-husbandry associations in farmed crocodiles in Queensland and the Northern Territory. 808 Apr 5

A clinical assessment of fungal infection in hepatobiliary and pancreatic diseases during 1975 and 1991 was made and 25 cases of systemic mycosis were noted. Among 25 cases there were 20 liver diseases (hepatocellular carcinoma 12, liver cirrhosis 5, fulminant hepatitis 2, polyarteritis nodosa 1), 2 cases of gallbladder cancer and 3 cases of pancreatic cancer. The fungus was consisted of 14 cases (56%) of Candida, 9 cases of Aspergillus (36%), and 2 cases of Cryptococcus (8%). Fungal infection was most frequent in the lung (8 cases) and esophagus (6 cases), but rarely in the stomach, lymph node, liver, thyroid, kidney and gallbladder. Generalized fungus infection was noted in four cases (16%). Fatal fungal infection was complicated in liver cirrhosis (2 cases), fulminant hepatitis (one case), gallbladder cancer (one case) and cystadenocarcinoma of the pancreas (one case). In five fatal cases three cases of Aspergillus pneumonia and two cases of Candida septicemia were included. Glucocorticoid was used in 13 cases (52%) and anti-cancer drugs was administered in two cases (12%). However, in 9 cases (36%) without treatment of glucocorticoid or anti-cancer drug fungal infection was detected. In conclusion, there is a possibility of fungal infection in grave hepatic diseases and empirical administration of anti-fungal agent may be necessary.
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PMID:[Fungal infection in hepatobiliary and pancreatic diseases: clinical evaluation in autopsy cases]. 820 88

The oral azole drugs--ketoconazole, fluconazole, and itraconazole--represent a major advance in systemic antifungal therapy. Among the three, fluconazole has the most attractive pharmacologic profile, including the capacity to produce high concentrations of active drug in cerebrospinal fluid and urine. Ketoconazole, the first oral azole to be introduced, is less well tolerated than either fluconazole or itraconazole and is associated with more clinically important toxic effects, including hepatitis and inhibition of steroid hormone synthesis. However, ketoconazole is less expensive than fluconazole and itraconazole--an especially important consideration for patients receiving long-term therapy. All three drugs are effective alternatives to amphotericin B and flucytosine as therapy for selected systemic mycoses. Ketoconazole and itraconazole are effective in patients with the chronic, indolent forms of the endemic mycoses, including blastomycosis, coccidioidomycosis, and histoplasmosis; itraconazole is also effective in patients with sporotrichosis. Fluconazole is useful in the common forms of fungal meningitis--namely, coccidioidal and cryptococcal meningitis. In addition, fluconazole is effective for selected patients with serious candida syndromes such as candidemia, and itraconazole is the most effective of the azoles for the treatment of aspergillosis.
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PMID:Oral azole drugs as systemic antifungal therapy. 819 Jan 49

The success in acute myeloblastic leukemia (AML) treatment for the last 10 years has been referred to growing intensity of chemotherapy. The efficacy of treatment has been assessed in 56 patients under 60 years of age. Double induction of remission according to the scheme TAD-9 (2-day administration of cytosar) and consolidation by large-dose cytosar (1 g/m2) with rubomycin have increased the frequency of 2-year recurrence-free running from 13 to 35%. Resistance to treatment was absent. Maintenance prolonged total and recurrence-free survival. Mycosis and hepatitis were factors responsible for inadequate intensity of chemotherapy. These need more advanced prevention. The intensive double induction and consolidation did not raise general toxicity and immediate lethality compared to standard regimens which proved inferior to the proposed treatment.
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PMID:[Advances and difficulties of present-day treatment of acute myeloblastic leukemia]. 864 85

Fungal infections are associated with a high mortality rate after liver transplantation. To describe risk factors for fungal infections, 405 consecutive liver transplant recipients were analyzed. Forty-five patients (11%) developed invasive fungal infection. Median posttransplantation time to the first episode was 60 days. Pathogens were Candida species (spp) (n=24, 53%), Cryptococcus neoformans (n=10, 22%), Aspergillus spp (n=6, 13%), Rhizopus spp (n=l), and others (n=4). Presentations of infection included disseminated (n=9), intra-abdominal (n=9), esophageal (n=9), lung (n=8), blood (n=6), and central nervous system infections (n=3), and sinusitis with esophagitis (n=1). Eighteen patients (40%) with invasive fungal infection died, and 13 (72%) of these deaths were attributable to fungi. Mortality in the nonfungal infection group was 12%. Univariate analysis identified separate risk factors for Candida (intra-abdominal bleeding), Aspergillus (fulminant hepatitis), and cryptococcal (symptomatic cytomegalovirus infection) infections. In both univariate and multivariate analyses, a high intratransplant transfusion requirement and posttransplant bacterial infection were identified as significant risk factors for all types of fungal infection. The risk factor analysis reported here suggests that different pathogenic processes lead to Candida and non-Candida infection in liver transplant recipients. Their identification should prompt specific prophylactic measures to reduce morbidity and mortality in this population.
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PMID:Risk factors of invasive Candida and non-Candida fungal infections after liver transplantation. 887 86

In a retrospective analysis, 18 instances of invasive fungal infections were observed in 512 (3.5%) renal transplant recipients. These included candidiasis (8), aspergillosis (5), cryptococcosis (3) and zygomycosis (2). All patients with candidiasis had Candida isolated from blood and one or more additional sites. One of them had superadded fungaemia with Torulopsis glabrata. Pulmonary disease in four and subcutaneous infection in one were encountered in the five patients with aspergillosis. Central nervous system involvement in two and cutaneous lesion in one were the findings in patients with cryptococcosis. Zygomycosis involved the lung in one and the allograft itself in the other. Prolonged fever not responding to antibacterial drugs was the most common clinical presentation. Fungal infections occurred during the first 4 months in 10 (55.5%) and 12 to 108 months in eight (44.5%) patients. Infections with cytomegalovirus and hepatitis viruses were concommitantly present in 12 (66.7%) and eight (44.5%) patients respectively. Fourteen episodes of fungal infections (77.8%) occurred in live unrelated kidney recipients who formed only 48% of our total transplant population. Nine patients were treated with systemic and/or local amphotericin B and six with amBisome. Fluconazole was administered alone in three and in combination with amphotericin B in two. Fourteen patients died but mortality was only directly attributable to fungal infection in 11. We conclude that invasive fungal infections continue to be an important cause of morbidity and mortality in renal transplant recipients. A high index of suspicion. prompt diagnosis and early institution of specific antifungal therapy are needed.
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PMID:Invasive fungal infections in renal transplant recipients. 888 96

In following a formerly successful protocol designed to produce antibodies to A. fumigatus (Fres) we observed a disseminated, lethal fungal infection in healthy, specific pathogen-free (SPF) rabbits. The pathomorphological findings included multiple miliary to avenaceous whitish nodules in the livers and kidneys, mycotic mesencephalitis, nephritis, hepatitis, myocarditis, hemorrhagic enteritis, and splenitis. The hyphae were surrounded by necrosis, which also occurred in the liver without the hyphae. Comparative gas chromatographic and metabolic investigations on this strain and some environmental A. fumigatus strains showed significant differences. The findings are discussed with particular reference to the pathogenicity of A. fumigatus.
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PMID:Case report: pathomorphology of an experimental disseminated Aspergillus fumigatus infection in rabbits. 902 24

The authors report the clinical and microbiological findings of a 6-month follow-up of nine AIDS patients affected with cryptococcosis. Among these, seven patients suffered from meningoencephalitis and two from disseminated infection. The antifungal therapy during acute illness included the administration of amphotericin B at doses of 0.6 mg kg-1 day-1 i.v. plus flucytosine at doses of 100 mg kg-1 day-1 i.v. during the first 15 days followed by itraconazole at doses of 400 mg day-1 p.o. in the following 15 days. The maintenance treatment included itraconazole at doses of 200 mg day-1 p.o. indefinitely. During the 6-month follow-up, one patient died of hepatic failure related to C virus (HCV) hepatitis reactivation and another patient died of polymicrobial pneumonia. In two patients, the presence of multiple nodular lesions in the cerebral computerized tomography (CT) scan, related to cryptococcal granulomas, was associated with the persistance of fungi in the cerebrospinal fluid. In three patients with meningoencephalitis the three-drugs regimen was effective in eradicating the neurological infection, and relapses were not observed during the maintenance therapy with itraconazole during the 6-month follow-up. The two patients with haematogenous cryptococcosis did not relapse after the 6-month follow-up.
Mycoses 1997 Oct
PMID:Efficacy of a short-term amphotericin B + flucytosine combination therapy followed by itraconazole monotherapy in acute and chronic AIDS-associated cryptococcosis. 947 89

A wide range of nontumorous hepatic diseases may have an impact on liver function and serve as indications for computed tomographic (CT) or magnetic resonance (MR) imaging. New imaging techniques such as spiral CT and fast MR imaging aid in detecting and characterizing these disease processes and in assessing the extent of disease. Infectious liver disease (eg, hepatic abscess, echinococcal disease, fungal infection) typically has low attenuation at CT and high signal intensity at T2-weighted MR imaging. Cholangitis is characterized by ductal dilatation at both CT and MR imaging. In acute portal vein thrombosis, the thrombus has low attenuation at CT and is hyperintense relative to liver at MR imaging. Hepatic infarcts usually appear as well-circumscribed, peripheral, wedge-shaped areas of decreased attenuation at CT. The causes or complications of cirrhosis can be most readily identified with MR imaging. In patients with chronic radiation-induced hepatitis, CT shows the irradiated parenchyma as a region of increased attenuation, whereas T1- and T2-weighted MR imaging demonstrate geographic areas of low and high signal intensity, respectively. Hemachromatosis has homogeneously increased liver attenuation at CT and decreased signal intensity at gradient-echo MR imaging in particular. Familiarity with the CT and MR imaging features of the spectrum of nonneoplastic conditions of the liver is essential in making an accurate diagnosis.
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PMID:Nonneoplastic liver disease: evaluation with CT and MR imaging. 967 68


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