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Query: UMLS:C0020505 (hyperphagia)
 6,116 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Two patients with acute myeloblastic leukemia are described who developed fungemia due to Trichosporon cutaneum. Fungemia occurred at the leukocyte nadir following the administration of anti-cancer chemotherapy. One patient was cured but the other died. Both patients received prednisolone continuously and had central venous catheters in place for parenteral hyperalimentation. T. cutaneum isolates were resistant to 5-fluorocytosine and moderately susceptible to fluconazole. One case was complicated by endophthalmitis due to T. cutaneum; this is the second report of such a complication in the world. We investigated the serum levels of beta-D-glucan, D-arabinitol, and Candida antigen (CAND-TEC); beta-D-glucan was elevated in both cases, which suggests that simultaneous measurements of these laboratory values are useful for the diagnosis and possibly for the evaluation of therapy for this fungal infection.
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PMID:Trichosporon cutaneum fungemia in patients with acute myeloblastic leukemia and measurement of serum D-arabinitol, Candida antigen (CAND-TEC), and beta-D-glucan. 816 83

Clinical efficacy of fluconazole on fungal infections was evaluated. Fluconazole was administrated orally or intravenously to 16 cases with fungal infections (chronic renal failure 4, congestive heart failure 2, cerebral infarction 2, etc). All cases were suspected of mycosis. The details of those administrated were 16 cases of pneumonia 3 cases, fungemia 9 cases (suspected 7 cases) and urinary tract infection 3 cases. Clinical efficacy rate was 71.4%. Side-effects were observed in only 1 case, and this consisted of transient increase of leukocytes and thrombocytes. Fluconazole is considered to be a potent, safe antifungal agent for the treatment of suspected fungal infection during intravenous hyperalimentation.
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PMID:[Clinical studies of fluconazole in patients with deep-seated fungal infection in intravenous hyperalimentation (IVH)]. 869 90

A case of catheter-related fungemia due to Hansenula anomala is reported. A 61-year-old male was diagnosed as having stage 3 ascending colon carcinoma stenosing the colon severely and was admitted to our hospital to receive an operation of the carcinoma. Just after admission, an intravenous hyperalimentation (IVH) catheter was inserted and IVH was started to prevent development of ileus and to prepare for laparotomy. Nine days later, he developed a fever. On the next day, the IVH catheter was removed and cultures of blood and the catheter revealed the presence of yeast-like organisms that were identified as H. anomala. Laboratory data showed hypogranulocytemia, slight disturbances of liver and kidney, a prolongation of PT, an increase of FDP and positive reaction of candida antigen by CAND-TEC. He improved after the removal of the catheter, and treatment with intravenous infusion of fluconazole 2 days after the removal was thought to be useful for recovery and to prevent the reappearance of infection though susceptibility to fluconazole was not good. Human infections due to H. anomala are rare and this is the 8th case of H. anomala fungemia in Japan. From this report and a review of the literature, risk factors for developing this fungemia include the use and abuse of central venous catheters such as IVH-catheter. It appears that H. anomala has recently emerged as a potential pathogen in the immunocompromised hosts and patients after insertion of central venous catheters and that these organisms should be added to the growing list of unusual fungal pathogens in these patients.
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PMID:[Hansenula anomala fungemia in a patient undergoing IVH-treatment with ascending colon carcinoma]. 885 93

This retrospective study was designed to investigate the related factors and outcome of systemic fungal infection in very low-birth-weight (VLBW) infants. Medical records of infants admitted to the neonatal intensive care unit of National Cheng Kung University Hospital between January 1990 and June 1994 were reviewed. Of the 262 VLBW infants, 15 (5.7%) had fungemia (14 Candida 1 Cryptococcus) during the study period. Among the fungemic infants, 60% also had urinary tract infection; 18% had central nervous system infection. Their mean birth weight was 1079 +/- 78 g (504-1474 g), and the gestational age was 28.6 +/- 0.6 weeks (23-32 weeks). Thirteen of them (87%) had respiratory distress syndrome and patent ductus arteriosus, while 60% had chronic lung disease. The percentage of antibiotic usage, parenteral hyperalimentation, endotracheal intubation, placement of central venous line and steroid therapy were 100%, 100%, 73%, 67% and 36% respectively. The mean age at diagnosis of fungemia was 40.5 +/- 4.8 days (10-76 days). Common clinical manifestations were respiratory deterioration (93%), poor feeding (58%) and fever (53%). The frequency of side effects of amphotericin B in decreasing order were: hypokalemia (54%), hyponatremia (31%) and decreased urine amount (23%). The mortality rate was 40%. It was concluded that systemic fungal infection in VLBW infants might result in high mortality and the side effects were high in the treated infants.
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PMID:Systemic fungal infection in very low-birth-weight infants. 885 49

Torulopsis glabrata is a yeastlike fungus that has recently become recognized as an important opportunistic pathogen. Only four cases of T glabrata infection in neonates have been reported. We report two cases of fungemia caused by this organism in premature infants. Both patients were treated with amphotericin B and survived the fungemia, but one patient later died of bacterial sepsis. Both patients had been treated with surfactant, artificial ventilation, intravascular catheters (arterial and venous), broad spectrum antibiotics, and hyperalimentation, which appear to be risk factors for T glabrata fungemia. A review of the literature indicates that T glabrata is susceptible to amphotericin B and 5-fluorocytosine and is resistant to fluconazole. In addition, it is less susceptible to ketoconazole, clotrimazole, and itraconazole than is Candida albicans. We recommend that T glabrata infections be treated initially by reducing iatrogenic risk factors and beginning amphotericin B therapy. If necessary, 5-fluorocytosine should be added to the drug regimen.
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PMID:Neonatal Torulopsis glabrata fungemia. 904 84

Invasive infections due to Candida krusei are often observed in immunocompromised patients who have received prior therapy with fluconazole, although infection has also occurred in patients in the absence of this antifungal agent. From August 25 through September 19, 1995, we identified four patients with C. krusei fungemia on our hematology/oncology unit. Molecular typing of all the isolates was performed by restriction endonuclease analysis of genomic DNA using HinfI. A total of 7 patients found to be colonized or infected with C. krusei were matched with 14 controls. There was no difference between the cases and controls with respect to underlying disease, duration of hospitalization, or neutropenia. The numbers of days of hyperalimentation, corticosteroids, and antibiotics were similar between both groups. The mean number of antibiotics was greater in the cases versus controls (5.0 versus 2.5; p = .003). There was no difference with respect to total dose or duration of fluconazole administration. Molecular typing of the isolates revealed that four had identical DNA banding patterns, plus another two that differed by one band and were considered related. Three historical strains were unrelated. In conclusion, this report demonstrates that molecular typing can be used to define clonality and, thereby, support increased infection control practices to eliminate such outbreaks when evidence of clonal spread is present.
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PMID:Molecular typing for investigating an outbreak of Candida krusei. 907 46

A clinical analysis on 127 cases out of 140 cases presenting with fungemia at Fukuoka University Hospital between 1984 and 1994 was done. The number of the positive blood cultures during the same period was 1188 and the rate of fungemia was 11.8%. The rates generally increased in recent years, 9.0% (1984-1986), 10.2% (1987-1989) and 13.6% (1990-1994), but decreased after 1992. C. albicans has shown a tendency to decrease while C. parapsilosis and C. glabrata have increased in recent years thus suggesting the effect of the prevalence of intravenous hyperalimentation (IVH) and azole antifungal agents. Only 3.9% of the fungemia were preceded by bacteremia. In addition to the known risk factors for fungemia such as IVH (89.0%) and the antibacterial agents, H2-receptor antagonists were used in 58.3% of the cases. 14 cases of the fungemia were observed during the prophylactic use of antifungal drugs. Therefore, fungemia should always be kept in mind regarding the differential diagnosis for bacteremia when an indwelling venous catheter is used. The prompt extubation of the catheter in addition to the adjustment of the dosage of antifungal drugs in response to the status of the host defense system are thus considered to be important in the treatment of fungemia.
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PMID:[Clinical analysis on 127 cases of fungemia in Fukuoka University Hospital between 1984 and 1994]. 958 2

During a 5-month period, 17 infants hospitalized in neonatal intensive care units of a medical center and a branch hospital developed 18 episodes of Candida parapsilosis fungemia. The mean age at onset was 35 days. Prior to fungemia, all the infants had received hyperalimentation and antibiotics, and 15 infants had had central venous catheters. The presenting symptoms were variable but only vague in 40% of the episodes. Despite administration of antifungal agents, subsequent eradication of fungemia was achieved in only two-thirds of the episodes. None of the environmental samples was positive for C. parapsilosis, while 20% of hand-washing samples of staff working in both units yielded this microorganism. Four genotypes with two main types were identified from 14 outbreak strains and eight genotypes from 14 hand-washing strains, with one type predominant. The results suggest that C. parapsilosis fungemia increases the morbidity and mortality of neonates but does not cause acute lethal events. The outbreak was caused by two main genotypes, possibly via cross-infection by the hands of health care workers.
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PMID:Outbreak of Candida parapsilosis fungemia in neonatal intensive care units: clinical implications and genotyping analysis. 1021 38

The present study used two molecular typing methods to investigate a cluster of eight cases of Candida parapsilosis fungemia in a hospital in Rio de Janeiro, Brazil. Candida parapsilosis is an important opportunistic pathogen that is frequently involved in outbreaks of nosocomial fungemia. Identification of a common source of infection and determination of genetic relatedness among the strains involved in outbreaks are important for infection control. Candida parapsilosis strains were isolated from the bloodstream of patients housed in an intensive-care unit (n=5) and in individual rooms (n=3). An additional strain of Candida parapsilosis was isolated from a hyperalimentation infusion flask, which was implicated by molecular typing to be the source of infection. All strains were identified using morphological and biochemical methods. The genetic relationship between patients' strains and the hyperalimentation infusion strain was assessed by electrophoretic karyotype (EK) analysis and random amplification of polymorphic DNA (RAPD). Both methods resulted in patterns that allowed differentiation of the isolates. Candida parapsilosis fungemia, in three of the eight patients, resulted from a common source of infection, as demonstrated by molecular typing methods. Image analysis of EK patterns indicated that these strains were closest to Candida parapsilosis Group II, a grouping that is a less frequent clinical isolate than the major Group I strains.
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PMID:Strain characterization of Candida parapsilosis fungemia by molecular typing methods. 1096 22

We report a 63-year-old male with central venous catheter-related infection caused by Malassezia sympodialis after total gastrectomy for a gastric cancer. He had fever and his leukocyte counts and C-reactive protein were elevated 14 days after his operation. After his central venous hyperalimentation catheter was removed, the inflammatory signs immediately disappeared, suggesting an intravenous catheter-related infection. A yeast-like fungus was cultured in brain-heart infection semi-solid agar ten days later, and was diagnosed morphologically as Malassezia sp. This strain was identified as M. sympodialis by Tween assimilation test and was confirmed by whole-sequence of internal transcribed spacer 1 regions (ITS1). This is the first report of catheter-related infection caused by M. sympodialis. This strain grew and was subcultured on CHROMagar Candida, potato dextrose agar and Sabouraud agar. There have been no reports of such a lipid-independent Malassezia sp. except for M. pachydermatis. The mechanism of lipid independence of this strain is undetermined and future work is needed. Malassezia sp. is receiving increased attention as an etiologic pathogen of catheter-related fungemia in clinical microbiology laboratories and infectious disease sections.
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PMID:[A Case of central venous catheter-related infection with Malassezia sympodialis]. 1170 51


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