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

Systemic candidiasis is frequently unrecognized before death of the patient because of lack of specific clinical signs, insensitive laboratory tests, and difficulties in culturing Candida albicans from the blood. Recent attention has been focused on the use of serologic testing and ocular signs to increase the rate of diagnosis of candidiasis. Because of the association between hyperalimentation fluids and disseminated candidiasis, a preliminary prospective study was carried out to determine more accurately the incidence in patients receiving hyperalimentation fluids of inapparent candida infection, candida endophthalmitis, or positive candida precipitins. Five of 23 patients developed small, white eye lesions consistent with candida endophthalmitis. Three of the five patients with eye lesions had blood cultures positive for C. albicans, and no patients without eye lesions had positive blood cultures. Candida precipitins were positive in three of the five patients with eye lesions. The results of this study suggest that unrecognized systemic candida infection may be more frequent in patients receiving hyperalimentation than previously suspected.
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PMID:Association of infection due to Candida albicans with intravenous hyperalimentation. 41 98

Fifteen premature babies developed systemic candidiasis during the administration of intravenous hyperalimentation in the Beilinson Neonatal Intensive Care Unit. Candida albicans was found in the blood cultures of all the babies and in the urine cultures of 66.7% of them. Repeated funduscopic examinations revealed no evidence of septic embolization in the retinal or choroidal circulation. It should be noted that acute retinopathy of prematurity (ROP) grade 2 or 3 was found in all the babies.
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PMID:Systemic candidiasis in babies with retinopathy of prematurity. 142 46

The clinical courses of 25 infants with systemic candidiasis who were treated in the neonatal intensive care unit at Kaplan Hospital, Rehovot, Israel, during the period 1980-1989 were retrospectively analyzed. Twenty-three (92%) weighted less than 1,500 g at birth. Candidemia was associated with prolonged antibiotic therapy, hyperalimentation, and intravenous fat emulsions in all cases and with previous tracheal intubation in 80% of cases. Only one infant had a central venous catheter placed; for all others, hyperalimentation was administered by means of peripheral intravenous catheters. The mean age at onset of systemic candidiasis was 30 +/- 14 days, although an earlier onset (25 +/- 8 days) was noted during the last 3 years of the study period. Candida species were isolated from the blood of 24 infants and from the urine of 10 infants. Microscopic examination of the urine was positive for Candida organisms for three infants and led to a rapid diagnosis. Candidal skin abscesses were present in 11 infants (44%); for two of these infants, the early occurrence of such abscesses prompted the initiation of therapy before confirmation of the diagnosis of systemic candidiasis. All infants were treated with intravenous amphotericin B and oral 5-fluorocytosine. The mortality rate was 20%, but death was directly attributable to candidemia in only three infants (12%).
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PMID:Systemic candidal infections associated with use of peripheral venous catheters in neonates: a 9-year experience. 152 Aug 9

Systemic candidiasis, especially candidemia, is an increasing problem among high risk neonates. Although possible predisposing factors have been suggested, no case-control study has evaluated potential risk factors. By retrospective chart review we identified 21 infants admitted to the neonatal intensive care unit between 1976 and 1983 (0.9% of all admissions) who had documented nosocomial candidemia before 4 months of age. Twenty patients were matched to a control infant with similar birth weight and date of admission. We found that the median durations of exposure to the following risk factors were significantly longer in patients compared with controls: hyperalimentation; intravenous fat emulsion; endotracheal tubes; and/or tracheostomies and antibiotic therapy. However, by discriminant analysis, duration of antibiotic therapy remained the variable most strongly (and independently) associated with the development of candidemia. Treatment of the 22 episodes of candidemia was variable including catheter removal alone in 12 and a combination of catheter removal, amphotericin, 5-fluorocytosine and/or ketaconazole in the others. Although the overall mortality for the series was 5 of 20 cases (25%), no infant larger than 2000 g died. We conclude that development of candidemia in neonates is associated with, and possibly caused by, prolonged exposure to antibiotics (as documented by multivariate analysis), hyperalimentation, intravenous fat emulsion and tracheal intubation (as documented by univariate analysis). To the greatest extent possible consistent with good clinical care, exposure to these risk factors should be minimized in high risk neonates.
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PMID:Risk factors associated with candidemia in the neonatal intensive care unit: a case-control study. 310 75

Ten babies who required neonatal intensive care developed systemic candidiasis. Eight were extremely preterm (28 weeks' gestation or less) and all received prolonged ventilation, multiple courses of broad spectrum antibiotics, and intravenous hyperalimentation. Diagnosis was established by culture of yeasts from suprapubic urine specimens; venous blood cultures proved unreliable. Initial treatment with 5-flucytosine alone in eight babies and combined with amphotericin B in two, eradicated the infection in nine babies, the treatment failure arising through diagnostic delay and development of resistance to 5-flucytosine. Prophylactic topical antifungal drugs, regular screening of suprapubic urine specimens, and prompt use of systemic antifungal agents before multifocal infection becomes established may reduce the incidence and improve outcome.
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PMID:Neonatal systemic candidiasis. 400 13

Two premature neonates with birth weight less than 1,200 g developed systemic candidiasis during treatment with multiple antibiotics and parenteral hyperalimentation. Clinical findings included signs of necrotizing enterocolitis in one patient and multiple fungal renal cortical abscesses in the other. The Candida antigen, mannan, was present in the sera of both patients at the time of clinical deterioration. Multiple blood cultures and urine and stool samples from both patients grew Candida albicans. Systemic antifungal therapy was given for a 6-week period and was associated with prolonged antigenemia despite negative findings on follow-up cultures. Antifungal therapy was stopped soon after antigen was no longer detected. Both patients recovered without evidence of further fungal infection. Candida antigen detection may be useful in the diagnosis and follow-up of premature infants with disseminated candidiasis.
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PMID:Candida antigen detection in two premature neonates with disseminated candidiasis. 643 83

A 95-year-old woman complained of sudden onset of disturbance of consciousness and right hemiparesis on April 20, 2003 and was admitted on the next day. She was drowsy and showed moderate right motor and sensory hemiparesis. The blood laboratory tests showed slight inflammatory reaction. A low density area was found in the left basal ganglia by brain CT, which was also coincided with the high signal region in T2, FLAIR and diffusion-MR images. The MRA of the intracerebral arteries presented no remarkable abnormality. The hemiparesis and impaired consciousness improved partially in the following week. However, she did not fully recover, since aspiration pneumonia and mild generalized inflammation continued. Percutaneous gastrostomy and intravenous hyperalimentation were started to improve her nutrition. The moderate inflammatory state persisted for several weeks. Her blood pressure suddenly fell and she died on June 12. Autopsy showed a mildly brownish and necrotic lesion from the left caudate to the putamen through the internal capsule. There was no liquefaction. On the microscopic examination, the necrosis surrounded by small vessels was consisted of numerous neutrophils and macrophages with pseudohypha and blastospore of candida. Small fragments of fungus were phagocytosed by macrophages. Small abscesses and necrotic foci due to candidiasis were observed in the bladder, kidneys, lungs, myocardium and thyroid gland. In this case, cerebral candidiasis probably occurred via hematogenous dissemination from a primary focus in the urinary tract. The intracerebral arteries revealed rather mild atherosclerotic changes and there was no occlusion by thromboembolism. Intracerebral lesion was diagnosed as candidiasis and there was no cerebral infarction by thromboembolism. If the infection occurred after cerebral infarction, there should not be any inflammatory reaction in the center of necrotic area. There have been few reports of cerebral candidal infection in patients without diabetes mellitus or immunosuppressive conditions. None of them had been diagnosed before death. Caution should be exercised for the presence of systemic candidiasis in elderly patients who are bedridden and with continuous low grade inflammatory reactions.
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PMID:[A 95-year-old female with autopsy-proven cerebral necrosis due to candidiasis who developed stroke-like manifestations]. 1583 94