Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0042963 (vomiting)
 31,883 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Our main objective consists in evaluating the frequency of digestive signs and digestive opportunistic infections in AIDS patients with diarrhea. The prospective study occurred from January 1997 to July 1998 in Bamako hospitals. The patients underwent a clinical examination, blood and stools tests, and sometimes upper digestive endoscopy. Among 434 cases of AIDS, 426 patients (98%) had at least one digestive sign. The main digestive signs were diarrhea (80.1%), abdominal pains (62.2%), vomiting (47.2%) and dysphagea (36.6%). Isospora belli and Cryptosporidium parvum have been pointed up in respectively 9% and 16.3% of examined specimen. Echerichia coli was found in 8.6% of stool cultures and in 2.9% in the case of Salmonella Arizonae. Twenty cases of Kaposi's sarcoma were diagnosed and mycosis was found in 71.9% of patients. In conclusion, digestive change is a constant phenomenon in AIDS patients. Patients survival could be improved by early management, improvement of diagnosis and provisioning of medicines.
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PMID:[Gastrointestinal manifestations of AIDS in adults in Mali]. 1259 72

Cryptococcal meningitis is an uncommon but often fatal complication of systemic lupus erythematosus (SLE). We report on a 13-year-old girl with SLE using high-dose prednisolone for several months, presented to us with low grade fever, intermittent vomiting and headache. Physical examination, including papilloedema and meningeal irritation, was unremarkable. Serum and cerebrospinal fluid (CSF) cryptococcal antigen titer was 1: 128 by latex agglutination method. CSF culture yielded Cryptococcus neoformans. We used amphotericin B deoxycholate (a cumulative dose of 1.95 gm) and fluconazole (200 mg day-1) for 6 weeks. Clinical response was good. Then, we continued fluconazole 200 mg per qd as suppressive therapy for thirty-four months. There were no neurological sequelae or relapse after 20-month follow-up. Timely diagnosis and effective antifungal therapy could improve the prognosis of cryptococcal meningitis in SLE patients.
Mycoses 2003 Apr
PMID:Cryptococcal meningitis in pediatric systemic lupus erythematosus. 1287 Feb 7

A promising approach to improving outcomes in patients with cryptococcal meningitis is to use adjunctive passive immunotherapy with a monoclonal antibody (MAb) directed against the capsular polysaccharide of Cryptococcus neoformans. This is the first application of MAb therapy for the treatment of a fungal disease in humans. We determined the safety and maximum tolerated dose of the murine anticryptococcal MAb 18B7 in a phase I dose-escalation study. The subjects were human immunodeficiency virus-infected patients who had been successfully treated for cryptococcal meningitis. Six dosing cohorts received MAb 18B7 at 0.01 to 2 mg/kg of body weight as a single infusion. Three patients each received 0.01, 0.05, 0.2, and 0.5 mg of MAb 18B7 per kg without significant adverse events. Four of the subjects who received the 1-mg/kg dose had mild study drug-associated toxicity, including transient nausea, vomiting, back pain, and urticarial rash. Two of the subjects who received 2 mg/kg developed drug-associated mild to moderate nausea, vomiting, chills, and myalgias. One of the subjects who received 2 mg/kg developed intracranial hypertension 10 weeks after MAb 18B7 administration. Serum cryptococcal antigen titers in the cohorts receiving doses of 1 and 2 mg/kg declined by a median of twofold at 1 week and a median of threefold at 2 weeks postinfusion, but the titers subsequently returned toward the baseline values by week 12. The half-life of MAb 18B7 in serum was approximately 53 h, while the MAb was undetectable in the cerebrospinal fluid of all patients. These data support the continued investigation of MAb 18B7 at a maximum single dose of 1.0 mg/kg.
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PMID:Phase I evaluation of the safety and pharmacokinetics of murine-derived anticryptococcal antibody 18B7 in subjects with treated cryptococcal meningitis. 1572 88

The objectives of this study were to determine the incidence of infection by respiratory viruses in preterm infants submitted to mechanical ventilation, and to evaluate the clinical, laboratory and radiological patterns of viral infections among hospitalized infants in the neonatal intensive care unit (NICU) with any kind of acute respiratory failure. Seventy-eight preterm infants were studied from November 2000 to September 2002. The newborns were classified into two groups: with viral infection (Group I) and without viral infection (Group II). Respiratory viruses were diagnosed in 23 preterm infants (29.5%); the most frequent was respiratory syncytial virus (RSV) (14.1%), followed by influenza A virus (10.2%). Rhinorrhea, wheezing, vomiting and diarrhea, pneumonia, atelectasis, and interstitial infiltrate were significantly more frequent in newborns with nosocomial viral infection. There was a correlation between nosocomial viral infection and low values of C-reactive protein. Two patients with mixed infection from Group I died during the hospital stay. In conclusion, RSV was the most frequent virus in these patients. It was observed that, although the majority of viral lower respiratory tract infections had a favorable course, some patients presented a serious and prolonged clinical manifestation, especially when there was concomitant bacterial or fungal infection.
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PMID:Incidence of respiratory viruses in preterm infants submitted to mechanical ventilation. 1572 73

Zygomycosis (Mucor- and Entomophtoramycosis) of the gastrointestinal tract is rare compared to other mycoses in the gastrointestinal area. The infection occurs mainly in immunosuppressed patients but rare cases concerning immunocompetent persons are also documented. Zygomycosis occurs in the gastrointestine primarily or due to disseminated disease. We report on a 48-year-old female alcohol-addicted patient who underwent gastric biopsies. The biopsy results showed invasive zygomycosis. Shortly thereafter, the patient died of sepsis. The second case presented here is a 15-year-old female patient with recurrent vomiting. Histological and immunohistochemical analysis of duodenal biopsy specimens revealed fungi of the class Zygomycetes. In addition, histological and/or microbiological examination demonstrated the presence of Candida in both cases.Zygomycosis of the gastrointestinal tract can have an aggressive course, making it important to know the morphological characteristics of the disease to facilitate early diagnosis and therapy. This is all the more important because the cultivation of fungi, as in our cases, is not always successful.
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PMID:[Zygomycetes in biopsies of the gastrointestinal tract]. 1595 83

A 3-year-old Boxer was presented with progressive diarrhea, vomiting, and lethargy of 5-months duration. The dog had watery black feces, a mature neutrophilia, and microcytic anemia. Cytologic evaluation of a direct fecal smear stained with Wright's-Giemsa revealed numerous encapsulated, narrow-based, budding organisms consistent with Cryptococcus sp. Pyogranulomatous inflammation and Cryptococcus organisms also were observed in ultrasound-guided fine-needle aspirates of the small intestine and mesenteric lymph nodes, and in histologic sections of colonic biopsies obtained by endoscopy. Multifocal chorioretinitis by fundic examination was consistent with systemic mycosis, and the reciprocal antigen titer (1600) on a cryptococcal antigen latex agglutination test for Cryptococcus neoformans was markedly increased. Using immunohistochemistry, the organism was identified further as C neoformans var. grubii (C neoformans var. neoformans serotype A). After 3 weeks of antifungal treatment, ultrasound examination revealed urinary bladder wall thickening, and Cryptococcus organisms were found in a urine sediment preparation. After 4 months of treatment, the dog was clinically normal and had no abnormal findings on CBC, serum biochemistry, urinalysis, or fecal cytology; however, the antigen titer remained unchanged, mesenteric lymphadenomegaly and jejunal wall thickening were still evident, and cytologic evaluation of fine-needles aspirates of the jejunal wall revealed budding Cryptococcus organisms. Intestinal involvement in dogs with cryptococcosis is rare, and diagnosis by fecal cytology has not been documented previously.
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PMID:Diagnosis of systemic cryptococcosis by fecal cytology in a dog. 1627 Feb 70

Recently, the incidence of fungal infections in children, including children with shunt-dependent hydrocephalus, has increased. The analysis comprised 8 children treated in the III Clinic of Pediatrics of ICZMP during the period of 12 months (12% of all infectious complications of the shunt system). The clinical picture of fungal infection included symptoms of shunt dysfunction: febrile conditions, vomiting, distress and loss of appetite. The most common pathogens isolated from the cerebro-spinal fluid were fungi from the Candida species. Mean value of pleocytosis in the cerebro-spinal fluid was 812 cell/microl, and mean protein concentration was 311 mg/dl. Treatment consisted of monotherapy with Diflucan, monotherapy with Ancotil or combined treatment with Ancotil and Amphotericine B. The drugs were administered intravenously and intraventricularly after removal of the shunt and application of external drainage. Sterility of cerebro-spinal fluid was obtained in the shortest time with the use of Ancotil. Prophylactic application of antifungal drugs decreases the frequency of infections in children with shunt-dependent hydrocephalus.
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PMID:[Mycotic complications of shunt infection in children with primary hydrocephalus]. 1688 73

Invasive pulmonary aspergillosis (IPA) poses major management problems for clinicians caring for patients with haematological diseases. The clinical courses of patients with IPA who had been hospitalised in Hematology Unit, Bone Marrow Transplantation Unit and Infectious Diseases and Clinical Microbiology Unit between 1998 and 2005, the efficacy and adverse effects and costs of antifungal drugs (conventional amphotericin B deoxycholate, liposomal amphotericin B, amphotericin B lipid complex and caspofungin) used in the therapy of these patients were analysed in this study. Ninety-three patients with IPA were reviewed retrospectively. Mean age of the patients was 40.4 +/- 15.1 years (range 14-70 years). Fifty-eight male patients and 35 female patients were included in the study. Manageable hypopotassemia, nausea/vomiting and headache were the most commonly observed side-effects during antifungal (AF) therapy. While it was not found to be statistically significant with regard to the mean time to resolution of fever (P = 0.8), it was found to be statistically significant with regard to radiological regression at 30th day, and mean duration of therapy between patients who were dead or alive (P < 0.05, P < 0.001). Total cost of AF therapy for 93 patients was found to be US$4 461 824 (minimum US$387-maximum US$279 023). Of this amount, US$4 272 845 represents the payment for AF drugs, US$188 979 the payment for other expenditures. Mean cost of therapy for a patient with IPA was found to be US$49 336. Although it seemed to be difficult, investigations should primarily focus on providing standardisation of parameters relating to the duration of AF therapy. Despite the less-than-optimal safety profile of CAB, it often remains to be the preferred first line option for the treatment of fungal infections because of its broad spectrum, activity and low acquisition cost.
Mycoses 2008 Jul
PMID:The clinical and pharmacoeconomic analysis of invasive aspergillosis in adult patients with haematological diseases. 1833 49

Histoplasmosis is a fungal infection caused by Histoplasma capsulatum. In the normal individual, both disseminated histoplasmosis and symptomatic adrenal histoplasmosis are rare. Herein, we describe the case of a 50-year-old gentleman residing in western Sudan who presented with a 7-month history of generalized body weakness, easy fatigue, and frequent attacks of vomiting and diarrhea. Physical examination and laboratory investigations confirmed the diagnosis of Addison's disease due to Histoplasma capsulatum var duboisii infection of the adrenal glands. He was treated with intravenous hydrocortisone, followed by oral prednisolone and itraconazole.
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PMID:Addison's disease due to Histoplasma duboisii infection of the adrenal glands. 1852 76

Fungal peritonitis is a relatively uncommon complication of peritoneal dialysis that contributes significantly to morbidity, drop out from the continuous ambulatory peritoneal dialysis (CAPD) program, and mortality. Candida sake infections were rarely published in literature. We present the first case of peritonitis due to C. sake. A 41-year-old man was admitted to our hospital with abdominal pain, nausea, vomiting, fever, weakness. Abdominal ultrasonography demonstrated a fistula tract, which has an opening at inferolateral of the umbilicus extending 5 cm from the skin into the abdominal cavity with a foreign body (11 x 10 mm length) inside the fistula. The foreign body was removed by surgery being apparently a part of a previously inserted peritoneal catheter. Postoperative specimens revealed polymorph leucocytes and yeast cells in Gram stain, and culture on Sabouraud dextrose agar (SDA) yielded a growth of a fungus, subsequently identified as C. sake with Api ID 32C. Fluconazole (200 mg/day) therapy was started. He recovered after two weeks of therapy. In conclusion, C. sake, a rare type of Candida species, should be considered as a probable peritoneal pathogen in patients with multiple episodes of bacterial peritonitis, previous broad-spectrum antibiotic therapy and diabetes mellitus.
Mycoses 2009 May
PMID:First case of continuous ambulatory peritoneal dialysis peritonitis due to Candida sake. 1862 71


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