• Title/Summary/Keyword: Immunocompromised Patient

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Pneumonia in Immunocompromised Patients (면역저하 환자에서의 폐렴)

  • Yoon, Hyoung-Kyu
    • Tuberculosis and Respiratory Diseases
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    • v.70 no.5
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    • pp.371-383
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    • 2011
  • The number of immunocompromised patients has increased over the past decades due to HIV infection, solid and stem cell transplantation, intensified chemotherapy and treatment of autoimmune disease. Pneumonia is a major cause of both morbidity and mortality in immunocompromised patients. Clinical management of pneumonia is difficult, since differential diagnosis in this setting is broad and includes both infectious and noninfectious processes. Because the development of pneumonia in immunocompromised patients is frequently life threatening, early therapeutic and diagnostic intervention is essential to obtain better outcomes.

Cervical Spondylodiscitis Caused by Candida Albicans in Non-Immunocompromised Patient

  • Moon, Hyung-Ho;Kim, Jae-Hoon;Moon, Byung-Gwan;Kim, Joo-Seung
    • Journal of Korean Neurosurgical Society
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    • v.43 no.1
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    • pp.45-47
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    • 2008
  • Fungal infections of the spine are relatively uncommon. Moreover, cervical spondylodiscitis due to Candida albicans in non-immunocompromised patient is very rare. We report a case of Candida spondylodiscitis in a 64-year-old woman who complained of neck pain. The clinical feature and treatment option are presented with a review of pertinent literatures.

Clinical Diagnosis and Treatment of Herpes Zoster in an Immunocompromised Dental Patient: A Case Report

  • Kim, Hyun-Suk;Ahn, Kyo-Jin;Kim, Young-Kyun
    • Journal of Korean Dental Science
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    • v.7 no.2
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    • pp.99-105
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    • 2014
  • Herpes zoster (HZ) is an acute, unilateral inflammatory viral infection characterized by a rash with painful blisters in a localized area of the body. HZ is often associated with intense pain in the acute phase and presents postherpetic neuralgia in the chronic phase. During the prodromal stage of the HZ from the trigeminal nerve, however, the only presenting symptom may be odontalgia, which could be particularly difficult to diagnose. This distinctive syndrome occurs predominantly in the immunocompromised or elderly individuals. In this article, we report a case of HZ developed in the trigeminal nerve of a 60-year-old immunocompromised female patient, whose symptoms including atypical, non-odontogenic odontalgia had improved after series of antiviral treatments.

Primary Laryngeal Aspergillosis in Immunocompetent Patient - A Case Report and Review -

  • Kang, Sung-Mi;Hong, Hyun-Jun;Bae, Yoon-Sung;Yoon, Sun-Och
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.22 no.1
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    • pp.60-62
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    • 2011
  • Primary laryngeal aspergillosis is rare, It is most often found in immunocompromised patient, such as leukemia, malignant disease, diabetes or immunosuppressive drugs. These days the occurrences of laryngeal aspergillosis in immunocompetent patients are increasing. The cause of laryngeal aspergillosis in immunocompetent patients is not clear, but a few factors are considered such as iatrogenic factors, vocal abuse, vocal fold cyst and occupational factors. The histopathologic characteristics are somewhat different between that of immunocompromised patients and immunocompetent patients. We report a case of primary vocal cord aspergillosis in immunocompetent patient who had treated with only surgery and brief review of the pertinent literature.

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A Case of a 16-Year-Old Patient With Chronic Invasive Aspergillosis in the Trachea Treated With Segmental Tracheal Resection and Cricotracheal Anastomosis

  • Heo, Yujin;Choi, Nayeon;Yoo, Keon Hee;Chung, Man Ki
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.33 no.1
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    • pp.42-44
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    • 2022
  • Chronic invasive aspergillosis is a life-threatening disease, especially in immunocompromised patients. The diagnosis and treatment of tracheal aspergillosis (TA) are challenging because of its rarity and nonspecific clinical presentations. The treatment standard of TA has been medical treatment like other forms of invasive aspergillosis, but patients with medically resistant TA require surgical intervention. We demonstrated a successful surgical outcome of chronic invasive TA in a 16-year-old patient with immunocompromised status related to acute myelocytic leukemia.

Clinical and Imaging Characteristics of SARS-CoV-2 Breakthrough Infection in Hospitalized Immunocompromised Patients

  • Jong Eun Lee;Jinwoo Kim;Minhee Hwang;Yun-Hyeon Kim;Myung Jin Chung;Won Gi Jeong;Yeon Joo Jeong
    • Korean Journal of Radiology
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    • v.25 no.5
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    • pp.481-492
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    • 2024
  • Objective: To evaluate the clinical and imaging characteristics of SARS-CoV-2 breakthrough infection in hospitalized immunocompromised patients in comparison with immunocompetent patients. Materials and Methods: This retrospective study analyzed consecutive adult patients hospitalized for COVID-19 who received at least one dose of the SARS-CoV-2 vaccine at two academic medical centers between June 2021 and December 2022. Immunocompromised patients (with active solid organ cancer, active hematologic cancer, active immune-mediated inflammatory disease, status post solid organ transplantation, or acquired immune deficiency syndrome) were compared with immunocompetent patients. Multivariable logistic regression analysis was performed to evaluate the effect of immune status on severe clinical outcomes (in-hospital death, mechanical ventilation, or intensive care unit admission), severe radiologic pneumonia (≥ 25% of lung involvement), and typical CT pneumonia. Results: Of 2218 patients (mean age, 69.5 ± 16.1 years), 274 (12.4%), and 1944 (87.6%) were immunocompromised an immunocompetent, respectively. Patients with active solid organ cancer and patients status post solid organ transplantation had significantly higher risks for severe clinical outcomes (adjusted odds ratio = 1.58 [95% confidence interval {CI}, 1.01-2.47], P = 0.042; and 3.12 [95% CI, 1.47-6.60], P = 0.003, respectively). Patient status post solid organ transplantation and patients with active hematologic cancer were associated with increased risks for severe pneumonia based on chest radiographs (2.96 [95% CI, 1.54-5.67], P = 0.001; and 2.87 [95% CI, 1.50-5.49], P = 0.001, respectively) and for typical CT pneumonia (9.03 [95% CI, 2.49-32.66], P < 0.001; and 4.18 [95% CI, 1.70-10.25], P = 0.002, respectively). Conclusion: Immunocompromised patients with COVID-19 breakthrough infection showed an increased risk of severe clinical outcome, severe pneumonia based on chest radiographs, and typical CT pneumonia. In particular, patients status post solid organ transplantation was specifically found to be associated with a higher risk of all three outcomes than hospitalized immunocompetent patients.

Comorbid Gastric Adenocarcinoma and Gastric and Duodenal Strongyloides stercoralis Infection: A Case Report

  • Seo, An Na;Goo, Youn-Kyoung;Chung, Dong-Il;Hong, Yeonchul;Kwon, Ohkyoung;Bae, Han-Ik
    • Parasites, Hosts and Diseases
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    • v.53 no.1
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    • pp.95-99
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    • 2015
  • Strongyloides stercoralis can cause systemic infection, termed strongyloidiasis, and gastrointestinal ulcer disease in immunocompromised patients. However, to our knowledge, there are no reported cases of comorbid gastric adenocarcinoma and S. stercoralis infection. Here, we report a case of an 81-year-old Korean man who presented with S. stercoralis infection coexisting with early gastric adenocarcinoma (T1aN0M0). S. stercoralis eggs, rhabditiform larvae, and adult females were observed in normal gastric and duodenal crypts. They were also observed in atypical glands representative of adenocarcinoma and adenoma. Preliminary laboratory tests revealed mild neutrophilic and eosinophilic leukocytosis. A routine stool test failed to detect rhabditiform larvae in the patient's fecal sample; however, S. stercoralis was identified by PCR amplification and 18S rRNA sequencing using genomic DNA extracted from formalin-fixed paraffin-embedded tissues. Postoperatively, the patient had a persistent fever and was treated with albendazole for 7 days, which alleviated the fever. The patient was followed-up by monitoring and laboratory testing for 4 months postoperatively, and no abnormalities were observed thus far. The fact that S. stercoralis infection may be fatal in immunocompromised patients should be kept in mind when assessing high-risk patients.

Septicemia Caused by Leuconostoc lactis with Intrinsic Resistance to Vancomycin in a Patient with Biliary Stent

  • Shin, Kyeong Seob;Han, Kyudong;Hong, Seung Bok
    • Biomedical Science Letters
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    • v.19 no.3
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    • pp.280-283
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    • 2013
  • Leuconostoc spp. is intrinsically resistant against vancomycin and rarely causes the infection in immunocompromised patients. In this report, we describe a fatal case of Leuconostoc lactis bacteremia in a patient with biliary tract stent insertion to resolve the biliary tract obstruction by multiple pseudocysts in the pancreatic head region. Leuconostic lactis isolated from the blood of the patients was confirmed by 16S rRNA sequencing and this isolate was susceptible against most antibiotics, including levofloxacin, penicillin, erythromycin and cefotaxime except vancomycin. The septic shock and multi-organ failure was abruptly progressed due to delayed use of adequate antibiotic. Using vancomycin as the empirical antibiotics in a bacteremic patient by Gram positive cocci, the treatment failures by the isolates with intrinsic resistance against vancomycin have to be considered. In addition, the prompt and accurate identification of Leuconostoc spp. are very important to select the adequate antibiotics.

Acute Pulmonary Mycetoma Due to Candida albicans in AML patient : Case Report (급성 백혈병 환자에서 Candida에 의한 급성 폐진균 감염)

  • Lee, Jae-Kyo;Hwang, Mi-Soo;Kim, Mi-Jin
    • Journal of Yeungnam Medical Science
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    • v.12 no.1
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    • pp.135-140
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    • 1995
  • Acute cavitating pulmonary infection with a mycetoma is sometimes occur in immunocompromised patient. Most mycetoma lesions are due to Aspergillus species, and lesion caused by Candida species is rare. So we report an experienced case that pulmonary and rib infection caused by Candida species in AML patient and complete remission with previous reports.

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Aspergillus Tracheobronchitis in a Mild Immunocompromised Host

  • Cho, Byung Ha;Oh, Youngmin;Kang, Eun Seok;Hong, Yong Joo;Jeong, Hye Won;Lee, Ok-Jun;Chang, You-Jin;Choe, Kang Hyeon;Lee, Ki Man;An, Jin-Young
    • Tuberculosis and Respiratory Diseases
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    • v.77 no.5
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    • pp.223-226
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    • 2014
  • Aspergillus tracheobronchitis is a form of invasive pulmonary aspergillosis in which the Aspergillus infection is limited predominantly to the tracheobronchial tree. It occurs primarily in severely immunocompromised patients such as lung transplant recipients. Here, we report a case of Aspergillus tracheobronchitis in a 42-year-old man with diabetes mellitus, who presented with intractable cough, lack of expectoration of sputum, and chest discomfort. The patient did not respond to conventional treatment with antibiotics and antitussive agents, and he underwent bronchoscopy that showed multiple, discrete, gelatinous whitish plaques mainly involving the trachea and the left bronchus. On the basis of the bronchoscopic and microbiologic findings, we made the diagnosis of Aspergillus tracheobronchitis and initiated antifungal therapy. He showed gradual improvement in his symptoms and continued taking oral itraconazole for 6 months. Physicians should consider Aspergillus tracheobronchitis as a probable diagnosis in immunocompromised patients presenting with atypical respiratory symptoms and should try to establish a prompt diagnosis.