Total splenic infarct due to Aspergillus and AIDS

A case of splenic infarction possibly attributable to Mycoplasma pneumoniae infection without accompanying pneumonia

We report a case of a patient with splenic infarction possibly attributable to Mycoplasma pneumoniae infection without accompanying pneumonia. A 24-year-old man was admitted to our hospital with a 7-day history of fever, sore throat, and left upper-quadrant abdominal pain. Chest radiography revealed no active lung lesions; however, abdominal computed tomography showed hepatosplenomegaly with splenic infarction. At the time of admission, the patient's serum IgM titer for M. pneumoniae was 79.7 U/mL (positive titer >70 U/mL). Two weeks later, the serum IgM titer for M. pneumoniae had markedly increased to 3,158.1 U/mL. The patient was treated with azithromycin, and his symptoms began to improve. After 5 weeks, the spleen size decreased, and a scar was observed at the site of the infarct.

Cytotoxicity of Aspergillus strains isolated from the neonatal intensive care unit environment

PURPOSE

It is essential in the medical care for immunocompromised patients that the environment should create minimal infection risk. Particularly, it concerns fungal infections. Fungi belonging to the Aspergillus genus are second frequent group of nosocomial pathogens producing opportunistic infections.

MATERIAL AND METHODS

The objective of the study was evaluation of prevalence and cytotoxicity of selected Aspergillus strains isolated from the neonatal intensive care unit environment. During 5 consecutive days, 30 samples of indoor air and 120 imprints from the ward environment were collected. Cytotoxicity of 17 strains was evaluated using a MTT (3-(4,5-dimethylthiazol-2-yl) 2,5 diphenyltetrazolium bromide) test.

RESULTS

Mean numbers of fungi in the indoor air varied from 50 to 2370 c.f.u.xm-3 while in the imprints from 0.04 to 8.83 c.f.u.xcm-2. Moulds were isolated from most of the materials. All of the 17 strains subject to MTT test were cytotoxic.

CONCLUSION

All of the Aspergillus strains isolated from the neonatal intensive care unit were cytotoxic. Cytotoxic Aspergillus strains present in the environment of immunocompromised patients may be potentially dangerous to them.

Mycoplasma pneumoniae, splenic infarct, and transient antiphospholipid antibodies: a new association?

We report 2 children with Mycoplasma pneumoniae pulmonary infection with splenic infarcts and transient antiphospholipid antibodies. This association has not been reported previously.

Fatal, complete splenic infarction and hepatic infection due to disseminated Trichosporon beigelii infection

We report on a 56-year-old woman with acute lymphocytic leukemia who presented with right upper quadrant pain, fever, nausea, and vomiting. Laboratory studies confirmed fungemia with Trichosporum beigelii, and contrast-enhanced computed tomography of the abdomen demonstrated numerous low-attenuation liver lesions and a hypodense spleen with capsular enhancement suggestive of complete splenic infarction. Subsequent splenectomy confirmed that the spleen was completely infarcted and infiltrated with Trichosporum. The patient had a difficult postoperative course and died despite aggressive antifungal therapy.