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Yoshinouchi T, Yamamoto K, Migita M, Yokoyama T, Nakamura T, Matsuoka M. Diagnosis and clinical management of Exophiala dermatitidis pneumonia in a patient with anorexia nervosa: A case report. Med Mycol Case Rep 2023; 42:100617. [PMID: 38022890 PMCID: PMC10661607 DOI: 10.1016/j.mmcr.2023.100617] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2023] [Revised: 11/05/2023] [Accepted: 11/07/2023] [Indexed: 12/01/2023] Open
Abstract
We report a patient with anorexia nervosa without bronchiectasis and cystic fibrosis who developed acute pneumonia caused by Exophiala dermatitidis (E. dermatitidis). The black fungus found in multiple sputum cultures was determined to be E. dermatitidis using mass spectrometry and identified using genetic analysis. Although the initiation of antifungal therapy was late, the pneumonia gradually improved with long-term treatment. This case highlights the need for early diagnosis and effective long-term treatment of the fungal etiologic agent.
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Affiliation(s)
- Tatsuya Yoshinouchi
- Department of Laboratory Medicine, Kumamoto University Hospital, Kumamoto, 860-8556, Japan
| | - Keiichi Yamamoto
- Department of Laboratory Medicine, Kumamoto University Hospital, Kumamoto, 860-8556, Japan
| | - Mitsuru Migita
- Department of Neuropsychiatry, Faculty of Life Sciences, Kumamoto University, Kumamoto, 860-8556, Japan
| | - Toshiro Yokoyama
- Department of Laboratory Medicine, Kumamoto University Hospital, Kumamoto, 860-8556, Japan
| | - Tomofumi Nakamura
- Department of Laboratory Medicine, Kumamoto University Hospital, Kumamoto, 860-8556, Japan
- Department of Hematology, Rheumatology, and Infectious Diseases, Faculty of Life Sciences, Kumamoto University, Kumamoto, 860-8556, Japan
| | - Masao Matsuoka
- Department of Laboratory Medicine, Kumamoto University Hospital, Kumamoto, 860-8556, Japan
- Department of Hematology, Rheumatology, and Infectious Diseases, Faculty of Life Sciences, Kumamoto University, Kumamoto, 860-8556, Japan
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Nitsch A, Kearns M, Mehler P. Pulmonary complications of eating disorders: a literature review. J Eat Disord 2023; 11:12. [PMID: 36717849 PMCID: PMC9887828 DOI: 10.1186/s40337-023-00735-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Accepted: 01/11/2023] [Indexed: 02/01/2023] Open
Abstract
The medical complications of eating disorders (EDs) have been described in the literature; however, the pulmonary system has historically been described as relatively spared from the ravages of eating disorders and thus neglected in the literature. Here we review the pulmonary complications that have been described in the literature, including the effects of starvation on the lungs of nutritionally deprived animals and patients with anorexia nervosa. There is clear evidence of weakness of respiratory muscles with starvation in both groups. However, there is discordance in the literature as to whether starvation results in "nutritional emphysema," and if so, by what mechanism and at what degree of malnutrition it develops. We also explore the growing concern for the risk of non-tuberculosis mycobacterium infection as well as risk for pneumomediastinum and pneumothorax in patients with restrictive EDs. From the limited literature, it is clear the lungs, in fact, are not spared and that further research is needed to fully understand the full extent of pulmonary complications instigated by EDs.
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Affiliation(s)
- Allison Nitsch
- ACUTE Center for Eating Disorders at Denver Health, 777 Bannock Street, Denver, CO, 80204, USA.,Department of Medicine, University of Colorado School of Medicine, 13001 E 17th Pl, Aurora, CO, 80045, USA
| | - Mark Kearns
- Department of Pulmonary and Critical Care Medicine, Denver Health, Denver, USA.,Department of Medicine, University of Colorado School of Medicine, 13001 E 17th Pl, Aurora, CO, 80045, USA
| | - Philip Mehler
- ACUTE Center for Eating Disorders at Denver Health, 777 Bannock Street, Denver, CO, 80204, USA. .,Department of Medicine, University of Colorado School of Medicine, 13001 E 17th Pl, Aurora, CO, 80045, USA. .,Eating Recovery Center, 7351 E Lowry Blvd, Denver, CO, 80230, USA.
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Shirahata T, Akimoto M, Minegishi K, Endo S, Nakamura H, Nagata M. Video-assisted thoracic surgery for a case of chronic progressive pulmonary aspergillosis undergoing haemodialysis complicated by anorexia nervosa: a case report. Respirol Case Rep 2021; 9:e00727. [PMID: 33664960 PMCID: PMC7900710 DOI: 10.1002/rcr2.727] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2020] [Revised: 02/08/2021] [Accepted: 02/09/2021] [Indexed: 11/18/2022] Open
Abstract
We describe the case of a 37-year-old female with chronic progressive pulmonary aspergillosis (CPPA) with anorexia nervosa (AN) while undergoing haemodialysis for renal failure, who had video-assisted thoracic surgery (VATS) due to recurrent haemoptysis. She was referred to the Department of Respiratory Medicine for evaluation of an abnormal chest shadow. She was diagnosed with CPPA by serological examinations, radiological features, and bacterial culture. She was initially treated with oral antifungal therapy and transcatheter embolization. VATS lobectomy was eventually performed despite the AN and haemodialysis because of poorly controlled haemoptysis. The postoperative course was uneventful, and the final histopathological examination confirmed CPPA.
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Affiliation(s)
- Toru Shirahata
- Department of Respiratory MedicineSaitama Medical UniversitySaitamaJapan
| | - Maho Akimoto
- Department of Diagnostic Pathology, Saitama Medical CenterJichi Medical UniversitySaitamaJapan
| | - Kentaro Minegishi
- Department of General Thoracic Surgery, Saitama Medical CenterJichi Medical UniversitySaitamaJapan
| | - Shunsuke Endo
- Department of General Thoracic Surgery, Saitama Medical CenterJichi Medical UniversitySaitamaJapan
| | - Hidetoshi Nakamura
- Department of Respiratory MedicineSaitama Medical UniversitySaitamaJapan
| | - Makoto Nagata
- Department of Respiratory MedicineSaitama Medical UniversitySaitamaJapan
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Alhanna J, Purucker M, Steppert C, Grigull-Daborn A, Schiffel G, Gruber H, Borgmann S. Mycobacterium chimaera causes tuberculosis-like infection in a male patient with anorexia nervosa. Int J Eat Disord 2012; 45:450-2. [PMID: 21656541 DOI: 10.1002/eat.20942] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/17/2011] [Indexed: 11/07/2022]
Abstract
Here we present a 27-year-old male patient--with a known prolonged history of anorexia nervosa (AN)--suffering from tuberculosis like infection. At the time he was admitted to clinical treatment, he had developed fever up to 40°C and survived on a body mass index of 11.8. In this case, Mycobacterium chimaera, generally recognized for low pathogenicity, was identified as the causative agent. Remission from lung infection was achieved after antibiotic treatment according to laboratory susceptibility testing while earlier antituberculosis therapies had failed. Because of a large cavity in the upper left lung, surgical excision was necessary to prevent recurrence of lung infection. Moreover, stabilization of the patient general health problem needs to be supported by a lasting psychotherapy.
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Affiliation(s)
- Joseph Alhanna
- Department of Internal Medicine 2, Klinikum Bayreuth, Bayreuth, Germany
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Sagan D, Goździuk K, Korobowicz E. Predictive and Prognostic Value of Preoperative Symptoms in the Surgical Treatment of Pulmonary Aspergilloma. J Surg Res 2010; 163:e35-43. [DOI: 10.1016/j.jss.2010.06.039] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2010] [Revised: 06/11/2010] [Accepted: 06/15/2010] [Indexed: 10/19/2022]
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Parker KL, Zervos MD, Darvishian F, Bizekis CS. Video-Assisted Thoracoscopic Lobectomy for Pulmonary Aspergilloma After Life-Threatening Hemoptysis in a Patient With Lupus. Ann Thorac Surg 2010; 89:291-2. [DOI: 10.1016/j.athoracsur.2009.06.084] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2009] [Revised: 05/26/2009] [Accepted: 06/16/2009] [Indexed: 11/25/2022]
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