Curvularia urinary tract infection: a case report

A healthy 5-year-old child had recurrent symptomatic urinary tract infections, the last of which was accompanied by black specks in her urine. These specks were identified asCurvularia species, a dermatiaceous mold. Symptoms resolved and fungi disappeared with long-term hydration, without specific antifungal treatment.     

原位肝移植术后真菌感染43例次诊治体会

目的 探讨原位肝移植术后真菌感染的诊断、治疗及预防。方法 回顾总结为175位患者所施行的180次原位肝移植的临床资料，并对可能导致真菌感染的危险因素进行统计学分析。结果 全组29例患者出现43例次真菌感染，感染率为16．6％(29／175)。其中念珠菌占98％(42／43)，曲霉菌2％(1／43)。发病中位时间为术后26d(3～96d)。常见感染部位依次是肺部37％(16／43)，肠管19％(8／43)和血液16％(7／43)。26例患者接受氟康唑治疗，感染严重的8例患者改用脂质体两性霉素B治疗。病死率45％(13／29)，直接与真菌感染有关的病死率为4．0％(7／175)。全胃肠外营养时间较长、抗生素治疗超过3周或出现肝动脉并发症的患者真菌感染的发生率显著增加。结论 真菌感染是影响肝移植生存率的重要原因之一。最常见的感染部位和病原菌分别是肺部和念珠菌。减少各种危险因素将有助于降低真菌感染的发生率。早期诊断和及时治疗是治愈的关键，严重的真菌感染应及时给予两性霉素B或其脂质体治疗。     

Urinary tract infection associated with urinary calculi. 1. The significance of urinary tract infection in urinary calculi

We investigated 158 cases of urinary stones (infection stones 56, metabolic stones 102) with special reference to pyuria, bacteriuria, stone culture and urease activities of isolated bacteria. Abacterial pyuria was noted in 9 out of 49 (18%) infection stones and in 53 of 77 (69%) metabolic stones. Bacteriuria was noted in 79% of the infection stones and 26% of the metabolic stones. Sixty-seven percent of the infection stones were infected with mainly urea splitting bacteria such as Proteus mirabilis and Staphylococcus. Twenty-three percent of metabolic stones were also infected. Though E. coli, a non-urea splitting bacteria, was isolated most frequently from metabolic stones, urease positive Staphylococcus and Pseudomonas were also isolated. Bacteria within stones could be predicted on the basis of urine culture results of only 20 of 41 infection stones and 8 of 24 metabolic stones. These facts are useful for selection of some antibiotics in the treatment of urinary tract infections associated with urinary calculi. Urinary infections of urea splitting bacteria in infection stones are thought to be initial factors of stone formation and those of non-urea splitting bacteria are to be superimposed. However, urea splitting bacteria in metabolic stones may convert them into infection stones in future.     

Fungal mastitis. Case report

Fungal (cryptococcal) mastitis in a young woman seemed to be a systemic manifestation of the infection, since it recurred contralaterally within 4 months. Diagnostic problems are discussed. Only two previous reports of deep mammary mycosis were found. In addition to excision, ketoconazole is recommended to prevent recurrence or serious complications.     

Fungal infection of aortoiliac endograft: a case report and review of the literature

Infection of aortoiliac endografts is, to date, a rare complication of endovascular surgery. Staphylococcus species are the most common responsible pathogens, just as in cases with infected grafts after open aortic surgery. We report a case of a 65-year-old man with a history of diabetes mellitus and bladder cancer who developed stent-graft infection 3 years after endovascular treatment for a 5.6 cm abdominal aortic aneurysm. The diagnosis of endograft infection was established radiologically by computed tomographic scans. After intravenous administration of antibiotics and fluids to improve his clinical condition, the patient underwent surgical excision of the infected prosthesis and a bifurcated rifampicin-impregnated Dacron graft was placed in situ. Cultures from the purulent fluid around the aorta and from the endograft revealed development of Candida albicans. To our knowledge, this is the first case of an infected endograft due to a fungus. The patient died from septic shock 3 days postoperatively in the intensive care unit.     

Fungal infection of a vascular prosthesis.

Chronic debilitating hematological disorders and cytotoxic drugs may create conditions causing a predisposition to fungal infections of vascular grafts. Under such circumstances routine bacteriological investigations should be supplemented by specific fungal media cultures and microscopic examination of removed infected graft.     

尿路真菌感染（附20例报告）

报告２０例尿路真菌感染，上尿路感染３例，下尿路感染１７例。病原菌为白色念珠菌，酵母样菌，平滑球拟酵母菌和曲霉菌。上尿路真菌感染的治疗以应用抗真菌药嘛康唑或氟康唑获佳良效果。这些新型抗真菌药抗菌谱广，疗效佳，安全而副作用少，下尿路真菌感染应用两性霉素Ｂ或咪康唑滴注膀胱治疗获良好疗效。     

Fungal infections of the urinary tract

Funguria, fungal urinary tract infections, are most commonly caused by Candida species but may also be caused by Cryptococcus neoformans, Aspergillus species, and the endemic mycoses. Candiduria presents as an increasingly common nosocomial infection, which may involve all anatomic levels of the urinary tract, resulting in a spectrum of disease varying from asymptomatic candiduria to clinical sepsis. Although several successful systemic or local therapeutic options exist for the eradication of candiduria, knowledge of the pathogenesis and natural history of candiduria has lagged. This has resulted in confusion among practitioners as to when antifungal therapy is indicated. Treatment guidelines have recently been formulated and are described herein.     

重症急性胰腺炎合并深部真菌感染(附40例报告)

目的 探讨重症急性胰腺炎（SAP）合并深部真菌感染的临床特点及相关因素。方法 回顾分析对比1994年1月-2001年12月SAP合并真菌感染（F具菌组）和单纯细菌感染（细菌组）病例的临床资料。结果 真菌组40例，细菌组84例；两组的年龄、性别、病因，APACHEⅡ评分差异均无显著性，真菌组住院时间明显比细菌组长（P=0.044)；糖尿病，SAPⅡ级，多次手术，肠和/或胆瘘与真菌感染相关；真菌组的死亡率明显高于细菌组（P=0.02)。结论 糖尿病、SAPⅡ级，多次手术，肠和/或胆瘘是SAP发生真菌感染的危险因子；真菌组的死亡率明显增高，胰外器官真菌感染多见于消化道、呼吸道、泌尿系，不明原因的意识改变，大出血应高度怀疑真菌感染。     

Labial fusion causing urinary incontinence and recurrent urinary tract infection in a postmenopausal female: a case report

A 73-year-old postmenopausal woman was admitted with recurrent urinary tract infection and a history of incontinence. General physical examination was normal. Complete labial fusion was noticed on genital examination. Surgical intervention was performed. This therapy alleviated incontinence and recurrent urinary tract infection.     

Fungal burn wound infection. A 10-year experience

To evaluate our experience with fungal burn wound infection, we performed a 10-year review for comparison with our experience with bacterial burn wound infection. During the study period, a marked decline occurred in bacterial wound infection but not in fungal wound infection. Patients with either bacterial or fungal burn wound infection had massive injury, with burn size averaging greater than 50% of the total body surface area. Factors that appear to have markedly reduced bacterial burn wound infection, including patient isolation, topical chemotherapeutic agents, and burn wound excision, do not appear to have had a similar effect on fungal wound infection. The mechanism of spread and colonization of fungi, and the lack of effective topical chemotherapeutic antifungal agents, may explain in part our findings.