Date: 26 November 2013
Patient MB X rays and CT scans. Chronic calcified maxillary sinusitis, patient had a palate defect.A. fumigatus cultured.
Images A&B Plain X rays antero-posterior and lateral, pre-operatively of Pt MB aged 76 who presented with unilateral nasal stuffiness and difficulty getting dentures fitted. She had hda these symptoms for many years. A large irregular calcified mass can be seen replacing the right maxillary sinus.
Images C D & E Coronal CT scan images of Pt MB showing a completely obstructed nasal cavity bilaterally and loss of internal nasal architecture. On the right side is large lamellar calcified lesion embedded in the extensive inflammatory material. Loss of bony margins is seen in numerous locations. This material was all removed surgically and showed mostly necrotic debris with Charcot-Leyden crystals and a few eosinophils and degenerate fungal hyphae. Aspergillus fumigatus was cultured from the material, especially infero-laterally on the right.
Image F Photograph through the mouth post-operatively showing the palate and a large defect in its right side. Through the defect can be seen the interior of the right maxillary sinus and nasal cavity with the inferior turbinate just visible.
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Patient with chronic productive cough, chest pain and ABPA, unable to take itraconazole or nebulised amphotericin B. Smokes at least 40 roll up cigarettes a day.
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Laryngeal aspergillosis, probably related to inhaled corticosteroids.
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VL-2397 (formerly known as ASP2397) is a novel antifungal drug initially developed by our partner, Astellas Pharma. This drug was isolated from a leaf litter fungus Acremonium species collected in a Malaysian national park. Astellas presented two posters at the 2014 ICAAC meeting which described the in vitro and the in vivo antifungal activities of this drug. The differentiating attributes from the preclinical data of VL-2397 include:
- A novel mechanism of action, with a potential to be complementary or synergistic with the existing classes of antifungals.
- Rapid fungal cell kill activity demonstrated in preclinical models, which was faster than marketed antifungals.
- Activity against azole-resistant fungal species.
- Low propensity for P450 drug-drug interactions.
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SCY-078, new orally available beta-1,3-d-glucan synthase inhibitor, Formely MK-3118.
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Pt DSM Community acquired primary Aspergillus pneumonia. Two x-rays taken on 02/02/2010 then 05/03/2010
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