Date: 5 August 2014
Pt SD congestive heart failure 5 images
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FIT
Notes:
This 63 year old woman with a lung nodule, probably caused by Aspergillus, was treated with itraconazole 300mg daily. After 3 weeks, she noticed dizziness and her blood pressure was reduced at 100/60. A week later, she was complaining of headaches, feeling unwell and fluctuating blood pressure. Her BP was 133/62 and pulse 90/min and regular. Her thyroid replacement therapy was excessive and so reduced, as was her itraconazole dose, although subsequent itraconazole levels were in the therapeutic range. Six days later she was admitted to hospital very breathless with bilateral pleural effusions. Itraconazole was stopped.
Her CXR shows bilateral effusions, probable cardiac enlargement and some upper lobe vessel fullness in the lungs. The CT scan confirms bilateral flexural effusions, with associated consolidated lung and fluid in the fissure on the right. The heart is enlarged and right ventricle dilated. In May, all had resolved and she is left with a nodule in the left lower lobe.
Images library
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Image D & E. A case of onychomycosis associated with Aspergillus ochraceopetaliformis as described in Nail infection by Aspergillus ochraceopetaliformis. Med Mycol. 2009 Mar 9:1-5, 2009, Brasch J, Varga J, Jensen JM, Egberts F & Tintelnot K
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Further details
Image 5. Oral itraconazole pulse therapy was given to the patient (200 mg twice daily for 1 week, with 3 weeks off between successive pulses, for four pulses) and treatment was successful.
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This patient was 28 yr old with adult lymphocytic leukaemia. She received induction chemotherapy and this infection developed 2 days after recovering from neutropenia.
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Close-up image of the lesion on the left thigh showing a mat of hyphae over the wound.
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Eosinophilic mucin with A. flavus in the nasal cavity. Irregular crust of 2.5 cm from a patient diagnosed as allergic fungal sinusitis. Patient with allergic fungal sinusitis
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GMS stain of eosinophilic mucin reveals a darkly stained dichotomously branched A. flavus hyphae within cellular background. Patient with allergic fungal sinusitis
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4 Total obstruction of the sinuses due to inflamed mucosa. (Patient 04)
