Echocardiographic detection of fungal vegetations in Candida parasilopsis endocarditis

Echocardiographic detection of fungal vegetations in Candida parasilopsis endocarditis

C. parasllopsls endocardltis Echocardiography as diagnostic tool in Candida A case of primary Candida parasilopsis endocarditis in a heroin addict i...

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C. parasllopsls endocardltis Echocardiography as diagnostic tool

in Candida

A case of primary Candida parasilopsis endocarditis in a heroin addict involving the aortic valve is presented. Abnormal echoes in the aortic root during diastole and in the aortic valve during systole and diastole produced by fungal vegetations were found. The demonstration of fungal vegetations by echocardiography in the absence of positive blood cultures and systemic embolization is a useful diagnostic tool which should be utilized when fungal endocarditis is suspected.

tance of Tatz JS: Echocardiographic detection of fungal vegetations parasilopsis endocarditis. Am J Med 61: 273-276, 1976.

GomesJAC, Calderon J, Lajam F, Sakurai H, Friedman HS with the technical assis-

Fungal vegetatlons Heroin addict

Controversy exists regarding the relative safety of intravenously administered lidocaine and procainamide to patients with acutely impaired hemcdynamics. Accordingly, their effects were studied in 15 such patients, 14 with acute myocardial infarction and one with cardiomyopathy and severe congestive heart failure. All had elevated levels of pulmonary capillary wedge pressure (> 15 mm Hg) and/or low cardiac index (<2.5 liters/min/m2). Patients were given lidocaine, a 100 mg bolus followed by a 3 mg/min infusion and, after at least a 30 minute recovery period, procainamide, a 100 mg bolus over 2 minutes followed by a 20 mglmin infusion for 20 to 25 minutes. Small, clinically insignificant differences were observed in the hemodynamic responses to the drugs, and no clinically significant deterioration occurred with either. Conventional therapeutic doses of intravenous procainamide can be administered by this regimen.

1976.

Synovial biopsy Synovial fluld findings Polymorphonuclear leukocytes

Two cases of tuberculous arthritis with synovial fluid findings are presented and the major series with culture results and synovial fluid analyses are reviewed. Little experience with closed needle biopsy has been published. About one-fifth of the patients with tuberculous arthritis will have a positive synovial fluid acid-fast smear for tubercle bacilli. Most fluids exhibited a predominance of polymorphonuclear leukocytes. The importance of bacteriologic or histologic study of synovial fluid and membrane in establishing the diagnosis is emphasized. In general, this disease is different from tuberculous involvement of serous membranes both in the frequency of positive cultures and in the difference in cellular response.

Wallace R, Cohen AS: Tuberculous arthritis. A report of two cases with review of biopsy and synovial fluid findings. Am J Med: 61: 277-282, 1976.

luberculous arthrltls Mucin clot formatlon

Clinical associations were determined in 50 patients with late-onset idiopathic immunoglobulin deficiency. Both sexes were equally affected. The onset in men peaked in the third decade; in women it was more uniform. Respiratory tract infections, bronchiectasis, diarrhea, steatorrhea. giardiasis, achlorhydria, and small-bowel mucosal changes were common. Among 20 patients without diar+ea, giardiiis was detected in only one patient, achlorhydria in two patients. Tumors were common. Thyroid disorders occurred in six patients. The percentage of blood B lymphocytes was normal in eight of 10 patients tested.

1976.

cy. Clinical observations in 50 patients. Am J Med 61: 221-237,

Congenital agammaglobulinemia Thyroid abnormalities

Hermans PE, Diaz-Buxo JA, Stobo JD: idiopathic late-onset immunoglobulin deficien-

Late-onset immunoglobulin deficiency Diarrhea Malabsorption

BurtonJR, MathewMT, ArmstrongPW: Comparativeeffects of lidocaineand procain-

Impaired hemodynamlcs Cardiac index

amide on acutely impaired hemodynamics. Am J Med 61: 215-220,

Intravenous lidocaine/procainamlde Pulmonary capillary wedge pressure