FRINK Linked Data Fragments server

Matches in SemOpenAlex for { <https://semopenalex.org/work/W2474866163> ?p ?o ?g. }

• W2474866163 endingPage "120" @default.
• W2474866163 startingPage "119" @default.
• W2474866163 abstract "A 65-year-old man, an avid duck hunter presented for management of newly diagnosed AML (acute myeloid leukemia). One week before, he developed pruritus and erythema on his left leg after recently walking through tall grass in Louisiana wetlands. He developed a “black spot” and ulcer in the center of the worsening erythematous area. Physical examination by a local physician revealed a painful erythematous ulcerated lesion over left lower extremity with central black eschar (Fig. 1A). Initial peripheral blood workup revealed 33% blasts and pancytopenia (hemoglobin-4.3 g/dL, WBC-1.17 K/μL, platelets-50 K/μL). After transfer to our institution and further evaluation, the AML was found to have trisomy13 and IDH1 mutation. Meanwhile, his left leg ulcer had expanded significantly and was aggressively debrided. The patient was started on broad spectrum intravenous antibiotics and voriconazole which was changed to high dose posaconazole, 10 days after presentation. During this time, he was also started on induction chemotherapy with idarubicin and cytarabine and remained afebrile throughout the first two weeks. Wound culture from leg grew Exserohilum spp. His lower extremity wound was clinically improving; however, he remained pancytopenic and developed fatigue with fever. The patient was placed in isolation due to progressive neutropenia. He then developed a new scrotal lesion 1 cm in size. A chest CT scan revealed multiple pulmonary nodules raising the suspicion of disseminated fungal infection. An echocardiogram did not detect valvular vegetations. He rapidly developed respiratory failure, atrial fibrillation and multiorgan failure with septic shock and was transferred to ICU. The patient was treated with liposomal amphotericin-B, and high dose posaconazole followed by isavuconazonium. Scrotal skin biopsy demonstrated extensive dermal and angioinvasion by septate hyphal organisms Fig. 1(B–E). Respiratory and blood cultures as well as the scrotal lesion eventually grew Scedosporium prolificans, while the rest of the infectious workup was negative. Unfortunately, he died within 4 weeks of diagnosis with active AML. A–E: Clinical and Histopathologic features of invasive fungal infection (A) Leg ulcer with black central eschar, which grew Exserohilum sp. B: Epidermal ulceration with fibrin crust (top right) with several thrombosed blood vessels (arrows) and purple fluffy material representing fungal organisms seen throughout the dermis. C: Numerous nonpigmented branching hyphae and rare conidia (arrow head). Branching at right-angles can be easily appreciated (arrows). D: Grocott's methenamine silver (GMS) stain highlights the angioinvasive fungal organisms with numerous septate (arrow heads) hyphae and several intravascular conidia (arrows). The vessel wall is indicated by the dashed line. E: Some hyphae are arranged parallel to each other, with branching at right angles, resulting in H-shaped structures (arrows). Several conidia (arrows) are also seen. Invasive fungal infection in patients with newly diagnosed AML is a major cause of death. Infection by S. prolificans and Exserohilum spp. in adults with AML is rarely described 1, 2. S. prolificans. is a rare multidrug resistant opportunistic fungus, refractory to antifungal treatments with an aggressive clinical course 3. These fungi are saprophytic and grow in soil and specifically in environments with oil contamination 4. In a large retrospective study with 8633 patients with acute leukemia, S. prolificans. was reported from only 5 patients. Lungs, soft tissues, and muscles were commonly involved 3. In vitro studies have shown that triazoles are superior to amphotericin-B against Scedosporium 5. Cases where Scedosporium infection was treatable were those where the neutrophil counts were normalized, indicating that host immunity is critical for infection control. It is possible that our patient might have acquired a mixed fungal infection through contamination of leg wound with soil from the wetlands. While Exserohilum probably caused local skin infection, Scedosporium may have penetrated via the wound and disseminated systemically after chemotherapy induced immunosuppression. This case illustrates the potential of early infection by unusual “earth” fungi by direct inoculation event early in the course of AML treatment. Clinicians treating patients with AML should be aware of rare fungal infections with potentially grave prognosis. PJ, PN, PP, and NP gathered data, evaluated the pathology and organized the figures CB, DK, VM, and NP managed the patient. All Authors have reviewed and approved the manuscript and do not have any disclosures." @default.
• W2474866163 created "2016-07-22" @default.
• W2474866163 creator A5013945697 @default.
• W2474866163 creator A5020340537 @default.
• W2474866163 creator A5041039527 @default.
• W2474866163 creator A5043723479 @default.
• W2474866163 creator A5067777914 @default.
• W2474866163 creator A5070904381 @default.
• W2474866163 creator A5085419504 @default.
• W2474866163 creator A5087851907 @default.
• W2474866163 creator A5088307376 @default.
• W2474866163 date "2016-07-14" @default.
• W2474866163 modified "2023-10-06" @default.
• W2474866163 title "Mixed angioinvasive exserohilum and scedosporium infection in a patient with AML" @default.
• W2474866163 cites W2099115535 @default.
• W2474866163 cites W2101752468 @default.
• W2474866163 cites W2155071468 @default.
• W2474866163 cites W2161633414 @default.
• W2474866163 cites W2313683562 @default.
• W2474866163 doi "https://doi.org/10.1002/ajh.24455" @default.
• W2474866163 hasPubMedCentralId "https://www.ncbi.nlm.nih.gov/pmc/articles/5884637" @default.
• W2474866163 hasPubMedId "https://pubmed.ncbi.nlm.nih.gov/27341684" @default.
• W2474866163 hasPublicationYear "2016" @default.
• W2474866163 type Work @default.
• W2474866163 sameAs 2474866163 @default.
• W2474866163 citedByCount "2" @default.
• W2474866163 countsByYear W24748661632019 @default.
• W2474866163 countsByYear W24748661632022 @default.
• W2474866163 crossrefType "journal-article" @default.
• W2474866163 hasAuthorship W2474866163A5013945697 @default.
• W2474866163 hasAuthorship W2474866163A5020340537 @default.
• W2474866163 hasAuthorship W2474866163A5041039527 @default.
• W2474866163 hasAuthorship W2474866163A5043723479 @default.
• W2474866163 hasAuthorship W2474866163A5067777914 @default.
• W2474866163 hasAuthorship W2474866163A5070904381 @default.
• W2474866163 hasAuthorship W2474866163A5085419504 @default.
• W2474866163 hasAuthorship W2474866163A5087851907 @default.
• W2474866163 hasAuthorship W2474866163A5088307376 @default.
• W2474866163 hasBestOaLocation W24748661631 @default.
• W2474866163 hasConcept C126322002 @default.
• W2474866163 hasConcept C141071460 @default.
• W2474866163 hasConcept C16005928 @default.
• W2474866163 hasConcept C2776694085 @default.
• W2474866163 hasConcept C2777063308 @default.
• W2474866163 hasConcept C2778041864 @default.
• W2474866163 hasConcept C2778729363 @default.
• W2474866163 hasConcept C2779020398 @default.
• W2474866163 hasConcept C2779117419 @default.
• W2474866163 hasConcept C2779382419 @default.
• W2474866163 hasConcept C2779548794 @default.
• W2474866163 hasConcept C2780007613 @default.
• W2474866163 hasConcept C2780206043 @default.
• W2474866163 hasConcept C2780690907 @default.
• W2474866163 hasConcept C71924100 @default.
• W2474866163 hasConceptScore W2474866163C126322002 @default.
• W2474866163 hasConceptScore W2474866163C141071460 @default.
• W2474866163 hasConceptScore W2474866163C16005928 @default.
• W2474866163 hasConceptScore W2474866163C2776694085 @default.
• W2474866163 hasConceptScore W2474866163C2777063308 @default.
• W2474866163 hasConceptScore W2474866163C2778041864 @default.
• W2474866163 hasConceptScore W2474866163C2778729363 @default.
• W2474866163 hasConceptScore W2474866163C2779020398 @default.
• W2474866163 hasConceptScore W2474866163C2779117419 @default.
• W2474866163 hasConceptScore W2474866163C2779382419 @default.
• W2474866163 hasConceptScore W2474866163C2779548794 @default.
• W2474866163 hasConceptScore W2474866163C2780007613 @default.
• W2474866163 hasConceptScore W2474866163C2780206043 @default.
• W2474866163 hasConceptScore W2474866163C2780690907 @default.
• W2474866163 hasConceptScore W2474866163C71924100 @default.
• W2474866163 hasIssue "1" @default.
• W2474866163 hasLocation W24748661631 @default.
• W2474866163 hasLocation W24748661632 @default.
• W2474866163 hasLocation W24748661633 @default.
• W2474866163 hasLocation W24748661634 @default.
• W2474866163 hasOpenAccess W2474866163 @default.
• W2474866163 hasPrimaryLocation W24748661631 @default.
• W2474866163 hasRelatedWork W1498271295 @default.
• W2474866163 hasRelatedWork W1826724364 @default.
• W2474866163 hasRelatedWork W1971698933 @default.
• W2474866163 hasRelatedWork W2058521439 @default.
• W2474866163 hasRelatedWork W2081883131 @default.
• W2474866163 hasRelatedWork W2340490413 @default.
• W2474866163 hasRelatedWork W2789581733 @default.
• W2474866163 hasRelatedWork W2911250108 @default.
• W2474866163 hasRelatedWork W3000385729 @default.
• W2474866163 hasRelatedWork W3000997319 @default.
• W2474866163 hasVolume "92" @default.
• W2474866163 isParatext "false" @default.
• W2474866163 isRetracted "false" @default.
• W2474866163 magId "2474866163" @default.
• W2474866163 workType "article" @default.