Daniel H. Connor

Cardiac fungal infections: Review of autopsy findings in 60 patients

An autopsy study of 60 patients with fungal infections of the heart was undertaken. The patients ranged in age from 2 months to 79 years. Fifteen of the patients had undergone cardiac surgery; neoplasms were found in 13, renal failure in eight, bacterial infections in five, liver disease in five, gastrointestinal disorders in five, and immune disease in four; two had been intravenous drug abusers; other miscellaneous disorders were observed in three. The fungal infection was limited to the myocardium in 27 patients and to the endocardium in 17 patients. Myocardium and endocardium were involved in nine patients and pericardium and myocardium in five; two patients had pericarditis alone. The most frequent organism was Candida (62 per cent). Aspergillus (12 per cent) and Phycomycetes (12 per cent) were also found frequently. In 51 patients (85 per cent) other deep organs, usually lung, kidney, brain, or spleen were involved. Cultures for fungus had been positive in 26 patients prior to death, and postmortem cultures were positive in 29 patients. Patients who had undergone cardiac surgery had a higher incidence of endocarditis (93 per cent), with Candida (53 per cent) being the most frequent cause. Patients who had received antineoplastic drugs, antibiotics, or corticosteroids had a higher incidence of myocarditis (79 per cent), again most often due to Candida (60 per cent).

Liesegang Rings in Tissue: How to Distinguish Liesegang Rings from the Giant Kidney Worm, dioctophyma renale

Liesegang rings (LRs) are periodic precipitation zones from supersaturated solutions in colloidal systems. They are formed by a process that involves an interplay of diffusion, nucleation, flocculation or precipitation, and supersaturation. Examples include LRs of calcium carbonate in oolitic limestone (in nature), LRs of silver chromate in gelatin (in vitro), and LRs of glycoprotein in pulmonary corpora amylacea (in vivo). Here we describe LRs in lesions from 29 patients—mostly lesions of the kidney, synovium, conjunctiva, and eyelid. The LRs formed in cysts, or in fibrotic, inflamed, or necrotic tissue. The LRs in this study varied greatly in shape and size, measuring 7-800 μm. Special stains and energy-dispersive radiographic analysis or scanning electron microscopy revealed that some LRs contained calcium, iron (hemosiderin), silicon, and sulfur. Some pathologists have mistaken LRs for eggs, larvae, or adults of the giant kidney worm, Dioctophyma renale. D. renale is a large blood-red nematode that infects a variety of fish-eating mammals, especially mink. Fourteen documented infections of humans have been recorded, usually with adult worms expelled from the urethra. The adult worms are probably the largest helminth to parasitize humans. Eggs of D. renale are constant in size (60-80 μm × 39-47 μm), contain an embryo, and have characteristic sculpturing of the shell. Liesegang rings should not be mistaken for eggs, larvae, or adults of D. renale, or for any other helminth.

Pitted Keratolysis: A Manifestation of Human Dermatophilosis

A case of pitted keratolysis caused by Dermatophilus congolensis is reported. The organism was isolated from the lesion and identified by its morphological, cultural, and biochemical characteristics. A survey of the literature revealed that it rarely causes human infections, but is a common causative agent of disease in domesticated and wild animals. Human infections reported previously were traced to contact with infected animals or contaminated soil. We report pitted keratolysis in a 44-year-old physician with no known history of such a contact.

Effects of placental malaria on mothers and neonates from Zaire

AbstractOf one hundred placentas collected consecutively in the Ubangi district, Zaire, 64 hadfalciparum malaria. Mothers and infants of the 64 malarious and 36 non-malarious placentas were compared. The malarious placentas had no consistent relationship to infant length or head circumference, APGAR score, birthweight, maternal anemia, splenomegaly or hydramnios. The rate of hydramnios, in fact, was higher in the mothers with non-malarious placentas. Mothers with malarious placentas were younger (

An onchocercal nodule appearing during diethylcarbamazine therapy.

\bar x

Infections Caused by Penicillium marneffei in China and Southeast Asia: Review of Eighteen Published Cases and Report of Four More Chinese Cases

24) than mothers with non-malarious placentas (

Onchocercal dermatitis: ultrastructural studies of microfilariae and host tissues, before and after treatment with diethylcarbamazine (Hetrazan).

\bar x