Skin invasion by Aspergillus is infrequent. We here describe six immunocompromised patients with skin manifestations caused by Aspergillus. A heart transplant recipient developed a primary cutaneous aspergillosis; two patients (one with chronic granulomatous disease and another treated with a high dose of corticosteroids) presented with nodular lesions secondary to haematogenous dissemination; and three patients with acute myelogenous leukaemia had skin dissemination by contiguity from orbit and sinus invasion. A. flavus was isolated in the three cases of leukaemia; the infection was due to A. fumigatus in the transplant recipient; A. fumigatus and A. versicolor were isolated in the patients with the secondary aspergillosis. In most cases, amphotericin B was useful, with clinical and mycological remission in four patients. A patient with leukaemia died without undergoing treatment, and a child carrier of chronic granulomatous disease died after only 12 days of treatment.
This study presents pollen-analytical data from continental and offshore Iberian Peninsula sites that include pollen curves of Quercus suber, to provide information on the past distribution and ecology of the cork oak (Q. suber). Results centre on a new pollen record of Navarrés (Valencia, eastern Spain), which shows that the cork oak survived regionally during the Upper Pleistocene and was important during a mid-Holocene replacement of a local pine forest by Quercus-dominated communities. This phenomenon appears linked to the recurrence of fire and reinforces the value of the cork oak for reforestation programmes in fire-prone areas. In addition to Navarrés, other Late Quaternary pollen sequences (Sobrestany, Casablanca-Almenara, Padul, SU 8103, SU8113, 8057B) suggest last glacial survival of the cork oak in southern and coastal areas of the Peninsula and North Africa. Important developments also occur from the Late Glacial to the middle Holocene, not only in the west but also in the eastern Peninsula. It is suggested that, in the absence of human influence, Q. suber would develop in non-monospecific forests, sharing the arboreal stratum both with other sclerophyllous and deciduous Quercus and Pinus species.
Most unsuccessful palynological work is never published. As a consequence, pollen analysts waste time re-processing sterile sediments, and the available literature exhibits a uniformly positive record of success in pollen extraction. Here we report failures with Quaternary pollen analyses in the Iberian Peninsula; that is, case studies where it was not possible to extract palynomorphs for pollen counting. Both totally sterile and partially sterile sites are considered. Sites and perspectives for future studies are suggested. The majority of the failed studies are openair archaeological and palaeontological sites, caves and rockshelters, but there are prominent cases of success. Peat bogs have provided positive results, but only with sequences formed under continuous sedimentation processes in marshy environments. Lakes are often successful sites, but a multi-core strategy, following the facies change along a transect from the shore to the depositional centre, is recommended for saline lacustrine deposits, salt marshes and lagoons, especially when there is evidence of temporary desiccation. Cave and rockshelter infills should be considered case-by-case, and these sites definitely require a palyno-taphonomical approach to post-depositional processes. Indurated deposits are sometimes surprising in their high pollen concentration, but one must be prepared for sterility. Coprolites have been insufficiently exploited, and offer a great potential, especially those of Pleistocene Crocuta. This article shows that venturing into sediments assumed a priori to be 'difficult', like fluvial terraces, slope deposits, speleothems, cave travertines, and palaeosols, may nevertheless be successful. A
The patient was treated with itraconazole (600 mg/day) plus trimethoprim (1600 mg/day)-sulfamethoxazole (320 mg/day) for 8 weeks, with complete remission of the lesions.
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