Cisplatin was the first platinum compound to be introduced as a chemotherapeutic agent with antineoplastic activity against a wide variety of solid tumors. Renal impairment with a decline in glomerular filtration has been the classical nephrotoxicity of cisplatin. Renal salt wasting syndrome is yet another, though it is not common. Previous studies were identified by searching the Pubmed database using the following keywords: cisplatin, cisplatin nephrotoxicity, renal salt wasting, and salt loosing nephropathy. Renal salt wasting syndrome has been described in 17 case reports since 1984. It is a rare side effect of cisplatin that manifests with polyuria, hypovolemia, and hyponatremia, and, because of similarities in clinical settings and laboratory values, it is frequently misdiagnosed as a syndrome of inappropriate antidiuretic hormone. Other causes of polyuria and hyponatremia should be excluded. Treatment aims at restoring the lost water and salt. Substituting cisplatin with carboplatin depends on individual clinical settings. Prognosis is excellent, as recovery was the rule in all the reported cases.

Mucormycosis is a rare but devastating infection. We present a case of fatal disseminated mucormycosis infection in a renal transplant patient. Uncontrolled diabetes mellitus and immunosuppression are the major predisposing factors to infection with Mucorales. Mucorales are angioinvasive and can infect any organ system. Lungs are the predominant site of infection in solid organ transplant recipients. Prompt diagnosis is challenging and influences outcome. Treatment involves a combination of surgical and medical therapies. Amphotericin B remains the cornerstone in the medical management of mucormycosis, although other agents have been used. Newer agents are promising.

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Acute kidney injury in the intensive care unit (ICU) is a manifestation of an underlying severe illness that commonly involves other organ systems. Pulmonary, cardiac, and hepatic failures are the most prevalent. This article provides a simplified review of the technical aspects of extracorporeal cardiopulmonary and liver support devices used in the adult ICU patient, as well as a summary of the most relevant and up-to-date clinical evidence that supports their use.

whole-brain radiation and highly active antiretroviral therapy (haart). CASE DESCRIPTIONA 43-year-old man presented to our hospital with headaches and right facial twitching for few days, associated with nausea and dizziness. His past medical history was significant for infection with hiv diagnosed 10 years earlier. Because of financial circumstances, the patient had stopped his haart 10 months earlier.On physical examination, the patient was alert and oriented. His vital signs were normal. He had a mild word-finding deficit, right facial droop, right pronator drift, and mild right arm hyperreflexia. The rest of the physical examination was normal.Laboratory work up showed a white blood cell count of 3400/mL, a CD4 count of 78/mL (normal: 493-1666/mL), an hiv viral load above 500,000/mL, positive Toxoplasma immunoglobulin G antibodies, negative serum cryptococcal antigen, and a nonreactive rapid plasma reagin test.Magnetic resonance imaging (mri) of the brain showed a large mass in the left frontoparietal region, with small non-enhancing lesions in the brain (Figure 1). A presumptive diagnosis of cerebral toxoplasmosis was made, for which the patient was treated with pyrimethamine, sulfadiazine, and leucovorin, with phenytoin for seizure prophylaxis. To avoid possible complications of anemia and immune reconstitution syndrome, haart was planned to be restarted 2 weeks later.The patient improved symptomatically and was discharged home. A follow-up brain mri 10 days later demonstrated no significant changes.One month later, the man came to our emergency department with a history of progressively increasing partial focal seizures that had started after he had stopped his medications 2 weeks earlier because of financial concerns. Brain mr i showed a slight increase of the old left frontoparietal lesion ABSTRACTAccording to the published data, most primary central nervous system lymphomas (pcnsls) are B-cell lymphomas; primary T-cell lymphomas are rare. In a search of the medline database, we found only 6 cases of primary T-cell pcnsl. Here, we present the case of a 43-year-old man with aids, not on highly active antiretroviral therapy, who presented with focal neurologic symptoms and was found on magnetic resonance imaging to have multiple brain lesions. A biopsy showed T-cell lymphoma, and the patient was subsequently treated with whole-brain radiation, to marked clinical response. Reported cases from the literature of primary T-cell pcnsl in aids patients are summarized in this review.