An Atypical Source of Persistent Fungemia in the Intensive Care Unit

Wiggins, Alexandra; Reddy, Raju

doi:10.12659/ajcr.936223

Cited by 3 publications

(2 citation statements)

References 11 publications

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“…Initiation of endocarditis, and infective thrombophlebitis by C. albicans resides in its ability to colonize fibrin clots matrices [38,44,45]. In addition, candidal sepsis, as a result of biofilm formation, is linked to a variety of implanted medical products including vascular bypass grafts, abiotic heart valves, dental implants, vascular catheters, knee and hip joints, and cerebral shunts, all of which can function as sites for fibrin deposition, and subsequent substrates for biofilm growth [46][47][48]. In addition to fibrin deposition in the clot matrices, there will also be the presence of other host proteins and plasma components, including lipids, [49,50].…”

Section: Discussionmentioning

confidence: 99%

“…The mechanism of surface-surface interaction dependent on hydrophobic adherence is reliant on the relative level of cell surface hydrophobicity, which could alter the initiation events for endocarditis and thrombophlebitis [48,61]. Elevated levels of associated lipids, as a result of the accompanying hyperlipidemia, could be due to plasma preexposure to either obesity-associated hyperlipidemia, or conditions of temporary drug-induced dyslipidemia [31,62].…”

Section: Discussionmentioning

confidence: 99%

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Adherence of Candida albicans to fibrin-clot matrices in a rat model for type 2 diabetes

Balbina J. Plotkin,

Monika I. Konaklieva

2024

World J. Bio. Pharm. Health Sci.

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Individuals with type 2 diabetes are at increased risk for the development of infective endocarditis and septic thrombosis. Adherence to fibrin clot matrices by Candida albicans is the initial step in initiation of the infective processes. Clots made from lean (Fa/fa) and obese (fa/fa) Zucker rat plasma were used to measure adherence of yeast grown at environmental temperature and human body temperature. Adherence to clots by C. albicans was influenced both by source of plasma and temperature of yeast growth. Amphotericin B was effective in diminishing the candidal binding to lean but not obese clots. The degree of fungal surface hydrophobicity did not correlate with adherence to clots. However, Candida adherence to clots from both lean and obese Zucker rats was inhibited by the pretreatment of cells with mannose. These findings indicate that treatment of thrombi-associated candidal infections with ergosterol-targeting drugs e.g., amphotericin B alone in hypercholesterolemic individuals may have decreased clinically efficacy.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Adherence of Candida albicans to fibrin-clot matrices in a rat model for type 2 diabetes

Balbina J. Plotkin,

Monika I. Konaklieva

2024

World J. Bio. Pharm. Health Sci.

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Micafungin

2023

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Ketosis-prone Diabetes Presenting with Acute Esophageal Necrosis or “Black Esophagus”: An Intriguing New Clinical Association

Pollis,

Furlanetto,

Pagin

et al. 2024

EMIDDT

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Background:: Ketosis-prone diabetes (KPD) is an intermediate subtype of diabetes mellitus, usually affecting Afro-American adults, presenting with diabetic ketoacidosis (DKA), without the classic phenotype of autoimmune type 1 diabetes. Patients require insulin therapy at onset for the acute decompensation, then usually remain insulin-free for prolonged periods with diet alone or with other antidiabetic drugs. DKA can be rarely complicated by upper gastrointestinal bleeding and mucosal necrosis, a severe complication named acute esophageal necrosis (AEN) burdened by high mortality. The association of KPD presenting with DKA complicated by AEN is here reported for the first time, to the knowledge of the authors, in the medical literature. Case Presentation:: Here we report an interesting case of middle-aged African woman, newly diagnosed with KPD, presenting with DKA hematemesis. The patient was first treated at Intensive Care Unit for the ketoacidosis with intravenous fluids combined with continuous insulin infusion, and then switched to subcutaneous regimen. At the same time, esophagogastroduodenoscopy (EGD) was performed to diagnose acute esophageal necrosis, which was promptly managed with proton pump inhibitors infusion, fasting, and parenteral nutrition. After the correct clinical evaluation, the patient was switched to oral antidiabetic and basal insulin at discharge and an EGD follow-up was scheduled. Conclusions:: KPD remains an under-recognized and under-diagnosed type of diabetes which can present as DKA. Since DKA could be a possible trigger of AEN, a rare but potentially lifethreatening condition, that clinicians should be aware of, in patients presenting with upper gastrointestinal bleeding and ketoacidosis. The prompt management and classification of DKA, combined with the EGD execution for early AEN diagnosis and follow-up, is essential.

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An Atypical Source of Persistent Fungemia in the Intensive Care Unit

Cited by 3 publications

References 11 publications

Adherence of Candida albicans to fibrin-clot matrices in a rat model for type 2 diabetes

Adherence of Candida albicans to fibrin-clot matrices in a rat model for type 2 diabetes

Micafungin

Ketosis-prone Diabetes Presenting with Acute Esophageal Necrosis or “Black Esophagus”: An Intriguing New Clinical Association

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