Aspergillus sinusitis is usually a lethal condition in bone marrow transplanted patients. We report the case of a patient known to have a sinus infection with Aspergillus flavus before treatment with allogenic bone marrow transplantation for a refractory acute myelogenous leukemia. Exacerbation of the sinusitis during the neutropenic period required a multidisciplinary approach. Cure was achieved after treatment with a combination of surgery (Caldwell-Luc procedure), long term ABCD (amphotericin B colloidal dispersion) therapy (7 months) and granulocyte transfusions during the period preceding engraftment. The use of granulocyte transfusion in this salvage setting is discussed. Aggressive multimodality management of aspergillus sinusitis in immunosuppressed patients may lead to a cure and might not preclude allogenic transplantation.
The explosive outbreak of pandemic influenza A (H1N1) in Argentina lasted about six weeks, from mid May to late June, with widespread transmission across the country. Influenza virus represented 82.13% of the cases reporting respiratory virus. Consultations for influenza-like illness in general practices and emergency departments peaked at 309 consultations for every 10,000 inhabitants. Children and young adults were the age groups most affected. From 7 May to 31 October, 2009, 10,248 confirmed cases, 12,471 hospitalizations for severe respiratory disease, and 600 deaths were reported to the Ministry of Health. The most affected group was children under five years of age (hospitalization rate 72.99/100,000), followed by the 45-54 year age group. In this latter group, the most frequent preexisting conditions were cardiovascular, respiratory, and metabolic diseases. As in other countries, obesity and pregnancy were risk factors for increased morbidity. The experience of this first pandemic wave has taught us that coordinated work, community education, early treatment with antiviral drugs, and vaccine administration during the next season for high-risk groups are likely to be fundamental tools against the next pandemic wave.-37 -
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