The significance of blood cultures positive for Aspergillus species for patients with cancer remains unclear. The significance of aspergillemia in 36 cancer patients over a 10-year period was evaluated. True aspergillemia was rare, occurred late in the course of aspergillosis, and was seen exclusively in patients with hematologic malignancies.
Aspergillus PCR on whole blood samples is highly sensitive for the detection of IPA and is predictive for IPA. The sensitivity appears to be correlated with the certainty of diagnosis as proven by tissue invasion.
Hyponatremia after chemotherapy is not an uncommon clinical syndrome. Both renal salt-wasting syndrome (RSWS) and syndrome of inappropriate antidiuretic hormone secretion (SIADH) have been reported as the underlying mechanisms for chemotherapy-induced hyponatremia. However, these two clinical syndromes have distinct clinical characteristics and managements. The key differential diagnostic feature for RSWS is the excessive urinary excretion of sodium, whereas the urinary excretion of sodium in SIADH is normal or decreased. The treatment for RSWS is supplement of salt, which is opposite to the treatment of SIADH. We report a case of a patient with hyponatremia and excessive urinary excretion of sodium after cisplatin-based chemotherapy. RSWS was diagnosed and the patient was treated with a sodium supplement. We also summarize the key diagnostic features and the most common differential diagnoses for hyponatremia syndrome.
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