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Invasive Fungal Infections Encountered in Saudi Arabia Hail M. Al-Abdely, MD Section of Infectious Diseases Department of Medicine King Faisal Specialist Hospital & Research Center Riyadh, Saudi Arabia. Number of Allogeneic BMT Cases done at KFSH & RC 1984-2003. Cases. Total cases: 1407.
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Invasive Fungal Infections Encountered in Saudi ArabiaHail M. Al-Abdely, MDSection of Infectious DiseasesDepartment of MedicineKing Faisal Specialist Hospital & Research CenterRiyadh, Saudi Arabia
Number of Allogeneic BMT Cases done at KFSH & RC 1984-2003 Cases Total cases: 1407
Prevalence of C. albicans isolates compared to non-albicans Candida species
Distribution of Candidemia Cases in adults by Clinical Service
Distribution of Aspergillus species in Sinus and Invasive Disease %
Cryptococcosis • Rare infection in Saudi Arabia • Only 6 cases from 1985 to 2003 • Two of the cases were courtesy of John Perfect visit 1995 • 4 HIVs, 1 brain tumor on steroids and 1 with idiopathic CD4 cytopenia
History • 62 y/o male from AlAhasa with Type II DM on insulin • DM complications with retinopathy and nephropathy leading to ESRD HD • February 12, 2000: NRLKTx in Iran. • Uneventful perioperative course and normal graft function.
History • 22/4/2000: • Presented to ARAMCO hosp. With 2 days h/o left sided hemiparesis and hemisensory loss. • No h/o fever, seizures or synchope. • Meds • Cyclosporin, prednisone, Amlodipine.
Clinical • Alert and oriented • Afebrile. BP 170/90 • Left sided hemiparesis, power 4/5 • Marked left hemisensory loss. • Chest, CVS and abdomen: unremarkable
WBC= 6.2 HgB= 118 Plt= 250 Creatinine=104 ALP= 168 ALT= 30 ALB= 31 Labs/imaging • PPD= negative • CXR= unremarkable • USS abd.= normal • CT brain
Hospital Course • 25/4/2000: • Started on Amphotericin B Lipid Complex (ABLC) 5 mg/kg/day and Itraconazole 200 mg BID. • 13/5/2000: • Neurologically the same. • MRI brain
Case 2- Hospital Course • 23/5/2000 (ARAMCO): • Slightly worse. More weak. • On same meds. • MRI brain
Hospital Course • 31/5/2000:Transfer to KFSH. • Clinically the same • Started on • AmBisome 5mg/kg/day, • Itraconazole 250mg IV Q12hrs • 5-Flucytosine 20mg/kg IV Q8hrs.
KFSH Course • 13/6/2000: • Clinically the same • MRI brain