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Fungal infections should be aggressively pursued in colonized patients and in patients with risk factors. Isolation of Candida or Aspergillus from superficial sites may indicate infection.
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Fundus examination, blood and respiratory cultures, and Aspergillus and Cryptococcus antigen detection tests must be performed. Infections in Organ Transplants in Critical Care Parasitic infections are uncommon, but toxoplasmosis and leishmaniasis should be considered if diagnosis remains elusive.
The possibility of a Toxoplasma primary infection should be considered when a seronegative recipient receives an allograft from a seropositive donor. Patients with toxoplasmosis have fever, altered mental status, focal neurological signs, myalgias, myocarditis, and lung infiltrates. Rejection, malignancy, adrenal insufficiency, and drug fever were the most common noninfectious causes. If it is not persistent or accompanied by other signs or symptoms, it should not trigger any diagnostic action.
It is usually related to an impairment of the allograft function and requires histological confirmation. It is more common in the first six months, especially in the first 16 days after transplantation in one study Another setting of potential adrenal insufficiency is in renal transplants that return to dialysis , Occasionally, lymphoproliferative disease may present with adrenal insufficiency after liver transplantation Other causes of noninfectious fever include thromboembolic disease, hematoma reabsortion, pericardial effusions, tissue infarction, hemolytic uremic syndrome, and transfu- sion reaction.
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A number of existing illustrations have been replaced by more representative high-quality color plates. The original text has been revised and updated to keep pace with the latest concepts in oral medicine. For more clinical information, readers may refer to my major book Color Atlas of Oral Diseases, third edition, , and for treatment details to my recent book Treatment of Oral Diseases, , both published by Georg Thieme Publishers. Usage subject to terms and conditions of license 1 1 hite Lesions White lesions of the oral mucosa are a multifactorial group of disorders, the color of which is produced by the scattering of the light through an altered epithelial surface.
The diagnosis and differential diagnosis of oral white lesions should be made on the basis of the medical history, clinical features, and laboratory tests.
Usage subject to terms and conditions of license 2 White Lesions Leukoplakia Definition Leukoplakia is a clinical term, and the lesion is defined as a white patch or plaque, firmly attached to the oral mucosa, that cannot be classified as any other disease entity. Tobacco, alcohol, chronic local friction, and Candida albicans are important predisposing factors. Speckled and verrucous leukoplakia have a greater risk for malignant transformation than the homogeneous form. The buccal mucosa, tongue, floor of the mouth, gingiva, and lower lip are the most commonly affected sites.
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