Case Study : Acute Liver Failure From Fungal Toxins

DIAGNOSTIC DATA: White count was 13.4, hemoglobin and hematocrit 15.4 and 45.8, platelets 206, with an 89% shift. Sodium 133, potassium 3.7, chloride 99, bicarb 24, BUN and creatinine are 18 and 1.1, respectively. Glucose 146, albumin 4.3, total bilirubin 1.7. The remainder of the LFTs is within normal limits. Urinalysis reveals trace ketones with 100mg per decilitre protein and a small amount of blood. CT scan was performed revealing evidence of acute appendicitis with pericecal inflammation, as well as, dilatation of the appendix and

Bilirubin is a yellow pigment that is created in the body during the normal recycling of old red blood cells. The liver helps break down bilirubin so that it can be removed from the body in the stool.

One of these symptoms is jaundice, which is characterized by yellowish skin and eyes because of an inability of the liver to remove bilirubin from the blood. Patient with cirrhosis also suffering from itching, due to deposited bile's products in the skin. This patient also suffers from accumulation of fluid in legs that is called edema. As a result of the blockage of blood flow via the liver, fluid accumulation in abdomen which is worsen by the decrease in protein production. Other symptoms include fatigue, weakness, loss of appetite, weight loss and nausea. As the disease progress, complications may develop ,such as varices that happens with cirrhosis patient when the blood flow through the liver slows, so the blood from intestine go back to the vessels of the stomach and esophagus, these vessels are not meant to carry this much of blood so they dilate (varices), with increasing

The sporozites have traveled ot Ed’s liver; how is the function of hepatocytes related to blood?

A 49 year old Afro-Cuban male with a history of chronic alcoholism and hypertension presented with a three day history of fever (106ᵒ F), change in mental status, and body aches in August, 2016. On admission, he was febrile 103.1ᵒ F, with a heart rate of 137 beats per minutes, blood pressure of 156/79 mm of Hg, and respiration rate of 32 breaths per minute. The patient’s laboratory results on admission included white cell count 9.2 x 103/microL, platelets 71 x 103/microL , PT 28 seconds, PTT 43 seconds, INR 2.62, albumin 3.1, Tblb (total bilirubin) 13.6 mg/dl , AST (aspartate transaminase) 133, and ALT (alanine transaminase) 56. Lactic acid was 6.2 mmol/L, and blood alcohol level checked the next day was less than 10 mg/dl. In addition, he

This is an 82-year-old gentleman, who was referred from Dr. Gretchen Marsh’s office because the patient’s BUN and creatinine were high, as he has acute kidney injury. The patient went to Dr. Marsh’s office yesterday and was having generalized weakness. He does not have any vomiting. No diarrhea. No fever. No cough with expectoration. No sharpness. No wheezing. No headache. No dizziness. No passing out. No rectal bleeding. No hematemesis. No abdominal pain. No sore throat. No stuffy nose. No cough with expectoration. No burning, frequency, or

The death cap mushroom, Amanita phalloides, is responsible for about 90 percent of mushroom ingestion fatalities. While initially people may feel fine after eating the mushrooms, within 12-24 hours they will feel gastrointestinal distress, and then within two days start to show decline in liver function as evidenced by deterioration of liver enzyme tests and jaundice. Acute liver failure follows and renal function also deteriorates. Within one to three weeks, patients die from multiple organ failure, disseminated intravascular coagulation, mesenteric thrombosis, and convulsions. There is no antidote. Treatment consists of detoxification, chemotherapies, and liver transplant. (Santi, Maggioli, Mastroroberto,Tufoni, Napoli,Caraceni 2012)

The abnormality composition of blood and lymph is caused by non beneficial selection and combinations of food that have no nutritional value. A clear example of the abnormality composition of blood and lymph is digestive issues. The client does have digestive issues which is worse when she eats meat, heavy food or eat greens. the client has had a history of gastrointestinal illness when she travels due to the consumption of large amount of alcohol and sugar. The fact that the client also experiences gas and bloating states that she is

In 1872 Michael Anton Biermer described a blood condition in a German article. He chose to name the rare disease he discovered “Pernicious anemia” because of the lethality and incurability at the time. Biermer’s disease or Pernicious anemia is a genetic disease where patients’ stomachs do not produce intrinsic factor which is a protein of the mucus membrane layer of the stomach.When the stomach does not make enough intrinsic factor, the intestine cannot properly absorb vitamin B12. The body needs vitamin B12 in order to function properly and remain healthy. Vitamin B12 assists in the production of red blood cells, DNA, and tissues, while helping keep nerve cells alive and healthy.This vitamin is found in many animal products such as beef, poultry, shellfish and more.

Albumin is the most significant amount of protein in the plasma formation by the liver and is a useful indicator of liver function, because the half-life of the albumin in serum is much than (20 days), and the level of serum albumin is not a reliable indicator of protein synthesis in the liver in acute liver disease. The site of albumin synthesis is only in the liver. In the patients sever from liver cirrhosis and ascites usually have low serum level. The normal serum range (3.5g/dl - 4.5 g/dl).

The outbreak of Turkey X disease in England in 1960 and later outbreaks of a similar disease in ducklings in Kenya and Uganda resulted in extensive research, which indicated that the common factor in all the disease outbreaks was the presence of toxic Brazilian groundnut meal in animal feed (13) During an examination of a sample of this toxic meal it was found that up to 20% of the pieces of groundnut-cotyledon tissue contained fungal hyphae which were absent in a sample of nontoxic meal (5). Attempts to culture them showed that hyphae were dead. Sargeant et al (89) however, succeeded in producing pure cultures of certain fungal species present in a highly toxic sample of groundnuts from Uganda. One of the fungi isolated contained a factor, which was toxic to ducklings and produced the characteristic symptoms associated with Turkey X disease. The toxin-producing fungus was identified as Aspergillus flavus (89) and the toxin was named “aflatoxin”.

Mycotoxin is naturally occurring secondary metabolite of toxic in low concentration and low molecular weight (MW <700) (Sorriano,2007; Haschek & Voss, 2013). Several fungal species of the Alternaria genus are known producers of mycotoxins. Some of the powerful Alternaria toxins have been implicated in a variety of adverse health effects.

Invasive fungal infection (IFI) is one of the most common healthcare-associated infections in patients in intensive care units (ICUs), especially caused by Candida spp., typically ranking as third or fourth most common cause of bloodstream infection, which is related to considerable mortality and morbidity, posing a serious threat to the patient’s health as well as tremendous economic losses1-6. A prompt, appropriate antifungal treatment of IFI generally improves patients’ prognosis7,8. However, the treatment was frequently compelled to significant delay because of the relative insensitivity of blood cultures and the long turnaround time for culture to yield growth, leading to worse outcomes and higher mortality5,9,10.

Other causes of liver injury were excluded and all had similar histopathological findings characterized by multilobular necrosis; two of them had a background of chronic liver disease. Unfortunately, all patients had resumed chewing khat before their second visit resulting in further liver damage, a high concentration of cathinone was identified in a sample of damaged liver tissue from one patient. Five patient developed fulminant or subfulminant hepatic failure and underwent orthotopic liver transplantation, (Chapman et al., 2010).

In order to identify what food, and ultimately from which restaurant Parry ate the day of his poisoning, four experiments were carried out. Each experiment tested for the presence of the following four macromolecules in Parry’s vomit: