This article describes an outbreak of scabies on a 30-bed acute spinal cord injury unit and the measures taken to eradicate the infestation. Because spinal cord injury patients have sensorimotor deficits, the sensation of itching often is absent, making an infestation of scabies more difficult to identify. A total of 30 patients and 38 employees were exposed and treated for scabies. Educational programs about scabies were instituted immediately for all employees. Routine daily activities and therapy schedules were severely hampered by the outbreak. Despite the efforts of staff to solve the problems associated with the outbreak, frustration and anger were sometimes displayed by many of the staff, patients, and families because of the difficulties they encountered. The outbreak was halted, however, and no further cases were reported, although several employees had to be treated twice.

Cross Infection↗

PubMedDate not supplied

Synergy of fluconazole with macrophages for antifungal activity against Candida albicans.

The possible between macrophages and fluconazole for antifungal activity against different isolates of C. albicans was studied. The susceptibility of C. albicans isolates to fluconazole (FCZ), when incubated in RPMI-1640 with 10% fetal bovine serum (FBS) and 10% fresh mouse serum (test medium, TM) was determined by using a quantitative culture methodology, Multiplication of isolate Sh27 was strongly inhibited by FCZ, even at 1.0 microgram/ml. However, FCZ even at 100 microgram/ml was not fungicidal. Resident murine peritoneal macrophages (MP) incubated for 48 h in RPMI-1640 + 10% FBS (tissue culture medium, TCM), then challenged with Sh27 in TM for 24 h, were fungistatic (20 +/ 9%, n = 4). Cultured macrophages synergized with FCZ (10 micrograms/ml) for fungicidal activity when co-cultured with sh27 in TM for 24 h (46 +/ 8%) and for 48 h (74 +/ 5%), n = 3. Macrophages and FCZ (10 micrograms/ml) could not synergize for significant killing of a less FCZ-sensitive C. albicans isolate 94-164. Multiplication of a FCZ-resistant isolate (94-20) was not inhibited by FCZ at 10 micrograms/ml TM; however, macrophages and FCZ (10 micrograms/ml) could synergize for fungistatic (64%), but not fungicidal, activity.

Animals↗

PubMedDate not supplied

Problems in antifungal chemotherapy.

The field of antifungal chemotherapy is undergoing rapid change at present, with an accelerating pace of introduction of new agents. The problems at present include the need for more effective agents, particularly with novel modes of action. Fungal infection must be considered more frequently in differential diagnosis, and methods developed for early diagnosis. The literature must be improved, with more precise terms. Trials comparing agents are needed, as are studies directed at determining the appropriate length of therapy. In vitro susceptibility testing must be standardized, and clinical correlations examined. Particular problem areas in current therapy are deep candida infections, zygomycotic infections, fungal endocarditis and meningitis, cryptococcosis in AIDS patients, and ocular infections with Fusarium species. Immunomodulating or "pro-host" drugs present an as yet unexplored avenue for clinical therapy. Regimes to prevent fungal infection need improvement. Until the needed advances occur, we must be resourceful in minimizing the toxicity of the agents presently available.

Adjuvants, Immunologic↗

PubMedDate not supplied

Physiologic and motor conditioning and generalization in children with minimal brain dysfunction.

Explore the source record for details and available documents.

Action Potentials↗

PubMedDate not supplied

Virus infections.

Explore the source record for details and available documents.

Acute Disease↗

PubMedDate not supplied

Cross-resistance phenotypes of fluconazole-resistant Candida species: results with 655 clinical isolates with different methods.

Candida species test results with two broth macrodilution antifungal susceptibility methods were compared using 655 clinical isolates, and the frequency of fluconazole resistance and phenotypes of azole cross resistance are detailed. A method with an 80% inhibition endpoint (as compared to clear tube endpoint) suggested greater fluconazole susceptibility to C. albicans but had a less pronounced effect on C. glabrata, and seemed to have a negligible influence on results with C. parapsilosis and C. tropicalis. The latter were grouped as susceptible and resistant (based on achievable blood levels), respectively, by both methods. Cross resistance was method dependent and more pronounced with itraconazole than ketoconazole. In vivo correlations are needed to validate the groupings proposed by any in vitro method.

Antifungal Agents↗