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PubMed2004

Antifungal susceptibility of 50 Candida isolates from invasive mycoses in Chile.

We determined the antifungal susceptibility of 50 Candida isolates from invasive mycoses in intensive care unit patients in Chile. Candida albicans (27 isolates) and C. parapsilosis (12 isolates) were the most common etiologic species. Candida glabrata (five isolates) was isolated only from children. Our data are consistent with those of recent Brazilian and Argentinean studies but differ from those of some US, Canadian and Norwegian studies, in which the relatively azole-resistant C. glabrata was the predominant non-C. albicans species seen. All isolates in this study were susceptible to amphotericin B. Itraconazole and fluconazole resistance were observed in 6 and 4% of the isolates, respectively.

Amphotericin B↗
PubMedDate not supplied

Itraconazole for deep mycoses: preliminary experience in Mexico.

Itraconazole has been used as oral therapy for deep mycoses since July 1984 in our institution. So far, therapy has been evaluated for eight patients: one with cutaneous coccidioidomycosis; two with chromomycosis (Fonsecaea pedrosoi); and five with sporotrichosis (three fixed, one lymphangitic, and one disseminated). Clinical and mycologic evaluations were done at the beginning of treatment, 15 days after the initiation of treatment, and monthly thereafter. Dosage was 100-200 mg per day, and duration of treatment was based on response. The cases of coccidioidomycosis and lymphangitic sporotrichosis were mycologically cured after two and seven months of treatment with 100 mg per day, respectively. The six other patients required higher doses. Two patients with sporotrichosis and one with chromomycosis were cured, and one patient with sporotrichosis and one with chromomycosis were markedly improved. In one patient with sporotrichosis, treatment was discontinued because of the slow response. No adverse reactions to treatment were reported.

Adult↗
PubMedDate not supplied

The aetiological agents of superficial cutaneous mycoses in Jos, Plateau State of Nigeria.

A survey of superficial skin mycoses was carried out among miners and office workers employed in different establishments in Jos, Nigeria. Mycotic infection was demonstrable by microscopy and culture in 45 (10.4%) subjects: 20 males and 25 females. Malassezia furfur was the predominant aetiological agent, followed by Candida albicans and Trichophyton soudanense. Other aetiological agents frequently recovered were T. rubrum., T. mentagrophytes., Microsporum audouinii and Trichosporon beigelii.

Adolescent↗
PubMedDate not supplied

Fungi responsible for skin mycoses in Turin (Italy).

There has been a recent increase in the frequency of skin mycoses, coupled with changes in the epidemiology and distribution of the species responsible. Periodic epidemiological analyses of these disease are thus required to ensure their efficacious control. Hair fragments, skin scrapings, specimens from vesicles and blisters and nail parings were seeded on Petri dishes loaded with Sabouraud or Mycosel agar, supplemented with chloramphenicol and with chloramphenicol plus cycloheximide respectively. Parts of each specimen were also mounted in 10% potassium hydroxide for examination under the microscope. Yeasts prevailed over dermatophytes. Microsporum canis was the most frequent dermatophyte, followed by Trichophyton rubrum, T. mentagrophytes and Epidermophyton floccosum. Tinea corporis was the most common mycosis, followed by tinea unguis, tinea capitis and tinea pedis. Men were chiefly bearers of tinea cruris and tinea pedis, women of tinea corporis, and children and teenagers of tinea capitis. Some examples of the transmission of infection through interhuman contact, via animals and from the soil are also presented.

Adolescent↗
PubMed2005

Superficial mycoses due to Trichophyton violaceum in Athens, Greece: a 15-year retrospective study.

This is a retrospective study on the superficial mycoses due to Trichophyton violaceum in the greater Athens area for the last 15 years - 1989-2003. During this period 104 patients were found to have an infection due to T. violaceum- an incidence rate of 0.75% of all dermatophytosis. Of the patients 59 were Greeks, 15 Greek Gypsies and 30 immigrants mostly from Albania (50%). Of them 58 were children, 46 adults (mainly women, 34 cases). Trichophyton violaceum infection was presented with a variety of manifestations (127 cases). The prevailing was tinea capitis present in 85 patients - 57 children, 24 women and four men (women : men 6 : 1). Tinea capitis together with other forms of the infection was found in 14 patients. Tinea facie, corporis, manuum, barbae and unguium were seen in nineteen patients. The isolation rate of T. violaceum infection in the Greek population remained at a low level for three decades after the mid-1960s. However, a substantial increase in the isolation rate is observed in the mid-1990s attributed mainly to the influx of economic immigrants from countries where the infection is endemic.

Adolescent↗
PubMed2004

Photodynamic therapy of interdigital mycoses of the feet with topical application of 5-aminolevulinic acid.

BACKGROUND: Findings of in vitro studies have demonstrated that dermatophytes and yeasts can be effectively photosensitized after topical delivery of 5-aminolevulinic acid (ALA). This procedure, called photodynamic therapy (PDT), seems to lack mutagenic activity and hazard of selection of drug-resistant strains. METHODS: Twenty percent ALA preparation in Eucerin cream was applied under an occlusive dressing to skin lesions of nine patients with clinical and microbiological evidence of interdigital mycosis of the feet. After 4 h, lesions were irradiated with 75 J/cm(2) of broad-band red light. Interdigital lesions of the other foot served as control (treated with only light or only ALA). After 7 days from the first treatment, no further treatment was delivered if lesions were not clinically evident and direct microscopic examination was negative. Otherwise, three additional weekly treatments were delivered. Four weeks after the last treatment, patients had a final follow-up clinical and laboratory examination. RESULTS: Clinical and microbiological recovery was seen in six out of nine patients after one (four cases) or four (two cases) treatments. However, after 4 weeks, recurrences were seen in four patients. Overall tolerability was always good. CONCLUSION: Under the conditions employed in the present study, ALA-PDT had good therapeutic effects on interdigital mycosis of the feet. However, recurrences were quick. In vivo environmental conditions, i.e. temperature, humidity and pH of the interdigital skin, could induce a poor cell uptake of ALA and a deficient biosynthesis of photosensitizing protoporphyrin IX. In addition, the irregular tridimensional shape of this peculiar anatomical area could lead to a non-uniform delivery of light and/or ALA cream. However, the present results can stimulate further studies on the PDT of superficial skin mycoses.

Administration, Cutaneous↗
PubMed1995

Thoracic mycoses from opportunistic fungi: radiologic-pathologic correlation.

Fungi of the genera Aspergillus, Candida, and Cryptococcus and the class Zygomycetes are the most common causes of thoracic opportunistic mycoses in immunocompromised patients. Candidiasis and zygomycosis usually manifest as severe, often life-threatening, pneumonias. Aspergillus species are commonly implicated as the causative organisms in a broad spectrum of pulmonary disorders, ranging from hypersensitivity lung disease in atopic patients to invasive pneumonia in immunocompromised patients. Cryptococcus neoformans infects both immunologically normal and abnormal patients, with variable clinical and radiologic findings. The diagnosis of an opportunistic mycosis requires familiarity with the epidemiology of the disease, the various modes of clinical presentation, and the full spectrum of radiologic manifestations. Because many of these fungi may normally colonize in the upper respiratory tract, sputum cultures are considered diagnostically unreliable. Instead, definitive diagnosis hinges on either culture of the fungus from infected tissue or demonstration of the organism at microscopic examination.

Adult↗
PubMed1981

Superficial mycoses in the west of Scotland.

Ringworm formed almost 70 per cent of all superficial mycoses diagnosed. The feet and nails were most frequently affected and a single species, Trichophyton rubrum was responsible for the majority of infections that required specialist attention. Scalp ringworm which, until the middle of this century, was the most common form of the disease now constitutes only 5 per cent of infections and the majority of these are caused by the zoophilic fungus Microsporum canis. The anthropophilic dermatophytes which were once so prevalent as the cause of scalp infections are now rarely encountered. Yeasts, especially Candida albicans were most frequently encountered as a cause of mucosal infections but were not unimportant as a cause of disease of skin and nail.

Aged↗
PubMedDate not supplied

[Value of direct and indirect diagnostic methods in systemic mycoses associated with AIDS].

One hundred and seventeen patients suffering systemic mycosis and AIDS were studied during 5 years in the Muñiz Hospital of Buenos Aires City. Seventy four of them presented cryptococcosis, 39 histoplasmosis and 4 both mycoses. The following specimens were studied for the diagnosis: skin and mucous membrane scrapings, bone marrow aspirations, bronchial secretions, biopsies of different organs, cerebral spinal fluid and blood cultures. Sera were also collected for serologic tests. A total of 203 samples from patients with histoplasmosis were studied, 46.3% of them showed H. capsulatum in microscopic examinations or in cultures, skin scraping was the most sensitive diagnostic method (94.7% of positive results), followed by biopsies (80%) and bone marrow cultures (42.1%). Specific antibodies were detected in 45.4% of the patients with histoplasmosis, using 2 different antigens and 3 types of serologic reactions (complement fixation test, immunodiffusion and counterimmunoelectrophoresis). A total of 413 samples from patients with cryptococcosis were examined, 69% of them confirmed the diagnosis. The mycologic study of CSF was the most sensitive method of study, since it registered positive results in 89.5%, followed by blood cultures (61.2%), skin scrapings (42.9%), and urine cultures (41.7%). Polysaccharyde antigens from C. neoformans in organic fluids were detected in almost all the cases. The aim of this study is to compare all the suitable diagnostic methods which can be used in systemic mycosis associated with AIDS in order to find the most rapid way of diagnosis.

AIDS-Related Opportunistic Infections↗
PubMed1992

Cost-effectiveness analysis of treatment with liposomal amphotericin B versus conventional amphotericin B in organ or bone marrow transplant recipients with systemic mycoses.

Economic appraisal of pharmaceuticals is becoming increasingly important. In a retrospective study of patient records from 58 organ or bone marrow-transplanted patients with systemic mycoses, the cost-effectiveness of treatment with a liposomal amphotericin B formulation was compared with that of conventional amphotericin B. Treatment with liposomal amphotericin B results in fewer adverse reactions, increased life expectancy and higher costs than treatment with conventional amphotericin B. Pricing liposomal amphotericin B at about SKE6000 per patient treatment day will result in an additional cost per life-year gained of about SEK150 000 relative to that using conventional amphotericin B for patients receiving kidney, kidney and pancreas, or pancreas transplants. For liver and bone marrow transplant (BMT) recipients the marginal cost-effectiveness ratio was about SEK195 000 and SEK150 000 per life-year gained. Compared with alternative use of resources in society and health care, use of liposomal amphotericin B rather than conventional amphotericin treatment can be considered cost-effective at the price assumed.

Adult↗
PubMed1998

[Exotic pulmonary mycoses].

The so-called exotic pulmonary mycoses are imported diseases in France. They are infrequent or exceptional and for this reason can be underdiagnosed or recognized with delay. Nevertheless, they are easily treatable infections with available antifungal agents. As a rule, the site of primary infection is the lung with ensuing clearance or chronic local infection and/or dissemination. Immunocompromised hosts are more prone to develop severe forms or reactivation of the disease.

AIDS-Related Opportunistic Infections↗
PubMed2000

[1996 epidemiological survey of dermatophytoses in Japan. Epidemiological Investigation Committee for Human Mycoses in the Japanese Society for Medical Mycology].

An epidemiological investigation on dermatophytoses in Japan for the year 1996 was carried out with the following results. The number of dermatomycoses patients visiting the fifteen cooperating institutes that year was 8,402. New outpatients with this condition accounted for 13.1% of all new outpatients in these institutes. Dermatophytoses patients numbered 7,395 and were composed of: tinea pedis 4,764 (64.4%), tinea unguium 1,487 (20.1%), tinea corporis 558 (7.5%), tinea cruris 369 (5.0%), tinea manuum 195 (2.6%), tinea capitis 11, kerion Celsi 7, tinea barbae 1 and other forms 3. Of these, 113 were children under 15 years of age. Species and incidences of the 2,615 strains isolated from the patients with dermatophytoses were as follows: Trichophyton (T.) rubrum 1,828 (69. 9%), T. mentagrophytes 743 (28.4%) Epidermophyton floccosum 20 (0. 8%), Microsporum (M.) canis 13 (0.5%), M. gypseum 5, T. violaceum 2, and 4 undetermined strains. Candidiasis was found in 722 individuals: intertrigo 299, erosio interdigitalis 95, erythema infantum 89, oral candidiasis 63, paronychia et onychia 56, genital candidiasis 56, onychomycosis 24, chronic mucocutaneous candidiasis 1 and other atypical forms of candidiasis 39. Patients with tinea versicolor numbered 265 and those with Malassezia folliculitis 15. There were five cases of deep dermal mycoses: three of sporotrichosis, one of chromomycosis and one of aspergillosis. The results of superficial dermatophytoses for the year 1996 differed from those of 1991-92 in the following points: Tinea corporis and tinea cruris were lower in number, while tinea unguium had increased in ratio and number. M. canis infection tended to decrease gradually. In the age-distribution of tinea, in every clinical form the peak of distribution curve shifted to a more elderly age group.

Adolescent↗
PubMed1979

Role of Aspergillus and Candida species in allergic bronchopulmonary mycoses. A comparative study.

Allergic bronchopulmonary aspergillosis (ABPA) and allergic bronchopulmonary candidiasis (ABPC) has been diagnosed in 20 and 13 cases respectively with one case in common, on the basis of laboratory and clinical findings. Most of the ABPA cases (60%) diagnosed had an early onset of respiratory symptoms, i.e. below the age of 30 years, while most of ABPC cases (69%) had a late onset of respiratory symptoms, i.e. after the age of 30 years. The precipitin bands in ABPA and ABPC were R-type and H-type, respectively. Apparently, ABPA and ABPC are independent of one another in origin as suggested by specific precipitins and dual skin reaction. In ABPA, A. fumigatus appears to be the primary causal organism although the contributory role of other species of Aspergillus, which include A. flavus, A. nidulans, A. terreus and A. niger, is evident from the present study. It is concluded that allergic bronchopulmonary mycoses (ABPM) could be caused by several fungal species independently or jointly belonging to the genera Asperigillus and Candida.

Antigens, Fungal↗
PubMed1997

[Oral mycoses in the AIDS era].

The present advancement and generalization of oral mycosis is probably due to different factors associated to the progress and development of the countries and the presence of medically compromised patients and immunosupressor therapies. From all these mycoses, oral candidosis is the commonest, but histoplasmosis and paracoccidioidomycosis are also important. The main clinicopathologic and therapeutic features of those oral diseases are reviewed in this paper.

English Abstract↗
PubMed1998

Human mycoses and current antifungal therapy.

The Focus on Fungal Infections meeting has become a popular conference for specialists in medical mycology and antifungal chemotherapy. Highlights of the 8th meeting are reported, with a focus on infection and therapy. Although the incidence of mycoses has increased, the identification of these fungal etiologic agents remains difficult. Mucosal candidiasis caused by endogenous Candida albicans and Candida species remains the most common fungal manifestation in HIV-infected patients, while systemic infection by Aspergillus species also has increased in HIV patients. Two presenters at the meeting debated whether fungal infections in AIDS patients are becoming less common and less important. Various strategies for antifungal therapy in AIDS or HIV-positive patients were presented. Most fungal infections in solid organ transplant patients are due to Candida species or Aspergillus species; however, dematiaceous (dark-pigmented) fungi are becoming more common fungal pathogens in these patients. Antifungal therapy remains difficult in this patient group. The meeting included an overview of the current status of diagnosing fungal infections through serodiagnostic techniques. If properly validated, serology can be useful in fungal diagnosis since antigens and antibodies are easier to detect than the invading organism. Premature infants are at high risk for developing invasive fungal infections. Antifungal drugs have not been tested in controlled clinical trials in these patients, thus therapy is accomplished using adult treatment regimens and anecdotal experience. As regards the new lipid-based formulations of amphotericin B, published clinical studies are only now appearing in the literature and these reports suggest that the new formulations have reduced toxicity and comparable efficacy compared to conventional amphotericin B under various clinical conditions. Correlation of minimum inhibitory concentration (MIC) values with clinical response to therapy is beginning to emerge. Two fungal cell wall-active compounds have recently entered clinical trials: an echinocandin and the chitin-synthesis inhibitor nikkomycin Z. Pradimycin and analogues have been studied through experimental animal models with good success; however, phase I clinical trials suggested drug-related toxicities and development was stopped. New molecular targets also are being investigated in antifungal therapy.

Journal Article↗
PubMed2000

[Present and future in the immunodiagnosis of the animal mycoses].

The problems that exist in the clinical, microbiological, and histopathological diagnosis of animal mycoses establish the necessity to investigate immunological methodologies in the diagnosis of these diseases. In this way, it may be possible to develop easy and fast techniques, allowing early detection of the disease, and efficient therapy. In our laboratory we have developed an indirect ELISA methodology to the diagnosis of aspergillosis in dog, cat, cow, sheep and birds, and dermatophytoses in dog and cat. Our results suggest this kind of technique may be useful not only in the diagnosis of animal mycosis, but in important fields as the elucidation of the fungal pathogenicity or the elaboration of effective vaccines, and with the possible application in human medicine.

English Abstract↗
PubMedDate not supplied

[Invasive mycoses in liver transplantation].

Seventy three adults underwent orthotopic liver transplantations between February 1987 and November 1989 and were followed (54 retrospectively and 19 in a prospective study) with the aim of establishing the incidence of deep mycoses (3 disseminated candidiasis due to C. albicans, 1 invasive aspergillosis due to A. fumigatus and 1 invasive pulmonary aspergillosis due to A. niger and A. fumigatus). 4/5 of these infections occurred in the first month after transplantation. All the patients were associated with the following clinical risk factors: previous use of wide spectrum antibiotics (5/5); more than 1 abdominal laparotomy (4/5), due to primary failure of the graft (3/4) and thrombosis of the hepatic artery (1/4). Two of the three patients [corrected] with invasive candidiasis had previous episodes of documented fungemia. 24 patients of the group who didn't show MIP had some risk factor which in all of them was the previous use of high dose steroids and/or of wide spectrum antibiotics, in addition to the used in surgical prophylaxis. In our series, the one risk factor associated with MIP was more than one previous laparotomy (p less than 0.001). Other significant associated infections were 3 bacterial sepsis (2 due to Enterococcus faecalis and 1 due to Staphylococcus epidermidis) and one viral (Cytomegalovirus viremia). The mortality rate was 100%, however the cause of death was multifactorial.

Adrenal Cortex Hormones↗
PubMed1990

[Urban cycles of zoonotic mycoses].

Based on their own results assembled during mycological examinations of 9958 subjects, 5496 animals and 648 specimens of non-animal substrates, and using data from the literature, the authors tried to formulate general laws concerning the prevalence of causal agents of mycoses with a zoonotic character which circulate steadily in urban areas: Microsporum canis, M. persicolor, Trichophyton mentagrophytes, M. equinum and T. equinum, T. verrucosum, some geophilic dermatophytes, Cryptococcus neoformans and Emmonsia crescens. In the characteristics of different urban cycles they used as a basis the evaluation of the prevalence of reservoir animals and reservoir substrates on the territory of towns and the evaluation of the most frequent routes of transmission of the agents from extrahuman sources to man. Preventive provisions leading to a reduction of the risk of the disease in humans must be specific with regard to different urban cycles.

Animals↗