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PubMed1977

[Influence on the function of lymphocytes in children with generalised mycosis during treatment with 5-fluorocytosin (author's transl)].

After LT Tests with PHA, PPE and Candidin in mixed cultures negativ or decreased results of cellular immunoreactions were obtained in cases of generalised mycosis, taking into account age-specific variations. The generalised form of mycosis having disappeared, the findings returned to normal. While in other diseases the use of metabolites always diminishes cellular immunoreactions, there is no decrease of lymphozyte transformation during treatment with 5-fc in mycosis. After a successful therapy even an increase may be found in this case. Our studies confirm the opinion that 5-FC does not influence the function of T-lymphocytes.

Candidiasis↗
PubMed2003

[Mycosis of the tonsil].

OBJECTIVE: To evaluate the early diagnosis ways of the tonsil mycosis. METHOD: The study was designed to investigate 18 patients with mycosis of tonsil in the PUMC hospital since 1995 year. Direct smear and microscopical examination of secretory material, tissues from tonsil infection were conducted; fungus culture was performed in the fungi positive cases for microscopical identification. RESULT: The diagnosis of all patients were demonstrated by the pathogeny check at last. CONCLUSION: The direct smear examination and fungus culture are important methods for early diagnosis to the mycosis of tonsil.

Adolescent↗
PubMedDate not supplied

[Frequency of mycosis in immunosuppressed patients at a regional hospital of Mexico City].

OBJECTIVE: To isolate and identify the fungi in specimens collected from immunocompromised patients seen in Mexico City hospital, and to assess their association with mycosis. MATERIAL AND METHODS: A total of 268 specimens from 108 patients were processed for mycological study, including direct examination, smears, cultures, and microcultures in specific media, in addition to biochemical tests. Most of the patients had been diagnosed with pulmonary tuberculosis and Acquired Immunodeficiency Syndrome (AIDS). RESULTS: One hundred and eighty-three yeasts and 66 mycelial fungi were isolated. Forty-five mycoses were diagnosed; the most frequent mycosis was pulmonary candidosis (32 cases). Candida albicans and C parapsilosis were the predominant species associated with mycotic infection. Five Cryptococcus neoformans var. neoformans, one C albidus, three Histoplasma capsulatum and one Geotrichum candidum isolates were associated with mycosis. CONCLUSIONS: Of the studied patients, 41.6% showed a mycotic infection, principally associated with AIDS and pulmonary tuberculosis. The English version of this paper is available at:http://www.insp.mx/salud/index.html.

Adolescent↗
PubMed2005

[Pathogenic and clinicopathologic study of invative mycosis in nose and paranasal sinus].

OBJECTIVE: To investigate the mechanism of fungi invasion into the mucosal tissue, and to analyse the clinical-pathological relationship. METHODS: The clinical data of 16 patients with invasive mycosis in the nose and paranasal sinus proved by pathologic examination between Apr, 1984 and Aug, 2002 were reviewed retrospectively. There were 7 males and 9 females with an average age of 48.6 years. The pathologic morphology of fungi found in these patients was investigated. Fourteen of 16 tissue samples from the paranasal sinuses obtained by endoscopic operation were cultivated for the fungi. One sample of invasive mycosis was observed under electron-microscope. RESULTS: Fourteen cases were found to have following underlying conditions, including diabetes (n = 4), malignant tumor (n = 5). The infected sites were as follows: 7 cases presenting in unilateral maxillary sinus, 6 cases involving over two nasal sinuses, 8 cases invading the orbit. Of all 16 patients, 15 were positive (93.7%) for the culture. The positive rate of aspergillus was 62.5% and mucoraceae was 25.0%. The overall mortality rate was 50.0% after investigation from 6 months to 5 years. From 16 surgical specimens, hypha were proved in all cases for histopathologic methods. All of the 16 granulomatous and crumbley materials from the paranasal sinuses were found that inflammatory responses were predominantly neutrophilic leucocytes invasion (100%), suppurative granuloma formed in 15 cases (93.7%). Invasive diseases were characterized by prominent infarcts (27.8%), angio-invasion (100%), and surprisingly, prominent optic nervous invasion (16.7%) in biopsies. CONCLUSIONS: The incidence of invasive mycosis is correlated with patients who suffered from diabetes, malignant tumor and other basic diseases causing depression of immunological function. The pathologic study shows that the fungi which invade the tissue are mostly aspergillus or mucoraceae, and the fungal vasculitis is the direct reason for tissue damage.

Adult↗
PubMed2005

[Bacterial flora and mycosis of the vagina in women with symptoms of vaginal inflammation].

OBJECTIVES: To estimate the microbiological profile of vaginal flora in 30 women with gynecologic problems and 20 pregnant women complaining about pathological symptoms {pruritus, burning, vaginal discharge}. MATERIALS AND METHODS: The discharge from posterior vaginal vault was examined microbiologically on the Columbia Agar with sheep blood, MacConkey and Sabourand cultures incubated of 48 hours in the temperature of 37 degrees C. RESULTS: Bacterial infections were detected in 33 cases (66%), 12 of these women (24%) lived in urban, 21 (42%) in rural environment. From bacteria isolated from the vagina, most often because at 14 women stepped out Streptococcus agalactiae, at 11 Enterococcus faecalis at 8 Escherichia coli. In 5 cases bacterial inflammation was caused by two kinds of bacterium. At two women stepped out both Enterococcus faecalis and Escherichia coli. In single cases it was Klebsiella pneumoniae and Proteus vulgaris, Escherichia coli and Streptococcus agalactiae. In all cases of inflammation mycosis was called out by from Candida albicans. One ascertained it at 14 among all given an examination women. Mixed inflammations called out both by mycosis and bacterial stepped out in 3 cases in age of 21-30. At two women it was Candida albicans and Streptococcus agalactiae, at one inflammation mycosis accompanied Enterococcus faecalis. CONCLUSIONS: The common reason of vaginitis are bacterial infections caused by Streptococcus agalactiae, Enterococcus faecalis, E coli. Both, place of living and women' s age influence the type of etiological factor.

Adolescent↗
PubMed1991

[Susceptibility to miconazole (base) of isolates from the oral cavity and esophagus of patients with mycosis].

An antifungal agent of the imidazole class, miconazole (MCZ) (base), was investigated for its in vitro antifungal activities against isolates from the oral cavity and esophagus of patients with mycosis, and the following findings were obtained: 1. Those yeast-like fungi which were presumed to be the causative agents were isolated from the oral cavity and esophagus of patients with mycosis, and identified. Candida albicans was the most frequently occurring species, accounting for 71.4% of all the isolates. Less frequently, several other Candida species, such as Candida krusei, Candida tropicalis, Candida lusitaniae and Candida lipolytica were also isolated mostly from patients with polymicrobial infections. 2. The MICs of MCZ against the isolates of Candida species which were obtained from materials from patients with oral and esophageal candidiasis as the presumable causative agent distributed through such a wide range as less than or equal to 0.04 to 20 micrograms/ml, and susceptibilities of these isolates to MCZ proved to be no less than those to amphotericin B, which was used as the control drug. The results suggest that an appropriate preparation of MCZ (base) will be effective in treating mycosis of the oral cavity and esophagus.

Candida↗
PubMed1980

Systemic mycosis complicating high dose corticosteroid treatment of chronic active liver disease.

Four patients with severe chronic active liver disease, treated with 30-200 mg. of prednisone daily for one-half month to seven months because of lack of response to smaller doses, developed systemic mycosis. Presentation was variable, consisting of cryptococcal meningitis, cryptococcal pneumonia, aspergillus cerebral vasculitis and disseminated histoplasmosis originating from a histoplasma pneumonia. None of 114 patients in the Mayo Clinic trials on conventional treatment for at least six months, but only one of 25 patients (4%) on high dose prednisone, developed systemic mycosis. Low dose prednisone or its equivalent can be maintained to control hepatic inflammation during vigorous antifungal therapy without jeopardizing cure of the fungal infection. We conclude that systemic mycosis is infrequently associated with corticosteroid therapy for severe chronic active liver disease but can occur on high dose regimens as a subtle, progressively debilitating and potentially fatal complication that justifies prompt recognition and aggressive treatment with amphotericin-B alone or in combination with 5-fluorocytosine.

Adult↗
PubMed1993

[Efficacy of fluconazole on systemic mycosis associated with hematologic malignancies and a study on diagnostic value of plasma beta-D-glucan levels].

Efficacy of fluconazole (FLCZ), an anti-fungal agent of triazole derivatives, was evaluated in patients with systemic mycoses and suspected mycoses associated with hematologic malignancies including leukemia, myelodysplastic syndrome and malignant lymphoma. Plasma beta-D-glycan levels, the differences between the levels determined toxicolor test and in endospecy test, were also investigated. Fourteen patients with systemic mycoses and 31 patients with suspected mycotic infections were treated with intravenous administration of FLCZ at a daily dose of 400 mg. Excellent to good responses were observed in 4 of the 14 patients (28.6%) with definitive diagnosis of mycosis, and in 18 of the 31 patients (58.1%) with suspected fungal infections, with an overall efficacy rate of 48.9% (22/45). Levels of plasma beta-D-glycan correlated well with efficacies of FLCZ in 19 of 30 patients. In several cases, however, plasma beta-D-glucan levels were low during the entire course of treatment. Even in 10 cases of definite mycosis, 4 cases showed low levels of plasma beta-D-glucan (below 15 pg/ml by repeated determinations). The results indicate that FLCZ is an effective agent for the treatment of severe systemic fungal infections in patients with hematologic disorders. Deep seated mycosis cannot be ruled out even when its plasma levels of beta-D-glucan are low.

Adolescent↗
PubMed2002

Quantifying skin disease burden in mycosis fungoides-type cutaneous T-cell lymphomas: the severity-weighted assessment tool (SWAT).

OBJECTIVE: To develop a quantitative tool to assess severity of mycosis fungoides. DESIGN: Prospective analysis of a cohort. SETTING: University department of dermatology-based cutaneous lymphoma clinic. PATIENTS: From 1984 to 1995, 1186 visits from 323 referred patients seen in a multidisciplinary cutaneous lymphoma program. MAIN OUTCOME MEASURES: Severity-weighted assessment tool (SWAT) scores were obtained for patients at each visit. This score represents the product of the percentage total body surface area (%TBSA) involvement of each lesion type (patch, plaque, and tumor or ulceration), multiplied by a weighting factor: SWAT = (patch %TBSA x 1) + (plaque %TBSA x 2) + (tumor or ulcer %TBSA x 3). In addition, the standard measurements of TBSA involvement and physician global assessments were recorded for comparison. RESULTS: The SWAT score correlated well with %TBSA (r = 0.95, P<.001), physician global assessment (r = 0.60, P<.001), and time to complete remission during psoralen-UV-A therapy (r = 0.80, P<.001), therefore indicating validity against standard measures. Analysis of individual and subsets of patients demonstrated that the SWAT score more accurately quantified changes in skin disease burden, including mixed responses to treatment, than did %TBSA alone. CONCLUSIONS: The SWAT score is a useful clinical measurement for mycosis fungoides. The SWAT score captures overall physician impressions of disease status on a continuous dimensionless numerical scale, therefore providing a defined, objective, and sensitive quantitative measure. This tool is suitable for individual patient assessment, clinical trials, and outcome comparisons.

Cohort Studies↗
PubMed2003

Topical nitrogen mustard in the management of mycosis fungoides: update of the Stanford experience.

OBJECTIVE: To evaluate and update the response and survival outcomes and toxic effects in patients treated with topical nitrogen mustard (mechlorethamine hydrochloride) as primary therapy. DESIGN: A single-center, retrospective cohort analysis. SETTING: Academic referral center for cutaneous lymphoma. PATIENTS: A total of 203 patients with mycosis fungoides (clinical stages I-III) treated with topical nitrogen mustard as initial therapy. MAIN OUTCOME MEASURES: Long-term actuarial survival, freedom-from-relapse, and freedom-from-progression results as calculated by the Kaplan-Meier method. RESULTS: The overall response rate for the 203 patients was 83%, with a complete response rate of 50%. The median time to achieve complete response was 12 months (T1, 10 months; T2, 19 months), and the median time to relapse was 12 months. The duration of complete response increased with longer maintenance therapy; however, after completion of therapy, the response duration or relapse rate was similar regardless of maintenance regimen. Patients with T1 disease had better response and survival outcomes than those with T2 disease, with overall and complete response rates in T1 of 93% and 65%, respectively, and in T2, 72% and 34%, respectively. A similar clinical response was seen for patients with stage IIA vs IB. Sixty-eight percent of 203 patients received only topical nitrogen mustard therapy throughout their follow-up course, including most of the patients who achieved an initial complete response. The clinical response to topical nitrogen mustard as salvage therapy was similar to initial response rates. The efficacy results were similar in patients treated with aqueous vs ointment preparations. Freedom-from-progression rates in T1 disease (no progression to higher T classification or worse clinical stage) at 5 and 10 years were 92% and 85%, respectively, and in T2, 83% at 5 and 10 years. Fewer than 10% of patients experienced contact hypersensitivity reactions when topical nitrogen mustard was used as an ointment preparation. Only 8 patients (4%) developed secondary cutaneous malignancy, none attributable to topical nitrogen mustard monotherapy. Pediatric patients experienced no significant toxic effects with topical nitrogen mustard therapy. CONCLUSIONS: Topical nitrogen mustard remains an effective primary initial or salvage therapy in mycosis fungoides for patients with T1 and T2 disease. Long-term follow-up results confirm its safety.

Administration, Topical↗
PubMed1975

Frequent low doses of intravenous mechlorethamine for late-stage mycosis fungoides lymphoma.

Ninety-two courses of daily low-dose intravenous nitrogen mustard were administered to 46 patients with advanced cutaneous lymphomas (mycosis fungoides, Sezary syndrome and lymphoma cutis). Seventy-eight % of patients showed objective clinical remission, and 35% reached a clinically disease-free state following 1 or more courses. The response rate was greater in patients with the plaque-tumor type of mycosis fungoides than in those with erythrodermic variants. Therapy was free of significant side effects.

Adult↗
PubMed1976

T and B cells and cell-mediated immunity in mycosis fungoides.

T anb B cells in peripheral blood were evaluated in 13 patients with mycosis fungoides (MF) and in two patients with Sézary's syndrome. T cells were identified by their capacity to bind sheep red blood cells to their surfaces and the B cells were identified by the presence of surface immunoglobulins in immunofluorescence assay. Seven patients with MF and two with Sézary's syndrome were shown to have T-cell values below normal and elevated levels of null cells, i.e., cells with markers for neither T nor B cells. Low T-cell values and elevated Null-cell values were found predominantly in patients with advanced mycosis fungoides (stages III-IV). Furthermore, these patients had impaired cell-mediated immunity, as shown by in vivo skin testing with recall antigens and attempts at sensitization to dinitrochlorobenzene.

Adult↗
PubMed1976

Tumor cell characterization in mycosis fungoides.

Five patients with tumor stage mycosis fungoides had tumor lesions excised and examined by light and electron microscopy. The tumor cells were also isolated and the percentages of E rosettes (T cells) and EAC rosettes (B cells) were determined and the rosettes examined by electron microscopy. The predominant cell type isolated from four of the five tumors was a T cell. Peripheral lymphocyte function measured by LTT to phytohemagglutinin and pokeweed mitogen was normal. Serum immunoglobulins gave variable results. The results support the concept that mycosis fungoides is primarily a T cell tumor involving the skin and morphologically similar to the Sézary cell.

Aged↗
PubMed1976

Oral methoxsalen photochemotherapy of mycosis fungoides.

The cutaneous manifestations of mycosis fungoides have been successfully treated in nine patients for 16 to 28 months with oral methoxsalen and subsequent irradiation with longwave ultraviolet light. The efficacy of this therapy was confirmed in one patient, who showed complete clearing of generalized plaques after 1 month (12 treatments) except for a shielded control area which worsened during this period. Methoxsalen photochemotherapy may prove a valuable addition to therapies currently available for mycosis fungoides and may obviate some of the problems associated with conventional management of this disorder.

Administration, Oral↗
PubMed1976

Woringer-Kolopp disease. An epidermotropic variant of mycosis fungoides.

Woringer-Kolopp disease is characterized by the presence of a monomorphic, tumorous infiltrate in the epidermis. A light- and electron microscopic study, and cytophotometry, of one case were performed and the results are discussed. No explanation has been found for the epidermotropic character of this condition, although an intraepidermal origin of the tumor infiltrate seems improbable. The cytomorphologic characteristics of the tumor cells shows a striking analogy to the atypical cells in the Sezary syndrome and mycosis fungoides. These findings support the hypothesis that Woringer-Kolopp disease represents a clinical variant of mycosis fungoides and the Sezary syndrome.

Aged↗
PubMed1977

The treatment of mycosis fungoides: adjuvant topical mechlorethamine after electron beam therapy.

The feasibility of employing adjuvant topical mechlorethamine after electron beam therapy in the treatment of patients with mycosis fungoides is demonstrated. Patients treated with a planned adjuvant topical mechlorethamine schedule had a median disease-free interval of 25 months compared to 17 months for the group treated with electron beam therapy alone. Projected relapse-free survivals are slightly better in the adjuvant group--37% versus 29%. Patients receiving adjuvant topical mechlorethamine after the electron beam were observed to have a low incidence of contact allergy to the medication. The topical medication can be continued if a contact allergy develops by using a planned desensitization program. We currently treat all mycosis fungoides patients with electron beam therapy, randomizing half to receive adjuvant topical mechlorethamine.

Administration, Topical↗
PubMed1978

Lymphocyte transformation in patients with staged mycosis fungoides and Sézary syndrome.

Lymphocyte transformation was studied in patients with mycosis fungoides and the Sézary syndrome with particular reference to the stage of disease. Phytohemagglutinin-induced lymphocyte blastogenesis was normal in stage II, became depressed in stage III and was greatly reduced in stage IV disease. Similar abnormalities were found in patients with the Sézary syndrome once the proportion of abnormal cells in the peripheral blood exceeded 10%. It is concluded that stag III mycosis fungoides is probably a critical period in determining dissemination of the disease.

Adult↗
PubMed1978

Banding studies of chromosomes in a patient with mycosis fungoides.

Chromosomes from a patient with mycosis fungoides were examined in detail with banding techniques. Hyperdiploid cells from a lymph node had common anomalies of certain chromosomes which formed three similar clones. The abnormalities involved chromosomes No. 1, 2, 5, 8, 9, 10, 14, and 18, in addition to an unkwown small metacentric marker (M3). Although there were a number of mitotic cells in peripheral blood cultured both with and without PHA, none of the few cells with abnormal karyotypes was similar to the clonal cells of the lymph node. One of the abnormalities in the lymph node was a 14q rearrangement, which could be the result of a translocation of Nos. 8 and 14 involving a third chromosome, No. 2. An abnormality in the blood resulted from a translocation between the long arms of Nos. 1 and 14. These findings could be useful for studies in which mycosis fungoides is compared with the Sézary syndrome and other lymphoid malignancies.

Bone Marrow Examination↗