Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “MYCOSES”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 505 records · Page 28Linked to original sources
PubMed2006

Is there a role for polyenes in treating invasive mycoses?

PURPOSE OF REVIEW: This is a clinical review on the current role of polyene antifungals in the treatment of invasive fungal infections. It is timely and relevant because the number of new antifungals being developed has never been greater than today. In addition to re-examining the landmark clinical trials of the past, the more recent findings are put into perspective. The past year has been particularly rich in clinical trials. RECENT FINDINGS: The main topics of this review are invasive candidiasis, invasive aspergillosis, and the so-called rare fungal infections: zygomycosis, fusariosis, cryptococcosis and histoplasmosis. SUMMARY: Practical implications of the recent developments are the almost complete replacement of amphotericin B deoxycholate by lipid-based formulations; antifungal efficacy without compromising safety; and treatment choices for infections previously considered untreatable.

Amphotericin B↗
PubMed2006

Antifungal prophylaxis for invasive mycoses in high risk patients.

PURPOSE OF REVIEW: New broader spectrum antifungal agents with favorable safety profiles have been available for the last 15 years making prophylaxis feasible. The purpose of this article is to review recent studies in patient populations at high risk for invasive fungal infections. RECENT FINDINGS: Itraconazole, lipid formulations of amphotericin B, posaconazole, caspofungin and micafungin have been utilized for prophylaxis in different immunocompromised host settings. Itraconazole and caspofungin remain an option especially in patients with hematological diseases. Low dose liposomal amphotericin B shows a lower morbidity rate in patients treated for acute myeloid leukemia. Posaconazole demonstrated survival benefits in this setting although data have only been presented at an international meeting. In the transplantation setting, micafungin was superior to fluconazole during the early neutropenic phase and posaconazole was superior to fluconazole in preventing invasive aspergillosis in hematopoietic transplant recipients treated for graft-versus-host disease. Results from the latter study have thus far only been presented in abstract form. SUMMARY: Prophylaxis should only be given to a high-risk population. Results of studies should demonstrate morbidity and mortality advantages. The new generation of azoles and echinocandins have a favorable safety and drug interaction profile and appear advantageous in specific settings of immunosuppression. Pending full publication, posaconazole appears to be an appropriate agent for prophylaxis in acute myeloid leukemia patients or patients treated for graft-versus-host disease. Micafungin is superior to fluconazole in the neutropenic phase of hematopoietic transplantation.

Antifungal Agents↗
PubMed2006

Antigen detection, serology, and molecular diagnosis of invasive mycoses in the immunocompromised host.

Understanding the uses and limitations of methods for rapid diagnosis of fungal disease is essential in order to diagnose and treat these infections early in their course. Antigen detection methods are useful for diagnosis of aspergillosis, cryptococcosis, histoplasmosis, blastomycosis, paracoccidioidomycosis, and penicilliosis marneffei. The accuracy of the beta-glucan assay for diagnosis of aspergillosis and candidiasis and its role in fungal diagnosis remains unclear, in part because the few published studies report widely varying specificity. Serologic tests for antibodies are also useful for diagnosis of histoplasmosis and coccidioidomycosis, but their sensitivity may be reduced by immunosuppression. While molecular diagnostic methods have been described and are available at some reference and university laboratories, their role in patient care remains uncertain, largely because of the lack of well-characterized assays and studies establishing their accuracy. Culture methods, although essential for establishing the diagnosis in some cases, have limitations for rapid diagnosis, namely insensitivity, need for invasive procedures, and delayed growth.

Antigens, Fungal↗
PubMedDate not supplied

Rapid microscopical diagnosis of deep-seated mycoses following maceration of fresh specimens and staining with optical brighteners.

A fluorescent staining procedure, which used to be recommended for the detection of fungi in skin and nail scrapings, can be adapted for the rapid detection of fungal elements in non-sectioned biopsies or respiratory secretions. The specimens are directly stained with an optical brightener (Blankophor P flüssig, Cellufluor, Uvitex 2B) preferentially after exposure to 20% aqueous potassium hydroxide solution. The procedure can also be applied to Gram-stained microscopic mounts. The high intensity of the fluorescence elicited allows rapid microscopic screening at low magnifications.

Fluorescent Dyes↗
PubMed1997

[Mycoses in patients with psoriasis or atopic dermatitis].

Both, psoriasis and atopic dermatitis are multifactorial diseases with an unknown pathogenesis. To elucidate the influence of fungal infections in the onset or recurrence of those inflammatory skin disease we determined the frequencies of Candida and dermatophyte infections of the skin and orointestinal tract concomitantly seen in patients with psoriasis or atopic dermatitis. We analyzed the files of more than 40,000 in-patients of the Department of Dermatology, Kiel. Sex- and age-adjusted relative risk were calculated. The results demonstrate that patients with psoriasis (N = 3006) presented with a decreased rate of tinea. This was significant for tinea corporis (RR = 0.13, p < 0.01). Candida infections of the skin were seen more often in psoriasis patients compared to controls. Differentiating between Type I (early onset) and Type II (late onset) psoriasis only Type I psoriasis patients presented with decreased dermatophyte infections and increased Candida colonization of the intestinum. However, patients with Type II psoriasis demonstrated an increased rate of candidosis cutis and candidosis oris as compared to controls. Patients with atopic dermatitis (N = 1808) displayed a decreased overall incidence of tinea and Candida infections. Furthermore, in patients with atopic dermatitis a Candida colonization of the orointestinal tract was found elevated (RR = 1.51, p < 0.01), whereas tinea corporis (RR = 0.24, p < 0.01) and candidosis cutis (RR = 0.30, p < 0.001) was found decreased compared to controls. Our results show that the influence of fungal infections on the two skin diseases investigated is not as strong as often considered. The increased relative risk in patients with atopic dermatitis to present with Candida colonization in the digestive tract or vice versa may contribute to the pathogenesis of atopic dermatitis.

Candidiasis↗
PubMed1997

Mycoses of the urogenital tract.

Mycotic infections of the urogenital tract are rarely caused by primary fungal pathogens, often however, by opportunistic fungi such as Candida species. Opportunistic fungi infect the urogenital tract either by haematogenous spread from a distant site, or a break of tissue integrity, or by retrograde ascension from the perianal region, or by wound contamination. After an initial polymorphonuclear reaction macrophages may invade giving rise to a granulomatous response. Risk factors for mycotic urogenital infections are extremes of age, long lasting and broad spectrum antimicrobial therapy, diabetes mellitus, immunosuppression, malignancy, x-ray therapy, contaminated i.-v. catheters, oral contraceptives, pregnancy, surgery, obstructive uropathy and indwelling urethral catheters.

Antifungal Agents↗
PubMed2004

[Early signals of systemic mycoses--guidelines for therapeutic decisions?].

Clinical applications and in vitro studies show that all antimycotics are most effective against infection when applied as early as possible. An early diagnosis is, therefore, essential. At this time for aspergillosis and particularly candidosis, a statement is only possible by combining several diagnostic methods. Inflammatory parameters like procalcitonin, C-reactive protein and proinflammatory cytokines are most important evidence of infection. Antigen tests are more significant by higher sensitivity. Attention should be focused on the detection of mannan by ELISA test, beta-glucan and D-arabinitol. Given the present research level in the field of proteomics, the diagnostic importance of transmembranal receptor proteins or other regulatory proteins seems promising.

Antifungal Agents↗
PubMed1996

Amphotericin B Lipid Complex (Abelcet) in the treatment of invasive mycoses: the North American experience.

Abelcet, or Amphotericin B lipid Complex, is unique formulation, comprising an equimolar mixture of amphotericin B complexed with two lipids. In preclinical studies, Abelcet was clearly demonstrated to be less toxic than amphotericin B desoxycholate and to be effective in models where amphotericin B was ineffective at its maximum tolerated dose. Pharmacokinetic studies in animals also showed that the concentration of Abelcet in blood is similar or reduced compared to levels seen with conventional amphotericin B, with accumulation in the liver, lungs and spleen. Phase I clinical trials determined the optimum tolerated dose of Abelcet to be 5 mg/kg d-1. Data are now available for 228 cases (including 51 paediatric cases) of invasive fungal infection treated with Abelcet in an open-label emergency-release protocol. All patients had to have failed on previous amphotericin B or other conventional antifungals, or to have unacceptable toxicity on amphotericin B, or underlying renal disease, or nephrotoxicity due to other drugs. Abelcet was administered at a dose of 5 mg/kg d-1 for 4 wk. Approximately one-third of patients had candidiasis, one-third aspergillosis and one-third other infections, including fusariosis. Of 183 cases evaluable for response, 126 (69%) had a clinical response (cure or improvement) which was mycologically confirmed in 55% (61/110 tested). Results in paediatric cases were similar to or better than those seen in the group as a whole. When comparisons were made between cases with different types of infection, underlying disease/immunosuppressive disorder, and degree of neutropenia, the response rates were very consistent from group to group. Treatment with Abelcet was well tolerated and mean serum creatinine levels actually declined during therapy, particularly in patients with pre-existing renal dysfunction.

Amphotericin B↗