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[Mycoses].

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Animals↗

[Prevalence of superficial mycoses in an urban ecosystem in Sfax (Tunisia)].

The authors studied the epidemiological aspects and the frequency of the various etiological agents of the superficial mycosis found in the region of Sfax, from 1,724 mycologic samples collected during 3 years (1989-1991). The rate of positivity is of 49%. The anthropophile dermatophytic species are often isolated dominated by the Trichophyton rubrum and the Trichophyton violaceum. The fungus of Candida albicans type and Malassezia furfur are the most frequently identified. The frequent localisations are the athlete foot and the onychomycosis where the rate of positivity is beyond 60%. The tinea of scalp are about to 77% due to Trichophyton violaceum, and sporadic form of tinea favosa have been described.

Candida albicans↗

[In vitro susceptibility to fluconazole of fungal strains freshly isolated from child patients with deep-seated mycoses].

The susceptibility to fluconazole (FLCZ) were evaluated for 40 strains of 8 yeast species and 4 strains of 3 Aspergillus species, all of which were isolated from clinical specimens during clinical trials of FLCZ in child patients performed from January 1991 to January 1993 in this country. The in vitro activity of FLCZ against yeast isolates and Aspergillus isolates were measured using the microdilution method with semisolid SAAMF (synthetic amino acid medium fungal) agar and the macrodilution method with Eagle MEM (minimum essential medium), respectively, using amphotericin B (AMPH) and flucytosine as the reference drugs. Out of all yeast species tested, Candida albicans and Candida tropicalis were the most susceptible to FLCZ with geometric mean (GM)-MICs of < 0.4 microgram/ml that were far less than the corresponding values for AMPH or flucytosine. On the other hand, FLCZ showed the lowest activity against Candida krusei and Candida glabrata with GM-MICs of approximately 10 micrograms/ml that were slightly higher than those for AMPH. The susceptibilities to FLCZ of Candida parapsilosis, Candida pelliculosa (anamorph of Hansenula anomala), Candida famata, and Trichosporon cutaneum were intermediate. Antifungal activities of FLCZ and the 2 reference drugs against aspergilli were determined on the basis of the amount of total protein recovered from drug-treated cultures relative to that from drug-free control cultures. Fifty percent and 90% inhibitory concentrations of FLCZ against 2 isolates of Aspergillus fumigatus were 6.25-25 micrograms/ml and 50 micrograms/ml, respectively. Against this and 2 other species of Aspergillus, AMPH appeared more highly active than FLCZ.

Amphotericin B↗

[A clinical study of fluconazole-granules and -injectable in pediatric patients with deep-seated mycoses].

Fluconazole (FLCZ) is an antifungal agent of triazole class developed by Pfizer, Inc. Its oral and injectable forms have been available on the market since June 1989 in Japan. FLCZ exhibits potent antifungal activities against Candida spp., Aspergillus spp. and Cryptococcus spp. and, as orally or intravenously administered, is widely distributed into organs and tissues. For its low protein binding rate of about 10 per cent and long serum half life of about thirty hours in adults, FLCZ has been proved highly effective and useful in the treatment of deep-seated mycosis in adult patients. In the present study, we have investigated the clinical effectiveness and antifungal activities of FLCZ granules, a new dosage form of the drug, and of intravenous form in pediatric patients with deep mycosis. A total of 72 patients were treated either with granules orally or with intravenous injection and 47 patients among them were evaluable on the clinical efficacy of the drug. Also, a study on the pharmacokinetics of pediatric patients including premature/new born babies was conducted employing multiple dose regimens in a total of 27 patients. The clinical efficacy rates were 79.5% (35 patients out of 44) in candidiasis and 100.0% (3 of 3) in aspergillosis. The safety of the drug was assessed in 63 patients. No side effects were observed. Clinical laboratory test abnormalities were observed in some patients with an incidence of 9.7% (6 patients out of 62) but most of the abnormalities were only mild and transient. The pharmacokinetics at repeated doses indicated that a steady-state is reached in 4 days after the initial administration of either granules or intravenous form. From these results, it may be concluded that FLCZ is a very useful medication in the treatment of deep mycosis in pediatric patients.

Administration, Oral↗

[Mycoses of the maxillary sinus. Apropos of 40 cases].

Between 1985 and 1992, 40 patients with mycosis of the maxillary sinus were treated in the department at Hôpital Saint Michel and of otolaryngology, head-neck surgery at Hôpital Saint Michel and their charts retrospectively analysed. The clinical signs, radiological findings and etiopathological hypothesis are described. The authors report their experience of functional endoscopic sinus surgery for treatment of mycosis of maxillary sinus. A high rate of postoperative successes, a low rate of complications, the recovery of a normal intrasinusal aerial flow and the easy endoscopic follow-up lead them to adverate the use FESS in primary treatment for mycosis of the maxillary sinus.

Adult↗

Experimental mycoses in congenitally immunodeficient rodents.

Congenitally immunodeficient rodents are playing a major role in clarifying host defense mechanisms and elucidating the virulence factors of a variety of mycotic agents. These murine models are also being used to study the histopathology and chemotherapy of a variety of fungal infections. Recent development of immunodeficient transgenic mice will make these murine models even more valuable for studies on the diagnosis, pathogenesis, immunity, and chemotherapy of fungal infections.

Animals↗

[Treatment of oropharyngeal and esophageal mycoses in immunodeficient patients with fluconazole (Diflucan, Pfizer)].

Thirteen patients with oropharyngeal and oesophageal mycosis were treated with a new triazole antimycotic, fluconazole. In the whole group in addition to the basic neoplastic disease as multifactorial predisposition to mycotic infection was revealed. After treatment a 100% clinical as well a laboratory effect was achieved. However, within one month a relapse developed in three of eight patients and reinfection in four of eight (renewal of laboratory evidence). The preparation was well tolerated by the patients, no laboratory signs of organ toxicity were revealed. In patients with cumulation of predisposing factors for mycotic infection the authors recommend long-term prophylactic protection with a small dose of fluconazole.

Adult↗

[The fungi causing superficial mycoses found in and around Ankara].

In this research the agents in the specimens taken from 400 patients whose diagnosis were superficial cutaneous infection were investigated. The specimens were collected from the Dermatology Clinics of Hacettepe Hospital and Numune Hospital. As a result of our experiments we isolated T. mentagrophytes, T. rubrum, E. floccosum, T. schoenleini, M. canis, T. violaceum, M. audouini, M. gypseum. It is also established that beside C. albicans, other Candida species are also the causes of cutaneous fungus infection.

Candida↗