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PubMed1989

[Mycoses in otorhinolaryngology. Apropos of 167 cases].

The authors observed 167 cases of E.N.T. mycoses over a 14-year period (1974-1988) in the E.N.T. Departments of the Abidjan University Hospitals in the Ivory Coast, and in two private health institutions in the city. The majority of cases involve candidiasis (91 cases, or 54.5%), followed by aspergillosis (72 cases, 43.1%) and rhinoentomophtorosis (4 cases, 2.4%). Men are more affected than women (125 as against 42). Men suffering from rhinoentomophtorosis are, for the most part, farmers. Among the contributory factors, we found respectively the abuse of antibiotics, either alone or in association with corticoids for general or local use (ear drops), bathing in lagoons, and diabetes. Bacterial infection is often associated with these mycoses--mainly streptococci and staphylococci aurei. Clinical signs are dominated by pruritus, dull pains, a feeling of fullness in the ear, or of burning in the pharynx. An association of systemic Miconazole and Amphotericin B (local use) has given the best results for candidiasis and aspergillosis. For rhinoentomophtorosis, treatment was long, and even disappointing, until the use of Ketoconazole which may without doubt be considered as the medicament of choice.

Adult↗
PubMed1986

Immunodiagnosis of systemic mycoses in animals: a review.

Immunologic methods have been used with varying success in the diagnosis and prognosis of systemic mycoses in animals. Information on the application of the tests and on the interpretation of test results in monitoring therapy was complied. Serotesting provided diagnostic and prognostic data in immunocompetent patients, and predicted relapse in one case after apparent clinical cure. The tests were useful in the management of animals with mycoses that respond slowly and unpredictably to therapeutic agents for which pharmacologics and pharmacokinetics have not been established in domestic animals. Certain tests were not useful in some cases.

Agglutination Tests↗
PubMed1988

Mycoses in immunocompromised patients. An histopathologic study of 61 cases.

The histopathologic pattern of secondary mycoses in 61 immunocompromised patients is presented. The underlying diseases were: neoplasms, organ transplants, AIDS and a variety of other debilitating diseases. Three patients with AIDS had a double fungal infection. Candida spp. accounted for the majority of deep-seated mycoses, with 27 cases (44.2%); disseminated candidiasis was responsible of 18.5% of these patients death. Aspergillosis was seen in 23 subjects (37.7%), 18 of them (78.2%) died for systemic infection. These patients were severely debilitated by disease and/or iatrogenic procedures. The other fungal infections were: actinomycosis (10 cases), gerotrichosis (2 cases), histoplasmosis (1 case) and cerebral phaeohyphomycosis (1 case).

Adolescent↗
PubMedDate not supplied

[Deep mycoses rarely described].

Beside deep mycoses very well known: histoplasmosis, candidosis, cryptococcosis, there are other mycoses less frequently described. Some of them are endemic in some countries: South American blastomycosis in Brazil, coccidioidomycosis in California; some others are cosmopolitan and may affect everyone: sporotrichosis, or may affect only immunodeficient persons: mucormycosis. They do not spare Africa, we may encounter basidiobolomycosis, rhinophycomycosis, dermatophytosis, sporotrichosis and, more recently reported, rhinosporidiosis. Important therapeutic progresses have been accomplished with amphotericin B and with antifungus imidazole compounds (miconazole and ketoconazole). Surgical intervention is sometime recommended in chromomycosis and rhinosporidiosis.

Adult↗
PubMed1979

[Therapy of opportunistic mycoses].

The author presents the drugs that are available for the treatment of opportunistic mycoses: amphotericin B, nystatin, 5-fluorocytosine, miconazole and the newest imidazole derivative econazole. He presents his experience with econazole in 4 cases with deep mycoses. He speaks of the mode of application and the therapeutical limits of these products as well as of the favorable factors and the prophylactic measures to be taken.

Adult↗
PubMed1981

Deep mycoses in West Africa: a report of 13 cases and review of the Nigerian literature.

Thirteen cases of deep mycoses were found among 12,506 new patients attending two University clinics in Northern Nigeria. Patients with chromoblastomycosis due to Cladosporium carrionii, paracoccidioidomycosis, rhinophycomycosis, and sporotrichosis appear to be the first cases of these conditions recognized in the Savanna region of West Africa. The literature on systemic mycoses in Nigeria is reviewed and a need for a greater awareness of the problem is stressed.

Adult↗
PubMed1982

[Histopathology of mycoses in ORL].

This article is a histopathological review of fungus and actinomycosis infections seen in otorhinolaryngology. Actinomycosis with its charactéristic grains but sometimes difficult to differentiate from saprophytic bacterial granules. Aspergilloma and aspergillosis are seen frequently. Aspergillus filaments may be differentiated from those of Mucorales and those of Entomophtorales, agents responsible for tropical phycomycoses, the latter being characterised by the fibrinoid cuff which surrounds them. Candidiasis and yeast mycoses in the tissues also represent a very important area. Alongside cryptococcosis and sporotrichosis, emphasis is placed upon the frequency of mucosal localisations of histoplasmosis due to H. capsulatum. Sources of error related to false mycoses can be avoided by the routine use of PAS and Gomori-Grocott stains and careful morphological study.

Diagnosis, Differential↗
PubMed1994

[Clinical evaluation of combined use of miconazole and G-CSF on deep-seated mycoses in patients with gynecological cancers].

A combined therapy using miconazole (MCZ) and G-CSF was evaluated in clinical patients who developed deep-seated mycoses and fever of unknown etiology following chemotherapy for malignant gyneco-obstetrical tumors. 1. Combined administration of 100 to 250 micrograms/day of G-CSF, 400 to 800 mg/day of MCZ, and various antibiotics (Group I) was evaluated in 7 patients with mycoses (fungemia and fungal infections of the digestive and respiratory systems). The efficacy of the treatment was found to be 3/3. When 200 to 1,200 mg/day of MCZ was combined with various antibiotics (Group III), the therapy was found to be slightly effective (2/4). The rate of fungal eradication was 3/5. 2. The efficacy of combined administration of 400 to 800 mg/day of MCZ, 100 to 250 micrograms/day of G-CSF, and various antibiotics (Group II) in patients with fever of unknown etiology (n = 8) was 4/4. The efficacy of combined administration of 400 to 800 mg/day of MCZ and various antibiotics (Group III) was 3/4. 3. Leukocyte counts were recorded in the 7 patients who had received G-CSF (Groups I and II). The counts rose from < 1,000/microliters before the chemotherapy to > 5,000/microliters in 6 patients (6/7) in 5 to 8 days following drug administration. The favorable clinical efficacy was recorded in all who received MCZ and antibiotics. 4. The objective or subjective adverse effects of this therapeutic modality were limited to mild nausea in a single case. No deviations from norm were noted in clinical or other tests.

Adult↗
PubMed1995

[HIV-associated mycoses].

Candidosis, cryptococcosis, and histoplasmosis often occur as HIV-associated mycoses. However, aspergillosis can be observed quite recently. The morphology of the pathogen of HIV-associated mycoses in vivo and in vitro is demonstrated and discussed.

AIDS-Related Opportunistic Infections↗
PubMed1993

[Changes in the nomenclature of mycoses].

The author gives an account of a report of the Nomenclature Committee of the International Society for Human and Animal Mycology making the present terminology of mycoses more precise and unified. Changes recommended by the Committee are designed to eliminate the instability of currently used terms influenced by new names of mycological taxonomy as well as by clinical aspects and the pathology of mycoses. The essential feature of the changes is a recommendation for fungal disease names not based on the word derived from the taxon of the causative fungal genus but providing, in a narrow or broader way, information on the clinical and pathological entity caused by the fungus. The individual recommendations are supplemented by explanatory examples and a list of accepted and rejected fungal disease names is tabulated.

Humans↗
PubMedDate not supplied

[The incidence, etiology and clinical significance of visceral mycoses in patients with AIDS].

The incidence, aetiology and clinical significance of visceral mycoses in HIV-infected subjects were evaluated by a retrospective survey of the clinical and microbiological records of 237 consecutive AIDS patients followed-up since 1984. Seventy-four patients out of 237 (31.2%) (56 males, 18 females; 55 IV drug abusers, 7 heterosexuals, 6 homobisexuals, 3 blood recipients and 3 children with congenitally-acquired HIV infection) presented 77 different episodes of visceral fungal infection as a whole, represented by candidiasis in 56 cases (oesophageal 45, pulmonary 5, sepsis 2, eye involvement 2, endocarditis and invasive oropharyngeal infection in the remaining 2 patients), cryptococcosis in 17 cases (meningoencephalitis in all subjects, with disseminated infection in 11 of them), and aspergillosis in 4 cases (pulmonary 2, cerebral and cranio-facial in the remaining 2 patients). In 57 out of 74 patients (77%), visceral mycoses were diagnostic or concurrent with the diagnosis of AIDS. Fungal diseases, as a whole, showed a significantly higher incidence (p < 0.03) among drug abusers, whereas homobisexual men presented a significantly lower frequency (p < 0.001, chi-square test) than AIDS patients with other risk factors for HIV infection. The onset of cryptococcosis was significantly associated with the male sex (p < 0.005, Fisher exact test). All subjects suffering from a visceral mycosis were severely immunosuppressed, with a higher rate of neutropenia in patients developing Candida and Aspergillus spp. infection (23 out of 56 patients with visceral candidiasis and 3 out of 4 cases of aspergillosis had an absolute neutrophil count lower than 1500 cells/mm3), while a severe reduction in CD4+ lymphocyte count was more evident among patients with cryptococcosis (13 out of 17 patients had a CD4+ cell count lower than 50/mm3). After remission of the primary episode of fungal infection (obtained in 80.5% of cases), the incidence of relapse observed in a long follow-up period (mean time 57.6 +/- 39.2 weeks) was elevated both for patients with cryptococcosis (7 cases out of 17) and subjects with candidiasis (19 cases out of 53), with no significant difference among patients receiving a secondary prophylaxis or not (22 relapses observed in 53 patients treated with maintenance antifungals versus 4 episodes in 8 patients followed for a comparable mean time with no antimycotic treatment). Fifty-two out of 74 patients (70.3%) have died up to now; in 21 of them death was due to or associated with the visceral mycosis (cryptococcosis in 11 cases, candidiasis in 8, aspergillosis in 2).(ABSTRACT TRUNCATED AT 400 WORDS)

AIDS-Related Opportunistic Infections↗
PubMed1996

[Systemic mycoses: therapy with a new antifungal drug diflucan].

A new antifungal drug of systemic action diflucan (Pfizer, USA) has been tried in 10 patients (mean age 35.9 + (-)3.7 years) with various disseminated mycoses. The drug was used in a daily dose 200 mg intravenously or orally for 23.6 + (-)3.3 days. The response was achieved in all the patients with disseminated mycoses caused by yeast fulgi. Side effects were not registered.

AIDS-Related Opportunistic Infections↗
PubMed1977

[Generalized mycoses and their therapy].

After valuation of the increasing significance of the medical mycology as an interdisciplinary branch of science which concerns all clinicians the causes for the permanent increase of the endomycoses by yeasts and moulds are demonstrated. As secondary mycoses they need predisposing factors for manifestation which are to be taken into consideration more than up to now done in so-called risk patients. The pathomechanism is demonstrated with the help of the frequency of the lesion of organic systems in candidoses as well as in mould mycoses. Finally, the modern therapeutic possibilities are discussed.

Antifungal Agents↗
PubMedDate not supplied

[Production of fungal antigens from local strains for the immunodiagnosis of mycoses in Mexico].

Fungal antigens with good reactivity and specificity are essential for the immunodiagnosis of systemic mycoses. We give here data on crude and purified antigens of Histoplasma capsulatum, Coccidioidis immitis and Paracoccidioides brasiliensis from local strains and which are the more prevalent in Mexico. The crude antigens had good reactivity in precipitating and skin testing whereas the purified antigens (DPPC: deproteinized polysaccharide protein complex) had a higher specificity in more sensitive tests such as ELISA and complement fixation. Our efficiency analysis showed that the crude antigens are best for epidemiologic studies due to their low cost, easy handling and fast detection. The purified ones are suited to establish with more precision the diagnosis of systemic mycoses.

Antigens, Fungal↗
PubMed2005

Modern management of respiratory failure due to pulmonary mycoses following allogeneic hematopoietic stem-cell transplantation.

Pulmonary mycoses count among the most dangerous complications in allogeneic hematopoietic stem cell transplantation. Despite the establishment of antifungal chemoprophylaxis and empirical antifungal treatment, they frequently lead to respiratory failure and are still associated with an extraordinarily poor prognosis. However, the emergence of new antimycotics with alternative mechanisms of actions and decreased toxicity in combination with the development of new non culture-based diagnostic techniques may allow earlier, more aggressive and more effective antifungal treatment approaches. In addition, the optimized use of new technologies designed to augment spontaneous breathing efforts by patients, mechanical ventilation, as well as the advantages of early tracheostomy lead us to expect better outcomes in the treatment of respiratory failure due to pulmonary mycoses following allogeneic hematopoietic stem cell transplantation.

Hematopoietic Stem Cell Transplantation↗
PubMedDate not supplied

Comparative study of the efficacy of fluconazole versus amphotericin B/flucytosine in surgical patients with systemic mycoses.

In an open, prospective, randomized study, the efficacy of fluconazole was compared with that of the combination amphotericin B/flucytosine. Forty surgical patients with deep-seated mycoses were included in the study. Absolute inclusion criteria were histological finding of fungi in a tissue sample taken during surgery from e.g. peritoneum, pancreas, lungs or trachea, a positive blood culture or candida lesion of the eye. According to the random list 20 patients received up to 0.5 mg amphotericin B per kg body weight in combination with 3 x 2.5 g flucytosine (5-FC) daily and 20 patients received fluconazole, 400 mg on the first day and then 300 mg daily. The two therapy groups were comparable in terms of age, sex and underlying diseases. Gastrointestinal perforations (27 times) were the most frequent underlying diseases. Candida albicans was the fungus most frequently detected microbiologically (34 times). The pathogens were eliminated from 12 patients in the fluconazole group and 14 patients in the combination group. The median elimination time was 8.5 days in the fluconazole group and 5.5 days in the amphotericin B/5-FC group. Six patients died in the fluconazole group, whereas five patients died in the comparison group. Side effects which necessitated switching of therapy occurred twice in the combination group. In deep-seated candida mycoses, surgical patients receiving the combination therapy with amphotericin B/5-FC showed an earlier elimination than patients on monotherapy with fluconazole. With respect to cure rates there was no difference between these two regimens.

Adult↗
PubMed1981

Mycoses in India--study in Madras.

The incidence of mycoses is high in Madras accounting for over 13% of dermatoses diagnosed in a three-year period. Dermatophytoses (tinea corporis and tinea cruris) and pityriasis versicolor were most common in May and October. A correlation was observed between these infections and environmental temperature, humidity and rainfall. Most cases of all dermatophytoses except tinea capitis were recorded between 10 and 30 years of age but the latter was most common between one and 10 years. Males were predominantly affected with all except tinea axillaris, candidiasis and piedra. The incidence of piedra and deep mycoses was low.

Age Factors↗
PubMed2006

Endemic mycoses: blastomycosis, histoplasmosis, and sporotrichosis.

The endemic mycoses are diverse group of fungi that share several characteristics. They are able to cause disease in healthy hosts, they each occupy a specific ecologic niche in the environment, and they exhibit temperature dimorphism, existing as molds in the environment at temperature of 25 degrees C to 30 degrees C, and as yeasts, or spherules in the case of coccidioidomycosis, at body temperatures. This article discusses histoplasmosis and blastomycosis. Sporotrichosis, which differs in that it is usually a localized lymphocutaneous infection, is included because it shares the characteristics of endemic mycoses.

Antifungal Agents↗