Bronchopulmonary moniliasis complicated by peritonitis: evaluation of treatment of acute bronchopulmonary moniliasis.
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A previously unreported manifestation of esophageal moniliasis is described. Two patients with acquired immunodeficiency syndrome and Kaposi's sarcoma presented with solitary esophageal ulcers. Endoscopic biopsy confirmed the clinical diagnosis of esophageal moniliasis. The clinical and radiographic features of esophageal moniliasis are described.
A 35-year-old man with idiopathic hypoparathyroidism and moniliasis developed progressive dysphagia and weight loss. Diagnostic studies established the presence of esophageal moniliasis. Therapy with a viscous suspension of nystatin resulted in rapid clinical improvement; prolonged administration of the drug was associated with progressive widening of a narrowed segment of esophagus and complete disappearance of dysphagia. The chemotherapy of esophageal moniliasis is discussed in the light of current knowledge of the pharmacological action of nystatin.
The association of precipitating anti-adrenal antibodies with different subgroups of idiopathic Addison's disease were studied. We had previously found these antibodies in patients with the moniliasis-polyendocrinopathy syndrome. Sera of 36 adult patients suffering from different froms of Addison's disease were examined for the presence of adrenal antibodies demonstrable either by immunofluorescence (IFL) or by gel diffusion. 3 of the 17 patients with tuberculous and 17 of 19 patients with idiopathic Addison's disease had IFL antibodies but only one had precipitating antibodies. There was one typical case of Schmidt's syndrome, and four additional cases with Addison's disease combined with diabetes or thyroiditis, who may later develop the syndrome. None of htese patients had precipitating anti-adrenal antibodies. The only patients with precipitating adrenal antibodies had the moniliasis-polyendocrinopathy syndrome. He was not typical as Addison' disease appeared unusually late and he did not have hypoparathyroidism. The presence of precipitating anti-adrenal antibodies in this patient, and the absence of these in other groups of Addison's disease, is further evidence for the association of precipitating antibodies with the moniliasis-polyendocrinopathy syndrome.
Thirty cases of anogenital moniliasis were studied. Only five followed oral use of broad spectrum antibiotics. Although anogenital pruritus commonly follows the use of such drugs, it is rarely proved to be moniliasis, which is clinically diagnosed by symptoms of intertriginous denudation with satellite vesicopustules or the presence of cheesy, grossly detachable plaques. The diagnosis may be confirmed by microscopic observation of delicate hyphae and clusters of spores, or of chlamydospores on corn meal agar. One per cent aqueous gentian violet, 0.1 per cent gentian violet jel, or locally applied mercurials are the most effective forms of treatment, but effort must also be directed against predisposing factors (obesity, hyperhidrosis, oral or local use of broad spectrum antibiotics, diabetes and pregnancy).
Cellular immunity was studied in 73 patients with recurrent vaginal moniliasis and 37 healthy controls, by skin testing with the multitest CMI kit and Candida antigen, with measurement of lymphoblastic transformation to phytohemagglutinin, antigens of Candida albicans, mumps, and streptokinase. Eighteen patients (24.7%) had a hypoergic or anergic response to Candida antigen on skin testing versus two controls (5.4%), p = 0.01. Overall, the patient's lymphoblastic proliferation to mitogen and various antigens was not significantly different from that of the controls. However, a subgroup of younger women (19 to 29 years old) had impaired responses to Candida antigen when compared with age-matched controls, 58% versus 17%, p less than 0.005. Most women with current vaginal moniliasis had normal cellular immunity.
Mycoparasites collected from aerial parts of the cocoa plant (Theobroma cacao) have shown great promise in the control of black pod, caused by Phytophthora palmivora, and moniliasis, caused by Moniliophthora roreri. However, the ecology of epiphytic mycoparasites is still poorly understood although it has a direct bearing on applied biocontrol practices, ranging from the identification and isolation of promising biocontrol candidates to formulation needs and required application frequency. One objective of this study was to determine the natural abundance of mycoparasites on cocoa flowers and pods in relation to crop development stage and cultivar. For this purpose, native mycoparasites were detected on cocoa flowers and pods using the precolonised plate baiting technique. Furthermore, the survival of an applied Clonostachys rosea isolate on cocoa pods on shaded and non-shaded trees was compared as well as the recolonisation patterns of surface-sterilised pods by native mycoparasites under these conditions. Clonostachys spp. were the most commonly isolated native mycoparasites, followed by Fusarium spp. No differences in the occurrence of native, epiphytic mycoparasites were observed between the three main cocoa cultivars, 'Criollo', 'Forastero' and 'Trinitario', nor between clones within these groups. Thus, a single biocontrol inoculum can be suitable for application to cultivar mixtures of cocoa commonly grown together in a field. Different susceptibility classes of segregating F1 populations of hybrids with resistance against M. roreri and P. palmivora supported similar population levels and taxonomic assemblages of mycoparasites. Therefore, we reject the hypothesis that these antagonists mediate resistance. Mycoparasite abundance and genetic disease resistance to black pod and moniliasis are independent phenomena and should lead to additive effects if employed simultaneously in an integrated disease management programme. The survival of applied C. rosea was not affected by the shading regime or any other meteorological parameter measured. On the other hand, recolonisation of surface-sterilised cocoa pods by most native mycoparasites was faster in the shade. Only Trichoderma spp. colonised pods exposed to direct sunlight faster than shaded ones. The implications for the design of biocontrol inocula and formulation technology are discussed.
Oesophageal moniliasis is reviewed and the incidence of fistula formation discussed. A case of oesophageal moniliasis without any predisposing factors, with fistula formation and lung abscess, is presented.
Pregnancy creates conditions which favour the development and persistence of candidiasis (moniliasis). The resultant vaginitis is often refractory to treatment. A new fungicidal antibiotic, pimaricine (Pimafucine), was studied in 91 women with vaginal moniliasis, all of whom were pregnant. Fifty-six (63%) were cured on the basis of negative cultures and 28 became symptomfree in spite of positive cultures. In this series, 94.3% benefited from treatment.
The finding of multiple respiratory or skin allergies together with a high rate of improvement by desensitization leads the author to conclude that allergy is a predisposing factor for the chronicity or recurrence of vaginal or dermatologic moniliasis. Desensitization with Candida albicans antigen was the mainstay in the treatment of resistant dermatologic or vaginal moniliasis and the sole form of therapy in cases of nail involvement with deep seated lesions out of the reach of topical agents.
A case is described in which Hodgkin's disease was complicated by inclusion disease and gastrointestinal moniliasis. This is one of several cases of malignant disease complicated by uncommon infections.
Most previous reports of esophageal moniliasis have described diffuse changes in the esophagus. The authors describe two cases involving a localized polypoid lesion in the esophagus in patients with Candida infection. The pathogenesis is discussed.
A case of persistent oesophageal stricture due to moniliasis, which developed while the patient was symptomatic, is reported. The value and therapeutic implications of performing a repeat barium swallow even if the disease appears to be quiescent are discussed.