1/31. Funguria and Candida-specific immunoglobulins in patients with systemic candidosis.Funguria, indirect anti-Candida haemagglutination test (C-IHT) and Candida-specific immunoglobulins C-IgM, C-IgG and C-IgA were investigated under suspicion of systemic candidosis in critically ill patients. A total of 143 urine cultures were studied for Candida from 74 adults and a median count of log 3.0 CFU ml-1 was found. Most isolated Candida species were candida albicans and candida glabrata. In 14 cases of candidaemia there was no regular agreement between the finding of Candida species in blood and urine. In cases with candiduria > = or log 3.0 CFU ml-1 a stronger increase of C-IHT titres and all three Candida-specific immunoglobulins after 5-7 days was observed. Some statistically significant correlations were found between the levels of urinary yeast counts and immunological parameters concerning C-IHT, C-IgA and C-IgG on the first day and after 5-7 days. Clinical findings in some cases coincided well with funguria and courses of titres before and after treatment. CONCLUSION: In critically ill patients suspected of having systemic candidosis not only blood cultures should be made. Cultural studies with specimens taken from different sites including funguria are essential for a complete specific serological investigation.- - - - - - - - - - ranking = 1keywords = candida (Clic here for more details about this article) |
2/31. Candida sepsis following transcervical chorionic villi sampling.BACKGROUND: The use of invasive devices and broad spectrum antibiotics has increased the rate of candidal superinfections. Candida sepsis associated with pregnancy is rare. Candida sepsis following chorionic villi sampling (CVS) has never been reported. CASE: A 31 -year-old pregnant woman presented with signs of sepsis one day after undergoing transcervical CVS. blood culture and curettage material yielded C. albicans. She was treated with 400 mg of fluconazole daily for 4 weeks and completely recovered. CONCLUSION: Candida sepsis should be considered in the differential diagnosis of sepsis following CVS.- - - - - - - - - - ranking = 1keywords = candida (Clic here for more details about this article) |
3/31. Breakthrough candidaemias during empirical therapy with fluconazole in non-cancer and non-hiv adults caused by in vitro-susceptible Candida spp.: report of 33 cases.The objective of this study was to assess risk factors and the outcome of breakthrough fungaemias (BFs) occurring during fluconazole (FLU) therapy in non-cancer and non-hiv individuals. Thirty-three fungaemias occurring during therapy with FLU among a total of 310 fungaemias observed within a 10-y national survey were analysed. The agar disk diffusion method was used for antifungal susceptibility testing and the Vitek system for species identification. Univariate and multivariate analysis was performed to determine risk factors for BF. All BFs were due to species known to be susceptible to FLU: candida albicans (25/33), C. parapsilosis (6/33) and C. guillermondii (2/33). The mean number of positive blood cultures per episode was 2.4. The MIC of Candida spp. to FLU was 0.5-8 mg/ml (all strains were susceptible in vitro). Neonatal age (< 4 weeks), very low birth weight, prior surgery, central venous catheter placement, artificial ventilation, total parenteral nutrition and C. parapsilosis were significantly related to BF in univariate analysis, but only central venous catheter placement was significantly related in multivariate analysis. However, the outcome of BFs and non-BFs was similar. All BFs occurred in non-hiv patients who were not previously treated with azoles, and were caused by in vitro FLU-susceptible species (C. albicans and C. tropicalis). Thus factors other than in vitro susceptibility play a role in BFs.- - - - - - - - - - ranking = 4keywords = candida (Clic here for more details about this article) |
4/31. Candida dubliniensis candidaemia in an hiv-positive patient in ireland.Candida dubliniensis was first identified in Dublin in 1995 in oral isolates recovered from human immunodeficiency virus (hiv)-infected individuals. Although C. dubliniensis has been primarily recovered from the oral cavities of hiv-infected individuals, the number of reports describing its isolation from hiv-negative individuals, including cases of candidaemia, is growing. To date there has only been one report of C. dubliniensis candidaemia in an hiv-infected patient, in this case from the USA. In the present study, 2 Candida isolates recovered from blood samples were presumptively identified as C. dubliniensis on the basis of their dark green coloration on CHROMagar Candida medium and lack of growth at 45 degrees C. This identification was confirmed by carbohydrate assimilation profile analysis and by polymerase chain reaction (PCR) analysis with C. dubliniensis-specific PCR primers. Both isolates were susceptible to fluconazole. The isolates were found retrospectively to be from a single hiv-infected patient who was receiving broad-spectrum antibacterials at the time of isolation of C. dubliniensis from blood. This study represents the first documented case of C. dubliniensis bloodstream infection in ireland and is only the second case of C. dubliniensis bloodstream infection identified in an hiv-infected individual anywhere in the world.- - - - - - - - - - ranking = 6keywords = candida (Clic here for more details about this article) |
5/31. When candida turns deadly.Thrush, diaper rash, and vaginal yeast infection are all common manifestations of candida. But for the immunocompromised patient, this common fungal species can cause a host of problems, including life-threatening infections.- - - - - - - - - - ranking = 5keywords = candida (Clic here for more details about this article) |
6/31. Visual and anatomical outcome following submacular surgery for choroidal neovascularization secondary to Candida endophthalmitis.PURPOSE: To report the long-term visual and anatomical outcomes for patients treated with submacular surgery for choroidal neovascularization associated with endogenous candidal endophthalmitis. methods: review of the medical records, fluorescein angiograms, fundus photographs, and histopathologic specimens of patients treated with submacular surgery for choroidal neovascularization following candidal endophthalmitis. RESULTS: This series included 3 patients (1 woman and 2 men) who were 26, 30, and 60 years of age. Each patient had received systemic antifungal treatment for culture-proven candidal septicemia before the development of choroidal neovascularization. Each patient had bilateral choroidal neovascularization diagnosed by biomicroscopic examination and angiographic appearance: 2 eyes had an active subfoveal membrane; 2, an active juxtafoveal subretinal membrane; and 2, a mixture of active subfoveal neovascularization with subfoveal fibrosis. Submacular surgery was performed on five eyes with choroidal neovascularization; one eye with subfoveal fibrosis was observed. visual acuity improved substantially in 4 eyes of 3 patients treated with submacular surgery. Visual improvement was limited in the two eyes with preexisting submacular fibrosis. During 13-month to 82-month follow-ups, vision remained stable, with no recurrence of neovascularization. CONCLUSION: choroidal neovascularization can cause severe visual loss in patients with endogenous candidal infection. Submacular surgery with removal of choroidal neovascularization may restore vision in selected patients. Subfoveal fibrosis may limit visual improvement.- - - - - - - - - - ranking = 4keywords = candida (Clic here for more details about this article) |
7/31. Persistence of the same candida albicans strain despite fluconazole therapy. documentation by pulsed-field gel electrophoresis.candida albicans and other Candida species have emerged as major nosocomial pathogens associated with a high mortality. Therapeutic options for fungal infections are limited. amphotericin b has been the mainstay of treatment for serious systemic candidal infections, but it is relatively toxic and associated with a variety of side effects. fluconazole has been proposed as alternative therapy for the treatment of systemic candidiasis including candidemia. We report the case of a patient with fungemia in whom fluconazole failed to eradicate C. albicans and C. tropicalis. These pathogens were recovered from sputum and urine cultures, respectively, on day 12 of intravenous fluconazole therapy. Molecular epidemiologic techniques employing pulsed-field gel electrophoresis confirmed the persistence of the same C. albicans strain. Susceptibility studies showed a marked change in MICs of fluconazole between 24 and 48 hr, with an increase from less than or equal to 1.25 to greater than 80 micrograms/ml. Controlled trials will be needed to delineate the role of fluconazole in the treatment of disseminated candidiasis and its efficacy in comparison with amphotericin b. amphotericin b should remain the drug of choice for such infections until data from controlled trials are available.- - - - - - - - - - ranking = 1keywords = candida (Clic here for more details about this article) |
8/31. Polymicrobial candidaemia revealed by peripheral blood smear and chromogenic medium.Candida spp are the fourth most common group of nosocomial pathogens isolated from patients on medical, surgical, and intensive care wards. Polymicrobial candidaemia has rarely been described. The diagnosis of candidaemia from peripheral blood smears has not been widely reported. This report describes the case of a young woman suffering from Ewing's sarcoma who developed a syndrome of septic shock. Deep fungal infection was diagnosed from a systematic peripheral blood smear and yeasts were isolated within 24 hours. A subculture on CHROMagar Candida allowed the differentiation and presumptive identification of candida tropicalis and Candida krusei. Species identification was confirmed by the ID 32C system. This report underlines the usefulness of peripheral blood smears in the diagnosis of fulminant deep fungal infections, and of a differential isolation medium in the rapid presumptive identification of clinically important yeast species from clinical samples. This medium is particularly useful for the detection of mixed fungal infections, allowing early and better adapted antifungal treatment.- - - - - - - - - - ranking = 6keywords = candida (Clic here for more details about this article) |
9/31. Candida sepsis with intramyocardial abscesses mimicking left ventricular noncompaction.Left ventricular (LV) noncompaction is a rare abnormality characterized by more than three trabeculations protruding from the LV wall, distal to the papillary muscles and visible in one echocardiographic image plane. The intertrabecular spaces are perfused from the LV cavity, as visualized on color Doppler imaging. Differential diagnoses of LV noncompaction are intraventricular thrombi, false tendons, aberrant bands, intramyocardial hematoma, cardiac metastases and the apical type of hypertrophic cardiomyopathy. Intramyocardial abscesses have not been reported as a differential diagnosis of LV noncompaction. In the patient presented, cardiac microabscesses due to candida sepsis mimicked LV noncompaction and should be considered in the differential diagnosis of LV noncompaction.- - - - - - - - - - ranking = 1keywords = candida (Clic here for more details about this article) |
10/31. Disseminated candida tropicalis in a patient with chronic mucocutaneous candidiasis.Chronic mucocutaneous candidiasis is a heterogeneous group of immunodeficiencies associated with persistent candidal infections. patients with chronic mucocutaneous candidiasis are rarely associated with systemic infections caused by other fungi, but almost never by Candida. The authors report a case of a 16-year-old with chronic mucocutaneous candidiasis who developed a fungemia with candida tropicalis.- - - - - - - - - - ranking = 1keywords = candida (Clic here for more details about this article) |
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