1/11. Pulmonary cryptococcosis in the immunocompetent host. Therapy with oral fluconazole: a report of four cases and a review of the literature.Isolated pulmonary cryptococcosis (IPC) is an infrequently diagnosed infection, the management of which is not well defined. In past years, IPC traditionally has not been treated in the immunocompetent host, given its perceived benign and self-limited course and the toxicity associated with amphotericin b. However, some patients manifest prominent and disabling symptoms, and infection occasionally may disseminate. fluconazole is active against cryptococcus neoformans, is easily administered, and has an excellent safety profile. We present four healthy hosts with IPC who were treated with oral fluconazole for 6 to 8 weeks. A review of the literature was conducted to identify other cases of IPC in healthy hosts who were also treated with fluconazole. Our results and the limited experience reported in the literature suggest that fluconazole may be an appropriate choice for the treatment of IPC in the immunocompetent host. Indications for treatment are not defined, but symptomatic patients, those with multiple nodules or extensive infiltrates on chest radiographs, and/or those testing positive for serum cryptococcal antigen might be potential candidates for therapy.- - - - - - - - - - ranking = 1keywords = candida (Clic here for more details about this article) |
2/11. Septic candidasis with intrahepatic cholestasis and immunoglobuline deficiency after renal transplantation.Two renal allograft recipients with acquired immunoglobulin deficiency had a disseminated infection with candida albicans. Septic fever, intrahepatic cholestasis and pulmonary mycotic disease were the prominent clinical symptoms. recurrence of septic fever during the clinical course was associated with increase of intrahepatic cholestasis. On the other hand there was an amelioration of cholestasis when effective antimycotic therapy was instituted. In our patients there was no evidence that intrahepatic cholestasis was drug-related. It was assumed that toxic metabolits of candida albicans were responsible for intrahepatic cholestasis.- - - - - - - - - - ranking = 6keywords = candida (Clic here for more details about this article) |
3/11. Allergic granulomatous angiitis (churg-strauss syndrome) associated with allergic bronchopulmonary candidiasis.We describe a case of churg-strauss syndrome (CSS) associated with allergic bronchopulmonary candidiasis (ABPC). A 61-year-old man who had been given a diagnosis of ABPC based on serologic and radiographic findings experienced pain and purpuric rash on the left leg accompanied with motor weakness. The diagnosis of CSS was made from skin, nerve and muscle biopsies. Although immunosuppressant and prednisolone were administered and resulted in transient improvement, candidal pneumonia was suspected to have developed 60 days after the administration and the patient finally died of respiratory failure. To our knowledge, this is the first case of CSS associated with ABPC.- - - - - - - - - - ranking = 1keywords = candida (Clic here for more details about this article) |
4/11. miconazole in systemic candidiasis.Based on our experience with our first patients, miconazole is now the drug of choice in cases of systemic and pulmonary candidal infection. Initially we prefer the parenteral route of administration which is continued for only one or two weeks after a negative finding in culture. The dosage is 1.2 g per day for a 70 kg patient. Thereafter the treatment is continued orally for another four weeks. miconazole is well documented as a drug without serious side-effects, but the incidence of candidal infections in about 1% of our surgical patients does not justify its prophylactic administration. Like antibiotics, miconazole is given only when there is a clinical manifestation and a positive finding in culture.- - - - - - - - - - ranking = 2keywords = candida (Clic here for more details about this article) |
5/11. The first echinocandin: caspofungin.The antifungal agent caspofungin is the first echinocandin that has been approved in the US and in europe for treatment of invasive aspergillosis in adult patients who are refractory to or intolerant of conventional amphotericin b, its lipid-based formulations, and/or itraconazole. It is given as a 70 mg loading dose and a 50 mg daily maintainance dose as a one hour infusion. Due to low intestinal absorption an oral formulation has not been developed. Caspofungin is active against Candida spp. and aspergillus spp. by inhibition the synthesis of beta-(1,3)-D-glucan, a cell wall component. The drug is inactive against Cryptococcus spp., fusarium spp., trichosporon spp., rhizopus spp., and Pseudoallescheria spp. In invasive aspergillosis caspofungin resulted in higher response rates compared to a historic control under standard therapy. Efficacy data on persistently febrile neutropenic patients are pending. In several multicenter randomised double blind trials on candida infections caspofungin proved to be at least non-inferior to standard therapies. Reports of combination therapy or highly effective antifungal treatment (HEAT) in limited patient numbers are promising. New trials of combination therapy are warranted.- - - - - - - - - - ranking = 1keywords = candida (Clic here for more details about this article) |
6/11. Invasive candidiasis in infants: experience from saudi arabia.There are few reports about invasive candidiasis in infants in the tropics in general and in the Kingdom of saudi arabia in particular. Two Saudi infants with invasive candidiasis are reported and their clinical features and response to treatment are compared with that found in the paediatric literature, mainly from the developed world. Prematurity, low birthweight, invasive procedures, long hospital stay and prolonged use of broad-spectrum antibiotics were found to be predisposing factors in the two patients, and we believe that a lack of awareness of these by the referring physicians led to a delay in diagnosis. The need for greater awareness and vigilance, and the dangers inherent in overlooking isolates of candida from clinical materials are emphasized.- - - - - - - - - - ranking = 1keywords = candida (Clic here for more details about this article) |
7/11. Congenital candida pneumonia and sepsis: a case report and review of the literature.A term newborn with candida albicans infection of the lungs and blood is described. Although no maternal risk factors were identified, this patient's rapid clinical deterioration and postmortem findings suggest congenital infection. Related cases in the literature are reviewed. This case suggests that a diagnosis of fungal pneumonia should be considered in any infant presenting with severe respiratory distress.- - - - - - - - - - ranking = 4keywords = candida (Clic here for more details about this article) |
8/11. Intrauterine candida infection in premature baby.An autopsy case of pulmonary candidiasis occurring in an neonatal girl was reported. The mycological examination of the lung take at autopsy revealed only candida albicans and followed by the elucidation under the microscopic sections prepared with special stains; periodic acid-Schiff and methenamine silver, in the lung, stomach, umbilical cord, and amnion. The presence of candida vaginitis in her mother supported the concept that candida albicans was the etiological agent of the pulmonary candidiasis.- - - - - - - - - - ranking = 5keywords = candida (Clic here for more details about this article) |
9/11. Treatment of pulmonary aspergilloma by endoscopic intracavitary instillation of ketoconazole.The authors report a case of pulmonary aspergilloma in which a fungus ball was visualized and a biopsy specimen was obtained at fiberoptic bronchoscopy. The fungus ball was successfully treated with bronchoscopic instillation of ketoconazole. It appears that this approach can be useful in the treatment of patients who are high-risk candidates for pulmonary resection.- - - - - - - - - - ranking = 1keywords = candida (Clic here for more details about this article) |
10/11. Low-dose amphotericin b therapy for acute pulmonary histoplasmosis.A patient wtih acute epidemic pulmonary histoplasmosis was treated with 500 mg of amphotericin b. Traditionally, such patients have not been treated, since the illness is usually self-limited; however, fatalities have been reported, and some authorities have recommended therapy with small doses of amphotericin b. patients with acute pulmonary histoplasmosis who are acutely ill should be considered for low-dose treatment with amphotericin b, inasmuch as they are likely candidates for early dissemination. Cures have been reported with as little as 105 mg of amphotericin b administered intravenously.- - - - - - - - - - ranking = 1keywords = candida (Clic here for more details about this article) |
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