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Candidiasis  

Science.gov (United States)

... Diseases Share Compartir Candidiasis Photomicrograph of the fungus Candida albicans Candidiasis is a fungal infection caused by yeasts ... in humans, the most common of which is Candida albicans . Candida yeasts normally live on the skin and ...

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Candidiasis (Thrush)  

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... Take supplements of gamma-linoleic acid (GLA) and Biotin. They both seem to slow the spread of ... GLA is found in several cold-pressed oils. Biotin is a B vitamin. THE BOTTOM LINE Candidiasis ...

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Yeast Infection (Candidiasis)  

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newsletter | contact Share | Yeast Infection (Candidiasis) Information for adults A A A This is a candida (yeast) infection of the skin folds of the abdomen. Overview Candidiasis, commonly known as a yeast infection, is an infection with the common yeast ( ...

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Candidiasis vaginal en primigestas  

Scientific Electronic Library Online (English)

Full Text Available SciELO Venezuela | Language: Spanish Abstract in spanish Objetivo: Determinar evidencias de candidiasis vaginal en pacientes que acuden a la consulta prenatal de la Maternidad Castillo Plaza, utilizando como medio diagnostico el test Intray Colorex Yeast. Método: Se estudiaron embarazadas primigestas con sospecha clínica de candidiasis vaginal. Las muestr [...] as de secreción vaginal se inocularon en el medio Intray Colorex Yeast e incubaron a 37 °C durante 48 a 72 horas. Ambiente: Maternidad Castillo Plaza de Maracaibo, Estado Zulia. Resultados: Se demostró que un 38% (24 pacientes) presentaron candidiasis vaginal. Candida albicans fue la especie más frecuente (88%), seguida por glabrata (8%) y krusei (4%). Conclusión: El desarrollo de colonias verdes, rosado oscuro y rosado claro (albicans, glabrata y krusei respectivamente) sugiere la utilidad del medio Intray Colorex Yeast para la identificación rápida de las principales especies productoras de candidiasis. Abstract in english Objective: Determine evidence of vaginal candidiasis in first-pregnancy mothers who assisted to pregnancy control to the Maternidad Castillo Plaza, using the test Intray Colorex Yeast as a medium for diagnosis. Method: We were studied first-pregnancy mothers in prenatal control with clinical suspici [...] on of vaginal candidiasis. The samples of the vaginal secretions were inoculated on Intray Colorex Yeast medium and incubated to 37°C during 48- 72 hours. Setting: Maternidad Castillo Plaza . Maracaibo, Estado Zulia Results: The study demostrated that 38% (24 patients) presented vaginal candidiasis. Candida albicans was the most frequently isolated species (88%) followed by glabrata (8%) and krusei (4%). Conclusion: The development of the green colonies, dark pink and light pink characteristic of albicans, glabrata and krusei suggest the possible use of the Intray Colorex Yeast medium for quickly identification of the Candida species investigated.

Karleidy, Torres; Augusto, Soto; Desiré, Sandrea; María, Villalobos; Agustin, Rodríguez; Manzur, Hassanhi; Luz Mila, Mesa.

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Candidiasis vaginal en primigestas  

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Full Text Available Objetivo: Determinar evidencias de candidiasis vaginal en pacientes que acuden a la consulta prenatal de la Maternidad Castillo Plaza, utilizando como medio diagnostico el test Intray Colorex Yeast. Método: Se estudiaron embarazadas primigestas con sospecha clínica de candidiasis vaginal. Las muestras de secreción vaginal se inocularon en el medio Intray Colorex Yeast e incubaron a 37 °C durante 48 a 72 horas. Ambiente: Maternidad Castillo Plaza de Maracaibo, Estado Zulia. Resultados: Se demostró que un 38% (24 pacientes presentaron candidiasis vaginal. Candida albicans fue la especie más frecuente (88%, seguida por glabrata (8% y krusei (4%. Conclusión: El desarrollo de colonias verdes, rosado oscuro y rosado claro (albicans, glabrata y krusei respectivamente sugiere la utilidad del medio Intray Colorex Yeast para la identificación rápida de las principales especies productoras de candidiasis.Objective: Determine evidence of vaginal candidiasis in first-pregnancy mothers who assisted to pregnancy control to the Maternidad Castillo Plaza, using the test Intray Colorex Yeast as a medium for diagnosis. Method: We were studied first-pregnancy mothers in prenatal control with clinical suspicion of vaginal candidiasis. The samples of the vaginal secretions were inoculated on Intray Colorex Yeast medium and incubated to 37°C during 48- 72 hours. Setting: Maternidad Castillo Plaza . Maracaibo, Estado Zulia Results: The study demostrated that 38% (24 patients presented vaginal candidiasis. Candida albicans was the most frequently isolated species (88% followed by glabrata (8% and krusei (4%. Conclusion: The development of the green colonies, dark pink and light pink characteristic of albicans, glabrata and krusei suggest the possible use of the Intray Colorex Yeast medium for quickly identification of the Candida species investigated.

Karleidy Torres

2005-06-01

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Immunology of oral candidiasis.  

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A successful pathogen is one that is able to effectively survive and evade detection by the host immune defense. Oral candidiasis has adopted strategies, which evade host defense and eventually cause disease in at-risk patients. Host defense against infections with Candida spp. depends on rapid activation of an acute inflammatory response by innate immunity, followed by an incremental stimulation of specific immune responses mediated by T-cells (cellular immunity) or B-cells (humoral immunity). Understanding these complex pathways of immune evasion can potentially contribute to the development of novel therapeutic strategies against oral candidiasis. PMID:25210393

Dineshshankar, Janardhanam; Sivakumar, Muniapillai; Karthikeyan, M; Udayakumar, P; Shanmugam, K T; Kesavan, G

2014-07-01

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Diaper Dermatitis (Candidiasis)  

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newsletter | contact Share | Diaper Dermatitis (Candidiasis) A parent's guide for infants and babies A A A Small, white, distinct pus-filled lesions often ... candida infections, which are often found in the diaper region. Overview Candida albicans is a type of ...

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Neonatal invasive candidiasis.  

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Over the last two decades, systemic fungal infections have emerged to play a primary role in hospital-acquired infections. C. albicans is involved in 75% of neonatal candidiasis; however, the incidence of infection from C. parapsilosis is also increasing significantly. The higher incidence observed in the high-risk group of very low birth weight (VLBW) infants is linked to their special physical characteristics and the diagnostic and therapeutic invasive procedures they undergo. Colonization is a relevant risk factor depending on the colonized site , the fungal species and the type of colonization. Serological tests have a low specificity and sensitivity; in many cases, they do not distinguish between colonization and infection. Blood culture, although the best diagnostic test for determining systemic infection, can result negative, even in cases of deep organ involvement. In addition, fungi grow more slowly than bacteria in cultures. So, the difficulty in diagnosing systemic candidiasis and its aspecific clinical features may make empirical therapy appropriate. Amphotericin B (AmB) alone or combined with 5-fluorocytosine remains the drug of choice. Fluconazole represents a valid alternative. Recently developed new formulations of amphotericin incapsulated in liposomes can avoid possible adverse effects. Prognosis depends on the specific micro-organism involved; mortality is higher in the presence of C. albicans. As prognosis is associated with high mortality, prevention measures to reduce risk factors are of critical importance. PMID:17093376

Stronati, M; Decembrino, L

2006-12-01

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Diagnosis and Testing of Oral Candidiasis  

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... gov . Fungal Diseases Fungal Home Candidiasis Share Compartir Diagnosis & Testing of Oral Candidiasis A healthcare provider diagnoses ... positive culture by itself does not make the diagnosis. Print page Get email updates Contact Us: Centers ...

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Miconazole mucoadhesive tablet for oropharyngeal candidiasis  

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Oropharyngeal candidiasis is a commonly encountered problem in daily clinical practice. Topical therapies for oropharyngeal candidiasis are considered preferable to systemic therapies in most patient populations. However, traditional topical therapies have limitations including short contact time with the oral mucosa and the need for multiple doses each day. Miconazole mucoadhesive tablet has recently been approved in Europe (Loramyc®) and the USA (Oravig™) for the treatment of oropharynge...

Lalla, Rajesh V.; Bensadoun, Rene?-jean

2011-01-01

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Risk factors for recurrent vulvovaginal candidiasis  

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Full Text Available Background/Aim. Recurrent vulvovaginal candidiasis is relatively frequent condition, and may have serious health consequences, like chronic vulvovaginal pain syndrome. The aim of our study was to determine possible risk factors for recurrent vulvovaginal candidiasis in non-pregnant females within the reproductive age. Methods. The design of our study was of a case-control type. Case and control patients were selected from the gynecological patients at six primary care facilities in Serbia and in Montenegro. The data on the patients' health condition, concomitant therapy and diseases were taken from their records, and the data on habits were obtained by unstructured interview. For potential risk factors crude odds ratios were calculated, and then adjusted by logistic regression. Results. A total of fifty-one patients had four or more episodes of vulvovaginal candidiasis during the last year (cases, and 132 patients with one to three episodes of vulvovaginal candidiasis were sampled as controls, matched by age. The only two significant associations were found between recurrent vulvovaginal candidiasis and continual wearing of panty liners during the last year (Odds ratio - ORadjusted: 3.97; confidence interval - CI: 1.57-10.02; p = 0.004, and between recurrent vulvovaginal candidiasis and predominant use of vaginal tampons during menstruation in the last year (ORadjusted: 4.25; CI: 1.11-16.27; p = 0.035. The synergistic effect was observed for the concurrent continual wearing of panty liners during the last year and selfmedication with antimycotics. Conclusions. Local factors, like wearing of panty liners or use of tampons during menstruation, may promote recurrence of vulvovaginal candidiasis, especially in patients who practice selfmedication with antimycotics.

Jankovi? Slobodan

2010-01-01

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Vulvovaginitis Candidiasis Recurrence During Pregnancy  

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Full Text Available Vulvovaginitis is the most common gynecologic condition seen by practitioners rendering primary care to women. Vulvovaginitis Candidiasis (VVC is the most common type of vaginitis and this study aimed at specifying VVC recurrence during pregnancy. In this prospective study, 150 pregnant women suffering from vaginal excretion, morsus and itching were studied. Initially, the patients were treated using clotrimazole local cream (5 g for 7 successive days. After initial treatment, the patients were freely visited once a month until delivery considering vaginitis symptoms and VVC recurrence was examined during pregnancy. Mean age of the understudy mothers was 27.26±3.76. Mean of recurrence number was 0.17±0.48 during the first trimester. Mean of recurrence number was 0.92±0.76 during the second trimester. Mean of recurrence number was 2.16±0.63 during the third trimester. Statistically significant difference was between recurrences during three trimesters of pregnancy (p<0.001. There is statistically significant difference between mean number of recurrences during three trimesters of pregnancy.

R. Torab

2012-01-01

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Epidemiology and risk factors for invasive candidiasis  

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Full Text Available Nur Yapar Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Dokuz Eylül University, ?zmir, Turkey Abstract: The number of immunosuppressive patients has increased significantly in recent years. These patients are at risk for opportunistic infections, especially fungal infections. Candidiasis is one of the most frequent fungal infections determined in these immunosuppressive patients and its epidemiology has changed over the last two decades. Recently, new antifungal agents and new therapy strategies such as antifungal prophylaxis, secondary prophylaxis, and preemptive therapy have come into use. These changes resulted in the alteration of Candida species causing invasive infections. The incidence of Candida albicans was decreased in many countries, especially among patients with immunosuppressive disorders, while the incidence of species other than C. albicans was increased. In this review, incidence, risk factors, and species distribution of invasive candidiasis are discussed. Keywords: candidemia, invasive candidiasis, incidence, species distribution, risk factors

Yapar N

2014-02-01

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Candidiasis cutánea generalizada en recién nacido a término / Generalized cutaneous candidiasis in newborn at term  

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Full Text Available SciELO Colombia | Language: Spanish Abstract in spanish Introducción. La candidiasis cutánea es una enfermedad que afecta tanto a población infantil como adulta. Las forma de presentación puede ser localizada o sistémica y el agente etiológico múltiple, siendo las especies infecciosas de Candida albicans más prevalentes en niños. Objetivo. Presentar un c [...] aso de candidiasis cutánea congénita cuya causa aparente fue la transmisión vertical durante el parto. Material y metodología. Se describe el caso de un recién nacido a término expuesto a una candidiasis vaginal subclínica, que desarrolló una candidiasis cutánea congénita por C. albicans asociada a sepsis y dificultad respiratoria en las primeras 24 horas de vida. Se practicaron hemocultivos, biopsia cutánea de las lesiones pápulopústulo-vesiculosas, análisis de sangre y punción lumbar. Resultados. En la bioquímica y el hemograma se encontró una proteína C reactiva de 5,7 mg/dl, leucocitosis con desviación a la izquierda y anemia leve. A las 24 horas, en el control se encontró una proteína C reactiva (7,82 mg/dl) que fue en aumento progresivo durante tres días, por lo que se practicó punción lumbar. El hemocultivo fue positivo para Staphylococcus aureus. La biopsia cutánea dio como resultado histológico la candidiasis cutánea. Conclusiones. El diagnóstico precoz es fundamental para prevenir complicaciones derivadas del cuadro producido por C. albicans en neonatos. Abstract in english Introduction. Cutaneous candidiasis is a disease that affects children as well as adults. The presentation may be localized or systemic, and with multiple etiological agents. The most prevalent infecting species in children differs from that of the adult. Objective. A case is presented where a conge [...] nital cutaneous candidiasis was transmitted to the child during birth. Materials and methods. A full term newborn was exposed to a subclinical vaginal candidiasis infection, and 24 hr after birth, developed congenital cutaneous candidiasis. The etiological agent was Candida albicans, and was associated with sepsis and respiratory distress. Blood cultures, cutaneous biopsy of vesicular lesions, blood tests and lumbar puncture were performed. Results. Biochemistry and blood count showed a CRP of 5.7 mg/dl, leukocytosis with left shift and mild anemia. After 24 hr, the blood analyses showed an increase in a CRP (7.8 mg/dl) and increased progressively for three days; consequently, a lumbar puncture was performed. Blood culture was positive for Staphylococcus aureus. Cutaneous biopsy confirmed the cutaneous candidiasis. Conclusions. The early diagnosis is essential to prevent complications derived by the Candida albicans in newborns.

Husein Husein, El Ahmed; , Cañadas-De la Fuente; Rafael, Fernández-Castillo; Emilio, González-Jiménez; Jesús, Cantero-Hinojosa; Marita, Lardón-Fernández.

2012-06-01

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Candidiasis cutánea generalizada en recién nacido a término / Generalized cutaneous candidiasis in newborn at term  

Scientific Electronic Library Online (English)

Full Text Available SciELO Colombia | Language: Spanish Abstract in spanish Introducción. La candidiasis cutánea es una enfermedad que afecta tanto a población infantil como adulta. Las forma de presentación puede ser localizada o sistémica y el agente etiológico múltiple, siendo las especies infecciosas de Candida albicans más prevalentes en niños. Objetivo. Presentar un c [...] aso de candidiasis cutánea congénita cuya causa aparente fue la transmisión vertical durante el parto. Material y metodología. Se describe el caso de un recién nacido a término expuesto a una candidiasis vaginal subclínica, que desarrolló una candidiasis cutánea congénita por C. albicans asociada a sepsis y dificultad respiratoria en las primeras 24 horas de vida. Se practicaron hemocultivos, biopsia cutánea de las lesiones pápulopústulo-vesiculosas, análisis de sangre y punción lumbar. Resultados. En la bioquímica y el hemograma se encontró una proteína C reactiva de 5,7 mg/dl, leucocitosis con desviación a la izquierda y anemia leve. A las 24 horas, en el control se encontró una proteína C reactiva (7,82 mg/dl) que fue en aumento progresivo durante tres días, por lo que se practicó punción lumbar. El hemocultivo fue positivo para Staphylococcus aureus. La biopsia cutánea dio como resultado histológico la candidiasis cutánea. Conclusiones. El diagnóstico precoz es fundamental para prevenir complicaciones derivadas del cuadro producido por C. albicans en neonatos. Abstract in english Introduction. Cutaneous candidiasis is a disease that affects children as well as adults. The presentation may be localized or systemic, and with multiple etiological agents. The most prevalent infecting species in children differs from that of the adult. Objective. A case is presented where a conge [...] nital cutaneous candidiasis was transmitted to the child during birth. Materials and methods. A full term newborn was exposed to a subclinical vaginal candidiasis infection, and 24 hr after birth, developed congenital cutaneous candidiasis. The etiological agent was Candida albicans, and was associated with sepsis and respiratory distress. Blood cultures, cutaneous biopsy of vesicular lesions, blood tests and lumbar puncture were performed. Results. Biochemistry and blood count showed a CRP of 5.7 mg/dl, leukocytosis with left shift and mild anemia. After 24 hr, the blood analyses showed an increase in a CRP (7.8 mg/dl) and increased progressively for three days; consequently, a lumbar puncture was performed. Blood culture was positive for Staphylococcus aureus. Cutaneous biopsy confirmed the cutaneous candidiasis. Conclusions. The early diagnosis is essential to prevent complications derived by the Candida albicans in newborns.

Husein Husein, El Ahmed; , Cañadas-De la Fuente; Rafael, Fernández-Castillo; Emilio, González-Jiménez; Jesús, Cantero-Hinojosa; Marita, Lardón-Fernández.

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Micosis superficiales: Candidiasis y pitiriasis versicolor  

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Full Text Available SciELO Cuba | Language: Spanish Abstract in spanish Se exponen las características clínicas de las lesiones cutáneas en las candidiasis y la pitiriasis versicolor. Se hace hincapié en las medidas de educación, prevención y control de estas afecciones a nivel primario de atención médica. Se exponen además las diferentes maniobras terapéuticas, tanto t [...] ópicas como sistémicas, con las que se cuenta para su tratamiento, y se hace referencia a las medidas terapéuticas alternativas que brinda la medicina natural y tradicional para estas afecciones. Abstract in english The clinical characteristics of the skin lesions in candidiasis and pityriasis versicolor are dealth with. Emphasis is made on the measures of education, prevention and control of these affections at the primary health care level. The different topic and systematic therapeutic maneuvers to be used i [...] n the treatment are explained. Reference is made to the alternative therapeutic measures offered by traditional and natural medicine for these affections.

Rubén José, Larrondo Muguercia; Aymée Rosa, González Angulo; Luis Manuel, Hernández García.

2001-12-01

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Micosis superficiales: Candidiasis y pitiriasis versicolor  

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Full Text Available Se exponen las características clínicas de las lesiones cutáneas en las candidiasis y la pitiriasis versicolor. Se hace hincapié en las medidas de educación, prevención y control de estas afecciones a nivel primario de atención médica. Se exponen además las diferentes maniobras terapéuticas, tanto tópicas como sistémicas, con las que se cuenta para su tratamiento, y se hace referencia a las medidas terapéuticas alternativas que brinda la medicina natural y tradicional para estas afecciones.The clinical characteristics of the skin lesions in candidiasis and pityriasis versicolor are dealth with. Emphasis is made on the measures of education, prevention and control of these affections at the primary health care level. The different topic and systematic therapeutic maneuvers to be used in the treatment are explained. Reference is made to the alternative therapeutic measures offered by traditional and natural medicine for these affections.

Rubén José Larrondo Muguercia

2001-12-01

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Cellular immunity in recurrent vulvovaginal candidiasis  

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Impaired T cell function has been reported to predispose women to recurrent vulvovaginal candidiasis, but conflicting results have been noted in the literature. Most clinical episodes occur in the late luteal phase, suggesting hormonal influence on host resistance. The present study assesses the cellular immune responses of 28 women with recurrent vaginal candidiasis (patients) and 25 control women (controls), noting results in relation to whether the women were in the follicular or luteal phase of the menstrual cycle at the time of sampling. Candida-stimulated peripheral blood lymphocyte proliferation was significantly reduced in patients compared with controls. Interferon-gamma (IFN-?) production in response to both Candida and purified protein derivative (PPD) stimulation was significantly lower in patients compared with controls. Skin test responses were comparable in both groups. A significant reduction in Candida-stimulated IFN-? production was seen in patients but not controls in the follicular phase compared with those in the luteal phase. There was also a trend towards lower proliferation in response to Candida in patients but not controls in the follicular phase compared with patients in the luteal phase. These results suggest that there is a partial T cell dysregulation in recurrent vaginal candidiasis which may be exacerbated by the hormonal balance present during the follicular phase, correlating with the risk of clinical infection. PMID:9528901

Corrigan, E M; Clancy, R L; Dunkley, M L; Eyers, F M; Beagley, K W

1998-01-01

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Hepatosplenic candidiasis in acute leukemia patients  

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Full Text Available INTRODUCTION Hepatosplenic candidiasis is a disseminated invasive fungal infection that may affects patients with acute leukemia. The main clinical manifestation is a persistent fever in patients recovered from prolonged neutropenia after recent chemotherapy. CASE OUTLINE The authors present three patients, two women and one men, aged 23, 26 and 33 years, with acute leukemia; one with acute myeloblastic and two with acute lymphoblastic leukemia who developed hepatosplenic candidiasis. The diagnosis was based on prolonged fever, elevated serum bilirubin and alkaline phosphatase, as well as characteristic lesions on computed tomography, nuclear magnetic resonance and ultrasonographic findings and positive blood culture in one patient. The antifungal treatment was successful in one patient only. Two patients died due to progression of leukemia. CONCLUSION If leukemia patient in remission after chemotherapy develops a prolonged fever of unknown origin, hepatosplenic candidiasis has to be considered and all efforts should be done to diagnose it. The diagnosis is based on clinical presentation and imaging techniques. The positive cultures of fungi are not usually possible and are not mandatory. The antifungal treatment may be prolonged, sometimes 2 to 3 months or even more.

Raji? Zoran

2008-01-01

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Candidiasis hepatoesplénica en un paciente con leucemia mieloide aguda / Hepatosplenic candidiasis in acute myeloid leukemia  

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Full Text Available SciELO Argentina | Language: Spanish Abstract in spanish La candidiasis diseminada crónica, principalmente en su variedad hepatoesplénica, es una de las formas clínicas más características de infección invasora por Candida en pacientes hematológicos. Se presenta el caso clínico de un varón de 31 años, con leucemia mieloide aguda (LMA) M2, internado en el [...] Servicio de Clínica Médica del hospital, que luego del tratamiento quimioterápico de inducción y consolidación presentó neutropenia febril leve. La candidiasis hepatoesplénica fue diagnosticada por tomografía axial computada (TAC) y biopsia hepática. El enfermo fue tratado con anfotericina B, seguida de la forma liposomal hasta completar los 4 g. Se le dió el alta en espera de transplante de médula ósea. En este paciente se demostró que la sospecha temprana de candidiasis hepatoesplénica ayudó en la elección de un método de diagnóstico precoz y a su correcto tratamiento. Abstract in english Chronic diseminated candidiasis - mainly its hepatosplenic form- is one of the most characteristic invasive infection due to Candida in haematological patients. A case is presented of a 31 year old man admitted to the Clinical Department with acute mieloid leukosis M2, showing febrile neutropenia af [...] ter induction and consolidation chemotherapy. Hepatoesplenic candidiasis was diagnosed and confirmed by computered axial tomography (CAT) and hepatic biopsy; amphotericin B followed by liposome encapsuled amphotericin B up to complete a total dose of 4 g was used for treatment. The patient was discharged waiting for bone marrow transplantation. Early suspicion of hepatosplenic candidiasis helps to select a rapid diagnosis method and an effective treatment.

A., Larregina; B., Bartoletti; H., Romano; L., Paniccia; N. N., Polini.

2004-03-01

 
 
 
 
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Caspofungin Susceptibility Testing of Isolates from Patients with Esophageal Candidiasis or Invasive Candidiasis: Relationship of MIC to Treatment Outcome  

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The caspofungin clinical trial database offers an opportunity to assess susceptibility results for Candida pathogens obtained from patients with candidiasis and allows for correlations between efficacy outcomes and MICs. Candida isolates have been identified from patients enrolled in four studies of esophageal candidiasis and two studies of invasive candidiasis. The MICs of caspofungin for all baseline isolates were measured at a central laboratory using NCCLS criteria (document M-27A); MICs ...

Kartsonis, Nicholas; Killar, John; Mixson, Lori; Hoe, Chao-min; Sable, Carole; Bartizal, Kenneth; Motyl, Mary

2005-01-01

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[Guidelines for diagnosis and treatment of mucocutaneous candidiasis].  

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This document summarizes current knowledge about diagnosis and treatment of candidiasis affecting the skin and oral mucosa. Several clinical forms of mucocutaneous candidiasis are distinguished depending on a patient's age and infected site, e.g. Candida intertrigo, erythema mycoticum infantile, erosio interdigitalis blastomycetica, candidal paronychia and onychia, Candida onychomycosis, and oral candidiasis. The diagnosis of candidiasis is confirmed by observation of mycelial forms on microscopic examination. Since Candida yeasts (especially C. albicans) are normal inhabitants of the skin and oral mucosa, it must always be noted that positive culture does not always indicate the presence of candidal infection. The pathogenicity of Candida species is relatively low, and some special conditions are required for tissue invasion by the fungus. Predisposing factors, such as disturbances of the cutaneous and mucosal microenvironment and systemic or local immunosuppression, should be checked in patients with recurrent infection. Therapy for cutaneous candidiasis is dominated by topical antifungal agents. Azole antifungal cream (e.g., bifonazole, ketoconazole, neticonazole hydrochloride, lanoconazole and luliconazole) is most effective. Terbinafine hydrochloride and amorolfine hydrochloride are also useful. Cutaneous candidiasis usually requires a shorter duration of topical treatment (1-2 weeks) than superficial dermatophyte infections. For candidal paronychia and onychomycosis, oral therapy with itraconazole is recommended. The daily dose of itraconazole should be taken for several months, while its pulse therapy for candidiasis is not approved in Japan. Itraconazole oral solution is commonly used for oral candidiasis, and miconazole gel is also effective. PMID:19942790

Katoh, Takuro

2009-01-01

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CHRONIC MUCOCUTANEOUS CANDIDIASIS - A CASE REPORT  

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Full Text Available Chronic mucocutaneous candidiasis(CMC is a rare group of overlapping syndromes that have in common a clinical pattern of persistent and diffuse cutaneous or mucosal candidal infections. It is usually associated with multiple endocrine dysfunctions and autoimmune disorders therefore patients needs a complete systemic evaluation. Patients of CMC are also susceptible to other fungal and viral infections due to impaired cell mediated immunity. We report a case of CMC wherein the cutaneous and mucosal lesions were not associated with any systemic disorder. The patient responded to topical clotrimazole.

Hassan Iffat

2010-10-01

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Candidiasis mucocutánea crónica: Informe de un caso / Chronic mucocutaneous candidiasis: Case report  

Scientific Electronic Library Online (English)

Full Text Available SciELO Argentina | Language: Spanish Abstract in spanish La candidiasis mucocutánea crónica (CMC) es una inmunodeficiencia primaria que se caracteriza por infecciones candidiásicas persistentes o recurrentes en piel, uñas o membranas mucosas. La CMC puede asociarse con endocrinopatías, como hipoparatiroidismo, enfermedad de Addison, hipotiroidismo, diabet [...] es mellitus de tipo 1 o hipogonadismo; otras patologías asociadas son enfermedades autoinmunitarias, como gastritis autoinmunitarias y hepatitis autoinmunitaria. Se presenta una paciente con CMC con déficit específico de linfocitos T y células NK, sin otra enfermedad asociada. Abstract in english Chronic mucocutaneous candidiasis is a primary immunodeficiency characterized by persistent or recurrent candidal infections of the skin, nails and/or mucosal tissues. CMC can be associated with endocrinopathies such as hypoparathyroidism, Addison's disease, hypothyroidism, type 1 diabetes mellitus [...] or hypogonadism. Other associated conditions include autoimmune diseases such as autoimmune gastritis and autoimmune hepatitis. We report a patient with CMC and decreased T cell, natural killer cells without other associated condition.

Rolando Elías, Julián-González; Manuel Augusto, Valdebrán-Canales; Héctor Eduardo, Guidos-Morales.

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Mucocutaneous candidiasis in a mandrill (Mandrillus sphinx).  

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An adult male mandrill (Mandrillus sphinx) suffered from chronic ulceration of the facial and gluteal skin and the oral and nasal mucosa. The ulcers were resistant to therapy and led to deterioration in the general condition of the animal. Microscopical examination revealed a severe, chronic, multifocal, granulomatous and eosinophilic dermatitis and panniculitis. There was also stomatitis and rhinitis with numerous intralesional fungal elements. These organisms were identified by immunohistochemistry, transmission electron microscopy, polymerase chain reaction and fungal culture as Candida albicans. Species identification was confirmed by MALDI-TOF mass spectrometry. A specific predisposing immunosuppressive factor for the deep chronic mucocutaneous candidiasis was not identified; however, social stress and/or a primary defect in cell-mediated immunity could not be excluded as possible causes for a predisposing immunodeficiency in the animal. PMID:22300706

Zöller, M; Silinski, S; Ludwig, C; Weig, M; Mätz-Rensing, K; Kaup, F-J

2012-01-01

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Congenital cutaneous candidiasis: A rare and unpredictable disease  

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Full Text Available Congenital cutaneous candidiasis (CCC is an extremely rare disorder that presents within the first 6 days of life. The manifestations ranges from diffuse skin eruption without any systemic symptoms to respiratory distress, hepatosplenomegaly, sepsis, and death. We report a neonate who presented with generalized skin eruptions at birth, characterized by erythematous macules and papules. The eruption involved head, face, neck, trunk, and extremities. Candida albicans was demonstrated on direct KOH smear, skin biopsy. The disease implies a congenital intrauterine infection and is different from neonatal candidiasis, which manifests as thrush or diaper dermatitis. The infection is acquired from the maternal genital tract in an ascending fashion. Clinical features, direct smear examination of specimen, and appropriate cultures are useful in differentiating the lesions from other more common dermatoses of the neonatal period. Topical antifungal therapy is sufficient unless systemic candidiasis is present. Prognosis for congenital cutaneous candidiasis is good.

Jagtap Sujit

2011-01-01

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Congenital candidiasis: an uncommon skin eruption presenting at birth.  

Science.gov (United States)

We present the case of a preterm neonate who was born with respiratory distress and a papulovesicular rash that was diagnosed as congenital candidiasis (CC). The mother was asymptomatic. The cutaneous eruption and respiratory distress improved following treatment with systemic antifungals. Congenital candidiasis ranges in presentation from isolated cutaneous involvement to severe multisystem disease. Given its rarity among neonatal skin eruptions, heightened suspicion is required for prompt diagnosis and treatment. PMID:24897134

Siriratsivawong, Rick; Pavlis, Michelle; Hymes, Saul R; Mintzer, Jonathan P

2014-05-01

28

Lamisil versus clotrimazole in the treatment of vulvovaginal candidiasis  

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Background and Objectives: Vaginal candidiasis is a common disease in women during their lifetime and occurs in diabetes patients, during pregnancy and oral contraceptives users. Although several antifungals are routinely used for treatment; however, vaginal candidiasis is a challenge for patients and gynecologists. The aim of the present study was to evaluate terbinafine (Lamisil) on Candida vaginitis versus clotrimazole.Materials and Methods: In the present study women suspected to have vul...

Eskandar Moghimipour; Mahin Najafyan; Ali Zarei Mahmoudabadi; Maryam Alwanian; Zahra Seifi

2013-01-01

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Candidiasis esofágica en pacientes inmunocompetentes: Estudio clínico e inmunológico  

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Background: Esophageal candidiasis is associated with conditions that cause an immune depression. It is a defining disease for AIDS, is observed in poorly controlled diabetics, in patients with renal or hepatic failure, in patients with cancer and in subjects using medications causing immunosuppression or broad spectrum antimicrobials. Aim: To report the features of 10 immunocompetent patients with esophageal candidiasis. Patients and methods: Six males and four femal...

Claudia Cortés M; Danny Oksenberg R; Alejandro Afani S; Carlos Defilippi C; Ana María Madrid S

2004-01-01

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Mannose in body fluids as an indicator of invasive candidiasis.  

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Using gas-liquid chromatography, we measured five mannose in the serum of six nondiabetic patients with autopsy-proven invasive candidiasis. In all patients serum mannose concentrations were higher than mannose levels found in serum from normal adults and children or from patients with catheter-associated candidemia, mucosal candidiasis, and other mycoses. Spinal fluid from two patients with Candida meningitis showed increased free mannose as compared to seven non-inflammatory spinal fluid sa...

Monson, T. P.; Wilkinson, K. P.

1981-01-01

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Candidiasis esofágica en pacientes con sida. Estudio clínico y microbiológico  

Scientific Electronic Library Online (English)

Full Text Available SciELO Cuba | Language: Spanish Abstract in spanish Se estudiaron 18 pacientes con sida, que presentaban síntomas gastrointestinales altos o lesiones en la cavidad oral sugestivos de candidiasis. Se obtuvieron datos clínicos, muestras de la cavidad oral, biopsias y cepillado esofágico, así como suero de todos los pacientes. El síntoma que principalme [...] nte se observó en la candidiasis esofágica fue la disfagia; la candidiasis oral se comportó de forma asintomática. Candida albicans fue la especie que más se aisló con predominio del serotipo A. Se analizaron por la técnica de electroforesis en gel de poliacrilamida los perfiles proteicos de las 12 cepas pertenecientes a esta especie, se observó identidad de sus patrones de peso molecular, lo que sugiere que sea la misma cepa la que se halla en la cavidad oral y en el esófago. Se evaluó la respuesta de anticuerpos anti-C. albicans, no resultó útil la inmunodifusión doble para el diagnóstico de candidiasis esofágica. Abstract in english 18 AIDS patients who presented high gastrointestinal symptoms or lesions in the oral cavity suggestive of candidiasis were studied. Clinical data, specimen of the oral cavity, biopsies and esophageal brushing, as well as serum from all patients were obtained. Dysphagia was the main symptom observed [...] in the esophageal candidiasis. Candida albicans was the most isolated species with a predominance of serotype A. The protein profiles of 12 strains belonging to this species were analyzed by the polyacrylamide gel electrophoresis, and it was found that their molecular weight patterns were identical, which indicates that the same strain is in the oral cavity and in the esophagus. The response of the anti-C. albicans antibodies was evaluated. The double immunodiffussion was not useful for the diagnosis of esophageal candidiasis.

Zenia Flores, de Apodaca Verdura; Gerardo, Martínez Machín; Aroldo, Ruiz Pérez; Carlos M., Fernández Andreu; Mayra, Muné Jiménez; Mayda, Perurena Lancha.

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Candidiasis congénita en un recién nacido de muy bajo peso Congenital candidiasis in a very low birth weight premature infant  

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Full Text Available Las infeccciones por hongos, particularmente candida, han emergido como una causa importante de infecciones nosocomiales en recién nacidos de muy bajo peso. Las infecciones a candida pueden ser diseminadas, por colonización de un acceso venoso central o congénitas. La candidiasis congénita es una condición inhabitual producida por la infección a candida adquirida in utero. Reportamos el curso clínico de un recién nacido prematuro de muy bajo peso (peso 630 g, edad gestacional 24 semanas con una candidiasis congénita. Por otro lado, se revisan los factores de riesgo, presentación clínica, hallazgos de laboratorio, tratamiento y pronóstico de esta patología, basado en una revisión de los casos reportados en la literaturaSystemic candidiasis has become an important cause of nosocomial infections in very low birth weight infants (VLBW. In this vulnerable population candidal infection may be disseminated, be congenital or related to intravenous lines. Congenital candidiasis is a rare disorder acquired in utero. In this report we describe a VLBW infant (24 weeks of gestational age and birth weight of 630gm with congenital candidiasis, and discuss the risk factors, clinical and laboratory findings, treatment and the outcome of this condition based on a review of reported cases in the literature

Raúl Bustos B.

2003-03-01

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Oral candidiasis in HIV+ patients under treatment with protease inhibitors  

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Full Text Available SciELO Brazil | Language: English Abstract in english The purpose of this work was to evaluate the influence of Protease Inhibitors (PI) on the occurrence of oral candidiasis in 111 HIV+ patients under PI therapy (Group A). The controls consisted of 56 patients that were not using PI drugs (Group B) and 26 patients that were not using any drugs for HIV [...] therapy (Group C). The patient's cd4 cell counts were taken in account for the correlations. One hundred and ninety three patients were evaluated. The PI did not affect the prevalence of oral candidiasis (p = 0.158) or the frequency of C. albicans isolates (p = 0.133). Patients with lower cd4 cell counts showed a higher frequency of C. albicans isolates (p = 0.046) and a greater occurrence of oral candidiasis (p = 0.036).

Andréa Lusvarghi, Witzel; Fernando Ricardo Xavier da, Silveira; Maria de Fátima Costa, Pires; Mônica Andrade, Lotufo.

2008-12-01

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One-day therapy for vaginal candidiasis. A review.  

Science.gov (United States)

Shorter courses of therapy have been developed for most antifungal agents used for the treatment of vaginal candidiasis, including clotrimazole, econazole, isoconazole, miconazole, terconazole and fluconazole. A search of the medical literature identified 14 studies that compared single-dose therapy for vaginal candidiasis in nonpregnant women. These studies, conducted according to similar study designs, provided sufficient information to evaluate clinical and mycologic cure rates. There were few significant differences in either the clinical or mycologic cure rates of single-dose therapy, and no one therapy was consistently better than any other. Until further information is available, the choice of therapy will continue to be based on individual clinician preference. PMID:10394549

Edelman, D A; Grant, S

1999-06-01

35

Candidiasis invasoras en el paciente crítico adulto Invasive candidiasis in critically ill adult patient  

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Full Text Available Las infecciones invasoras por Candida spp, representan una patología relevante en los pacientes críticos. Para su oportuno diagnóstico es necesaria una elevada sospecha clinica, tomando en consideración el cuadro clinico y la presencia de factores de riesgo. Pese a la incorporación de nuevos fármacos al arsenal terapéutico durante la última década, mantiene una elevada mortalidad. Las claves para mejorar los desenlaces clínicos en estos pacientes son el empleo de una terapia precoz, eficaz y que permita la cobertura de distintas especies de Candida: C albicans y no albicans. Recientes guías internacionales sugieren la terapia empírica con equinocandinas ante la sospecha de candidiasis invasora en esta población de pacientes. Este grupo de fármacos ha documentado adecuada eficacia clínica y seguridad en estos pacientes. Se espera que la incorporación de nuevas equinocandinas al mercado aminore sus costos y mejore el acceso a este grupo de fármacos.Invasive infections by Candida strains are a relevant pathology in critically ill patients. Candida should be considered where a high risk of infection is present for a critical early diagnosis. Despite the incorporation of new drugs in the therapeutic armamentarium over the last decade, mortality remains high. The key in improving clinical outcomes of these patients are the use of early effective therapies that offer coverage against different strains of Candida: C. albicans and non-albicans. Recent international guidelines suggest empiric therapy with echinocandins in suspected invasive candidiasis in this patient population. This group of drugs adequately documented clinical efficacy and safe use in these patients. The emergence of new echinocandins could improve access to these drugs by reducing their cost.

Eduardo Tobar A

2011-02-01

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Candidiasis invasoras en el paciente crítico adulto / Invasive candidiasis in critically ill adult patient  

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Full Text Available SciELO Chile | Language: Spanish Abstract in spanish Las infecciones invasoras por Candida spp, representan una patología relevante en los pacientes críticos. Para su oportuno diagnóstico es necesaria una elevada sospecha clinica, tomando en consideración el cuadro clinico y la presencia de factores de riesgo. Pese a la incorporación de nuevos fármaco [...] s al arsenal terapéutico durante la última década, mantiene una elevada mortalidad. Las claves para mejorar los desenlaces clínicos en estos pacientes son el empleo de una terapia precoz, eficaz y que permita la cobertura de distintas especies de Candida: C albicans y no albicans. Recientes guías internacionales sugieren la terapia empírica con equinocandinas ante la sospecha de candidiasis invasora en esta población de pacientes. Este grupo de fármacos ha documentado adecuada eficacia clínica y seguridad en estos pacientes. Se espera que la incorporación de nuevas equinocandinas al mercado aminore sus costos y mejore el acceso a este grupo de fármacos. Abstract in english Invasive infections by Candida strains are a relevant pathology in critically ill patients. Candida should be considered where a high risk of infection is present for a critical early diagnosis. Despite the incorporation of new drugs in the therapeutic armamentarium over the last decade, mortality r [...] emains high. The key in improving clinical outcomes of these patients are the use of early effective therapies that offer coverage against different strains of Candida: C. albicans and non-albicans. Recent international guidelines suggest empiric therapy with echinocandins in suspected invasive candidiasis in this patient population. This group of drugs adequately documented clinical efficacy and safe use in these patients. The emergence of new echinocandins could improve access to these drugs by reducing their cost.

Eduardo, Tobar A; Francisco, Silva O; Roberto, Olivares C; Pablo, Gaete G; Mario, Luppi N.

37

T-cell deficiency with recurrent mucocutaneous candidiasis  

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Full Text Available A case had recurrent and chronic mucocutaneous candidiasis . The main immunological feature were gross T cell deficiency, anergy to common recall antigens but normal serum immunoglobulins, complement and phagocytosis. Ultimately, the multiple candida infections led to a fatal outcome.

Karnik A

1990-01-01

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Fluconazol versus Nistatina en niños con Candidiasis Orofaríngea  

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Full Text Available SciELO Venezuela | Language: Spanish Abstract in spanish La candidiasis orofaríngea constituye una patología frecuente en la población pediátrica. Con la finalidad de ofrecer una alternativa terapéutica segura y eficaz, se realizó un estudio multicéntrico, prospectivo, comparativo, simple ciego y de asignación aleatoria, donde se incluyeron 181 pacientes [...] con diagnóstico clínico y micológico de candidiasis orofaríngea; fueron asignados al azar para recibir Fluconazol suspensión a 5 mgrs/Kg dosis única diaria o Nistatina suspensión 50.000 unidades/Kg cada 6 horas. Se obtuvo una respuesta clínica satisfactoria al final del tratamiento con una diferencia estadística altamente significativa (p Abstract in english The Oropharyngeal Candidiasis constitute a frecuent pathology in the pediatric population. In order to offer a safe and efficient therapeutic alternative, an multicentric, prospective, single blind and randomized study was performed 181 patients which included clinic and micologic diagnostic of Orof [...] aringeal Candidiasis; they were asigned in a randomized way to received fluconazole suspensión containing 5 mgrs/Kg once daily or Nystatin suspensión 50.000 units/Kg every six hours. Satisfactory clinic response was obtained at the end of the treatment with a very significant statistic difference (p

B, Del Nogal; M, Carrabs; JA, Suárez; N, SandovaI; L, Escalona; O, Febres; A, González; A, Martin; Y, Izaguirre; G, Espinoza.

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Ultrasound scan in the diagnosis of neonatal renal candidiasis  

International Nuclear Information System (INIS)

To describe the most pertinent echographic findings regarding systemic and renal candidiasis in high-risk neonates. Echographic findings and clinical histories of 40 neonates in the neonatal intensive care unit were retrospectively analyzed. Thirty-eight presented systemic candidiasis with renal participation, while two showed only renal candidiasis. Ultrasound scans were performed using 7.5 MHz probes. Alterations in renal echo structure, presence of echogenic material without acoustic shadowing in the excretory system (mycetoma), presence of lithiasis, pyonephrosis and associated renal malformations were all evaluated. Ten patients presented renal alterations in ultrasound scan. Six children had originally shown increased eye-catching in the renal parenchyma which was resolved after medical treatment. Four children presented renal mycetoma, and in two there were renal malformations. Both of these exhibited a profile for pyonephrosis. One patient with renal mycetoma without urological abnormalities developed a lithiasis. Surgical intervention was unnecessary in all cases. The most common echographic findings in immature high-risk low-weight patients with systemic and renal candidiasis were alterations in the eye-catching of renal parenchyma and the presence of mycetoma. (Author) 22 refs

40

Ultrasound scan in the diagnosis of neonatal renal candidiasis; Ecografia en el diagnostico de la candidiasis renal neonatal  

Energy Technology Data Exchange (ETDEWEB)

To describe the most pertinent echographic findings regarding systemic and renal candidiasis in high-risk neonates. Echographic findings and clinical histories of 40 neonates in the neonatal intensive care unit were retrospectively analyzed. Thirty-eight presented systemic candidiasis with renal participation, while two showed only renal candidiasis. Ultrasound scans were performed using 7.5 MHz probes. Alterations in renal echo structure, presence of echogenic material without acoustic shadowing in the excretory system (mycetoma), presence of lithiasis, pyonephrosis and associated renal malformations were all evaluated. Ten patients presented renal alterations in ultrasound scan. Six children had originally shown increased eye-catching in the renal parenchyma which was resolved after medical treatment. Four children presented renal mycetoma, and in two there were renal malformations. Both of these exhibited a profile for pyonephrosis. One patient with renal mycetoma without urological abnormalities developed a lithiasis. Surgical intervention was unnecessary in all cases. The most common echographic findings in immature high-risk low-weight patients with systemic and renal candidiasis were alterations in the eye-catching of renal parenchyma and the presence of mycetoma. (Author) 22 refs.

Muro, D.; Sanguesa, C.; Torres, D.; Berbel, O.; Andres, V. [Hospital Infantil La Fe. Valencia (Spain)

2003-07-01

 
 
 
 
41

INVASIVE CANDIDIASIS IN NON-HEMATOLOGICAL PATIENTS.  

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Full Text Available

Candida is one of the most frequent pathogens isolated in bloodstream infections, and is associated with significant morbidity and mortality. In addition to haematological patients, there are several other populations with a substantial risk of developing invasive candidiasis (IC. These include patients undergoing prolonged hospitalisation with the use of broad-spectrum antibiotics, those fitted with intravascular catheters, admitted to both adult and neonate intensive care units (ICU or gastrointestinal surgery wards and subjects with solid tumours undergoing cytotoxic chemotherapy. As a general rule, every immunocompromised patient might be at risk of Candida infection, including, for example, diabetic patients.

The epidemiology of species responsible for IC has been changing, both at local and worldwide level, shifting from C. albicans to non-albicans species, that can be intrinsically resistant to fluconazole (C. krusei and, to some extent, C. glabrata, difficult to eradicate because of biofilm production (C. parapsilosis or than might acquire resistance to azole during therapy.

Delaying the specific therapy has been shown to increase morbidity and mortality, but traditional microbiological diagnosis is poorly sensitive and slow. Thus, culture-based treatment may result in therapy started too late. In order to reduce the mortality in IC, several management strategies have been developed: prophylaxis, empirical and pre-emptive therapy. Compared to prophylaxis, the latter approaches allow to reduce the use of antifungals by targeting only patients at very high risk of IC. Non-invasive serological markers and scores based on clinical prediction rules such as the presence of risk factors or Candida colonisation, have been developed with the aim of allowing prompt initiation of treatment. Although the use of these diagnostic tools in pre-emptive strategies is promising, the performance and cost-effectiveness should be tested in large trials.

Agents recommended for initial treatment of candidemia in severely ill patients include echinocandins and lipid formulations of amphotericin B, while stable patients without risk factors for azole-resistance might be treated with fluconazole.


Sandra Ratto

2011-01-01

42

Atypical presentations of congenital cutaneous candidiasis- presenting a cohort of 8 cases  

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Full Text Available Congenital cutaneous candidiasis is an extremely rare disorder that usually presents within the first 6 days of life. We report 8 neonates who presented with generalized skin eruptions within first 6 days of life, characterized by erythematous macules, papules, vesicles, bullae and pustules. Candida albicans was demonstrated on direct KOH smear, fungal culture and skin biopsy. The disease implies a congenital intrauterine infection and is different from neonatal candidiasis, which manifests as thrush or diaper dermatitis.Although congenital cutaneous candidiasis is a rare diagnosis and the predisposing factors like prematurity,candidial infection in the mother are not obvious, a high index of suspicion is required to diagnose the neonates with this condition and it is very evident that congenital cutaneous candidiasis has got a good prognosis. This article apart from revealing the atypical presentations of cutaneous congenital candidiasis, also emphasizes the need to screen all pregnant women for vaginal candidiasis .

Dr. Regina Divya*

2013-12-01

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Successful Management of an Extremely Premature Infant with Congenital Candidiasis  

Science.gov (United States)

Congenital candidiasis, which presents with a variety of clinical symptoms, is very rare in both term and preterm infants, and less than 100 neonatal cases have been reported in the medical literature. We describe the case of an extremely premature infant with congenital candidiasis, who was successfully treated and survived without major sequelae. A male infant was born at 25 weeks' gestation (weight, 834 g). He exhibited diffuse erythematous papules. Samples of his skin, pharyngeal mucus, gastric fluid, and tracheal aspirate were found to be Candida albicans—positive while blood cultures were negative. Further histopathological examinations revealed that Candida albicans mycelia had invaded the umbilical cord. After prompt antifungal therapy, the patient's skin lesions improved markedly, and he was discharged from hospital without any major complications. This report highlights the importance of characteristic skin lesions for the early diagnosis of Candida infections, especially in extremely premature infants. PMID:25032051

Iwatani, Sota; Murakami, Yuko; Mizobuchi, Masami; Fujioka, Kazumichi; Wada, Keiko; Sakai, Hitomi; Yoshimoto, Seiji; Nakao, Hideto

2013-01-01

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Conventional and alternative antifungal therapies to oral candidiasis  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: English Abstract in english Candida-associated denture stomatitis is the most common form of oral candidal infection, with Candida albicans being the principal etiological agent. Candida adheres directly or via an intermediary layer of plaque-forming bacteria to denture acrylic. Despite antifungal therapy to treat denture stom [...] atitis, infection is reestablished soon after the treatment ceases. In addition, many predisposing factors have been identified as important in the development of oral candidiasis, including malnourishment, common endocrine disorders, such as diabetis mellitus, antibacterial drug therapy, corticosteroids, radiotherapy and other immunocompromised conditions, such as acquired immunodeficiency syndrome (AIDS). These often results in increased tolerance to the most commonly used antifungals. So this review suggests new therapies to oral candidiasis.

Paula Cristina, Anibal; Janaina de Cássia Orlandi, Sardi; Iza Teixeira Alves, Peixoto; Julianna Joanna de Carvalho, Moraes; José Francisco, Höfling.

45

Conventional and alternative antifungal therapies to oral candidiasis  

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Full Text Available Candida-associated denture stomatitis is the most common form of oral candidal infection, with Candida albicans being the principal etiological agent. Candida adheres directly or via an intermediary layer of plaque-forming bacteria to denture acrylic. Despite antifungal therapy to treat denture stomatitis, infection is reestablished soon after the treatment ceases. In addition, many predisposing factors have been identified as important in the development of oral candidiasis, including malnourishment, common endocrine disorders, such as diabetis mellitus, antibacterial drug therapy, corticosteroids, radiotherapy and other immunocompromised conditions, such as acquired immunodeficiency syndrome (AIDS. These often results in increased tolerance to the most commonly used antifungals. So this review suggests new therapies to oral candidiasis.

Paula Cristina Anibal

2010-12-01

46

Conventional and alternative antifungal therapies to oral candidiasis.  

Science.gov (United States)

Candida-associated denture stomatitis is the most common form of oral candidal infection, with Candida albicans being the principal etiological agent. Candida adheres directly or via an intermediary layer of plaque-forming bacteria to denture acrylic. Despite antifungal therapy to treat denture stomatitis, infection is reestablished soon after the treatment ceases. In addition, many predisposing factors have been identified as important in the development of oral candidiasis, including malnourishment, common endocrine disorders, such as diabetis mellitus, antibacterial drug therapy, corticosteroids, radiotherapy and other immunocompromised conditions, such as acquired immunodeficiency syndrome (AIDS). These often results in increased tolerance to the most commonly used antifungals. So this review suggests new therapies to oral candidiasis. PMID:24031562

Anibal, Paula Cristina; de Cássia Orlandi Sardi, Janaina; Peixoto, Iza Teixeira Alves; de Carvalho Moraes, Julianna Joanna; Höfling, José Francisco

2010-10-01

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Role of posaconazole in the management of oropharyngeal and esophageal candidiasis  

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Mucocutaneous candidiasis (MC) is one of the first signs of human immunodeficiency virus (HIV) infection. Over 90% of patients with AIDS will eventually develop oropharyngeal candidiasis (OPC) at some time during their illness, and an additional 10% will develop esophageal candidiasis (EC). Although numerous antifungal agents are available, azoles, both topical (clotrimazole) and systemic (fluconazole, itraconazole), have replaced older topical antifungals (gentian violet and nystatin) in the...

Vazquez, Jose A.

2007-01-01

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Biotherapeutic effects of probiotic bacteria on candidiasis in immunodeficient mice.  

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Four species of probiotic bacteria were assessed for their capacities to protect athymic bg/bg-nu/nu and euthymic bg/bg-nu/+ mice from mucosal and systemic candidiasis. Each bacterial species and Candida albicans colonized the gastrointestinal tracts of both strains of mice. The presence of probiotic bacteria (Lactobacillus acidophilus, Lactobacillus reuteri, Lactobacillus casei GG, or Bifidobacterium animalis) in the gastrointestinal tracts prolonged the survival of adult and neonatal bg/bg-...

Wagner, R. D.; Pierson, C.; Warner, T.; Dohnalek, M.; Farmer, J.; Roberts, L.; Hilty, M.; Balish, E.

1997-01-01

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Efficiency of fenticonazole for the treatment of vaginal candidiasis  

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Full Text Available Introduction. Uncomplicated vulvovaginal candidiasis appears in 75% women of reproductive age. The most frequent causes are Candida albicans (85-95% or C. glabrata, and infrequently C. krusei, C. tropicalis, C. parapsilosis, C. pseudotropicalis, etc. Objective. The aim of the study was to investigate efficiency and safety of fenticonazole for vaginal candidiasis treatment. Methods. Therapeutic effect of a single 600 mg fenticonasole vaginal capsule was observed in 417 women, aged 16-67, in five centers in Serbia. In all women, before the treatment, vaginal candidiasis was confirmed by testing of vaginal smear. Based on smear findings and associated symptoms observed on the 7th and 28th day after therapy administration, treatment results were evaluated. On the next day after drug application the patients recorded by using a questionnaire their own feelings on withdrawal symptoms and possible side effects in the period prior to the first control. Results. Control after seven days showed a statistically significant decrease of symptoms. In 385 women, vaginal smear was found negative to yeast and yeast blastospores. Within the first seven days after treatment 84 women had to repeat therapy due to the persistence of symptoms or positive vaginal smear. After 28 days we recorded full recovery in 392 patients, clinical improvement in eight, no change in 16, and deterioration in one patient only. Side effects were very seldom, mostly in the form of a slight redness of the vulva and vagina, and mild itching during several days. Conclusion. Our observations confirmed good efficacy and safety of fenticonazole in the treatment of vaginal candidiasis.

Živaljevi? Biljana

2012-01-01

50

Lamisil Versus Clotrimazole in the Treatment of Vulvovaginal Candidiasis  

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Full Text Available Background and Objectives: Vaginal candidiasis is a common disease in women during their lifetime and occurs in diabetes patients, during pregnancy and oral contraceptives users. Although several antifungals are routinely used for treatment; however, vaginal candidiasis is a challenge for patients and gynecologists. The aim of the present study was to evaluate terbinafine (Lamisil on Candida vaginitis versus clotrimazole.Materials and Methods: In the present study women suspected to have vulvovaginal candidiasis were sampled and disease confirmed using direct smear and culture examination from vaginal discharge. Then, patients were randomly divided into two groups, the first group (32 cases was treated with clotrimazole and the next (25 cases with Lamisil. All patients were followed-up to three weeks of treatment and therapeutic effects of both antifungal were compared.Results: Our results shows that 12 (37.5% patients were completely treated with clotrimazole during two weeks and, 6(18.8% patients did not respond to drugs and were refereed for fluconazole therapy. Fourteen (43.8% patients showed moderate response and clotrimazole therapy was extended for one more week. When Lamisil was administrated, 19 (76.0% patients were completely treated with Lamisil in two weeks, and 1 (4.0% of the patients did not respond to the drug and was refereed for fluconazole therapy. Five (20.0% of our patients showed moderate response and Lamisil therapy was extended for one more week.Conclusion: Our results show that vaginal cream, 1% Lamisil, could be suggested as a first-line treatment in vulvovaginal candidiasis.

Eskandar Moghimipour

2013-03-01

51

Association among Vitamin D, Oral Candidiasis, and Calprotectinemia in HIV  

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Vitamin D deficiency is associated with negative health outcomes, including infections. Vitamin D modulates inflammation and down-regulates the expression of calprotectin, a molecule which influences neutrophil functions and which has been linked to oral candidiasis (OC), the most prevalent oral lesion in human immunodeficiency virus (HIV). We hypothesized a positive association between vitamin D deficiency and OC, and that this effect was partially modulated by calprotectinemia. Plasma calpr...

Sroussi, H. Y.; Burke-miller, J.; French, A. L.; Adeyemi, O. M.; Weber, K. M.; Lu, Y.; Cohen, M.

2012-01-01

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Pharmacodynamics of Fluconazole in a Murine Model of Systemic Candidiasis  

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In this study we defined the pharmacodynamic parameter that optimizes outcome in deep-seated Candida albicans infections treated with fluconazole. Using a murine model of systemic candidiasis, we conducted single-dose dose-ranging studies with fluconazole to determine the dosage of this drug that resulted in a 50% reduction in fungal densities (50% effective dose [ED50]) in kidneys versus the fungal densities in the kidneys of untreated controls. We found that the ED50 of fluconazole given in...

Louie, Arnold; Drusano, George L.; Banerjee, Partha; Liu, Qing-feng; Liu, Weiguo; Kaw, Pamela; Shayegani, Mehdi; Taber, Harry; Miller, Michael H.

1998-01-01

53

Zinc Level of Serum in Recurrent Vulvovaginal Candidiasis  

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Full Text Available Zinc status has been shown to influence various cell-mediated immunologic mechanisms. These cell-mediated mechanisms are important in preventing mucocutaneous infections caused by Candida albicans. This study evaluated the relationship between zinc status and recurrent vulvovaginal candidiasis by comparing plasma zinc in 51 patients with recurrent vulvovaginal candidiasis and 50 control healthy age-matched women. The results indicated that zinc concentration in plasma in patients with recurrent vulvovaginal candidiasis and control group showed no significant difference between case and control group (p = 0.605, 4(8% women of control group and 5(11/1% women of patients group had zinc concentration lower than normal. Also, no significant difference between the mean plasma zinc concentration (case group 48-189 ?g dL-1 and control group 57-120 ?g dL -1 in the patient and control group (87 ?g dL-1, std 23.5, 74.9 ?g dL-1, std 13 ?g dL-1 (p = 0.031 .

2008-01-01

54

Micafungin in the treatment of invasive candidiasis and invasive aspergillosis  

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Full Text Available Nathan P Wiederhold1, Jason M Cota2, Christopher R Frei11University of Texas at Austin College of Pharmacy, Austin, Texas, USA; 2University of the Incarnate Word Feik School of Pharmacy, San Antonio, Texas, USAAbstract: Micafungin is an echinocandin antifungal agent available for clinical use in Japan, Europe, and the United States. Through inhibition of ?-1,3-glucan production, an essential component of the fungal cell wall, micafungin exhibits potent antifungal activity against key pathogenic fungi, including Candida and Aspergillus species, while contributing minimal toxicity to mammalian cells. This activity is maintained against polyene and azole-resistant isolates. Pharmacokinetic and pharmacodynamic studies have demonstrated linear kinetics both in adults and children with concentration-dependent activity observed both in vitro and in vivo. Dosage escalation studies have also demonstrated that doses much higher than those currently recommended may be administered without serious adverse effects. Clinically, micafungin has been shown to be efficacious for the treatment of invasive candidiasis and invasive aspergillosis. Furthermore, the clinical effectiveness of micafungin against these infections occurs without the drug interactions that occur with the azoles and the nephrotoxicity observed with amphotericin B formulations. This review will focus on the pharmacology, clinical microbiology, mechanisms of resistance, safety, and clinical efficacy of micafungin in the treatment of invasive candidiasis and invasive aspergillosis.Keywords: micafungin, echinocandin, Candida, Aspergillus, invasive candidiasis, invasive aspergillosis

Nathan P Wiederhold

2009-01-01

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Candidiasis invasoras en recién nacidos: diagnóstico, tratamiento y prevención / Invasive candidiasis in newborns: diagnosis, treatment and prophylaxis  

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Full Text Available SciELO Chile | Language: Spanish Abstract in spanish Las infecciones fúngicas invasoras se han convertido en un problema cada vez más frecuente en las unidades de cuidados intensivos neonatales. La candidiasis invasora (CI) es una infección que se asocia a una significativa morbi-mortalidad, en especial en los recién nacidos (RN) prematuros. El objeti [...] vo de este documento es sugerir acciones de vigilancia, prevención farmacológica, diagnóstico, tratamiento y seguimiento de las CI en el RN. Abstract in english Invasive fungal infections have become an increasingly common problem in neonatal intensive care units (NICU). Invasive candidiasis (IC) is associated with substantial morbidity and mortality rates, especially in pre-term infants. The aim of this review is to suggest actions in monitoring, preventio [...] n, treatment and follow up of IC in the newborn infant.

Giannina, Izquierdo; María Elena, Santolaya.

2014-02-01

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Candidiasis invasoras en recién nacidos: diagnóstico, tratamiento y prevención / Invasive candidiasis in newborns: diagnosis, treatment and prophylaxis  

Scientific Electronic Library Online (English)

Full Text Available SciELO Chile | Language: Spanish Abstract in spanish Las infecciones fúngicas invasoras se han convertido en un problema cada vez más frecuente en las unidades de cuidados intensivos neonatales. La candidiasis invasora (CI) es una infección que se asocia a una significativa morbi-mortalidad, en especial en los recién nacidos (RN) prematuros. El objeti [...] vo de este documento es sugerir acciones de vigilancia, prevención farmacológica, diagnóstico, tratamiento y seguimiento de las CI en el RN. Abstract in english Invasive fungal infections have become an increasingly common problem in neonatal intensive care units (NICU). Invasive candidiasis (IC) is associated with substantial morbidity and mortality rates, especially in pre-term infants. The aim of this review is to suggest actions in monitoring, preventio [...] n, treatment and follow up of IC in the newborn infant.

Giannina, Izquierdo; María Elena, Santolaya.

57

Optimal management of oropharyngeal and esophageal candidiasis in patients living with HIV infection  

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Full Text Available Jose A VazquezDivision of Infectious Diseases, Henry Ford Hospital, Wayne State University School of Medicine, Detroit, MI, USAAbstract: Mucocutaneous candidiasis is frequently one of the f irst signs of human immunodeficiency virus (HIV infection. Over 90% of patients with AIDS will develop oropharyngeal candidiasis (OPC at some time during their illness. Although numerous antifungal agents are available, azoles, both topical (clotrimazole and systemic (fluconazole, itraconazole, voriconazole, posaconazole have replaced older topical antifungals (gentian violet and nystatin in the management of oropharyngeal candidiasis in these patients. The systemic azoles, are generally safe and effective agents in HIV-infected patients with oropharyngeal candidiasis. A constant concern in these patients is relapse, which is dependent on the degree of immunosuppression commonly seen after topical therapy, rather than with systemic azole therapy. Candida esophagitis (CE is also an important concern since it occurs in more than 10% of patients with AIDS and can lead to a decrease in oral intake and associated weight loss. Fluconazole has become the most widely used antifungal in the management of mucosal candidiasis. However, itraconazole and posaconazole have similar clinical response rates as fluconazole and are also effective alternative agents. In patients with fluconazole-refractory mucosal candidiasis, treatment options now include itraconazole solution, voriconazole, posaconazole, and the newer echinocandins (caspofungin, micafungin, and anidulafungin.Keywords: oropharyngeal candidiasis, esophageal candidiasis, HAART, antifungal agents, HIV, AIDS

Jose A Vazquez

2010-04-01

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New approaches in the development of a vaccine for mucosal candidiasis: progress and challenges.  

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Full Text Available The commensal fungus Candida albicans causes mucosal candidiasis in the rapidly expanding number of immunocompromised patients. Mucosal candidiasis includes orapharyngeal, esophageal, gastrointestinal, and vaginal infections. Vulvovaginal candidiasis (VVC and antimycotic-refractory recurrent VVC is a frequent problem in healthy child-bearing women. Both these mucosal infections can affect the quality of life and finding new therapeutical and preventive approaches is a challenge. A vaccine against candidal infections would be a new important tool to prevent and/or cure mucosal candidiasis and would be of benefit to many patients. Several Candida antigens have been proposed as vaccine candidates including cell wall components and virulence factors. Here we discuss the recent progress and problems associated with vaccination against mucosal candidiasis.

AnnaVecchiarelli

2012-08-01

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Time to initiation of antifungal therapy for neonatal candidiasis.  

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The effect of delayed antifungal therapy in critically ill infants with invasive candidiasis has not been studied. Our objective was to evaluate the effect of time to initiation of antifungal therapy (TIA) on mortality, disseminated disease, and postinfection hospital stay. We conducted a cohort study of critically ill infants with cultures positive for Candida from 1990 to 2008. TIA was defined as the number of hours from the collection of the first positive culture until the start of antifungal therapy. Of 96 infants, 57% were male, the median gestational age was 27 weeks (range, 23 to 41 weeks), and the median birth weight was 956 g (range, 415 to 6,191 g). Most subjects received amphotericin B deoxycholate. TIA was ? 24 h for 35% of infants, between 25 and 48 h for 42%, and >48 h for 23%. Eleven subjects died during hospitalization, and 22% had disseminated candidiasis. The median duration of hospital stay postinfection was 53 days (range, 6 to 217 days). Both univariate and multivariate analyses demonstrated that TIA was not associated with mortality, disseminated disease, or hospital stay postinfection. However, ventilator use for >60 days significantly increased the risk of death (odds ratio [OR], 9.5; 95% confidence interval [CI], 2.2 to 66.7; P = 0.002). Prolonged candidemia increased the risk of disseminated disease by 10% per day of positive culture (OR, 1.1; 95% CI, 1.08 to 1.2; P = 0.007), and low gestational age was associated with increased neonatal intensive care unit (NICU) stay after the first positive Candida culture by 0.94 weeks (95% CI, 0.70 to 0.98; P < 0.001). The TIA was not associated with all-cause mortality, disseminated candidiasis, and postinfection length of hospital stay. PMID:23507285

Le, Jennifer; Tran, Tu T; Bui, Ivilynn; Wang, Mike K; Vo, Andrew; Adler-Shohet, Felice C

2013-06-01

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Vaccine and Monoclonal Antibody That Enhance Mouse Resistance to Candidiasis ?  

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Previously we showed that antibodies specific for the glycan ?-1,2-mannotriose [?-(Man)3] on the cell surface of Candida albicans protect mice against disseminated candidiasis (H. Xin, S. Dziadek, D. R. Bundle, and J. E. Cutler, Proc. Natl. Acad. Sci. U. S. A. 105:13526–13531, 2008). Furthermore, six 14-mer peptides that are within the N-terminal portion of C. albicans wall proteins were conjugated to the glycan in an attempt to create immunogenic glycopeptide conjugates. By a dendritic c...

Xin, Hong; Cutler, Jim E.

2011-01-01

 
 
 
 
61

Autosensitisation (Autoeczematisation) reactions in a case of diaper dermatitis candidiasis.  

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Diaper dermatitis is the most common cutaneous diagnosis in infants. Most cases are associated with the yeast colonisation of Candida or diaper dermatitis candidiasis (DDC). It is an irritating and inflammatory acute dermatitis in the perineal and perianal areas resulting from the occlusion and irritation caused by diapers. Autoeczematization to a distant focus of dermatophyte infection very rarely presents as DDC. We present a 1-month-old boy with lesion on diaper area (gluteal area, perineum, groin and genitalia) and with clusters of pustules and vesicles on a large erythematous base over the dorsal area of both hands. PMID:25013264

Chirac, Anca; Brzezinski, Piotr; Chiriac, Anca E; Foia, Liliana; Pinteala, Tudor

2014-05-01

62

Adjuvant corticosteroid therapy in hepatosplenic candidiasis-related IRIS  

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Full Text Available

Hepatosplenic candidiasis (HSC is a form of invasive fungal infection that occurs most commonly in patients with acute leukemia treated with chemotherapy and requires protracted antifungal therapy. Immune reconstitution inflammatory syndrome (IRIS is best characterized as a dysregulated inflammatory responses triggered by rapid resolution of immunosuppression.

We present a child diagnosed with standard-risk precursor B cell-acute lymphoblastic leukemia who developed HSC and Candida-related IRIS during recovery of neutropenia associated with induction chemotherapy. Addition of corticosteroid therapy to antifungal treatment is associated with the resolution of the clinical symptoms and laboratory findings

Cengiz Bayram

2012-01-01

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Oral candidiasis in HIV+ patients under treatment with protease inhibitors  

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The purpose of this work was to evaluate the influence of Protease Inhibitors (PI) on the occurrence of oral candidiasis in 111 HIV+ patients under PI therapy (Group A). The controls consisted of 56 patients that were not using PI drugs (Group B) and 26 patients that were not using any drugs for HIV therapy (Group C). The patient's cd4 cell counts were taken in account for the correlations. One hundred and ninety three patients were evaluated. The PI did not affect the prevalence of oral cand...

Andréa Lusvarghi Witzel; Fernando Ricardo Xavier da Silveira; Maria de Fátima Costa Pires; Mônica Andrade Lotufo

2008-01-01

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Micafungin in the treatment of invasive candidiasis and invasive aspergillosis.  

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Micafungin is an echinocandin antifungal agent available for clinical use in Japan, Europe, and the United States. Through inhibition of ?-1,3-glucan production, an essential component of the fungal cell wall, micafungin exhibits potent antifungal activity against key pathogenic fungi, including Candida and Aspergillus species, while contributing minimal toxicity to mammalian cells. This activity is maintained against polyene and azole-resistant isolates. Pharmacokinetic and pharmacodynamic studies have demonstrated linear kinetics both in adults and children with concentration-dependent activity observed both in vitro and in vivo. Dosage escalation studies have also demonstrated that doses much higher than those currently recommended may be administered without serious adverse effects. Clinically, micafungin has been shown to be efficacious for the treatment of invasive candidiasis and invasive aspergillosis. Furthermore, the clinical effectiveness of micafungin against these infections occurs without the drug interactions that occur with the azoles and the nephrotoxicity observed with amphotericin B formulations. This review will focus on the pharmacology, clinical microbiology, mechanisms of resistance, safety, and clinical efficacy of micafungin in the treatment of invasive candidiasis and invasive aspergillosis. PMID:21694882

Wiederhold, Nathan P; Cota, Jason M; Frei, Christopher R

2008-01-01

65

Mannose-binding lectin levels and variation during invasive candidiasis.  

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The high morbi-mortality associated with invasive candidiasis (IC) is a persistent problem in hospitals. Mannose-binding lectin (MBL) plays a role in innate immunity through its interaction with mannosylated molecules of Candida albicans. A correlation between MBL deficiency and vulvovaginal candidiasis or peritonitis has been reported. We investigated circulating MBL levels and their evolution during the course of IC. Sixty-eight patients with proven IC, 82 hospitalized patients (HP) without evidence of infection, and 70 healthy subjects (HS) were studied in order to examine the relationship between serum MBL and IC. Serum MBL levels were measured by enzyme-linked immunosorbent assay (ELISA). MBL levels were significantly higher in IC patients than in HP and HS (p?high levels of circulating mannan (Mn). Like MBL levels, anti-mannan antibodies (AMn) increased after the mannanemia/blood culture period. These findings suggest a possible role of MBL during the early stage of IC. The mechanisms that regulate these observations in terms of effect and consequences on innate and adaptive immunity and the prognosis of IC require further investigation. PMID:22833166

Damiens, Sébastien; Poissy, Julien; François, Nadine; Salleron, Julia; Jawhara, Samir; Jouault, Thierry; Poulain, Daniel; Sendid, Boualem

2012-12-01

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A radioimmunoassay method for the rapid detection of Candida antibodies is experimental systematic candidiasis  

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Rabbits were employed as experimental models to evaluate a solid-phase radioimmunoassay (RIA) method for the diagnosis of systematic candidiasis. Ten rabbits were incubated subcutaneously to mimic superficial candidiasis and were found to produce no antibodies to Candida as determined by both immunodiffusion and RIA procedures. However, 94 per cent of 18 rabbits systematically infected by intravenous injection of Candida cells were observed to produce antibody as assessed by the RIA technique. These data encourage further tests with human sera and the continued development of this RIA procedure as a useful tool in the early serodiagnosis of systematic candidiasis. (Auth.)

67

Role of posaconazole in the treatment of oropharyngeal candidiasis  

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Full Text Available Voichita Ianas1, Kathryn R Matthias2, Stephen A Klotz11Section of Infectious Diseases and Department of Medicine, 2School of Pharmacy, University of Arizona, Tucson, Arizona, USAAbstract: Posaconazole is the newest azole antifungal approved by the US Food and Drug Administration, and possesses a broad spectrum of activity against numerous yeasts and filamentous fungi. It is available as an oral suspension and is generally well tolerated by patients, but gastrointestinal absorption is sometimes inadequate and remains a clinical concern in treating deep-seated infections. It is used routinely and effectively for the prophylaxis of invasive fungal infections in immunosuppressed hosts and is an effective treatment of oropharyngeal candidiasis, including azole-resistant disease.Keywords: posaconazole, azole, yeasts, filamentous fungi

Voichita Ianas

2010-06-01

68

Ocular and disseminated candidiasis in an immunosuppressed cat.  

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Ocular and systemic candidiasis was diagnosed in an immunosuppressed and diabetic 12-year-old cat that initially was examined because of polyuria, polydipsia, and urinary tract disease. Bilateral recurrent corneal erosions and chorioretinitis, urinary tract infections attributable to bacteria or Candida sp, and renal dysfunction developed during the next 2 months. Examination of corneal scrapings revealed spherical to oval, budding, yeast-like cells. The cat's condition progressively deteriorated, and it was euthanatized. Toxoplasmosis was diagnosed by fecal flotation and from serum titers, and pituitary-dependent hyperadrenocorticism was detected at postmortem histologic evaluation. Candida budding yeasts and pseudohyphae with blastospores were detected in the corneas, vitreous bodies, retinas, CNS, pharynx, trachea, esophagus, kidneys, and urinary bladder at postmortem examination. PMID:8050944

Gerding, P A; Morton, L D; Dye, J A

1994-05-15

69

Adjuvant Corticosteroid Therapy in Hepatosplenic Candidiasis-Related Iris  

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Candida infections are the most frequent infections in neutropenic patients. Hepatosplenic candidiasis (HSC) is a part of disseminated Candida infection that occurs most commonly in patients with hematologic malignancies treated with chemotherapy and requires protracted antifungal therapy. During invasive mycosis with rapid resolution of immunosuppression, immune reconstitution inflammatory syndrome (IRIS) which mimics treatment failure, drug toxicity or breakthrough infections may occur. Manifestation period, histopathologic findings and favorable effect of steroids to its inflammatory symptoms strongly suggest that HSC belongs to the invasive fungal infection induced IRIS. We present a child with B cell-acute lymphoblastic leukemia who developed HSC and addition of corticosteroid therapy to antifungal treatment achieved rapid resolution of the clinical symptoms and laboratory findings. PMID:22550563

Bayram, Cengiz; Fettah, Ali; Yarali, Nese; Kara, Abdurrahman; Azik, Fatih Mehmet; Tavil, Betul; Tunc, Bahattin

2012-01-01

70

Candidiasis caused by Candida kefyr in a neonate: Case report  

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Full Text Available Abstract Background Systemic Candidia infections are of major concern in neonates, especially in those with risk factors such as longer use of broad spectrum antibiotics. Recent studies showed that also term babies with underlying gastrointestinal or urinary tract abnormalities are much more prone to systemic Candida infection. We report a very rare case of candidiasis caused by Candida kefyr in a term neonate. Case Presentation Renal agenesis on the left side was diagnosed antenatally and anal atresia postnatally. Moreover, a vesico-ureteral-reflux (VUR grade V was detected by cystography. The first surgical procedure, creating a protective colostoma, was uneventful. Afterwards our patient developed urosepsis caused by Enterococcus faecalis and was treated with piperacillin. The child improved initially, but deteriorated again. A further urine analysis revealed Candida kefyr in a significant number. As antibiotic resistance data about this non-albicans Candida species are limited, we started liposomal amphotericin B (AMB, but later changed to fluconazole after receiving the antibiogram. Candiduria persisted and abdominal imaging showed a Candida pyelonephritis. Since high grade reflux was prevalent we instilled AMB into the child's bladder as a therapeutic approach. While undergoing surgery (creating a neo-rectum a recto-vesical fistula could be shown and subsequently was resected. The child recovered completely under systemic fluconazole therapy over 3 months. Conclusions Candidiasis is still of major concern in neonates with accompanying risk factors. As clinicians are confronted with an increasing number of non-albicans Candida species, knowledge about these pathogens and their sensitivities is of major importance.

Weichert Stefan

2012-03-01

71

Determination of Vaginal Candidiasis in Women Referred to Shahid  

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Full Text Available Background and objectives: Genital tract infections are among the mostcommon causes of patients referred to therapeutic centers. Nearly 75% ofwomen suffer from genital Candida infection, at least once in their lifetime.The aim of present study was detection of Candida species causing vaginitisand the evaluation of antimycotic effects of ketoconazol, clotrimazole andfluconazole against Candida species.Material and Methods: In this study, 210 vaginal samples were obtainedfrom the patients suspected of Vaginal Candidiasis. Direct examination andculture were carried out for all specimens to detect the yeast. The isolatedyeast species were then identified, using various different tests such as cultureon corn meal agar, tween-80, germ tube test, and assimilation test by API 20Ckit by using Sabouraud Dextrose Agar and microdilution broth, MIC90 andMIC50 of drug were measured and determined their drug resistance.Results: In the present study, 100 yeast colonies were isolated from patients;%80 are C. albicans and the rest are C. parapsilosis(2%, C. tropicalis(6%, C.glabrata(4%, C. krusei(2%, C. guilliermondii (3%, C.stellatoidea(3%. Interms of drug resistance test MIC50 and MIC90 of fluconazole for candidaalbicans are 5.33 and 35.27?g/ ml, respectively, and for non-albicans candidaare 3 and 21.4?g/ml, respectively. Clotrimazole MIC for Candida albicans(MIC50, MIC90 0.97 and 4.9?g/ml, respectively, and for non-albicans 0.63and 3.4/ml, respectively. Kectoconazole MIC for Candida albicans 2.43 and16.45?g/ml, respectively, and for non-albicans 1.12 and 6.6?g/ml,respectively.Conclusion: Clotrimazole has been better than the two other drugs forCandida species on the whole, non albicans species are more sensitive thanalbicans species in the presence of the drugs used in this study.Key words: Candida, vaginal candidiasis, Resistance drug , Tonekabon.

Nasrollahi omran A

2011-01-01

72

Candida Parapsilosis and Candida Guillermondii: Emerging Pathogens in Nail Candidiasis  

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Background: Onychomycosis of the fingernails and toenails is generally caused by dermatophytes and yeasts. Toenail mycoses involve mainly dermatophytes but when Candida is also involved, the strain most commonly isolated worldwide is C. albicans. Aims: To determine Candida strains prevailing in onychomycosis. Materials and Methods: A retrospective, observational and descriptive study of fungal cultures retrieved from the registry of the microbiology laboratory of the Pontificia Universidad Católica was performed. Specimens obtained from patients attending the healthcare network between December 2007 and December 2010 was analyzed. Statistical Analysis: A descriptive statistical analysis was performed. Results: Candida was retrieved from 467 of 8443 specimens (52% fingernails and 48% toenails). Cultures were negative in 5320 specimens (63.6%). Among Candida-positive cultures, parapsilosis was the most commonly isolated strain with 202 cases (43.3%). While isolates of Candida guillermondii were 113 (24.2%), those of Candida albicans were 110 (23.6%), those of spp. were 20 (4.3%) and there were 22 cases of other isolates (4.71%). Among the 467 patients with positive cultures for Candida, 136 (29,1%) were men and 331 (70,9%) were women. All patients were older than 18 years old. Clinical files were available for only 169 of the 467 patients with positive cultures for Candida. For those, age, gender, underlying illnesses and use of immunossupresive agents during the trial was reviewed. Conclusions: The present study shows that both C. parapsilosis as well as C. guillermondii appear as emerging pathogens that would be in fact taking the place of C. albicans as the most commonly isolated pathogen in patients with Candida onychomycosis. The relative percentage of C parapsilosis increases every year. Identification of Candida strains as etiological agents of nail candidiasis becomes relevant to the management both nail as well as systemic candidiasis, in view of the resistance to conventional treatments readily reported in the literature. PMID:24470656

Fich, Felix; Abarzúa-Araya, Alvaro; Pérez, Mario; Nauhm, Yalile; León, Eugenia

2014-01-01

73

Candidiasis Bucal: Una revisión sistemática de las pruebas de laboratorio / Oral Candidiasis: A systematic review about labs prubes  

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Full Text Available SciELO Venezuela | Language: Spanish Abstract in spanish En el manejo de la Candidiasis Bucal, los hallazgos clínicos no suelen ser suficientes, para determinar su diagnóstico e instaurar un tratamiento, siendo necesaria la realización de pruebas microbiológicas que garanticen una respuesta a la terapéutica instaurada, evitándose así, la resistencia a cie [...] rtos medicamentos. En la actualidad existe gran cantidad de pruebas de laboratorio para llegar a un diagnostico diferencial entre especies de Càndida, por lo que este artículo tiene por objetivo profundizar cuales de estas pruebas poseen mayor evidencia clínica en la determinación de la Candidiasis Bucal. Se utilizó la revisión sistemática como metodología que proporciona una apreciación crítica de datos que de otra manera serían inmanejables, integrando de manera eficiente toda información valida, la cual nos aporte una base racional para tomar decisiones en el establecimiento de políticas de atención. Al analizar los diversos trabajos, se determinó que las pruebas de laboratorio existentes, poseen poca evidencia clínica acerca de su utilidad, recomendándose realizar estudios que cumplan con los criterios de sensibilidad, especificidad y valor predictivo que garanticen su validez clínica. Abstract in english Oral mycosis management, the clinics reward’s its not be enough, to determine it’s diagnosis and restore a treatment. It is be necessary to make labs prubes microbiology that guarantied a response an adequate treatment, it to avoid its resistance to some medicament. Actually exist a lot of labs prub [...] es to find a differential diagnosis between species of Candida, the objective of this article its to low about which one of the labs prubes have the greatest clinic evidence to determine Oral Candidiasis, its used systematic review as methodology to proportion a critic appreciation of information in other way it would be unmanageable, to integrate of efficiency way validity information, the which one proportionated us a base rational to make decisions to establishment attention politics . At analyzed the different works, it determine that the existent lab prubes, it isn’t clinic evidence of its utility, we recommended to make studies that perform with the criterions sensibility, specify and predictive value.

Elba, Añez; Thaìs, Rojas-Morales; José Luis, Calleja; Rita, Navas.

2009-09-01

74

Determinants of Incident Vulvovaginal Candidiasis in Human Immunodeficiency Virus-Positive Women  

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Full Text Available Objective: Mucosal infections including vulvovaginal candidiasis are a common problem for women with human immunodeficiency virus (HIV infection. Our objective was to determine which factors predict the development of symptomatic disease among HIV-infected women.

Debra Matityahu

2000-01-01

75

Efficacy of Caspofungin in a Juvenile Mouse Model of Central Nervous System Candidiasis ?  

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Neonatal candidiasis is an increasingly common occurrence causing significant morbidity and mortality and a higher risk of dissemination to the central nervous system (CNS) than that seen with older patients. The current understanding of optimal antifungal therapy in this setting is limited. We have developed a model of disseminated candidiasis with CNS involvement in juvenile mice to assess the efficacy of the echinocandin caspofungin relative to amphotericin B (AmB). Juvenile mice were inoc...

Flattery, Amy M.; Hickey, Emily; Gill, Charles J.; Powles, Mary Ann; Misura, Andrew S.; Galgoci, Andrew M.; Ellis, Joan D.; Zhang, Rena; Sandhu, Punam; Ronan, John; Abruzzo, George K.

2011-01-01

76

US and MR imaging of candidiasis of the nervous system in premature infants: two case reports  

International Nuclear Information System (INIS)

Candidiasis of central nervous system (CNS) is rare condition and like other opportunistic fungal infections, most commonly occurs in immune-compromised patients. Because of the increasing use of antibiotics and the improving survival rate of premature infants requiring intensive care, the incidence of fungal infection in the brain has increased. We report the findings of ultrasonography and MR imaging in two cases of candidiasis of the CNS in premature infants

77

The diagnosis of hepatosplenic candidiasis by DNA analysis of tissue biopsy and serum  

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Hepatosplenic candidiasis is traditionally diagnosed by blood culture, magnetic resonance imaging (MRI), and histological analysis. The limitations of these methods include: low sensitivity (blood culture) and failure to isolate the organism (MRI/histology). This report describes a case of hepatosplenic candidiasis diagnosed by simultaneous polymerase chain reaction (PCR) analysis of liver biopsy and serum. PCR of biopsy and/or serum may offer a sensitive and specific diagnostic test for hepa...

Kirby, A.; Chapman, C.; Hassan, C.; Burnie, J.

2004-01-01

78

The value of chronic suppressive therapy with itraconazole versus clotrimazole in women with recurrent vaginal candidiasis.  

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OBJECTIVE--To determine the comparative efficacy of oral itraconazole versus intravaginal clotrimazole in suppressing recurrent episodes of vulvovaginal candidiasis. DESIGN--Prospective randomised open study of women with recurrent vulvovaginal candidiasis. Clinical and microbiological assessments were made monthly for 12 months. SETTING--Women's Clinic of a University teaching hospital. SUBJECTS--Forty-four otherwise healthy, non-pregnant women, with at least four proven episodes of candida ...

Fong, I. W.

1992-01-01

79

The value of prophylactic (monthly) clotrimazole versus empiric self-treatment in recurrent vaginal candidiasis.  

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OBJECTIVE--To determine the comparative efficacy and cost benefit of prophylactic monthly (perimenstrual) clotrimazole, versus empiric self-treatment with the same agent at the onset of symptoms in recurrent vulvovaginal candidiasis. DESIGN--Prospective, randomised, open cross-over study of women with proven recurrent vulvovaginal candidiasis. Clinical and microbiological assessments were done every two months for 12 months. SETTING--Women's Clinic of a University Teaching Hospital. SUBJECTS-...

Fong, I. W.

1994-01-01

80

Management of oropharyngeal candidiasis with localized oral miconazole therapy: efficacy, safety, and patient acceptability  

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Full Text Available Curtis D Collins1, Sarah Cookinham2, Jeannina Smith21Department of Pharmacy Services, 2Department of Medicine, Division of Infectious Disease, University of Michigan Health System, Ann Arbor, MI, USAAbstract: Oropharyngeal candidiasis is a very common localized infection of the mucus membranes of the oropharynx that is most commonly caused by the patient's own commensal Candida albicans. It is the most common opportunistic infection affecting patients with the human immunodeficiency virus (HIV and is also quite common in patients with hematological malignancies. Effective treatment options are of high importance given the worldwide incidence of these disease states and the potential for development of oropharyngeal candidiasis in these patients. Various systemic and topical treatment options for patients with oropharyngeal candidiasis have existed for many years. Miconazole buccal tablets have recently been approved by the US Food and Drug Administration for the treatment of oropharyngeal candidiasis. Clinical trials have demonstrated noninferiority in the treatment of oropharyngeal candidiasis when compared with clotrimazole troches in patients with HIV and against miconazole gel in patients with head and neck cancer. Miconazole buccal tablets exhibit few drug interactions because of low systemic absorption and are generally well tolerated with a safety profile similar to comparators. The once-daily dosing schedule may improve patient adherence compared with topical alternatives; however, the cost of therapy may be a barrier for some patients and should be considered by prescribers compared with alternative treatments.Keywords: esophageal candidiasis, miconazole, antifungal agents

Cookinham S

2011-07-01

 
 
 
 
81

Frequency of vaginal candidiasis in pregnant women attending routine antenatal clinic  

International Nuclear Information System (INIS)

To determine the frequency of vaginal candidiasis in clinically symptomatic and asymptomatic cases of pregnant women attending routine antenatal clinic. A total of 110 pregnant women were nonrandomly recruited by convenient sampling. The studied variables included the demographic data information on parity, trimester of pregnancy, presence of vaginal discharge and the presence or absence of diabetes. Vulva and vagina were inspected for signs of inflammation and discharge with sterile speculum and vaginal specimens were collected with sterile cotton tipped swabs. Swabs were subjected to Gram staining and examined microscopically for the diagnosis of candidiasis. The frequency of vaginal candidiasis during pregnancy was found to be 38%, in which 27% were symptomatic and 11% were asymptomatic group. Increased ratio of infection was observed in multigravida and diabetic women. There was no marked differences in results with respect to age and trimester of pregnancy. Although there is generally a high frequency of vaginal candidiasis, an increased ratio of vaginal candidiasis in multigravida and diabetic pregnant women requires these women to be routinely screened for vaginal candidiasis regardless of symptomatic status. (author)

82

Clinical and mycological spectrum of cutaneous candidiasis in Bombay.  

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Full Text Available A total of 150 patients with cutaneous candidiasis were studied. A detailed clinical history was taken. Scrapings were examined in 10% KOH, and the material cultured on Sabouraud?s agar. Species were identified by the serum germ tube test, sugar fermentation and sugar assimilation tests. Of 150 patients 79 were females. The commonest presentation was intertrigo (75, vulvovaginitis (19 and paronychia (17. A history of chronic exposure to water was obtained in 94 cases, all had erosio interdigitalis blastomycetica and/or paronychia. Diabetes melltius as a predisposing factor was observed in 22 patients. The 10 cases of balanoposthitis had associated diabetes mellitus. Smear and culture were positive in all the patients. C. albicans was isolated in 136 cases, C. tropicalis in 12, and C. guillermondi in 2. The cultures of C. albicans had positive serum germ tube test. The 6 patients in the paediatric age group having perianal/genital involvement had a stools culture positive for C. albicans.

Shroff P

1990-04-01

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Prevalence and epidemiological characteristics of vaginal candidiasis in the UAE.  

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Vaginal candidiasis (VC) continues to be a health problem to women worldwide. Although the majority of VC cases are caused by Candida albicans (C. albicans), non-albicans Candida spp. like C. glabrata and C. tropicalis are emerging as important and potentially resistant opportunistic agents of VC. The objective of this study was to evaluate the prevalence and epidemiology of VC in the UAE through retrospective analysis of pertinent data compiled by the microbiology and infection control unit at Latifa Hospital, Dubai between 2005 and 2011. The incidence of VC significantly increased from 10.76% in 2005 to 17.61% in 2011; average prevalence was 13.88%. C. albicans occurred at a frequency of 83.02%, C. glabrata at 16.5% and C. tropicalis at 1.2%. A single C. dubliniensis isolate was identified in the sample population. The percentage of C. albicans significantly decreased from 83.02% in the sample population as a whole to 60.8% in subjects over 45 years of age (P < 0.01) and that of C. glabrata, C. tropicalis and C. krusei significantly increased from 13.88%, 0.9% and 0.03% to 29.7%, 6.7% and 1.4% (P < 0.05) respectively. The incidence of VC in the UAE is on the rise and the frequency of non-albicans Candida spp. is noticeably increasing especially in postmenopausal women. PMID:24102778

Hamad, Mawieh; Kazandji, Norair; Awadallah, Samir; Allam, Hilda

2014-03-01

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Prevalence of Candida nivariensis and Candida bracarensis in Vulvovaginal Candidiasis.  

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Candida nivariensis and Candida bracarensis were isolated from patients with vulvovaginal candidiasis (VVC). Candida nivariensis and Candida bracarensis were found in presumptive Candida glabrata isolates, which were identified using the API Candida system. We retrospectively re-examined vaginal presumptive Candida glabrata isolates for Candida nivariensis and Candida bracarensis from January 1, 2003, through December 31, 2012, via detection of the ITS1 region and the 5.8S ribosomal RNA gene. Among 301 presumptive Candida glabrata isolates, 293 isolates were confirmed as C. glabrata (97.34 %), 7 isolates were identified as C. nivariensis (2.33 %) and 1 isolate was identified as C. bracarensis (0.33 %). The C. nivariensis and C. bracarensis isolates were confirmed by sequencing. All C. nivariensis isolates were susceptible to nystatin and susceptible or susceptible dose-dependent to fluconazole, itraconazole, miconazole, and clotrimazole. The C. bracarensis isolate was susceptible to nystatin and the tested azoles. Among the seven patients with VVC caused by C. nivariensis and who were treated with various antifungal agents, only one patient achieved mycological eradication at both the day 7-14 and day 30-35 follow-ups. The C. bracarensis isolate was isolated from a symptomatic pregnant woman; additional data for this patient were unavailable. We conclude that C. nivariensis and C. bracarensis existed in the vaginal samples of patients with VVC. Therapeutic efficacy in the patients with C. nivariensis was poor and inconsistent with the observed in vitro antifungal susceptibility, which requires further study. PMID:25118875

Li, Jianling; Shan, Yingying; Fan, Shangrong; Liu, Xiaoping

2014-10-01

85

Protocolo para el diagnóstico de Candidiasis Invasiva mediante amplificación de DNA ribosomal por PCR semi-nidada en muestras de plasma / Protocol for diagnosis of invasive candidiasis by amplified ribosomal DNA by semi-nest PCR in plasma samples  

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Ospina Barragán, William Pascual (2009) Protocolo para el diagnóstico de Candidiasis Invasiva mediante amplificación de DNA ribosomal por PCR semi-nidada en muestras de plasma / Protocol for diagnosis of invasive candidiasis by amplified ribosomal DNA by semi-nest PCR in plasma samples. Documento de trabajo. Sin Definir, Bogotá. (No publicado)

Ospina Barraga?n, William Pascual

2009-01-01

86

Chronic diarrhea due to duodenal candidiasis in a patient with a history of kidney transplantation.  

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Candida infection in the small intestine is uncommon. We report an unusual case of duodenal candidiasis that presented as chronic diarrhea in a patient who had previously undergone kidney transplantation. A 60-year-old man presented with profuse watery diarrhea that had lasted 6 months 13 years after kidney transplantation. Upper gastrointestinal endoscopy results indicated candidiasis within the esophagus and duodenum. Biopsy results revealed active duodenitis with hyphal and yeast forms of Candida overlying the duodenal epithelium in periodic acid Schiff staining. The patient was successfully treated with fluconazole. After 6 months of follow-up, the patient had no complaint of diarrhea. Duodenal candidiasis may be the result of chronic diarrhea in patients with a history of kidney transplantation. PMID:25362226

Nouri-Majalan, Nader; Moghaddasi, Sarasadat; Qane, Mohammad Davud; Shefaie, Farzane; Masoumi Dehshiri, Roghayyeh; Amirbaigy, Mohammad Kassem; Baghbanian, Mahmoud

2014-11-01

87

Frequency and Etiology of Vulvovaginal Candidiasis in Women Referred to a Gynecological Center in Babol, lran  

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Full Text Available Background: Vulvovaginal candidiasis is the most common fungal disease in sexually activewomen of which Candida albicans is the primary etiologic agent.Materials and Methods: This cross-sectional study was performed to determine the etiologic agentsof vulvovaginal candidiasis amongst 2000 women who presented to the Gynecological Center ofBabol Shahid Yahyanejad Educational Hospital from 2006-2007 with symptoms of vulvovaginalcandidiasis.Results: Discharge and pruritus were the most common symptoms in patients (80%. There were42 out of 97 (43.3% specimens which were positive for yeast. Of these, 80.95% belonged toCandida albicans and 14.29% were Candida krusei.Conclusion: Discharge and pruritus were the most common symptoms of vulvovaginal candidiasis.In our study, C. albicans was the most common species isolated from the specimens.

Seddigheh Esmaeilzadeh

2009-01-01

88

Primary renal candidiasis: fungal mycetomas in the kidney  

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Fungal infections of the urinary tract have a predilection for drainage structures rather than for the renal parenchyma. Of the causal factors, diabetes mellitus, immunosuppressed states, AIDS and prematurity are those most commonly encountered. The case of a young, diabetic man whose chief clinical presentation was dysuria is described. On further examination he was found to harbour fungal balls in the right kidney. Radiological manifestations of acute pyelonephritis were also present. Although primary renal candidiasis is often commensurate with systemic fungaemia, he displayed none of the clinical features of disseminate infection and, hence, was treated conservatively with oral antifungal agents. Fortuitously, spontaneous passage of fungal particulate matter in urine was later reported. A significant increase in the incidence of fungal cystitis has been found in recent years; however, the patient presents with many non-specific features of cystitis. Both sonography and CT show thickening of the bladder wall but, again, this lacks specificity. In the rare instance of prostate involvement, low attenuation foci on CT are seen within the gland. Despite the existence of a large number of fungal species, only a few are pathogenic to humans. Of those that cause disease in the urinary tract, Candida albicans is the most frequently encountered. A highly characteristic finding in such infections is of fungal balls, which are made up of aggregates of mycelia. However, care should be exercised in interpretation as a host of other conditions can mimic fungal bezoars. Although a CT scan at initial examination may qualify as the more descriptive, sonography provides a serial non-invasive means of evaluating the urinary tract. When in doubt, a urine culture clinches the diagnosis. Copyright (2002) Blackwell Science Pty Ltd

89

Virgin Coconut Oil (VCO) Enriched with Zn as Immunostimulator for Vaginal Candidiasis Patient  

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Disturbance on the immune system and deficiency of Zn is two factors which often trigger vaginal candidiasis patient. The aim of the research was to study the effect of virgin coconut oil (VCO) enriched with Zn to the amount of neutrophil and lymphocyte subset cells, and the level of IL-2 and IgG in vaginal candidiasis patient. Thirty women were grouped into three (ten women in each group): A, B and C, and intervened for two months. Women in A group were intervened with two tablespoon/day; t...

HERY WINARSI; HERNAYANTI; AGUS PURWANTO

2008-01-01

90

Abdominal aortic aneurysm in a premature neonate with disseminated candidiasis: Ultrasound and angiography  

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When using ultrasound for detection of kidney enlargement, we found an acute abdominal aortic aneurysm secondary to aortitis arising from umbilical artery catheterisation in a premature neonate with systemic candidiasis. Aortography was performed to provide vascular details such as involvement of celiac, renal, iliac and femoral arteries.

Khoss, A.E.; Ponhold, W.; Pollak, A.; Schlemmer, M.; Weninger, M.

1985-09-01

91

Addition of Caspofungin to Fluconazole Does Not Improve Outcome in Murine Candidiasis  

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Caspofungin is a potent antifungal inhibiting glucan synthesis in Candida species. However, caspofungin is not 100% curative in candidiasis. Therefore, we evaluated combinations of fluconazole with caspofungin for murine candidemia. We could not show any benefit of combined therapy over individual antifungal drugs.

Graybill, John R.; Bocanegra, Rosie; Najvar, Laura K.; Hernandez, Steve; Larsen, Robert A.

2003-01-01

92

Treatment and prophylaxis of invasive candidiasis with anidulafungin, caspofungin and micafungin - review of the literature  

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Abstract Working by a distinct cell wall-specific mechanism of action, the echinocandin class of antifungals has substantially expanded the range of available treatments for invasive Candida infections. Anidulafungin, caspofungin and micafungin were investigated versus drugs from earlier antifungal classes in large clinical trials that demonstrated their excellent clinical and microbiological efficacy in the primary treatment of invasive candidiasis. Therefore, and supporte...

Glöckner A

2011-01-01

93

New US and CT patterns of hepatic and spienic candidiasis in immunocompromised patients  

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Nine immunocompromised cancer patients with tissue-proved candidiasis underwent a total of eight serial abdominal US studies and 53 CT examinations. Four US patterns of hepatic and splenic candidiasis were recognized. Type 1 was a ''wheel within a wheel'', or a central hypoechoic nidus surrounded by a dense band, in turn surronded by a rim of hypoechoic tissue. Type 2 was the classic ''bull's eye'' lesion. Type 3, the most common, was a uniformly hypoechoic lesion, 1-4 cm in diameter. Type 4 was a small, dense, echogenic focus with no surrounding lucency and varying amounts of posterior shadowing. Types 1,2 and 3 were seen early in infection; types 3 and 4 were present later. Lesion types 2,3 and 4 were also identified on CT scans. In addition, periportal linear areas of increased attenuation, possibly calcified, were identified on follow-up, non-contrast-enhanced CT. Some abscesses were better seen on non-contrast-enhanced CT scans, while others became visible only after iodinated contrast medium was administered intravenously. Although lesions not seen on US were often seen on CT, the opposite was also true. In two cases pathologic proof of candidiasis was established even when all imaging studies were negative. Patients should be studied by US and by CT before and after contrast agent administration for maximum sensitivity. Even when both US and CT are negative, if there is a strong clinical suspicion of candidiasis, open biopsy is recommendediopsy is recommended

94

Comparison between Fluconazole with Oral Protexin Combination and Fluconazole in the Treatment of Vulvovaginal Candidiasis  

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Background. According to the limited studies reporting new treatments for vulvovaginal candidiasis, this study was designed to compare the combination of fluconazole and oral protexin with fluconazole in the treatment of vulvovaginal candidiasis. Methods. A double-blind clinical trial was conducted, involving 90 women who were referred to the gynecology clinic. Vulvovaginal candidiasis was diagnosed with itching, cheesy vaginal discharge, and any one of the following: dysuria, pH < 4.5, dyspareunia, vulvar erythema, or vulvar edema and if branched hyphae and Candida buds were visible after addition of KOH 10% in the culture and the result of cultivation in Sabouraud's dextrose agar medium was positive. Patients were randomly classified into two groups Absence of discharge, itching, and negative culture results 5–7 days after completion of treatment indicated treatment success. Data in this study were analyzed using the SPSS version 17.0 software. Results. The combinations, fluconazole-oral protexin and fluconazole-placebo, were equally effective in reduction of complaints and symptoms, but fluconazole-oral protexin combination elicited a better therapeutic response (?2 = 0.01, P = 6.7). In addition, fluconazole-oral protexin combination treatment demonstrated better recovery time (t = ?2.04, P = 0.04). Conclusion. This study demonstrated that complementary treatment with probiotic Lactobacillus increased the efficacy of fluconazole in treatment of vulvovaginal candidiasis. Further research is recommended. PMID:23119175

Nouraei, S.; Amir Ali Akbari, S.; Jorjani, M.; Alavi Majd, H.; Afrakhteh, M.; Ghafoorian, A.; Tafazzoli Harandi, H.

2012-01-01

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Prevalence of oral candidiasis in hospitalized patients and evaluation of risk factors  

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Full Text Available Introduction: Oral candidiasis (OC is an opportunistic fungalinfection, prevalent mainly in immunosuppressed patients. Objective:To investigate the prevalence of OC in hospitalized patients in twouniversity hospitals of Pontifical Catholic University of Paraná, Curitiba-PR, relating with local and systemic predisposing factors. Material and methods: A total of 160 patients were evaluated between the months of July to October 2006. Besides the analysis of medical records, each patient was questioned and intra-and extra-oral linically evaluated,looking for injuries consistent with candidiasis. Results: The results were analyzed by the tests of the chi-square (x2 and the difference between two ratios, with a level of significance of 5%. Prevalence of oral candidiasis was 30% (n = 48. In relation to the local risk factors, prevalence of oral candidiasis was statistically dependent on the use of upper removable total or partial prosthesis, on the time of use of the same prosthesis, on the use of prosthesis during hospitalization, on the hygiene condition, on the frequency of cleaning and on the continued use of the prosthesis (p < 0.05. Among the systemic factors analyzed,prevalence of oral candidiasis was statistically dependent on the age of the patients and on the use of nasogastric probe (p < 0.05. Conclusion:Results indicate that local risk factors have a strong association with the prevalence of OC in hospitalized patients, emphasizing the importance regarding the oral hygiene care and the prosthesis of these patients, especially the ones that use a nasogastric probe.

Roberta Targa STRAMANDINOLI

2010-03-01

96

Oral Candidiasis in children and adolescents with cancer: Identification of Candida spp  

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Full Text Available SciELO Spain | Language: English Abstract in english Oral candidiasis represents a serious problem for children with cancer. The mortality rate of this infection has increased due to fungal septicemia, associated with a primary buccal infection. Objective: Identify the Candida spp. in buccal lesions of patients with cancer, establish the predominant s [...] pecies and correlate them to age and sex of the patient, clinical presentation, type of neoplasic disease and cytostatic therapy received. Study design: 62 patients, between 0-16 years, were investigated in a cross sectional study. Sample inclusion criteria: Patients with malignant neoplasic disease that were receiving cytostatic treatment and had suspicious lesions of oral candidiasis. Patients with antifungal therapy, active caries, calculus or intraoral appliances were excluded. A clinical evaluation was carried out. The lesion sample was taken and studied by direct exam and culture in CHROMagar-Candida and Sabouraud-Dextrose Agar with chloramphenicol. The identification of the isolated yeast was done by the filamentation test, carbohydrate fermentation and assimilation. Results: Most of the cases (69.35%) were positive to oral candidiasis, C. albicans was the most frequent species found, followed by C. parapsilosis (14.89%), C. tropicalis (12.77%), C. krusei (4.26%), C. glabrata (2.13%) and C. lusitaniae (2.13 %). In some cases more than one specie were isolated (9.30%). The most frequent location of the lesion was in the tongue (72.70%). The pseudomembranous candidiasis was the most frequent clinical presentation found (78.71%). There were not significant statistically differences with regard to sex and age of the patient, type of neoplasic disease and cytostatic agent received. Conclusion: The results suggest that oral candidiasis is a frequent complication in the pediatric oncological population, being C. albicans the main etiological agent, however, there is an important participation of other Candida species.

Haylen, González Gravina; Evelyn, González de Morán; Olga, Zambrano; María, Lozano Chourio; Sofía, Rodríguez de Valero; Sandra, Robertis; Luz, Mesa.

2007-10-01

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Efficacy and tolerability of micafungin monotherapy for candidemia and deep-seated candidiasis in adults with cancer.  

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The response rate among 58 patients with cancer and candidemia or deep-seated candidiasis treated with micafungin monotherapy was 81%. Intensive care unit (ICU) stay, concomitant nonfungal infections, and acute kidney injury were significantly associated with the 30-day crude mortality rate. Severe neutropenia was an independent predictor of micafungin failure. The efficacy and safety of micafungin in cancer patients with invasive candidiasis were comparable to those reported for patients without malignancy and for cancer patients treated with caspofungin. PMID:24637687

Farmakiotis, Dimitrios; Tarrand, Jeffrey J; Kontoyiannis, Dimitrios P

2014-06-01

98

Intermittent prophylactic treatment of recurrent vaginal candidiasis by postmenstrual application of a 500 mg clotrimazole vaginal tablet.  

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The therapeutic efficacy of intermittent, monthly, postmenstrual prophylaxis with a single 500 mg clotrimazole vaginal tablet (n = 33) was compared with placebo tablets (n = 29) in 62 woman (age 28.1, SD 7.2 years) with recurrent vulvovaginal candidiasis. The number of episodes of acute vulvovaginal candidiasis experienced during the year prior to inclusion was 6.3, SD 1.9. The cumulative recurrence frequency after 6 months intermittent prophylaxis with clotrimazole (30.3%) was lower (p less ...

Roth, A. C.; Milsom, I.; Forssman, L.; Wa?hle?n, P.

1990-01-01

99

Candida y candidiasis invasora: un reto continuo para su diagnóstico temprano / Candida and candidiasis: the challenge continues for an early diagnosis  

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Full Text Available SciELO Colombia | Language: Spanish Abstract in spanish La candidiasis invasora representa el 75% de las infecciones por hongos en pacientes hospitalizados, con una mortalidad que alcanza cifras hasta del 78%. La frecuencia de estas infecciones varía de acuerdo con el servicio de hospitalización y los factores de riesgo de los pacientes. Paralelamente, s [...] e han venido observando cambios en la epidemiología de las especies de Candida, variaciones en su prevalencia y en la resistencia a los antimicóticos según su localización geográfica. Por todo lo anterior, es imperativo establecer un diagnóstico temprano que lleve a la identificación correcta de la especie implicada de manera que se instaure un pronto y adecuado tratamiento antimicótico. El diagnóstico de la candidiasis invasora continúa siendo un reto, en el cual combinar los diferentes métodos diagnósticos, los microbiológicos, los inmunológicos y los nuevos moleculares, aún en desarrollo y validación, es la mejor estrategia para lograr un dictamen oportuno. En esta revisión se describen los métodos disponibles, sus limitaciones y las perspectivas de los que están en etapa de desarrollo y validación. En la última década se cuenta con métodos de referencia para la medición de susceptibilidad in vitro a los antimicóticos, lo cual ha permitido conocer los perfiles de sensibilidad de las diferentes especies de Candida a escala mundial y local. Abstract in english Invasive candidiasis represents 75% of fungal infections in hospitalized patients, with reported mortalities up to 78%. The frequency of these infections varies according to the hospital services and the risk factors of the patients. In parallel, changes in the epidemiology of the Candida species ha [...] ve been observed, in particular variations in their prevalence and in their resistance to antifungals according to geographic location. For these reasons it is crucial to establish an early diagnosis that identifies the pathogen to the species level in order to allow an appropriate therapeutic decision. The diagnosis of invasive candidiasis continues to be a challenge, where combining the different available methods (microbiologic, immunologic and new molecular approaches) is the best strategy to achieve a prompt and accurate diagnosis. We review the currently available assays for conventional and molecular diagnosis, their limitations, and the perspectives for assays that are now in development and validation. In the last decade, well established reference methods have become available for testing antifungal susceptibility and this has allowed worldwide and regional sensitivity profiles to be established for the different Candida species.

Catalina, de Bedout; Beatriz L, Gómez.

100

Oral candidiasis as a clinical marker of highly active antiretroviral treatment failure in HIV-infected patients / La candidiasis bucal como marcador clínico de falla a la terapia antirretroviral altamente efectiva en pacientes infectados con VIH/sida  

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Full Text Available SciELO Colombia | Language: English Abstract in spanish Introducción: La candidiasis bucal es una infección oportunista fácilmente detectable en la clínica, por lo que se ha utilizado para valorar tanto el estado inmunológico de los pacientes con VIH como la efectividad de la terapia antirretroviral, altamente efectiva debido a que se encuentra sujeta a [...] diversos factores para lograr el éxito terapéutico. Objetivo: Determinar la frecuencia de candidiasis bucal entre indicadores asociados al éxito de la terapia antirretroviral. Material y método: Estudio transversal, analítico en donde inicialmente se realizaron grupos de acuerdo al uso o no de la terapia antirretroviral para proseguir con un interrogatorio que incluía preguntas sobre otros factores relacionados con la infección por cándida, así como la medición del flujo salival y la evaluación clínica de la cavidad bucal para determinar la frecuencia de la candidiasis. Resultados: La diferencia en la frecuencia de la candidiasis bucal entre los grupos con y sin terapia antirretroviral fue significativa, además de obtener una OR = 2,6 (1,58-4,48) y la asociación con la disminución en el conteo de linfocitos de CD4. Discusión: La resistencia a la terapia antirretroviral constituye uno de los problemas fundamentales en el éxito del tratamiento, en los pacientes infectados con virus de la inmunodeficiencia humana, al igual que las toxicidades y los problemas de adherencia. Los sensores clínicos como la candidiasis bucal son parámetros de fácil acceso para la detección temprana de falla en la terapia. Abstract in english Introduction: Oral candidiasis is an opportunistic infection that is readily detectable in the clinic. It has been used to assess the immune status of HIV patients as well as the effectiveness of highly active antiretroviral therapy. Objective: To determine the frequency of oral candidiasis infectio [...] n among various indicators associated with antiretroviral therapy effectiveness. Material and methods: Cross-sectional and analytical study, in which groups were initially created based on the use or not of antiretroviral therapy. Participants were subjected to questions on factors related to Candida infection, salivary flow measurements and a clinical examination of the oral cavity to determine the frequency of candidiasis Results: The difference in the frequency of oral candidiasis between groups with and without antiretroviral therapy was significant (OR 2.6 IC95% 1.5-4.4). There were also a significant association with decreased number of CD4 lymphocytes.. Discussion: Resistance to anti-retroviral therapy constitutes one of the fundamental barriers to a successful treatment in patients infected with the human immunodeficiency virus, as do toxicities and adherence problems. Clinical markers such oral candidiasis is an easily and accesible parameter for the early detection of treatment failure.

Sandra, Lopez-Verdin; Amalia, Torrecilla-Ramirez; Ana Cristina, Horta-Sandoval; Jaime Federico, Andrade-Villanueva; Ronell, Bologna-Molina.

2014-06-01

 
 
 
 
101

Chronic mucocutaneous candidiasis: a case with exuberant cutaneous horns in nipples  

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Full Text Available SciELO Brazil | Language: English Abstract in english Chronic mucocutaneous candidiasis is a rare disorder characterized by persistent and recurrent infections by Candida due to changes in cellular immunity and may be associated with autoimmune endocrine disorders. It is refractory to the usual antifungal treatments, which merely control it with imidaz [...] ole derivatives. This reports the case of a 50-year-old female patient who referred vaginal discharge associated with vulvar ulcerated lesions and whitish plaques on oral and genital mucous membranes of onset in adolescence besides cutaneous horns in nipples. The clinical picture, family history, culture and anatomopathological studies were consistent with chronic infection by candida. Treatment with systemic antifungals obtained partial response of lesions characterizing a clinical picture of Chronic Mucocutaneous Candidiasis.

Antônio, Chambô Filho; João Basilio de, Souza Filho; Christine Chambô, Pignaton; Ingrid, Zon; Alan Santos, Fernandes; Lia Quintaes, Cardoso.

2014-07-01

102

Sertaconazole: an antifungal agent for the topical treatment of superficial candidiasis.  

Science.gov (United States)

Sertaconazole is a useful antifungal agent against mycoses of the skin and mucosa, such as cutaneous, genital and oral candidiasis and tinea pedis. Its antifungal activity is due to inhibition of the ergosterol biosynthesis and disruption of the cell wall. At higher concentrations, sertaconazole is able to bind to nonsterol lipids of the fungal cell wall, increasing the permeability and the subsequent death of fungal cells. Fungistatic and fungicidal activities on Candida are dose-dependent. The antifungal spectrum of sertaconazole includes deramophytes, Candida, Cryptococcus, Malassezia and also Aspergillus, Scedosporium and Scopulariopsis. Sertaconazole also shows an antimicrobial activity against streptococci, staphylococci and protozoa (Trichomonas). In clinical trials including patients with vulvovaginal candidiasis, a single dose of sertaconazole produced a higher cure rate compared with other topical azoles such as econazole and clotrimazole, in shorter periods. Sertaconazole has shown an anti-inflammatory effect that is very useful for the relief of unpleasant symptoms. PMID:23566144

Carrillo-Muñoz, Alfonso Javier; Tur-Tur, Cristina; Giusiano, Gustavo; Marcos-Arias, Cristina; Eraso, Elena; Jauregizar, Nerea; Quindós, Guillermo

2013-04-01

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A case of hypopituitarism associated with Hashimoto's thyroiditis and candidiasis: lymphocytic hypophysitis or Sheehan's syndrome?  

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Sheehan's syndrome and lymphocytic hypophysitis often occur in relation to pregnancy, making their differentiation difficult. We describe a 52-yr-old woman with hypopituitarism, Hashimoto's thyroiditis and candidiasis. She was admitted to our hospital because of nausea, vomiting and constipation. Her menstruation stopped in her early thirties. She thereafter developed kyphosis and loss of axillary and pubic hair. Levels of serum Na, Cl and glucose were all low, and hormonal studies were consistent with anterior pituitary hypofunction. Although she had blood transfusion because of hemorrhage at her first delivery, the delivery of her second child was normal followed by resumption of regular menstruation. In addition to hypopituitarism, she had Hashimoto's thyroiditis and candidiasis. Laboratory tests showed an increased Thl ratio, which is related to induction of cellular immunity, and the presence of HLA DR4, which is often associated with polyglandular autoimmune syndrome. These results suggested that the pituitary lesion might be due to lymphocytic hypophysitis rather than Sheehan's syndrome. PMID:11789564

Iwaoka, T

2001-10-01

104

Factors involved in patient choice of oral or vaginal treatment for vulvovaginal candidiasis  

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Full Text Available Jack D SobelDivision of Infectious Diseases, Wayne State University School of Medicine, Detroit, MI, USAAbstract: Vulvovaginal candidiasis (VVC is an extremely common cause of vaginal symptoms in women. Multiple antifungal products are available by either the oral or vaginal route, although no new drugs have become available for two decades. Given the therapeutic equivalence of the antimycotic agents and their routes of administration, the specific drug and formulation selected is entirely arbitrary in relation to final treatment outcome. Nevertheless, multiple factors affecting preference, both practitioner-dependent and patient-dependent, impact on selection of a specific drug and route of administration.Keywords: antifungal drugs, antimycotics, Candida vaginitis, vulvovaginal candidiasis

Sobel JD

2013-12-01

105

Development of Film Dosage Forms Containing Miconazole for the Treatment of Oral Candidiasis  

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Full Text Available Film dosage forms (FDs containing miconazole (MCZ for the treatment of oral candidiasis were prepared using water-soluble polysaccharides, and the dissolution profiles of MCZ from the FDs were investigated. In addition, the forms were modified by the addition of a surface active agent to accelerate the drug dissolution rate. Circular films incorporating MCZ were obtained using each polysaccharide. Most FDs were easy to handle and resistant to tearing. No diffraction peaks were observed in the X-ray diffractograms of FDs. FDs prepared with sodium alginate or pullulan immediately swelled and disintegrated in aqueous medium, whereas MCZ incorporated in the FD gradually dissolved. A marked acceleration in the MCZ dissolution rate was observed when FD was prepared with polysaccharide containing a surfactant. These results confirmed that modified FDs are useful for treating localized conditions in the oral cavity, such as oral candidiasis, and that FDs can simplify the administration of drugs to patients.

Yoshifumi Murata

2013-05-01

106

Chronic mucocutaneous candidiasis: a case with exuberant cutaneous horns in nipples*  

Science.gov (United States)

Chronic mucocutaneous candidiasis is a rare disorder characterized by persistent and recurrent infections by Candida due to changes in cellular immunity and may be associated with autoimmune endocrine disorders. It is refractory to the usual antifungal treatments, which merely control it with imidazole derivatives. This reports the case of a 50-year-old female patient who referred vaginal discharge associated with vulvar ulcerated lesions and whitish plaques on oral and genital mucous membranes of onset in adolescence besides cutaneous horns in nipples. The clinical picture, family history, culture and anatomopathological studies were consistent with chronic infection by candida. Treatment with systemic antifungals obtained partial response of lesions characterizing a clinical picture of Chronic Mucocutaneous Candidiasis. PMID:25054753

Chambo, Antonio; de Souza, Joao Basilio; Pignaton, Christine Chambo; Zon, Ingrid; Fernandes, Alan Santos; Cardoso, Lia Quintaes

2014-01-01

107

Chronic mucocutaneous candidiasis: a case with exuberant cutaneous horns in nipples  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: English Abstract in english Chronic mucocutaneous candidiasis is a rare disorder characterized by persistent and recurrent infections by Candida due to changes in cellular immunity and may be associated with autoimmune endocrine disorders. It is refractory to the usual antifungal treatments, which merely control it with imidaz [...] ole derivatives. This reports the case of a 50-year-old female patient who referred vaginal discharge associated with vulvar ulcerated lesions and whitish plaques on oral and genital mucous membranes of onset in adolescence besides cutaneous horns in nipples. The clinical picture, family history, culture and anatomopathological studies were consistent with chronic infection by candida. Treatment with systemic antifungals obtained partial response of lesions characterizing a clinical picture of Chronic Mucocutaneous Candidiasis.

Antônio, Chambô Filho; João Basilio de, Souza Filho; Christine Chambô, Pignaton; Ingrid, Zon; Alan Santos, Fernandes; Lia Quintaes, Cardoso.

108

Congenital candidiasis: confirmation of mother-neonate transmission using molecular analysis techniques.  

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We describe a case of congenital acquired candidiasis in a preterm female delivered through Caesarean section due to the premature rupture of the amniotic membrane. The neonate presented with suspected chorioamnionitis and erythematous desquamative skin. Candida albicans was isolated from the placenta, mouth, groin, and periumbilical lesions. The infant developed candidemia due to Candida albicans and the same yeast was also isolated from a catheter. Culture inoculated with swabs from the mouth and vagina of the mother yielded C. albicans and C. krusei. All C. albicans isolates from the mother and the neonate were visually indistinguishable by molecular typing techniques which included chromosomal karyotyping and restriction endonuclease analysis followed by pulsed-field gel electrophoresis. These findings allowed the clinical condition to be confirmed as congenital acquisition of candidiasis in this case. PMID:19306215

Tiraboschi, Iris Carla Niveyro; Niveyro, Carla; Mandarano, Ana Maria; Messer, Shawn A; Bogdanowicz, Elizabeth; Kurlat, Isabel; Lasala, María Beatriz

2010-02-01

109

Effect of Streptococcus salivarius K12 on the In Vitro Growth of Candida albicans and Its Protective Effect in an Oral Candidiasis Model  

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Oral candidiasis is often accompanied by severe inflammation, resulting in a decline in the quality of life of immunosuppressed individuals and elderly people. To develop a new oral therapeutic option for candidiasis, a nonpathogenic commensal oral probiotic microorganism, Streptococcus salivarius K12, was evaluated for its ability to modulate Candida albicans growth in vitro, and its therapeutic activity in an experimental oral candidiasis model was tested. In vitro inhibition of mycelial gr...

Ishijima, Sanae A.; Hayama, Kazumi; Burton, Jeremy P.; Reid, Gregor; Okada, Masashi; Matsushita, Yuji; Abe, Shigeru

2012-01-01

110

Antifungal treatment with carvacrol and eugenol of oral candidiasis in immunosuppressed rats  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: English Abstract in english Carvacrol and eugenol, the main (phenolic) components of essential oils of some aromatic plants, were evaluated for their therapeutic efficacy in the treatment of experimental oral candidiasis induced by Candida albicans in immunosuppressed rats. This anticandidal activity was analyzed by microbiolo [...] gical and histopathological techniques, and it was compared with that of nystatin, which was used as a positive control. Microbiologically, carvacrol and eugenol significantly (p

N., Chami; F., Chami; S., Bennis; J., Trouillas; A., Remmal.

111

New mechanism of oral immunity to mucosal candidiasis in hyper-IgE syndrome  

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Oropharyngeal candidiasis (OPC, thrush) is an opportunistic infection caused by the commensal fungus Candida albicans. An understanding of immunity to Candida has recently begun to unfold with the identification of fungal pattern-recognition receptors such as C-type lectin receptors, which trigger protective T-helper (Th)17 responses in the mucosa. Hyper-IgE syndrome (HIES/Job’s syndrome) is a rare congenital immunodeficiency characterized by dominant-negative mutations in signal transducer...

Conti, Hr; Baker, O.; Freeman, Af; Jang, Ws; Holland, Sm; Li, Ra; Edgerton, M.; Gaffen, Sl

2011-01-01

112

?-D-Glucan Assay in Diagnosis and Monitoring the Systemic Candidiasis in a Rat Model  

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Full Text Available Background: Determination of ?-D-Glucan (BDG in the serum aids to diagnose the invasive fungal infections. The current study evaluated the diagnostic potential value of BDG assay in monitoring the disease in experimental systemic candidiasis in a rat model. The results can provide a useful preliminary data to improve this approach in developing countries. Objectives: The present study aimed to evaluate ?-D-Glucan assay in diagnosis and monitoring the systemic candidiasis in a rat model. Materials and Methods: Twenty one rats were infected with 106 Candida albicans blastospore per rat. Twelve rats were considered as the negative controls (six immunocompromised rats without infection and six intact rats. During a week, every 24 hours the BDG sera level was determined by both Fungitell and Wako kits. To confirm the systemic infection in each rat, the suspensions of their internal organs were cultivated on agar plates and the number of colony forming units (CFU of C. albicans was counted. Results: All the infected rats were positive with BDG tests. An increasing level of BDG was observed during early days after injection. The cutoff value for discrimination of BDG positive sera was obtained from the negative sera by the Fungitell kit. The sensitivity, specificity, positive and negative predictive values assessed for the Fungitell kit were 95%, 66.6%, 90.47% and 80%, respectively. These criteria for those of Wako were 90%, 83.3%, 94.7% and 71.4%, respectively. Conclusions: While BDG assay seems to be a sensitive and specific adjunctive tool to diagnose and monitor the experimental systemic candidiasis, it seems that measuring the positive cutoff value in different laboratory conditions is necessary for favorable establishment of these tests. Keywords: Beta-D-glucan; Systemic candidiasis; Diagnosis

Hossein Khodadadi

2014-06-01

113

Aislamiento, identificación y tipificación de levaduras en pacientes VIH positivos con candidiasis oral  

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Se realizó un estudio de candidiasis oral a 25 pacientes VIH positivos y SIDA. La forma clínica de presentación predominante fue la pseudomembranosa y las especies de levadura más frecuentes en los aislamientos fueron Candida albicans (54,1 %), Candida tropicalis (8,1 %) y Torulopsis glabrata (8,1 %). Se demostró que los pacientes con infecciones recurrentes suelen tener colonización de la cavidad oral por múltiples cepas y/o especies de levaduras con mayor frecuencia (30,8 %) que los ...

GERARDO MARTÍNEZ MACHÍN; MAYDA PERURENA LANCHA; JOSÉ NÚÑEZ CARVAJAL; Ferna?ndez Andreu, Carlos M.; FRANCISCO BANDERA TIRADO

1997-01-01

114

Immunological Effects of Honey Bee Venom in Mice with Intracerebral Candidiasis  

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Bee Venom (BV) is a natural substance, reported to booster the immune system. This study aimed at evaluating the effects of bee venom in stimulation of the immune system in mice infected with intracerebral Candidiasis probing for its possible use in treatment of this ailment. In vivo study included three groups of mice; bee venom-treated Candida infected group, untreated Candida-infected group and control group. Mice in the first two groups received intracerebral (...

Saleh, Nermine K. M.; Elsayed, Abeer A.

2009-01-01

115

Prevalence and Predisposing Factors to Candidiasis Infection in Women Supported by Health Centers of Tabriz, 2004.  

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Full Text Available Introduction: Vaginits is probably the most common infection in women during their reproductive years, resulting in 5-10 million health-care visits a year, worldwide. Vulvovaginal candidiasis (vvc is the second-most common form of vaginitis in the United States, which is associated with use of oral contraceptives containing high levels of estrogen and hormonal therapies. Midwives play an important role not only in the assessment and management of vaginal infections, but also in educating women about vaginal health. Recognizing risk factors associated with infections are the key to vaginal health.The aim of this study was to determine the prevalence and risk factors of Candidal vaginitis in women referring to Tabriz health centers. Methods: This was a cross sectional study carried out on 1000 women aged 15-49 years who were selected by multiple random method. A sample of vaginal discharge was taken from the posterior fornix of the cervix and from the vaginal wall using sterile cotton swabs. The mycelium was observed by microscopic examination of a wet mount of the secretions. Another sample was taken for culturing in Agar sabura and transported to the laboratory. In addition, questionnaires with personal and reproductive information were completed. Data was analyzed by using SPSS version 15 and chi-square and, t student statistical tests were used for analysis. Results : This investigation indicated that prevalence of candidiasis was 25.2%. There was no meaningful statistical relationship between age, marriage age, occupation, education status, body mass index, day of menstruation cycle and abortion history with candidal vaginitis (p>.05,but a statistically significant relationship was observed between number of deliveries, vaginal Ph with candidiasis. Also, there was a reverse statistical relationship between OCP, DMPA methods and candidiasis. Conclusion: Midwives and other health professionals have an important role to play by giving more information to women about infections and associated risk factors, thus improving their quality of life.

J Babapour

2007-04-01

116

Endogenous Thrombospondin-1 Regulates Leukocyte Recruitment and Activation and Accelerates Death from Systemic Candidiasis  

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Disseminated Candida albicans infection results in high morbidity and mortality despite treatment with existing antifungal drugs. Recent studies suggest that modulating the host immune response can improve survival, but specific host targets for accomplishing this goal remain to be identified. The extracellular matrix protein thrombospondin-1 is released at sites of tissue injury and modulates several immune functions, but its role in C. albicans pathogenesis has not been investigated. Here, we show that mice lacking thrombospondin-1 have an advantage in surviving disseminated candidiasis and more efficiently clear the initial colonization from kidneys despite exhibiting fewer infiltrating leukocytes. By examining local and systemic cytokine responses to C. albicans and other standard inflammatory stimuli, we identify a crucial function of phagocytes in this enhanced resistance. Subcutaneous air pouch and systemic candidiasis models demonstrated that endogenous thrombospondin-1 enhances the early innate immune response against C. albicans and promotes activation of inflammatory macrophages (inducible nitric oxide synthase+, IL-6high, TNF-?high, IL-10low), release of the chemokines MIP-2, JE, MIP-1?, and RANTES, and CXCR2-driven polymorphonuclear leukocytes recruitment. However, thrombospondin-1 inhibited the phagocytic capacity of inflammatory leukocytes in vivo and in vitro, resulting in increased fungal burden in the kidney and increased mortality in wild type mice. Thus, thrombospondin-1 enhances the pathogenesis of disseminated candidiasis by creating an imbalance in the host immune response that ultimately leads to reduced phagocytic function, impaired fungal clearance, and increased mortality. Conversely, inhibitors of thrombospondin-1 may be useful drugs to improve patient recovery from disseminated candidiasis. PMID:23144964

Martin-Manso, Gema; Navarathna, Dhammika H. M. L. P.; Galli, Susana; Soto-Pantoja, David R.; Kuznetsova, Svetlana A.; Tsokos, Maria; Roberts, David D.

2012-01-01

117

Efficacy of caspofungin in a juvenile mouse model of central nervous system candidiasis.  

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Neonatal candidiasis is an increasingly common occurrence causing significant morbidity and mortality and a higher risk of dissemination to the central nervous system (CNS) than that seen with older patients. The current understanding of optimal antifungal therapy in this setting is limited. We have developed a model of disseminated candidiasis with CNS involvement in juvenile mice to assess the efficacy of the echinocandin caspofungin relative to amphotericin B (AmB). Juvenile mice were inoculated intravenously with 5.64 × 10(4) CFU of Candida albicans MY1055. Treatment with caspofungin at 1, 2, 4, and 8 mg/kg of body weight/day, AmB at 1 mg/kg/day, or a vehicle control (VC) was initiated 30 h after infection and continued for 7 days. Pharmacokinetic parameters for caspofungin were also determined. Culture and histology showed evidence of disseminated candidiasis with multifocal encephalitis at the start of antifungal therapy. Survival was 100% in all treated groups, while mortality was 100% in the VC by day 11 after infection. By day 5, all mice in the caspofungin treatment (four doses) groups showed reductions in kidney and brain burden relative to the VC, while AmB treatment reduced kidney burden but gave no reduction of brain fungal burden. Systemic levels of caspofungin were similar in infected and uninfected mice, while brain levels were higher in infected animals. In this juvenile mouse model, caspofungin demonstrated dose-dependent activity, equivalent to or better than that of AmB at 1 mg/kg, against disseminated candidiasis with CNS involvement. PMID:21518846

Flattery, Amy M; Hickey, Emily; Gill, Charles J; Powles, Mary Ann; Misura, Andrew S; Galgoci, Andrew M; Ellis, Joan D; Zhang, Rena; Sandhu, Punam; Ronan, John; Abruzzo, George K

2011-07-01

118

Single-dose tioconazole compared with 3-day clotrimazole treatment in vulvovaginal candidiasis.  

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A total of 80 patients were equally randomized to receive a single dose of 6.5% tioconazole ointment or a 3-day course of 100-mg clotrimazole vaginal tablets for the treatment of vulvovaginal candidiasis. Of the 32 evaluable patients treated with tioconazole, 27 (84%) remained asymptomatic 4 weeks posttreatment, compared with 28 of 33 patients (85%) treated with clotrimazole. A total of 34 patients in each group could be evaluated for mycological response based on culture results 1 and 4 week...

Stein, G. E.; Gurwith, D.; Mummaw, N.; Gurwith, M.

1986-01-01

119

Placebo-controlled trial of itraconazole for treatment of acute vaginal candidiasis.  

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Itraconazole is a new orally active triazole antifungal agent with enhanced activity against Candida species. In the clinical trial described in this paper, we compared the efficacy and safety of itraconazole capsules with those of clotrimazole vaginal tablets and placebo oral capsules for women with acute vulvovaginal candidiasis. Ninety-five patients were randomized in a 2:1:1 fashion to receive itraconazole (200 mg/day), clotrimazole (200 mg/day), or placebo (two capsules per day) for 3 co...

Stein, G. E.; Mummaw, N.

1993-01-01

120

Patterns of Expression of Vaginal T-Cell Activation Markers during Estrogen-Maintained Vaginal Candidiasis  

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The immunosuppressive activity of estrogen was further investigated by assessing the pattern of expression of CD25, CD28, CD69, and CD152 on vaginal T cells during estrogen-maintained vaginal candidiasis. A precipitous and significant decrease in vaginal fungal burden toward the end of week 3 postinfection was concurrent with a significant increase in vaginal lymphocyte numbers. During this period, the percentage of CD3+, CD3+CD4+, CD152+, a...

Al-Sadeq Ameera; Hamad Mawieh; Abu-Elteen Khaled

2008-01-01

 
 
 
 
121

Antifungal treatment with carvacrol and eugenol of oral candidiasis in immunosuppressed rats  

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Carvacrol and eugenol, the main (phenolic) components of essential oils of some aromatic plants, were evaluated for their therapeutic efficacy in the treatment of experimental oral candidiasis induced by Candida albicans in immunosuppressed rats. This anticandidal activity was analyzed by microbiological and histopathological techniques, and it was compared with that of nystatin, which was used as a positive control. Microbiologically, carvacrol and eugenol significantly (p<0.05) reduced the ...

Chami, N.; Chami, F.; Bennis, S.; Trouillas, J.; Remmal, A.

2004-01-01

122

Antifungal treatment with carvacrol and eugenol of oral candidiasis in immunosuppressed rats  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: English Abstract in english Carvacrol and eugenol, the main (phenolic) components of essential oils of some aromatic plants, were evaluated for their therapeutic efficacy in the treatment of experimental oral candidiasis induced by Candida albicans in immunosuppressed rats. This anticandidal activity was analyzed by microbiolo [...] gical and histopathological techniques, and it was compared with that of nystatin, which was used as a positive control. Microbiologically, carvacrol and eugenol significantly (p

N., Chami; F., Chami; S., Bennis; J., Trouillas; A., Remmal.

2004-06-01

123

Molecular Analysis of Fungal Populations in Patients with Oral Candidiasis Using Internal Transcribed Spacer Region  

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Oral candidiasis is closely associated with changes in the oral fungal flora and is caused primarily by Candida albicans. Conventional methods of fungal culture are time-consuming and not always conclusive. However, molecular genetic analysis of internal transcribed spacer (ITS) regions of fungal rRNA is rapid, reproducible and simple to perform. In this study we examined the fungal flora in patients with oral candidiasis and investigated changes in the flora after antifungal treatment using length heterogeneity-polymerization chain reaction (LH-PCR) analysis of ITS regions. Fifty-two patients with pseudomembranous oral candidiasis (POC) and 30 healthy controls were included in the study. Fungal DNA from oral rinse was examined for fungal species diversity by LH-PCR. Fungal populations were quantified by real-time PCR and previously-unidentified signals were confirmed by nucleotide sequencing. Relationships between the oral fungal flora and treatment-resistant factors were also examined. POC patients showed significantly more fungal species and a greater density of fungi than control individuals. Sixteen fungi were newly identified. The fungal populations from both groups were composed predominantly of C. albicans, though the ratio of C. dubliniensis was significantly higher in POC patients than in controls. The diversity and density of fungi were significantly reduced after treatment. Furthermore, fungal diversity and the proportion of C. dubliniensis were positively correlated with treatment duration. These results suggest that C. dubliniensis and high fungal flora diversity might be involved in the pathogenesis of oral candidiasis. We therefore conclude that LH-PCR is a useful technique for diagnosing and assessing the severity of oral candidal infection. PMID:24979710

Ieda, Shinsuke; Moriyama, Masafumi; Takashita, Toru; Maehara, Takashi; Imabayashi, Yumi; Shinozaki, Shoichi; Tanaka, Akihiko; Hayashida, Jun-Nosuke; Furukawa, Sachiko; Ohta, Miho; Yamashita, Yoshihisa; Nakamura, Seiji

2014-01-01

124

Invasive Candidiasis due to Candida Norvegensis in a Liver Transplant Patient: Case Report and Literature Review.  

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Candida norvegensis is an emerging fluconazole-resistant pathogen isolated in most cases from skin and mucous membranes of immunocompromized patients. Documented invasive candidiasis (IC) due to C. norvegensis has been rarely reported, thus the clinical features of patients at risk for this pathogen are poorly defined. We report a liver transplant patient who developed IC due to C. norvegensis and review other cases of C. norvegensis IC published in the literature. PMID:25002960

Musso, Maria; Giannella, Maddalena; Antonini, Mario; Bordi, Eugenio; Ettorre, Giuseppe Maria; Tessitore, Loretta; Mariano, Andrea; Capone, Alessandro

2014-05-13

125

[Vaginal candidiasis: etiology and sensitivity profile to antifungal agents in clinical use].  

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Candida vaginitis is one of the most frequent infection of the female genital tract with a high incidence. Approximately 75% of sexually active women suffer at least one episode of Candida vaginitis and 10% of them have recurrent episodes. Pregnancy, diabetes mellitus and antibiotic treatment are the most common predisposing factors, C. albicans is the etiologic agent most frequently found. The widespread reports of fluconazole resistance in Candida species and the selection of non Candida albicans prompted the study of species distribution of vulvovaginal candidiasis and their in vitro susceptibility against current antifungal agents. A total of 314 women with vaginal infection were studied. Yeasts were isolated from 104 patients with vulvovaginal candidiasis. The following species were identified: C. albicans 87.5%, C. glabrata 8.6% and 3.9% included C. krusei, C. famata, C. tropicalis and S. cerevisiae. The minimal inhibitory concentration (MIC) was determined for nystatin, isoconazole, fluconazole and ketoconazole, using a broth microdilution method based on NCCLS procedure. Although most of the isolates were C. albicans, the high percentage of C. glabrata recovered suggests the need to identify the yeasts isolated. Fluconazole resistant C. albicans were isolated in 13.46% of the cases. Thus, further studies are required to correlate the possible role of these strains in recurrent vulvovaginal candidiasis. PMID:11833253

Saporiti, A M; Gómez, D; Levalle, S; Galeano, M; Davel, G; Vivot, W; Rodero, L

2001-01-01

126

Activity of potent and selective host defense peptide mimetics in mouse models of oral candidiasis.  

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There is a strong need for new broadly active antifungal agents for the treatment of oral candidiasis that not only are active against many species of Candida, including drug-resistant strains, but also evade microbial countermeasures which may lead to resistance. Host defense peptides (HDPs) can provide a foundation for the development of such agents. Toward this end, we have developed fully synthetic, small-molecule, nonpeptide mimetics of the HDPs that improve safety and other pharmaceutical properties. Here we describe the identification of several HDP mimetics that are broadly active against C. albicans and other species of Candida, rapidly fungicidal, and active against yeast and hyphal cultures and that exhibit low cytotoxicity for mammalian cells. Importantly, specificity for Candida over commensal bacteria was also evident, thereby minimizing potential damage to the endogenous microbiome which otherwise could favor fungal overgrowth. Three compounds were tested as topical agents in two different mouse models of oral candidiasis and were found to be highly active. Following single-dose administrations, total Candida burdens in tongues of infected animals were reduced up to three logs. These studies highlight the potential of HDP mimetics as a new tool in the antifungal arsenal for the treatment of oral candidiasis. PMID:24752272

Ryan, Lisa K; Freeman, Katie B; Masso-Silva, Jorge A; Falkovsky, Klaudia; Aloyouny, Ashwag; Markowitz, Kenneth; Hise, Amy G; Fatahzadeh, Mahnaz; Scott, Richard W; Diamond, Gill

2014-07-01

127

Galectin-3 plays an important role in protection against disseminated candidiasis.  

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Recent in vitro studies have implicated galectin-3 as an important receptor in host recognition and response to specific Candida species; however, its role in protection against disseminated candidiasis in vivo has not been evaluated. This study investigated the importance of galectin-3 in host defense against systemic infection with the highly virulent species Candida albicans, and the less virulent species, C. parapsilosis. Mice deficient in galectin-3 (gal3-/-) were more susceptible to infection than wild-type (WT) mice. When infected with C. albicans, gal3-/- mice died significantly faster and exhibited a trend towards increased fungal burden and increased abscess formation in infected brains compared to WT mice. When infected with C. parapsilosis, gal3-/- mice had significantly higher renal fungal burdens and abscess formation compared to WT mice. To evaluate whether galectin-3 may contribute to susceptibility to candidiasis in human infants, galectin-3 levels in sera of newborn infants, a patient population uniquely susceptible to infections with both C. albicans and C. parapsilosis, were compared to serum galectin-3 levels of adults. Galectin-3 levels were significantly lower in newborn infant sera compared to adult sera. These data indicate that galectin-3 plays an important role in a murine model of disseminated candidiasis and suggest a potential mechanism of neonatal susceptibility to these infections. PMID:23488971

Linden, Jennifer R; De Paepe, Monique E; Laforce-Nesbitt, Sonia S; Bliss, Joseph M

2013-08-01

128

Clinical assessment of oral mucositis and candidiasis compare to chemotherapic nadir in transplanted patients  

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Full Text Available SciELO Brazil | Language: English Abstract in english Oral mucositis is a chief complication in patients undergoing hematopoietic stem cell transplantation (HSCT). It is considered a toxic inflammatory reaction that interferes with the patient’s recuperation and quality of life. Oral candidiasis is a common fungal infection observed in dental practice, [...] particularly in immunocompromised patients. The aim of this study was to evaluate the presence of oral mucositis and oral candidiasis in patients who underwent HSCT and their correlation with the chemotherapeutic nadir (lowest possible outcome). We evaluated patients with different diagnoses who underwent HSCT at the Hospital Erasto Gaertner. No chemotherapeutic nadir curves could be associated with mucositis, and patients had different presentations of mucositis. No patient developed oral candidiasis during hospitalization. Together with cell counts, we collected demographic data including age, oral hygiene, habits harmful to health, and the use of oral prostheses. It was observed that patients who smoked cigarettes before hospitalization showed less mucositis, resulting in no feeding problems or other comorbid conditions due to the effect of mucositis. However, the nadir of the chemotherapy curve, in isolation, is not a predictive tool for the appearance (or no appearance) of oral mucositis.

PATUSSI, Cleverson; SASSI, Laurindo Moacir; MUNHOZ, Eduardo Ciliao; ZANICOTTI, Roberta Targa Stramandinoli; SCHUSSEL, Juliana Lucena.

2014-09-26

129

NDV-3 protects mice from vulvovaginal candidiasis through T- and B-cell immune response.  

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We have previously reported that vaccination with rAls3p-N protein of Candida albicans, formulated with alum adjuvant (also designated as NDV-3) protects immunocompetent mice from, lethal disseminated candidiasis and mucosal oropharyngeal candidiasis. NDV-3 vaccine was recently, tested in a Phase 1 clinical trial and found to be safe, well-tolerated, and induced robust humoral and, cellular immune responses with increased interferon (IFN)-gamma and interleukin (IL)-17 secretion. In preparation for a Phase 2 clinical trial against vulvovaginal candidiasis (VVC), we evaluated NDV-3, efficacy in a murine VVC model. Here, NDV-3 induced a strong immune response characterized by high, anti-rAls3p-N serum IgG and vaginal IgA titers. Furthermore, moderate doses of the vaccine (a range of 1-30?g given subcutaneously [SQ] or 0.3-10?g given intramuscularly [IM]) elicited a 10-1000 fold, decrease in vaginal fungal burden vs. control (mice injected with alum adjuvant alone) in both inbred, and outbred mice infected with different clinical C. albicans isolates. Additionally, NDV-3 required both, T and B lymphocytes for efficacy in reducing C. albicans tissue burden, which is followed by a reduction, in neutrophil influx to the affected site. Finally, anti-rAls3p-N antibodies enhanced the ex vivo killing, of C. albicans by neutrophils primed with IFN-gamma. These data indicate that NDV-3 protects mice, from VVC by a mechanism that involves the concerted priming of both humoral and adaptive immune, responses. PMID:24063977

Ibrahim, Ashraf S; Luo, Guanpingsheng; Gebremariam, Teclegiorgis; Lee, Hongkyu; Schmidt, Clint S; Hennessey, John P; French, Samuel W; Yeaman, Michael R; Filler, Scott G; Edwards, John E

2013-11-12

130

Treatment of asymptomatic vaginal candidiasis in pregnancy to prevent preterm birth: an open-label pilot randomized controlled trial  

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Full Text Available Abstract Background Although the connection between ascending infection and preterm birth is undisputed, research focused on finding effective treatments has been disappointing. However evidence that eradication of Candida in pregnancy may reduce the risk of preterm birth is emerging. We conducted a pilot study to assess the feasibility of conducting a large randomized controlled trial to determine whether treatment of asymptomatic candidiasis in early pregnancy reduces the incidence of preterm birth. Methods We used a prospective, randomized, open-label, blinded-endpoint (PROBE study design. Pregnant women presenting at Candida were randomized to 6-days of clotrimazole vaginal pessaries (100mg or usual care (screening result is not revealed, no treatment. The primary outcomes were the rate of asymptomatic vaginal candidiasis, participation and follow-up. The proposed primary trial outcome of spontaneous preterm birth Results Of 779 women approached, 500 (64% participated in candidiasis screening, and 98 (19.6% had asymptomatic vaginal candidiasis and were randomized to clotrimazole or usual care. Women were not inconvenienced by participation in the study, laboratory testing and medication dispensing were problem-free, and the follow-up rate was 99%. There was a tendency towards a reduction in spontaneous preterm birth among women with asymptomatic candidiasis who were treated with clotrimazole RR = 0.33, 95%CI 0.04-3.03. Conclusions A large, adequately powered, randomized trial of clotrimazole to prevent preterm birth in women with asymptomatic candidiasis is both feasible and warranted. Trial registration Australia and New Zealand Clinical Trials Register (ANZCTR: ACTRN12609001052224

Rickard Kristen

2011-03-01

131

Factors involved in patient choice of oral or vaginal treatment for vulvovaginal candidiasis.  

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Vulvovaginal candidiasis (VVC) is an extremely common cause of vaginal symptoms in women. Multiple antifungal products are available by either the oral or vaginal route, although no new drugs have become available for two decades. Given the therapeutic equivalence of the antimycotic agents and their routes of administration, the specific drug and formulation selected is entirely arbitrary in relation to final treatment outcome. Nevertheless, multiple factors affecting preference, both practitioner-dependent and patient-dependent, impact on selection of a specific drug and route of administration. PMID:24368881

Sobel, Jack D

2013-01-01

132

Antifungal treatment with carvacrol and eugenol of oral candidiasis in immunosuppressed rats  

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Full Text Available Carvacrol and eugenol, the main (phenolic components of essential oils of some aromatic plants, were evaluated for their therapeutic efficacy in the treatment of experimental oral candidiasis induced by Candida albicans in immunosuppressed rats. This anticandidal activity was analyzed by microbiological and histopathological techniques, and it was compared with that of nystatin, which was used as a positive control. Microbiologically, carvacrol and eugenol significantly (p<0.05 reduced the number of colony forming units (CFU sampled from the oral cavity of rats treated for eight consecutive days, compared to untreated control rats. Treatment with nystatin gave similar results. Histologically, the untreated control animals showed numerous hyphae on the epithelium of the dorsal surface of the tongue. In contrast no hyphal colonization of the epithelium was seen in carvacrol-treated animals, while in rats treated with eugenol, only a few focalized zones of the dorsal surface of the tongue were occupied by hyphae. In the nystatin treated group, hyphae were found in the folds of the tongue mucosa. Thus, the histological data were confirmed by the microbiological tests for carvacrol and eugenol, but not for the nystatin-treated group. Therefore, carvacrol and eugenol could be considered as strong antifungal agents and could be proposed as therapeutic agents for oral candidiasis.

N. Chami

2004-06-01

133

New mechanism of oral immunity to mucosal candidiasis in hyper-IgE syndrome.  

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Oropharyngeal candidiasis (OPC, thrush) is an opportunistic infection caused by the commensal fungus Candida albicans. An understanding of immunity to Candida has recently begun to unfold with the identification of fungal pattern-recognition receptors such as C-type lectin receptors, which trigger protective T-helper (Th)17 responses in the mucosa. Hyper-IgE syndrome (HIES/Job's syndrome) is a rare congenital immunodeficiency characterized by dominant-negative mutations in signal transducer and activator of transcription 3, which is downstream of the Th17-inductive cytokines interleukin (IL)-6 and IL-23, and hence patients with HIES exhibit dramatic Th17 deficits. HIES patients develop oral and mucocutaneous candidiasis, supporting a protective role for Th17 cells in immunity to OPC. However, the Th17-dependent mechanisms of antifungal immunity in OPC are still poorly defined. An often unappreciated aspect of oral immunity is saliva, which is rich in antimicrobial proteins (AMPs) and exerts direct antifungal activity. In this study, we show that HIES patients show significant impairment in salivary AMPs, including ?-defensin 2 and Histatins. This tightly correlates with reduced candidacidal activity of saliva and concomitantly elevated colonization with Candida. Moreover, IL-17 induces histatins in cultured salivary gland cells. This is the first demonstration that HIES is associated with defective salivary activity, and provides a mechanism for the severe susceptibility of these patients to OPC. PMID:21346738

Conti, H R; Baker, O; Freeman, A F; Jang, W S; Holland, S M; Li, R A; Edgerton, M; Gaffen, S L

2011-07-01

134

Virgin Coconut Oil (VCO Enriched with Zn as Immunostimulator for Vaginal Candidiasis Patient  

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Full Text Available Disturbance on the immune system and deficiency of Zn is two factors which often trigger vaginal candidiasis patient. The aim of the research was to study the effect of virgin coconut oil (VCO enriched with Zn to the amount of neutrophil and lymphocyte subset cells, and the level of IL-2 and IgG in vaginal candidiasis patient. Thirty women were grouped into three (ten women in each group: A, B and C, and intervened for two months. Women in A group were intervened with two tablespoon/day; those in B group were intervened with one tablespoon/day; while those in C group served as control (placebo. Blood was sampled at baseline time, one and two months after intervention. Hematological test by Micros-OT was done on a part of blood, and the plasma was used for IL-2 and IgG level tests using ELISA. The virgin coconut oil enriched with Zn maintained the number of neutrophil and NK cells, but increased Tc cells from 521 to 649 cells/mm3, increased Th cells from 1.090 to 1.380 cells/mm3. The enriched VCO also increase level of IL-2 from 0.25313 to 0.27337 pg/ml, while the IgG level changed from equivocal to negative. The recommended dosage was one tablespoon each day.

HERY WINARSI

2008-12-01

135

Evaluation of Syngonanthus nitens (Bong.) Ruhl. extract as antifungal and in treatment of vulvovaginal candidiasis.  

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The purpose of this study was to evaluate the in vitro anticandidal activity of a methanolic extract of Syngonanthus nitens scapes against different Candida species and clinical isolates from patients with vulvovaginal candidiasis (VVC), and its effect in vivo in the treatment of vaginal infection. Chemical characterization of the extract was performed by HPLC-UV analyses and showed the presence of flavones derivatives. The extract was effective against several Candida strains from our collection and species recovered from VVC patients, and was able to inhibit the yeast-hyphal transition. No cytotoxic activity against human female reproductive tract epithelial cells and no hemolytic activity against human red blood cells were observed. In the in vivo model of VVC, we evaluated the efficacy of the intravaginal treatment with a cream containing the extract at doses of 0.5, 1.0 and 2.0%. The treatment eradicated the vaginal fungal burden in infected rats after 8 days of treatment. S. nitens extract could be considered as an effective and non-toxic natural antifungal agent in the treatment of vulvovaginal candidiasis. PMID:23758104

de Freitas Araújo, Marcelo Gonzaga; Pacífico, Mariana; Vilegas, Wagner; Dos Santos, Lourdes Campaner; Icely, Paula Alejandra; Miró, Maria Soledad; Scarpa, Maria Virginia Costa; Bauab, Tais Maria; Sotomayor, Claudia Elena

2013-10-01

136

An antibody reactivity-based assay for diagnosis of invasive Candidiasis using protein array.  

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The increased incidence of invasive candidiasis and of patients at risk requires early diagnosis and treatment to improve prognosis and survival. The aim of this study was to set up a ten-protein array-based immunoassay to assess the IgG antibody responses against ten well-known immunogenic C. albicans proteins (Bgl2, Eno1, Pgk1, Pdc11, Fba1, Adh1, Als3, Hwp1, Hsp90 and Grp2) in 51 patients with invasive candidiasis (IC) and in 38 culture-negative controls (non-IC). Antibody levels were higher against Bgl2, Eno1, Pgk1, Als3, Hwp1 and Grp2, than against Adh1, Pdc11, Fba1 and Hsp90, irrespectively of the patient group considered. Moreover, the IgG levels against Bgl2, Eno1, Pgk1 and Grp2 were significantly higher in IC than in non-IC patients. Furthermore, the ROC curves generated by the analysis of the antibody responses against Bgl2, Grp2 and Pgk1 displayed AUC values above 0.7, thus discriminating IC and non-IC patients. According to these results, the employment of the microarray immunoassay (a rapid, sensitive and multiparametric system), in parallel with conventional diagnostics, can help to spot IC patients. This ultimately will allow to initiate an early, focused and optimized antifungal therapy. PMID:25280031

Ardizzoni, A; Posteraro, B; Baschieri, M C; Bugli, F; Sáez-Rosòn, A; Manca, L; Cacaci, M; Paroni Sterbini, F; De Waure, C; Sevilla, M J; Peppoloni, S; Sanguinetti, M; Moragues, M D; Blasi, E

2014-01-01

137

Long Term Vaginal Azoles Versus Prophylactic Oral Fluconazole in Treatment of Recurrent Vulvovaginal Candidiasis  

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Full Text Available Recurrent Vulvovaginal Candidiasis (RVVC is a fungal infection of the vagina and vulva that occur usually = 4 episodes in a year. Our object was to compare the efficacy and safety of a single oral dose of fluconazole (150 mg weekly with clotrimazole vaginal cream 150 mg twice weekly for 6 months as treatment of recurrent VVC. We conducted a clinical trial study among 124 women with Recurrent Vulvovaginal Candidiasis (RVVC among patients presenting to the Obstetrics and Gynecology Clinics of Tabriz University of Medical Sciences from 2002-2004. There was no significant difference in the therapeutic response as the recurrence rate during 12 months between the two groups. The drug side effects in the fluconazole group were significantly more than clotrimazole group. The satisfactory from the drug in the fluconazole group was significantly less than clotrimazole group. Due to the fewer side effects and more satisfactory of local treatment, we recommend profilactic use of Azole vaginal creams for treatment of RVVC especially in women who are pregnant or have systemic problems.

2007-01-01

138

Polymeric microparticles-based formulation for the eradication of cutaneous candidiasis: development and characterization.  

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Cutaneous candidiasis is a common topical fungal infection which may be more prominent in patients associated with AIDS. It is usually treated by conventional formulations such as cream, gel, which show various adverse effects on skin along with systemic absorption. To overcome these drawbacks, various novel drug delivery systems have been explored. Poly(lactic-co-glycolic acid) (PLGA)-based microparticulate systems have shown good dermal penetration after topical application. Therefore, in the present study clotrimazole-loaded PLGA microspheres were prepared for targeted dermal delivery. Microspheres were prepared by using a single emulsification (oil-in-water, O/W) evaporation technique and characterized for different parameters. Prepared microparticulate systems were dispersed in Carbopol 934® gel and antifungal activity was carried out on experimentally induced cutaneous candidiasis in immunosuppressed guinea pigs. Particle size of optimized formulation was 2.9?µm along with 74.85% entrapment of drug. Skin retention studies revealed that drug accumulation in the skin was higher with microspheres gel as compared to marketed gel. Confocal microscopy of skin further confirmed penetration of microspheres up to 50?µm into the dermal region. In-vivo antifungal activity studies demonstrated that microsphere gel showed better therapeutic activity, lowest number of cfu/ml was recorded, as compared to marketed gel after 96?h of application. Based on the results of the study, it can be concluded that PLGA microparticles may be promising carriers to deliver clotrimazole intradermally for the treatment of invasive fungal infections. PMID:23560821

Kumar, Lalit; Verma, Shivani; Jamwal, Sumit; Vaidya, Shubha; Vaidya, Bhuvaneshwar

2014-05-01

139

Lupus-like panniculitis in a patient with autoimmune polyendocrinopathy-candidiasis-ectodermal dystrophy (APECED).  

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Autoimmune polyendocrinopathy-candidiasis-ectodermal dystrophy (APECED) is a rare autosomal recessive disorder, characterised by a loss of self-tolerance to endocrine tissues, chronic candidiasis and ectodermal disorders. APECED is associated with mutations of a single gene, designated autoimmune regulator (AIRE). We describe a 31-year-old APECED patient with non-traumatic, cutaneous ulcers on both forearms with features of a lupus-like panniculitis. On admission to the ICU in September 2001, the patient suffered from a ketoacidotic, hyperglycemic coma and adrenal crisis due to an Enterobacter-cloacae sepsis, originating from multiple, necrotising deep cutaneous ulcers. These ulcers spontaneously developed on both forearms, some of which were just emerging, full blown or healing with scars. Histological examination showed signs of a scarring panniculitis and vasculitis. Immunohistochemistry and direct immunofluorescence with characterisation of immunoglobulin and complement-factor binding pattern revealed features of a lupus-like panniculitis. Sequence analysis of all 14 exons of the AIRE gene revealed a R257 X mutation in exon 6 resulting in a nonsense mutation at codon 257 confirming the diagnosis of APECED. Oral treatment with 60 mg/day corticosteroids for two weeks led to complete resolution of all ulcers. In conclusion, mutations in the AIRE gene may provide the genetic background against which additional factors can initiate an autoimmune process. Here, autoimmune panniculitis appears to be an associated feature of the APECED syndrome. Our findings support the use of immunosuppressive therapy for autoimmune disease components of the APECED syndrome. PMID:12951636

Füchtenbusch, M; Vogel, A; Achenbach, P; Gummer, M; Ziegler, A G; Albert, E; Standl, E; Manns, M P

2003-08-01

140

Patterns of Expression of Vaginal T-Cell Activation Markers during Estrogen-Maintained Vaginal Candidiasis  

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Full Text Available The immunosuppressive activity of estrogen was further investigated by assessing the pattern of expression of CD25, CD28, CD69, and CD152 on vaginal T cells during estrogen-maintained vaginal candidiasis. A precipitous and significant decrease in vaginal fungal burden toward the end of week 3 postinfection was concurrent with a significant increase in vaginal lymphocyte numbers. During this period, the percentage of CD3+, CD3+CD4+, CD152+, and CD28+ vaginal T cells gradually and significantly increased. The percentage of CD3+ and CD3+CD4+ cells increased from 43% and 15% at day 0 to 77% and 40% at day 28 postinfection. Compared with 29% CD152+ vaginal T cells in naive mice, > 70% of vaginal T cells were CD152+ at day 28 postinfection. In conclusion, estrogen-maintained vaginal candidiasis results in postinfection time-dependent changes in the pattern of expression of CD152, CD28, and other T-cell markers, suggesting that T cells are subject to mixed suppression and activation signals.

Al-Sadeq Ameera

2008-12-01

 
 
 
 
141

Autoimmune Polyendocrinopathy Candidiasis Ectodermal Dystrophy: Insights into Genotype-Phenotype Correlation  

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Autoimmune polyendocrinopathy candidiasis ectodermal dystrophy (APECED) is a rare autosomal recessive disease, caused by mutations of a single gene named autoimmune regulator gene (AIRE) which results in a failure of T cell tolerance within the thymus. Chronic mucocutaneous candidiasis, chronic hypoparathyroidism, and Addison's disease are the hallmarks of the syndrome. APECED is also characterized by several autoimmune endocrine and nonendocrine manifestations, and the phenotype is often complex. Moreover, even though APECED is a monogenic disease, its clinical picture is generally dominated by a wide heterogeneity both in the severity and in the number of components even among siblings with the same AIRE genotype. The variability of its clinical expression implies that diagnosis can be challenging, and a considerable delay often occurs between the appearance of symptoms and the diagnosis. Since a prompt diagnosis is essential to prevent severe complications, clinicians should be aware of all symptoms and signs of suspicion. The aim of this paper is to give an overview on the clinical presentation and diagnostic criteria of APECED and to focus on current knowledge on genotype-phenotype correlation. PMID:23133448

Capalbo, Donatella; De Martino, Lucia; Giardino, Giuliana; Di Mase, Raffaella; Di Donato, Iolanda; Parenti, Giancarlo; Vajro, Pietro; Pignata, Claudio; Salerno, Mariacarolina

2012-01-01

142

Acute Neutropenia Decreases Inflammation Associated with Murine Vaginal Candidiasis but Has No Effect on the Course of Infection  

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We have used a mouse model of vaginal candidiasis to determine the effect of neutrophil depletion on (a) the clearance of Candida albicans and (b) the degree of inflammation associated with infection. No differences in recoverable yeast number or rate of clearance were observed between normal and neutrophil-depleted mice; however, vaginal inflammation was significantly decreased in neutrophil-depleted animals. PMID:9488427

Black, C. Allen; Eyers, Fiona M.; Russell, Adrian; Dunkley, Margaret L.; Clancy, Robert L.; Beagley, Kenneth W.

1998-01-01

143

Acute Neutropenia Decreases Inflammation Associated with Murine Vaginal Candidiasis but Has No Effect on the Course of Infection  

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We have used a mouse model of vaginal candidiasis to determine the effect of neutrophil depletion on (a) the clearance of Candida albicans and (b) the degree of inflammation associated with infection. No differences in recoverable yeast number or rate of clearance were observed between normal and neutrophil-depleted mice; however, vaginal inflammation was significantly decreased in neutrophil-depleted animals.

Black, C. Allen; Eyers, Fiona M.; Russell, Adrian; Dunkley, Margaret L.; Clancy, Robert L.; Beagley, Kenneth W.

1998-01-01

144

Autoantibodies to IL-17A may be correlated with the severity of mucocutaneous candidiasis in APECED patients.  

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The relative roles of various autoantibodies against IL-17-type cytokines in susceptibility to chronic mucocutaneous candidiasis (CMC) in patients with autoimmune polyendocrinopathy-candidiasis-ectodermal dystrophy (APECED) remain poorly defined. The purpose of this longitudinal study was to analyze the relationship between the occurrence of mucocutaneous candidiasis and levels of anti-IL-17A, anti-IL-17F and anti-IL-22 autoantibodies. We studied six APECED patients from four families with various disease manifestations. Clinical data were collected during regular follow-up. Anti-endocrine organ antibody levels and clinical chemistry and immunology parameters were determined in routine laboratory assays on freshly isolated serum. Levels of autoantibodies against IL-17A, IL-17F, IL-22, IFN-?, IFN-? and TNF-?, and cytokine release by Candida-exposed blood cells were determined by ELISA. Mutations were analyzed by sequencing genomic DNA. Four patients carried the germline c.769C?>?T homozygous nonsense mutation, which results in R257X truncation of the AIRE protein, and two patients from the same family were compound heterozygous for the c.769C?>?T/c.1344delC mutation. We found persistently high levels of antibodies against IL-17A in the serum samples of one patient presenting CMC since infancy and low or undetectable anti-IL-17A antibody levels in the sera of five patients with no candidiasis or without severe candidiasis. By contrast, levels of autoantibodies against IL-17F and IL-22 were higher in all patients than in healthy controls. Release of IL-17-type cytokines by Candida-exposed blood mononuclear cells was low or negligible in all patients tested. We suggest that anti-IL-17A antibodies may play an important role in the predisposition to candidiasis of APECED patients. However, the lack of severe CMC in APECED patients with high levels of IL-17F and anti-IL-22 autoantibodies clearly calls into question the role of these antibodies as the principal cause of cutaneous and mucosal candidiasis in at least some APECED patients. These data also suggest that the impaired release of IL-17-type cytokines by blood cells may be an element of the immunopathology of CMC in APECED patients. PMID:24493573

Sarkadi, Adrien Katalin; Taskó, Szilvia; Csorba, Gabriella; Tóth, Beáta; Erd?s, Melinda; Maródi, László

2014-02-01

145

The relationship of candidiasis to linear gingival erythema in HIV-infected homosexual men and parenteral drug users.  

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Periodontal status was evaluated in two cohorts participating in a study of the natural history of human immunodeficiency virus (HIV) infection. One cohort consisted of 77 seropositive and 44 seronegative homosexual men, and the other cohort was comprised of 44 seropositive and 39 seronegative parenteral drug users (PDU). No differences were observed between seropositive and seronegative individuals within a cohort in terms of clinical periodontal parameters (percent of sites with > or = 4 mm probing depth, percent of sites exhibiting bleeding on probing, mean oral hygiene index). The PDU displayed more existing periodontal disease than the homosexual men. Periodontal disease in the seropositive individuals in both cohorts was not strictly related to the number of CD4+ lymphocytes. Linear gingival erythema (LGE), defined as an erythematous band of at least 2 mm extending between adjacent papilla, was observed in all 4 groups. Seropositive homosexual men displayed more LGE than seronegative homosexual men (16.6% vs. 11.4%) and seronegative PDU displayed more LGE than seropositive PDU (38.5% vs. 29.5%), but neither difference was significant. LGE tended to be related to reduced numbers of CD4+ lymphocytes, but this relationship did not reach statistical significance. A statistically-significant relationship was found between the presence of intraoral candidiasis and LGE in seropositive homosexual men: 42.9% of these subjects with candidiasis had LGE, while only 12.7% of the subjects without candidiasis had LGE (P < .05). For the seropositive PDU, 35.3% of the individuals with candidiasis had LGE and 25.9% of the subjects without candidiasis displayed LGE, but the difference was not statistically significant.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:7891247

Grbic, J T; Mitchell-Lewis, D A; Fine, J B; Phelan, J A; Bucklan, R S; Zambon, J J; Lamster, I B

1995-01-01

146

Aislamiento, identificación y tipificación de levaduras en pacientes VIH positivos con candidiasis oral  

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Full Text Available Se realizó un estudio de candidiasis oral a 25 pacientes VIH positivos y SIDA. La forma clínica de presentación predominante fue la pseudomembranosa y las especies de levadura más frecuentes en los aislamientos fueron Candida albicans (54,1 %, Candida tropicalis (8,1 % y Torulopsis glabrata (8,1 %. Se demostró que los pacientes con infecciones recurrentes suelen tener colonización de la cavidad oral por múltiples cepas y/o especies de levaduras con mayor frecuencia (30,8 % que los que cursan por su primer episodio de candidiasis oral (12,5 %. De los 3 medios de cultivo utilizados para el aislamiento inicial, la combinación del agar papa dextrosa (APD y el agar Sabouraud trifeniltetrazolium (AST permitió obtener el máximo de aislamiento y de diferenciación entre cepas. El agar Sabouraud (AS, el medio más utilizado para estos fines internacionalmente, fue menos útil que los anteriores. El AST resultó ser, además, un medio de gran utilidad para estudios de tipificación fenotípica de la mayoría de las especies de levaduras aisladas y especialmente de C. albicans, lo cual permitirá abordar estudios epidemiológicos.A study of oral candidiasis was conducted among 25 HIV-positive and AIDS patients. The predominant clinical form of presentation was the pseudomembranous one, whereas the most frequently yeast species found in the isolations were: Candida albicans (54.1 %, Candida tropicalis (8.1 %, and Torulopsis glabrata (8.1 %. It was demonstrated that patients with recurrent infections have colonization of the oral cavity by multiple strains and/or yeast species more often (30.8 % than those through their first episode of oral candiadisis (12.5 %. Of the 3 culture media used for the initial isolation, the combination of the potato-dextrose agar (PDA with Sabouraud triphenytletrazolium agar (STA allowed to obtain the maximum isolation and differentiation among strains. The Sabouraud agar (SA, the most used medium to these ends at the international level, proved to be less useful than the previous ones. The STA was very efficient in the studies of phenotypic typing of most of the isolated yeast species and specially of C. albicans, which will make possible to approach epidemiological studies.

GERARDO MARTÍNEZ MACHÍN

1997-12-01

147

Aislamiento, identificación y tipificación de levaduras en pacientes VIH positivos con candidiasis oral  

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Full Text Available SciELO Cuba | Language: Spanish Abstract in spanish Se realizó un estudio de candidiasis oral a 25 pacientes VIH positivos y SIDA. La forma clínica de presentación predominante fue la pseudomembranosa y las especies de levadura más frecuentes en los aislamientos fueron Candida albicans (54,1 %), Candida tropicalis (8,1 %) y Torulopsis glabrata (8,1 % [...] ). Se demostró que los pacientes con infecciones recurrentes suelen tener colonización de la cavidad oral por múltiples cepas y/o especies de levaduras con mayor frecuencia (30,8 %) que los que cursan por su primer episodio de candidiasis oral (12,5 %). De los 3 medios de cultivo utilizados para el aislamiento inicial, la combinación del agar papa dextrosa (APD) y el agar Sabouraud trifeniltetrazolium (AST) permitió obtener el máximo de aislamiento y de diferenciación entre cepas. El agar Sabouraud (AS), el medio más utilizado para estos fines internacionalmente, fue menos útil que los anteriores. El AST resultó ser, además, un medio de gran utilidad para estudios de tipificación fenotípica de la mayoría de las especies de levaduras aisladas y especialmente de C. albicans, lo cual permitirá abordar estudios epidemiológicos. Abstract in english A study of oral candidiasis was conducted among 25 HIV-positive and AIDS patients. The predominant clinical form of presentation was the pseudomembranous one, whereas the most frequently yeast species found in the isolations were: Candida albicans (54.1 %), Candida tropicalis (8.1 %), and Torulopsis [...] glabrata (8.1 %). It was demonstrated that patients with recurrent infections have colonization of the oral cavity by multiple strains and/or yeast species more often (30.8 %) than those through their first episode of oral candiadisis (12.5 %). Of the 3 culture media used for the initial isolation, the combination of the potato-dextrose agar (PDA) with Sabouraud triphenytletrazolium agar (STA) allowed to obtain the maximum isolation and differentiation among strains. The Sabouraud agar (SA), the most used medium to these ends at the international level, proved to be less useful than the previous ones. The STA was very efficient in the studies of phenotypic typing of most of the isolated yeast species and specially of C. albicans, which will make possible to approach epidemiological studies.

GERARDO, MARTÍNEZ MACHÍN; MAYDA, PERURENA LANCHA; JOSÉ, NÚÑEZ CARVAJAL; CARLOS M., FERNÁNDEZ ANDREU; FRANCISCO, BANDERA TIRADO.

1997-12-01

148

Invasive Candidiasis  

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... Get email updates Contact Us: Centers for Disease Control and Prevention 1600 Clifton Rd Atlanta, GA 30333 800-CDC-INFO (800-232-4636) TTY: (888) 232-6348 Contact CDC–INFO Fungal Diseases Types of Diseases Aspergillosis Definition Symptoms People ...

149

A case of pediatric acute lymphoblastic leukemia with invasive candidiasis: short review.  

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Mortality rate associated with invasive fungal infections is very high. Early suspicion for fungal infections is important during intensive chemotherapy for acute leukemia. Empirical treatment with antifungals amphotericin B or caspofungin should be started if patient is not responding to broad spectrum antibiotics and if expected duration of neutropenia is prolonged. We are reporting a 3 years old girl child with diagnosis of pre-B acute lymphoblastic leukemia who developed invasive candidiasis with typical clinical and radiological findings during induction chemotherapy. Candida non-albicans was isolated and she was treated with amphotericin B followed by caspofungin. Patient deteriorated after initial response and succumbed to death. Species identification and sensitivity pattern of fungus can help in selecting appropriate antifungal drug. PMID:25332550

Verma, S P; Dubashi, B; Narayanan, P; Basu, D; Dutta, T K; Dhanraj, K M

2014-09-01

150

Intestinal candidiasis in a loggerhead sea turtle (Caretta caretta): an immunohistochemical study.  

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Post mortem examination of a juvenile loggerhead sea turtle (Caretta caretta) stranded in the Canary Islands revealed a fishing-line in the small intestine. Histologically, severe necrotic enteritis, multiple haemorrhages, and marked oedema of the intestinal submucosa were observed. Yeast cells and fungal hyphae were seen in the lamina propria of the intestinal mucosa and in the connective tissue of the submucosa. Because fungal cultures were not taken at the time of necropsy, an immunohistochemical study was performed in order to identify the fungus involved. Specific monoclonal and heterologously absorbed polyclonal antibodies served as the primary reagents for identification of aspergillosis, candidiasis, fusariosis, geotricosis, scedosporiosis, and zygomycosis, using an indirect immunofluorescence staining technique. The fungal elements were strongly stained only by a polyclonal antibody against Candida albicans and a monoclonal antibody against C. albicans. There are no known previous reports of Candida sp. causing skin disease or systemic mycotic infection in sea turtles. PMID:14975396

Orós, J; Arencibia, A; Fernández, L; Jensen, H E

2004-03-01

151

CANDIDÍASE CUTÂNEA EM CEBUS APELLA (MACACO PREGO CUTANEOUS CANDIDIASIS IN A CEBUS APELLA (CAPUCHINS MONKEYS  

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Full Text Available

Leveduras do gênero Candida têm sido freqüentemente isoladas de animais domésticos e silvestres, entretanto, candidíase não tem sido reportada em primatas. Encaminhou-se à Faculdade de Veterinária, Departamento de Patologia Animal, um macaco-prego (Cebus apella para necropsia, que vinha apresentando emagrecimento profundo e lesões ulcerativas de pele e mucosas. Fragmentos de pele e órgãos foram processados para histologia e corados com H.E. e Groccot. Para micologia, coletaram-se fragmentos de órgãos, exsudato e crostas da pele, sendo realizado exame direto e cultivo a 37oC. Macroscopicamente, o animal apresentava alopecia, caquexia e ulcerações cutâneas de 1-4 cm. Histologicamente, nas ulcerações, a derme continha infiltrado de mononucleares e proliferação fibroblástica. Mediante utilização de Groccot, encontraram-se hifas e/ou pseudo-hifas e blastoconídeos intralesionais. Em cultivos de crostas e exsudato, observaram-se colônias brilhantes, com superfície lisa e coloração branca a creme. A microscopia das colônias revelou células leveduriformes ovaladas ou alongadas, com brotamento unipolar, gram-positivas. No microcultivo em fubá, observaram-se blastoconídeos globosos terminais, com parede espessa e pseudomicélio abundante e ramificado, com formação de tubo germinativo em albumina de ovo, sendo a levedura classificada como Candida albicans. O estudo aborda o risco da infecção por micoses oportunistas como a candidíase em animais silvestres em cativeiro.

 

PALAVRAS-CHAVES: Candidiasis, Candida albicans, pele, Cebus apella.

Candida spp has been frequently isolated from domestic and sylvan animals, however, Candidiasis has not been reported in primates. One Cebus apella, with progressive thinning and ulcerative skin lesions and mucous, was necropsied. Fragments of tissue were collected and processed for histology. Coloration of H.E. and Groccot was made. For mycology was collected tissue, exsudate, and skin crusts. Direct exam was made, and samples cultivated at 37oC in agar Sabouraud with cloranfenicol and agar corn. Macroscopically the animal presented; itself extremely thin with ulcerative lesions on the skin, ranging from 1 to 4 cm. Histologically, on dermis ulcerations, there was mononuclear infiltrate and fibroblastic proliferation. With Groccot, it was observed intralesionally hyphae and blastoconidia. The direct exam showed round and/or ovalate gram positive cells, compatible with yeast. The cultives showed shining colonies with a smooth surface, some of them with edges fringed and white-yellowish coloration. The colonies showed yeast cells with ovalate or alongate forms and sprouting unipolar on microscopy. With microcultive, it was found globosous blastoconidia, with wall thick and pseudohyfaes abundant and ramified. There was the formation of a germinative tube, confirming the C. albicans species. This study shows the risk of candidiasis in wildlife primates living on captivity.

 

KEY WORDS: Candidiasis, Candida albicans, Cebus apella, skin.

Anelise Oliveira Fonseca

2008-10-01

152

Systemic candidiasis and mesenteric mast cell tumor with multiple metastases in a dog.  

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A 5-year-old female miniature dachshund presenting with persistent vomiting and diarrhea had two concurrent rare pathological conditions: systemic candidiasis and mesenteric mast cell tumor with multiorgan metastases. Neoplastic mast cells formed mass in the mesentery of the cecal-colonic region and were also found in the liver, spleen, kidneys, lungs, adrenal grands, ovaries, bone marrow and other tissues. The cells had intracytoplasmic granules with metachromasia and were immunohistochemically positive for c-kit and histamine. Granulomatous lesions with fungal organisms were present in the heart, lungs, kidneys, pancreas, subserosal and surrounding adipose tissue of the duodenum, thyroid glands and mesenteric mass, and phagocytosed organisms were detected in the liver and bone marrow. Bacteriologically and immunohistochemically, the fungi were consistent with Candida albicans. PMID:19262039

Matsuda, Kazuya; Sakaguchi, Kanako; Kobayashi, Shintaro; Tominaga, Makiko; Hirayama, Kazuko; Kadosawa, Tsuyoshi; Taniyama, Hiroyuki

2009-02-01

153

The role of Human Dectin-1 Y238X Gene Polymorphism in recurrent vulvovaginal candidiasis infections.  

Science.gov (United States)

Recurrent vulvovaginal candidiasis (RVVC) is defined as having four or more symptomatic vulvovaginal candidiasis (VVC) attacks within a year. This study aimed to investigate whether Human Dectin-1 Y238X Gene Polymorphism plays a role in RVVC pathogenesis. In order to examine and explore this aim, an experimental study was undergone. The clinical study design was conducted with 50 women diagnosed with RVVC and had four or more symptomatic VVC attacks who were included in the experimental group; while 50 women who did not have previous RVVC history and diagnosis and did not have vaginal discharge and itching in the past year were included in the control group. Blood samples were collected from these patients and transferred to EDTA tubes, to investigate the Dectin-1 Y238X gene polymorphism, and stored at -80°. When Dectin-1 genotypes were compared, there was no significant difference between the two groups (p = 0.452, p = 0.615, p = 0.275). History of familial RVVC was significantly higher in the experimental group (p = 0.001). When the multivariate analysis was used to evaluate factors that could determine RVVC frequency, history of familial RVVC was found to increase the frequency of RVVC attacks by 3.3 units. This study is the first-of-its-kind to investigate the correlation between Dectin-1 Y238X polymorphism, which has not been previously studied in the Turkish population, and RVVC. The result of this study suggests that there is no correlation between this polymorphism and RVVC. PMID:25008994

Usluogullari, Betul; Gumus, Ilknur; Gunduz, Esra; Kaygusuz, Ikbal; Simavli, Serap; Acar, Muradiye; Oznur, Murat; Gunduz, Mehmet; Kafali, Hasan

2014-10-01

154

Oropharyngeal candidiasis and resistance to antifungal drugs in patients receiving radiation for head and neck cancer  

Directory of Open Access Journals (Sweden)

Full Text Available BACKGROUND: Oropharyngeal candidiasis is a common infection in patient receiving radiotherapy for head and neckcancer. Accurate and rapid identification of candida species is very important in clinical laboratory, because theincidence of candidiasis continues to rise after radiotherapy. The genus Candida has about 154 species that showdifferent level of resistance to antifungal drugs and have high degree of phenotypic similarity. The aim of this study wasto investigate oral yeast colonization and infection and resistance to antifungal drugs in these patients.METHODS: Thirty patients receiving a 6-week course of radiation therapy for treatment of head and neck cancer at theOncology Unit in Shafa Hospital, in 2008, were enrolled in the study. Specimens from patients were cultured weeklyfor Candida. All isolates were plated on CHROM agar and RPMI-based medium. They were subcultured and submittedfor antifungal susceptibility testing (nystatin, fluconazole, clotrimazole and ketoconazole and molecular typing.RESULTS: Infection (clinical and microbiological evidence occurred in 50% of the patients and Candida colonization(only microbiological evidence occurred in 70% of subjects in the first week. Candida albicans alone was isolated in94.9% of patient visits with positive cultures. Candida tropicalis was isolated from 5.1% of patient visits with positivecultures. All isolates were susceptible to nystatin, but did not respond to the other antifungal drugsCONCLUSIONS: The irradiation-induced changes of the intraoral environment such as xerostomia lead to increasedintraoral colonization by Candida species. All yeast isolates were susceptible to nystatin. Thus prophylactic therapywith nystatin should be considered for these patients.

Maryam Rad DMD, MSc

2012-04-01

155

Eosinofilia no sangue periférico de mulheres com candidiase vaginal recorrente / Eosinophilia in peripheral blood of women with recurrent vaginal candidiasis  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: Portuguese Abstract in portuguese OBJETIVO: Quantificar o número de células de defesa e os níveis de imunoglobulina E (IgE) no sangue periférico em amostra de mulheres com candidíase vaginal recorrente. MÉTODOS: Estudo de corte transversal com 60 mulheres, 40 com candidíase vulvovaginal e 20 do grupo controle (sem doença). As célula [...] s de defesa foram identificadas utilizando um sistema de impedância combinada com a citometria de fluxo, os níveis de IgE total e específica foram medidos por meio de técnicas de quimiluminescência, o teste de Mann-Whitney foi utilizado para variáveis nominais e do teste de Spearman para correlações das concentrações de IgE e de eosinófilos no sangue periférico. RESULTADOS: O número de eosinófilos no sangue periférico de pacientes com candidíase vulvovaginal, 302,60 (±253,07), foi significativamente maior do que o grupo controle, 175,75 (±109,24) (p=0,037). Os níveis séricos de IgE total e específica foram semelhantes em ambos os grupos de mulheres com e sem candidíase vulvovaginal recorrente (p=0,361). Entretanto, observou-se uma correlação positiva moderada entre eosinofilia e níveis de IgE total no sangue periférico de mulheres com candidíase vaginal recorrente (r=0,25). CONCLUSÃO: Mulheres com candidíase vaginal recorrente parecem ter maior concentração de eosinófilos no sangue periférico que as assintomáticas. Abstract in english PURPOSE: To quantify the number of defense cells and immunoglobulin E (IgE) levels in peripheral blood sampled from women with recurrent vulvovaginal candidiasis. METHODS: A cross-sectional study was conducted on 60 women, 40 with vulvovaginal candidiasis and 20 controls. The defense cells were iden [...] tified using an impedance system combined with flow cytometry and total and specific IgE was measured by chemiluminescence. The Mann-Whitney test was used for nominal variables and the Spearman test was used to determine the correlation of IgE concentration and eosinophils in peripheral blood. RESULTS: The number of eosinophils in peripheral blood from patients with recurrent vulvovaginal candidiasis, 302.60 (±253.07), was significantly higher compared to control, 175.75 (±109.24) (p=0.037). Serum levels of total and specific IgE were similar in the groups of women with and without recurrent vulvovaginal candidiasis (p=0.361). However, there was a moderate positive correlation between eosinophils and total serum IgE in the candidiasis group (r=0.25). CONCLUSION: Women with recurrent vulvovaginal candidiasis are more likely to have eosinophils in peripheral blood.

José, Queiroz Filho; Ana Katherine, Gonçalves; Geraldo Barroso, Cavalcante Júnior; Daliana Caldas, Pessoa; José, Eleutério Júnior; Paulo César, Giraldo; Valéria Soraya de Farias, Sales.

2013-10-01

156

Evolución favorable de trillizos prematuros con candidiasis sistémica neonatal tratados con caspofungina / Successfully evolution of premature triplets with systemic neonatal candidiasis treated with caspofungin  

Scientific Electronic Library Online (English)

Full Text Available SciELO Mexico | Language: Spanish Abstract in spanish Introducción: Las infecciones por especies de Candida son un problema que se ha incrementado de manera importante en pacientes de las unidades de cuidados intensivos neonatales (UCIN) y son una causa común de morbi-mortalidad en dicha población. La anfotericina B ha sido considerada como el principa [...] l agente terapéutico antifúngico; sin embargo, se ha asociado con efectos adversos como la fungemia persistente debido al aumento en la resistencia a Candida, particularmente especies no albicans, a menudo resistentes también a otros antifúngicos, como el fluconazol. Casos clínicos: Se trata de recién nacidos trillizos de 29 semanas de gestación, quienes recibieron soporte avanzado en la UCIN, incluyendo ventilación mecánica (VM), inserción de catéteres venosos centrales, nutrición parenteral total (NPT) y varios esquemas de antibióticos de amplio espectro, desarrollando sepsis por Candida parapsillosis en los tres casos; la terapia antifúngica fue iniciada con fluconazol, posteriormente con anfotericina B convencional y anfotericina B liposomal, sin mejoría clínica y con hemocultivos positivos. El deterioro fue revertido después del inicio de caspofungina (2 mg/kg/día) añadida a la anfotericina B liposomal. Los tres pacientes se recuperaron totalmente, sin ningún efecto adverso y con adecuada tolerancia. Conclusiones: La caspofungina resultó ser efectiva y bien tolerada en los pacientes tratados a dosis de 2 mg/kg/ día, por lo que se puede considerar una alternativa de tratamiento de la candidiasis invasiva en neonatos prematuros, aunque la dosis óptima no se ha determinado. Abstract in english Background: Infections caused by Candida sp. have been significantly increasing in patients in neonatal intensive care units (NICU) and are the most common causes of morbi-mortality in this population group. Amphotericin B has been considered to be the standard antifungal therapy. However, it has be [...] en associated with adverse effects such as persistent fungemia due to the increase of Candida resistance, in particular the non-albicans species, similar to the resistance shown by other antifungals such as fluconazol. Clinical cases: Triplets of gestational age of 29 weeks received advanced life support in the NICU, including mechanical ventilation (MV), insertion of venous catheters, total parenteral nutrition (TPN) and multiple regimes of broad-spectrum antibiotics. The three patients developed C. parapsilosis sepsis. Antifungal therapy was initiated with fluconazol prior to the use of conventional amphotericin B and liposomal amphotericin B. There was no clinical improvement and blood cultures remained positive. Clinical improvement was noted after the initiation of caspofungin (2 mg/kg/day) in addition to the use of liposomal amphotericin B. The triplets recovered completely with adequate tolerance to the medication and without adverse effects. Conclusion: Use of caspofungin proved to be an effective and well-tolerated therapy in these patients (2 mg/ kg/day). It can be considered an alternative treatment for invasive candidiasis in premature neonates, although optimal dosage remains undetermined.

Diana E., Granados-Perales; J. Horacio, Ugalde-Fernández.

2010-02-01

157

Efficacy of oral E1210, a new broad-spectrum antifungal with a novel mechanism of action, in murine models of candidiasis, aspergillosis, and fusariosis.  

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E1210 is a first-in-class, broad-spectrum antifungal with a novel mechanism of action-inhibition of fungal glycosylphosphatidylinositol biosynthesis. In this study, the efficacies of E1210 and reference antifungals were evaluated in murine models of oropharyngeal and disseminated candidiasis, pulmonary aspergillosis, and disseminated fusariosis. Oral E1210 demonstrated dose-dependent efficacy in infections caused by Candida species, Aspergillus spp., and Fusarium solani. In the treatment of oropharyngeal candidiasis, E1210 and fluconazole each caused a significantly greater reduction in the number of oral CFU than the control treatment (P disseminated candidiasis model, mice treated with E1210, fluconazole, caspofungin, or liposomal amphotericin B showed significantly higher survival rates than the control mice (P disseminated candidiasis caused by azole-resistant Candida albicans or Candida tropicalis. A 24-h delay in treatment onset minimally affected the efficacy outcome of E1210 in the treatment of disseminated candidiasis. In the Aspergillus flavus pulmonary aspergillosis model, mice treated with E1210, voriconazole, or caspofungin showed significantly higher survival rates than the control mice (P Aspergillus fumigatus pulmonary aspergillosis. In contrast to many antifungals, E1210 was also effective against disseminated fusariosis caused by F. solani. In conclusion, E1210 demonstrated consistent efficacy in murine models of oropharyngeal and disseminated candidiasis, pulmonary aspergillosis, and disseminated fusariosis. These data suggest that further studies to determine E1210's potential for the treatment of disseminated fungal infections are indicated. PMID:21788462

Hata, Katsura; Horii, Takaaki; Miyazaki, Mamiko; Watanabe, Nao-Aki; Okubo, Miyuki; Sonoda, Jiro; Nakamoto, Kazutaka; Tanaka, Keigo; Shirotori, Syuji; Murai, Norio; Inoue, Satoshi; Matsukura, Masayuki; Abe, Shinya; Yoshimatsu, Kentaro; Asada, Makoto

2011-10-01

158

Microbiological screening of Irish patients with autoimmune polyendocrinopathy-candidiasis-ectodermal dystrophy reveals persistence of Candida albicans strains, gradual reduction in susceptibility to azoles, and incidences of clinical signs of oral candidiasis without culture evidence.  

LENUS (Irish Health Repository)

Patients with autoimmune polyendocrinopathy-candidiasis-ectodermal dystrophy (APECED) are prone to chronic mucocutaneous candidiasis, which is often treated with azoles. The purpose of this study was to characterize the oral Candida populations from 16 Irish APECED patients, who comprise approximately half the total number identified in Ireland, and to examine the effect of intermittent antifungal therapy on the azole susceptibility patterns of Candida isolates. Patients attended between one and four clinical evaluations over a 5-year period, providing oral rinses and\\/or oral swab samples each time. Candida was recovered from 14\\/16 patients, and Candida albicans was the only Candida species identified. Interestingly, clinical diagnosis of candidiasis did not correlate with microbiological evidence of Candida infection at 7\\/22 (32%) clinical assessments. Multilocus sequence typing analysis of C. albicans isolates recovered from the same patients on separate occasions identified the same sequence type each time. Fluconazole resistance was detected in isolates from one patient, and isolates exhibiting a progressive reduction in itraconazole and\\/or fluconazole susceptibility were identified in a further 3\\/16 patients, in each case correlating with the upregulation of CDR- and MDR-encoded efflux pumps. Mutations were also identified in the ERG11 and the TAC1 genes of isolates from these four patients; some of these mutations have previously been associated with azole resistance. The findings suggest that alternative Candida treatment options, other than azoles such as chlorhexidine, should be considered in APECED patients and that clinical diagnosis of oral candidiasis should be confirmed by culture prior to the commencement of anti-Candida therapy.

McManus, Brenda A

2011-05-01

159

Effect of exogenous administration of Candida albicans autoregulatory alcohols in a murine model of hematogenously disseminated candidiasis.  

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Candida albicans supernatants contain a mixture of autoregulatory alcohols. In vitro, when added individually or in combination, these alcohols inhibit the yeast to filamentous form conversion. Here we evaluate the in vivo effect of the exogenous administration of a Cocktail solution simulating the composition of alcohols present in a C. albicans culture supernatant (1 ml; 94 ?mol l(-1) isoamyl alcohol, 70 ?mol l(-1) 2-phenylethanol, 3.2 n mol l(-1) E -nerolidol, and 18 n mol l(-1) E,E -farnesol) using the well established murine model of hematogenously disseminated candidiasis. Mice injected intraperitoneally with the Cocktail solution demonstrated increased survival and decreased organ fungal burden compared to control mice. Histological observations suggest that the Cocktail, to some extent, has an inhibitory effect on cell filamentation within the kidney. These findings suggest that the exogenous administration of C. albicans autoregulatory alcohols displays a protective effect during disseminated candidiasis. PMID:22052380

Martins, Margarida; Lazzell, Anna L; Lopez-Ribot, Jose L; Henriques, Mariana; Oliveira, Rosário

2012-08-01

160

Different tumor necrosis factor ? antagonists have different effects on host susceptibility to disseminated and oropharyngeal candidiasis in mice.  

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Tumor necrosis factor ? is important for the host defense against intracellular pathogens. We tested the effect of mouse analogs of human TNF-? antagonists, the rat anti-mouse TNF-? monoclonal antibody (XT22) and the soluble mouse 75 kDa TNF-? receptor fused to the Fc portion of mouse IgG1 (p75-Fc), on the susceptibility of mice to hematogenously disseminated candidiasis (HDC) and oropharyngeal candidiasis (OPC). Both XT22 and p75-Fc significantly reduced mice survival, increased kidney fungal burden, and reduced leukocyte recruitment during HDC. However, only XT22 significantly increased the oral fungal burden and reduced leukocyte recruitment during OPC. This result suggests that XT22 and p75-Fc affect host susceptibility to different types of Candida albicans infections by different inhibitory mechanisms. PMID:25007095

Park, Hyunsook; Solis, Norma V; Louie, James S; Spellberg, Brad; Rodriguez, Natalie; Filler, Scott G

2014-07-01

 
 
 
 
161

Lack of in vitro resistance of Candida albicans to ketoconazole, itraconazole and clotrimazole in women treated for recurrent vaginal candidiasis.  

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OBJECTIVE--To determine whether in vitro resistance of Candida albicans to the imidazoles (ketoconazole, clotrimazole and itraconazole) is associated with recurrence of candida vaginitis. DESIGN--Candida isolates were collected before, during and after treatment from women with recurrent vaginal candidiasis (> or = 4 episodes/year), randomised into two prospective studies: (1) 56 women treated with ketoconazole 400 mg/daily for 7 days; (2) 44 women randomised to receive itraconazole 200 mg or...

Fong, I. W.; Bannatyne, R. M.; Wong, P.

1993-01-01

162

A Supplement Based on Zn-Enriched Virgin Coconut Oil as an Antifungal agent for Vaginal Candidiasis Patients  

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This research was conducted to investigate the amount of Candida albicans in vaginal secretion of Vaginal Candidiasis patients administered with Zn-enriched virgin coconut oil. Thirty respondents were selected based on several criteria as follows: the number of C. albicans colonies in the vaginal secretion was more than 105 cfu.ml-1, voluntary, healthy, willing to sign the informed consent and resided in Purwokerto. In Group A, 10 women were administered 2 tablespoons per day of Zn-enriched v...

HERY WINARSI; HERNAYANTI; AGUS PURWANTO

2008-01-01

163

Identification of Candida species associated with vulvovaginal candidiasis by Multiplex PCR method  

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Full Text Available "n Normal 0 false false false EN-US X-NONE AR-SA MicrosoftInternetExplorer4 /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Table Normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-priority:99; mso-style-qformat:yes; mso-style-parent:""; mso-padding-alt:0in 5.4pt 0in 5.4pt; mso-para-margin:0in; mso-para-margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:11.0pt; font-family:"Calibri","sans-serif"; mso-ascii-font-family:Calibri; mso-ascii-theme-font:minor-latin; mso-fareast-font-family:"Times New Roman"; mso-fareast-theme-font:minor-fareast; mso-hansi-font-family:Calibri; mso-hansi-theme-font:minor-latin; mso-bidi-font-family:Arial; mso-bidi-theme-font:minor-bidi;} Background: Vulvovaginal candidiasis is a fungal disease with itching, and vaginal thick white discharge. Most of non-albicans species have less sensitivity to azoles. So, definition of candida species which lead to vulvovaginal candidiasis is very important to perfect usage of drugs. In the present study 191 Candida isolates from 175 patients who admitted in Gynecology department of Mahdieh Hospital during the period 1385-1387 were identified by multiplex PCR."n"nMethods: One hundred seventy five vaginal swab specimens from patients were cultured on Sabouraud Dextrose Agar (SDA. The internal transcribed spacer 1 (ITS1 region between the 18S and 5.8S rRNA genes and a specific DNA fragment within the ITS2 region of Candida albicans were amplified and the multiplex PCR products were separated by electrophoresis in 2% agarose gel (200 mA, 140V, visualized by staining with ethidium bromide, and photographed."n"nResults: One hundred ninety one Candida isolates were identified in vaginal swab specimens from 175 patients. In 89.7% of cases, single candida species and in 10.3% cases, multiple candida species were isolated. C. albicans (65.1%, C. glabrata (13.1%, C. tropicalis (6.2%, C. krusei (4%, C. guilliermondii (0.6%, C. parapsilosis (0.6%, C. glabrata and C. albicans (5.7%, C. albicans and C. parapsilosis (1.1%, C. glabrata and C. tropicalis (0.6%, C. krusei and C. tropicalis (0.6%, C. albicans and C. tropicalis (0.6%, C. krusei and C. albicans (0.6%, C. glabrata and C. krusei (0.6%, and C. glabrata and C. krusei and C. albicans (0.6% were the cause of disease."n"nConclusion: Our findings suggest that, the common cause of both recurrent and non-recurrent vulvovaginal candidiasis was C. albicans, and then C. glabrata. Also the most common mixtures of Candida species were combination of them

Mahmoudi Rad M

2009-12-01

164

Efficacy of FK463, a new lipopeptide antifungal agent, in mouse models of disseminated candidiasis and aspergillosis.  

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The efficacy of intravenous injection of FK463, a novel water-soluble lipopeptide, was evaluated in mouse models of disseminated candidiasis and aspergillosis and was compared with those of fluconazole (FLCZ) and amphotericin B (AMPH-B). In the candidiasis model, FK463 significantly prolonged the survival of intravenously infected mice at doses of 0.125 mg/kg of body weight or higher. In disseminated candidiasis caused by Candida species, including FLCZ-resistant Candida albicans, FK463 exhibited an efficacy 1.4 to 18 times inferior to that of AMPH-B, with 50% effective doses (ED(50)s) ranging from 0.21 to 1.00 mg/kg and 0.06 to 0.26 mg/kg, respectively, and was much more active than FLCZ. The protective effect of FK463 was not obviously influenced by the fungal inoculum size, the starting time of the treatment, or the immunosuppressed status of the host. The reduction in efficacy was less than that observed with FLCZ or AMPH-B. The efficacy of FK463 was also evaluated in the disseminated candidiasis target organ assay and was compared with those of FLCZ and AMPH-B. Efficacies were evaluated on the basis of a comparison between the mean log(10) CFU in kidneys in the groups treated with antifungal agents and that in control group. A single dose of FK463 at 0.5 mg/kg or higher significantly reduced the viable counts in kidneys compared with the numbers of yeast cells before treatment, and its efficacy was comparable to that of AMPH-B, while FLCZ at 4 mg/kg showed only a suppressive effect on the growth of C. albicans in the kidneys. In the disseminated aspergillosis model, FK463 given at doses of 0.5 mg/kg or higher significantly prolonged the survival of mice infected intravenously with Aspergillus fumigatus conidia. The efficacy of FK463 was about 2 times inferior to that of AMPH-B, with ED(50)s ranging from 0.25 to 0.50 mg/kg and 0.11 to 0.29 mg/kg, respectively. These results indicate that FK463 may be a potent parenterally administered therapeutic agent for disseminated candidiasis and aspergillosis. PMID:10681327

Ikeda, F; Wakai, Y; Matsumoto, S; Maki, K; Watabe, E; Tawara, S; Goto, T; Watanabe, Y; Matsumoto, F; Kuwahara, S

2000-03-01

165

Valor predictivo de la candidiasis oral como marcador de evolución a SIDA / Predictive value of oral candidiasis as a marker of progression to AIDS  

Scientific Electronic Library Online (English)

Full Text Available SciELO Spain | Language: Spanish Abstract in spanish Objetivo: Determinar la validez de la candidiasis oral (CO) como marcador clínico de evolución en los pacientes infectados por el Virus de la Inmunodeficiencia Humana. Diseño del estudio: En 1992, se efectuó una exploración oral a un colectivo de 200 pacientes infectados por VIH, con una edad media [...] de 36,8±7 años (rango 25-46 años) para establecer el diagnóstico de CO. Se registraron las variables edad, sexo, tiempo de evolución de la enfermedad, conducta de riesgo, número de linfocitos CD4/µL, estadio clínico y tratamiento antirretroviral. De los 200 pacientes del grupo de estudio, 157 no cumplían criterios de SIDA en el momento de la exploración basal y a éstos se les efectuó un seguimiento semestral hasta que cumplieron dichos criterios, concluyendo el estudio al final de 2001. Resultados: De los 157 pacientes seleccionados, 71 (45,2%) no presentaron CO y de éstos el 28,7% evolucionó a SIDA durante el período de seguimiento. De los 86 (54,8%) pacientes con CO, el 48,2% evolucionó a SIDA (RR=2,71). Al trasladar el origen del estudio al año 1997 cuando se inició la administración de la terapia antirretroviral de alta eficacia (TAAE), no se observaron diferencias en el porcentaje de pacientes que evolucionaron a SIDA en relación a la existencia o no de CO en la exploración basal. El análisis multivariante demostró que la asociación de la variable de exposición CO con la evolución a SIDA no alcanzó un valor predictivo. Conclusiones: El valor pronóstico a largo plazo de la CO, no se ha determinado en pacientes que reciben terapia antirretroviral de alta eficacia (TAAE). La recuperación inmunológica y la disminución de enfermedades oportunistas observadas tras la administración de TAAE, hacen que muchos pacientes que alcanzaron la condición de SIDA no cumplan en la actualidad dichos criterios, lo que obliga a renovar la propia definición del síndrome para poder evaluar marcadores de pronóstico. Abstract in english Objective: To determine the validity of oral candidiasis (OC) as a clinical marker of progression in patients with human immunodeficiency virus infection. Study design: In 1992, an oral examination was carried out on a group of 200 HIV-infected patients with a mean age of 36.8 ± 7 years (range 25-46 [...] years) to establish the diagnosis of OC. The following variables were recorded: age, sex, duration of the disease, risk behaviour, CD4 lymphocyte count, clinical stage and antiretroviral treatment. Of the 200 patients in the group evaluated, 157 did not fulfil the criteria for AIDS at the time of the baseline examination; these patients constitute the study group and underwent 6-monthly follow-up until they fulfilled these criteria. The study was concluded at the end of 2001. Results: Of the 157 patients selected, 71 (45.2%) did not present OC and, of these, 28.7% progressed to AIDS during the follow-up period. Of the 86 (54.8%) patients with OC, 48.2% progressed to AIDS (RR= 2.71). If the start date of the study was taken as 1997, when highly active antiretroviral therapy (HAART) was introduced, no differences were found in the percentage of patients who progressed to AIDS with respect to the presence or absence of OC at the baseline examination. Multivariate analysis demonstrated that the association of the presence of OC with progression to AIDS did not reach a predictive value. Conclusions: The long-term prognostic value of OC has not been established in patients receiving highly active antiretroviral therapy (HAART). The immunological recovery and the reduction in the number of opportunistic diseases observed after the administration of HAART means that many patients who developed AIDS do not currently satisfy these criteria, making a review of the definition of the syndrome itself a necessity in order to be able to evaluate prognostic markers.

Javier, Fernández Feijoo; Pedro, Diz Dios; Xosé Luis, Otero Cepeda; Jacobo, Limeres Posse; Javier de, la Fuente Aguado; Antonio, Ocampo Hermida.

2005-02-01

166

The role of Candida dubliniensis in oral candidiasis in human immunodeficiency virus-infected individuals.  

Science.gov (United States)

There is an increasing interest in non-albicans Candida species because of the increasing number of fungal infections they cause. Most of these infections can be found in immunocompromised individuals, especially in those infected with human immunodeficiency virus (HIV). Candida dubliniensis is a recently identified yeast, mostly isolated in HIV-positive individuals with oral candidiasis. Candida dubliniensis is a germ tube- and chlamydospore-form yeast. Thus, it shares diagnostic characteristics with Candida albicans. Probably, Candida dubliniensis has been present in the community for a long time and has been misidentified as Candida albicans. Significant phenotypic characteristics of Candida dubliniensis (difference in the carbohydrate assimilation profile, difference in colony color on CHROMagar Candida, and positive tetrazolium test, etc.) have been found, but none of them seem to be sufficient alone for the definitive identification of the species. Recently, PCR tests were developed to discriminate Candida albicans from Candida dubliniensis. However, these prove difficult in the context of routine mycological diagnostics. Moreover, an increased resistance to antifungal drugs has been described. This shows the importance of identification of Candida dubliniensis. To elucidate the current insight into Candida dubliniensis, the phenotypic and genotypic characteristics as well as the prevalence and the antifungal drug susceptibilities of this species are discussed from a clinical standpoint. PMID:10782340

Schorling, S R; Kortinga, H C; Froschb, M; Mühlschlegel, F A

2000-01-01

167

Calendula officinalis L. en el tratamiento tópico de la candidiasis vaginal recurrente  

Directory of Open Access Journals (Sweden)

Full Text Available La candidiasis vaginal recurrente (CVR es una enfermedad con una elevada prevalencia y los fitofármacos constituyen una opción en su tratamiento. Se realizó un estudio descriptivo para evaluar el efecto terapéutico y la seguridad de la Calendula officinalis L. por vía tópica en el tratamiento de la CVR. De 127 mujeres, 46 pacientes se seleccionaron aleatoriamente y se trataron con tintura de "calendula" 20%. La "calendula" se aplicó tres veces a la semana, en días alternos, durante dos semanas. Las pacientes fueron evaluadas al inicio del estudio, a los 21 y a los 30 días. La edad promedio fue de 23.7± 5.2 años y el 95.2% de las mujeres eran sexualmente activas. Al inicio del estudio, 85.7% presentó secreción vaginal abundante, pero a medida que el tratamiento progreso disminuyó el número de pacientes con leucorrea. Al inicio, la mayoría de las pacientes (83.3% presentó prurito, luego disminuyó significativamente. Se observó una reducción en el número de pacientes con cultivo vaginal positivo a los 21 días; sólo 7 pacientes (16.7% tuvieron cultivos positivos. La mayoría de las pacientes evolucionaron hacia la curación y no se reportaron efectos adversos. Se concluye que la Calendula officinalis L constituye una opción terapéutica en el tratamiento de esta enfermedad.

Pedro Miguel MILI\\u00C1N V\\u00C1ZQUEZ

2010-01-01

168

Invasive candidiasis in critical care setting, updated recommendations from "Invasive Fungal Infections-Clinical Forum", Iran  

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Invasive candidiasis (IC) bears a high risk of morbidity and mortality in the intensive care units (ICU). With the current advances in critical care and the use of wide-spectrum antibiotics, invasive fungal infections (IFIs) and IC in particular, have turned into a growing concern in the ICU. Further to blood cultures, some auxiliary laboratory tests and biomarkers are developed to enable an earlier detection of infection, however these test are neither consistently available nor validated in our setting. On the other hand, patients’ clinical status and local epidemiology data may justify the empiric antifungal approach using the proper antifungal option. The clinical approach to the management of IC in febrile, non-neutropenic critically ill patients has been defined in available international guidelines; nevertheless such recommendations need to be customized when applied to our local practice. Over the past three years, Iranian experts from intensive care and infectious diseases disciplines have tried to draw a consensus on the management of IFI with a particular focus on IC in the ICU. The established IFI-clinical forum (IFI-CF), comprising the scientific leaders in the field, has recently come up with and updated recommendation on the same (June 2014). The purpose of this review is to put together literature insights and Iranian experts’ opinion at the IFI-CF, to propose an updated practical overview on recommended approaches for the management of IC in the ICU. PMID:25374806

Elhoufi, Ashraf; Ahmadi, Arezoo; Asnaashari, Amir Mohammad Hashem; Davarpanah, Mohammad Ali; Bidgoli, Behrooz Farzanegan; Moghaddam, Omid Moradi; Torabi-Nami, Mohammad; Abbasi, Saeed; El-Sobky, Malak; Ghaziani, Ali; Jarrahzadeh, Mohammad Hossein; Shahrami, Reza; Shirazian, Farzad; Soltani, Farhad; Yazdinejad, Homeira; Zand, Farid

2014-01-01

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Vulvovaginal candidiasis: species distribution, fluconazole resistance and drug efflux pump gene overexpression.  

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The increasing incidence of vulvovaginal candidiasis (VVC) and the emergence of fluconazole resistance are an indisputable fact. However, little information is available regarding the correlation between fluconazole resistance in vaginal Candida albicans and the expression of drug efflux pump genes. In this study, we investigated the species distribution, fluconazole susceptibility profiles and the mechanisms of fluconazole resistance in Candida strains. In total, 785 clinical Candida isolates were collected from patients with VVC. C. albicans was the most frequently isolated species(n = 529) followed by C. glabrata (n = 164) and C. krusei (n = 57). Of all Candida isolates, 4.7% were resistant to fluconazole. We randomly selected 18 fluconazole resistant isolates of C. albicans to evaluate the expression of CDR1, CDR2, MDR1 and FLU1 genes. Compared with fluconazole-susceptible C. albicans isolates, CDR1 gene expression displayed 3.16-fold relative increase, which was statistically significant. CDR2, MDR1 and FLU1 overexpression was observed in several fluconazole-resistant C. albicans isolates, but statistical significance was not achieved. These results demonstrate a high frequency of non-albicans species (32.6%); however, C. albicans is the most common Candida species implicated in vaginitis, and this strain displays considerable fluconazole resistance. Meanwhile, our study further indicates that fluconazole resistance in C. albicans may correlate with CDR1 gene overexpression. PMID:24962255

Zhang, Jie-Yu; Liu, Jin-Hui; Liu, Fa-Di; Xia, Yan-Hua; Wang, Jing; Liu, Xi; Zhang, Zhi-Qin; Zhu, Na; Yan-Yan; Ying, Ying; Huang, Xiao-Tian

2014-10-01

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Prevalence of Candida albicans-closely related yeasts, Candida africana and Candida dubliniensis, in vulvovaginal candidiasis.  

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Isolates of Candida africana and C. dubliniensis were recovered from patients with vulvovaginal candidiasis (VVC). The isolates were initially identified as C. albicans through use of the API Candida System. We retrospectively reexamined 1014 vaginal isolates presumptively determined to be C. albicans at the Department of Obstetrics and Gynecology of Peking University Shenzhen Hospital from 1 January 2003 through 31 December 2012. Our objective was to determine, via detection of the HWP1 gene, if any of the isolates were C. africana or C. dubliniensis. One and a half percent of these isolates (15/1014) were found to be C. africana, whereas C. dubliniensis was not detected. The 15 C. africana isolates were susceptible to nystatin, fluconazole, itraconazole, miconazole, and clotrimazole. Candida africana could not be recovered from clinical vaginal specimens from the 15 patients at follow-up on days 7-14 and days 30-35 when treated with different antifungal agents. We conclude that C. africana, but not C. dubliniensis, was present in the vaginal samples of patients with VVC. The C. africana isolates were susceptible to the tested antifungal agents. VVC caused by C. africana appears to respond well to current therapies. PMID:25023482

Shan, Yingying; Fan, Shangrong; Liu, Xiaoping; Li, Jianling

2014-08-01

171

The essential oil of Melaleuca alternifolia (tea tree oil) and its main component, terpinen-4-ol protect mice from experimental oral candidiasis.  

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The therapeutic efficacy of tea tree oil (TTO), Melaleuca alternifolia, and its main component, terpinen-4-ol, were evaluated in a murine oral candidiasis model. Prednisolone -pretreated mice were orally infected with a fluconazole-susceptible (TIMM 2640) or a resistant (TIMM 3163) strain of Candida albicans to induce oral candidiasis. TTO or terpinen-4-ol was administrated with a cotton swab 3 h and 24 h after candida infection. These treatments clearly showed a decrease in the symptom score of tongues and in the viable candida cell number in the oral cavity at 2 d after azole-susceptible C. albicans infection, although the degree of the efficacy was less than that of fluconazole. Even against oral candidiasis caused by azole-resistant C. albicans, TTO and terpinen-4-ol were similarly effective, while fluconazole appeared ineffective. These results suggest that TTO and terpinen-4-ol may have the potential of therapeutic ability for mucosal candidiasis which may also be applicable to C. albicans oral candidiasis induced by the azole-resistant strain. PMID:22687476

Ninomiya, Kentaro; Maruyama, Naho; Inoue, Shigeharu; Ishibashi, Hiroko; Takizawa, Toshio; Oshima, Haruyuki; Abe, Shigeru

2012-01-01

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Species distribution and in vitro antifungal susceptibility of oral yeast isolates from Tanzanian HIV-infected patients with primary and recurrent oropharyngeal candidiasis  

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Full Text Available Abstract Background In Tanzania, little is known on the species distribution and antifungal susceptibility profiles of yeast isolates from HIV-infected patients with primary and recurrent oropharyngeal candidiasis. Methods A total of 296 clinical oral yeasts were isolated from 292 HIV-infected patients with oropharyngeal candidiasis at the Muhimbili National Hospital, Dar es Salaam, Tanzania. Identification of the yeasts was performed using standard phenotypic methods. Antifungal susceptibility to fluconazole, itraconazole, miconazole, clotrimazole, amphotericin B and nystatin was assessed using a broth microdilution format according to the guidelines of the Clinical and Laboratory Standard Institute (CLSI; M27-A2. Results Candida albicans was the most frequently isolated species from 250 (84.5% patients followed by C. glabrata from 20 (6.8% patients, and C. krusei from 10 (3.4% patients. There was no observed significant difference in species distribution between patients with primary and recurrent oropharyngeal candidiasis, but isolates cultured from patients previously treated were significantly less susceptible to the azole compounds compared to those cultured from antifungal naïve patients. Conclusion C. albicans was the most frequently isolated species from patients with oropharyngeal candidiasis. Oral yeast isolates from Tanzania had high level susceptibility to the antifungal agents tested. Recurrent oropharyngeal candidiasis and previous antifungal therapy significantly correlated with reduced susceptibility to azoles antifungal agents.

Rijs Antonius JMM

2008-08-01

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Asociación de LT-CD4 y carga viral con candidiasis bucal en pacientes VIH/SIDA en Talca, Chile Association between LT-CD4 and the viral load with oral candidiasis in HIV/AIDS patients in Talca, Chile  

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Full Text Available La candidiasis bucal aparece con frecuencia en las personas infectadas por el virus de la inmunodeficiencia humana (VIH y puede causar diversas manifestaciones clínicas y complicaciones. En los pacientes VIH la carga viral es considerada uno de los principales predictores en la progresión de la enfermedad. Se realizó un estudio en 29 pacientes adultos VIH-positivos para evaluar los niveles de linfocitos T-CD4 y carga viral; se estableció una relación con las manifestaciones de la candidiasis bucal. El análisis estadístico mostró que hubo relación entre la manifestación de la candidiasis bucal y la carga viral, pues en pacientes con cargas virales superiores a 10 000 copias/mL, las lesiones fueron más frecuentes.Oral candidiasis is frequently appearing in persons infected by human immunodeficiency virus (HIV and may to cause many clinical and complications manifestations. In HIV patients the viral load is considered one of the main predictors in disease progression. A study was conducted in 29 HIV-positive adult patients to assess the T-CD4 lymphocyte levels and the viral load establishing a relationship with oral candidiasis manifestations. The statistical analysis showed that there was a relationship between the oral candidiasis manifestation and the viral load since in patients with viral load higher than 10 000 copies/mL, lesions were more frequent.

Pedro Brevis Azocar

2009-12-01

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Candidíase invasiva e alterações bucais em recém-nascidos prematuros / Invasive candidiasis and oral manifestations in premature newborns  

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Full Text Available SciELO Brazil | Language: Portuguese Abstract in portuguese OBJETIVO: Investigar a prevalência de candidíase invasiva em Unidade de Terapia Intensiva Neonatal e avaliar alterações bucais e colonização bucal por Candida spp. em recém-nascidos prematuros com baixo peso. MÉTODOS: Estudo epidemiológico descritivo em duas etapas. Na primeira, analisou-se prevalên [...] cia de candidíase invasiva em base de dados de 295 prematuros com tempo de internação superior a 10 dias e peso ao nascer inferior a 2.000g. Na segunda etapa, avaliaram-se alterações bucais e colonização por Candida spp. em 65 pacientes com peso inferior a 2.000g, com até 4 semanas de idade, internados há mais de 10 dias e apresentando alterações bucais compatíveis com lesões fúngicas. Coletaram-se amostras com swab bucal e identificou-se a colonização fúngica. RESULTADOS: Na análise da base de dados, constatou-se que a prevalência de candidíase foi de 5,4%. Houve correlação com o tempo prolongado de internação (p Abstract in english OBJECTIVE: To investigate prevalence of invasive candidiasis in a Neonatal Intensive Care Unit and to evaluate oral diseases and Candida spp. colonization in low birth weight preterm newborns. METHODS: A descriptive epidemiological study performed in two stages. First, prevalence of candidiasis was [...] analyzed in a database of 295 preterm patients admitted to hospital for over 10 days and birth weight less than 2,000g. In the second stage, oral changes and Candida spp. colonization were assessed in 65 patients weighing less than 2,000g, up to 4 week-old, hospitalized for over 10 days and presenting oral abnormalities compatible with fungal lesions. Swab samples were collected in the mouth to identify fungi. RESULTS: Prevalence of candidiasis was 5.4% in the database analyzed. It correlated with prolonged hospital length of stay (p

José Endrigo, Tinoco-Araujo; Diana Ferreira Gadelha, Araújo; Patrícia Gomes, Barbosa; Paulo Sérgio da Silva, Santos; Ana Myriam Costa de, Medeiros.

2013-03-01

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Candidíase invasiva e alterações bucais em recém-nascidos prematuros / Invasive candidiasis and oral manifestations in premature newborns  

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Full Text Available SciELO Brazil | Language: Portuguese Abstract in portuguese OBJETIVO: Investigar a prevalência de candidíase invasiva em Unidade de Terapia Intensiva Neonatal e avaliar alterações bucais e colonização bucal por Candida spp. em recém-nascidos prematuros com baixo peso. MÉTODOS: Estudo epidemiológico descritivo em duas etapas. Na primeira, analisou-se prevalên [...] cia de candidíase invasiva em base de dados de 295 prematuros com tempo de internação superior a 10 dias e peso ao nascer inferior a 2.000g. Na segunda etapa, avaliaram-se alterações bucais e colonização por Candida spp. em 65 pacientes com peso inferior a 2.000g, com até 4 semanas de idade, internados há mais de 10 dias e apresentando alterações bucais compatíveis com lesões fúngicas. Coletaram-se amostras com swab bucal e identificou-se a colonização fúngica. RESULTADOS: Na análise da base de dados, constatou-se que a prevalência de candidíase foi de 5,4%. Houve correlação com o tempo prolongado de internação (p Abstract in english OBJECTIVE: To investigate prevalence of invasive candidiasis in a Neonatal Intensive Care Unit and to evaluate oral diseases and Candida spp. colonization in low birth weight preterm newborns. METHODS: A descriptive epidemiological study performed in two stages. First, prevalence of candidiasis was [...] analyzed in a database of 295 preterm patients admitted to hospital for over 10 days and birth weight less than 2,000g. In the second stage, oral changes and Candida spp. colonization were assessed in 65 patients weighing less than 2,000g, up to 4 week-old, hospitalized for over 10 days and presenting oral abnormalities compatible with fungal lesions. Swab samples were collected in the mouth to identify fungi. RESULTS: Prevalence of candidiasis was 5.4% in the database analyzed. It correlated with prolonged hospital length of stay (p

José Endrigo, Tinoco-Araujo; Diana Ferreira Gadelha, Araújo; Patrícia Gomes, Barbosa; Paulo Sérgio da Silva, Santos; Ana Myriam Costa de, Medeiros.

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Systemic Candidiasis in Extremely Low Birthweight (ELBW) Neonates Despite the Routine Use of Topical Miconazole Prophylaxis: Trends, Risk Factors and Outcomes over an 11-Year Period.  

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Introduction: This study aims to determine the incidence, trends of systemic candidiasis and meningitis in extremely low birthweight (ELBW) neonates (retinopathy of prematurity (ROP), patent ductus arteriosus (PDA) requiring treatment, necrotising enterocolitis (NEC), chronic lung disease (CLD) and cholestatic jaundice. Mortality and end organ involvement secondary to systemic candidiasis were identified as adverse outcomes. Results: Of the 757 ELBW neonates, 51 (6.7%) had evidence of systemic candidiasis with a significant 3-fold increase in trend noted in 2007 as compared against 1997 (12.1% vs 3.8%) (RR 1.2, 95% CI, 1.06 to 1.36, P <0.001). This corresponds to a significant increasing trend of preceding or co-existent bacterial blood stream infections (BSI) in neonates with systemic candidiasis (0% in 1997 vs 7.1% in 2007, RR 1.40, 95% CI, 1.04 to 1.25, P = 0.005). On logistic regression analysis, decreasing gestational age was an independent risk factor for systemic candidiasis (OR 2.0, 95% CI, 1.52 to 2.63, P <0.001). Candida meningitis was detected in 4/38 (10.5%) and end organ involvement in 17 (33%). The organisms isolated were Candida parapsilosis 31 (61%), Candida albicans 17 (33%) and Candida glabrata 3 (5.8%). Significantly higher mortality was seen in cases when compared to controls 10/51 (19.6%) vs 76/706 (10.7%) (OR 2.02, 95% CI, 1.02 to 4.40, P <0.001). Conclusion: Increasing trend in the incidence of systemic candidiasis despite routine use of topical miconazole prophylaxis is of concern and future studies comparing the use of systemic fl uconazole versus oral nystatin may need to be considered. PMID:24919490

Sriram, Bhavani; Agarwal, Pratibha K; Tee, Nancy Ws; Rajadurai, Victor S

2014-05-01

177

Invasive candidiasis in Pakistan: clinical characteristics, species distribution and antifungal susceptibility.  

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This study reports for the first time, to our knowledge, descriptive epidemiological data for 188 invasive Candida isolates from Pakistan, including species identification and antifungal susceptibility against fluconazole, itraconazole, voriconazole, caspofungin, micafungin, anidulafungin and amphotericin. Risk factors for invasive candidiasis (IC) were determined for 96 patients from Karachi, Pakistan. In adults and neonates, Candida tropicalis (38 and 36?%, respectively) was the most common species, followed in adults by Candida parapsilosis (17.8?%), Candida glabrata (15.9?%) and Candida albicans (12.3?%). C. albicans (21?%) was the second most common in neonates. In children, C. albicans (31.9?%), C. tropicalis (26.4?%) and C. parapsilosis (19.4?%) were the most common. C. albicans IC was significantly associated with paediatric age [crude odds ratio (COR) 3.46, 95?% confidence interval (CI) 1.63-7.32]. Rare species made up 17.5?% of the total isolates studied. Resistance to fluconazole was seen in C. glabrata (15?.0%) and Candida krusei (100?.0%). Only one isolate (C. glabrata) was resistant to all three echinocandins. Low MICs of fluconazole for 98?% (184/188) of isolates tested support its continued use as an empiric therapy for IC. Non-C. albicans IC was associated with the use of ?-lactam inhibitor combinations (COR 3.16, 95?% CI 1.05-9.57). Use of healthcare devices was documented in 85.4?% of IC patients, whilst 75?.0% had been admitted to special care units. Surprisingly, 66.7?% of patients with IC were not obviously immunosuppressed. The high frequency of modifiable risk factors in this population indicates that candidaemia can be reduced with stringent antibiotic and infection control measures. These data will be useful for empiric selection of antifungals in Karachi, and contribute to global assessments of antifungal resistance. PMID:23105021

Farooqi, J Q; Jabeen, K; Saeed, N; Iqbal, N; Malik, B; Lockhart, S R; Zafar, A; Brandt, M E; Hasan, R

2013-02-01

178

Diverse Vaginal Microbiomes in Reproductive-Age Women with Vulvovaginal Candidiasis  

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Vulvovaginal candidiasis (VVC) is one of the most prevalent vaginal infectious diseases, and there are controversial reports regarding the diversity of the associated vaginal microbiota. We determined the vaginal microbial community in patients with VVC, bacterial vaginosis (BV), and mixed infection of VVC and BV using Illumina sequencing of 16S rRNA tags. Our results revealed for the first time the highly variable patterns of the vaginal microbiome from VVC patients. In general, the alpha-diversity results of species richness and evenness showed the following order: normal control < VVC only < mixed BV and VVC infection < BV only. The beta-diversity comparison of community structures also showed an intermediate composition of VVC between the control and BV samples. A detailed comparison showed that, although the control and BV communities had typical patterns, the vaginal microbiota of VVC is complex. The mixed BV and VVC infection group showed a unique pattern, with a relatively higher abundance of Lactobacillus than the BV group and higher abundance of Prevotella, Gardnerella, and Atopobium than the normal control. In contrast, the VVC-only group could not be described by any single profile, ranging from a community structure similar to the normal control (predominated with Lactobacillus) to BV-like community structures (abundant with Gardnerella and Atopobium). Treatment of VVC resulted in inconsistent changes of the vaginal microbiota, with four BV/VVC samples recovering to a higher Lactobacillus level, whereas many VVC-only patients did not. These results will be useful for future studies on the role of vaginal microbiota in VVC and related infectious diseases. PMID:24265786

Liu, Mu-Biao; Xu, Su-Rong; He, Yan; Deng, Guan-Hua; Sheng, Hua-Fang; Huang, Xue-Mei; Ouyang, Cai-Yan; Zhou, Hong-Wei

2013-01-01

179

Prophylactic strategies in recurrent vulvovaginal candidiasis: a 2-year study testing a phytonutrient vs itraconazole.  

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The aim of the present study was to assess the clinical efficacy of a one week/month treatment with a phytocompound with antimycotic properties (K-712, with following 100 mg composition: 10 mg of oleoresin from Pseudowintera colorata at 30 percent concentration in Polygodial together with trace amounts of Olea europea) in recurrent vulvo-vaginal candidiasis (RVVC), as compared to once a week treatment with an azole drug for 24 months follow up. This prospective randomized study involving 122 women (19 to 63 years old) with a history of proven episodes of RVVC in the prior 12 months. Patients were allocated in two treatment groups of 61 patients each and given A) Itraconazole 200 mg orally once a week or B) 1 tab twice a day of K-712 for one week/month. Each treatment schedule was well tolerated with 19 patients in the azole group complaining of transient mild symptoms (nausea, abdominal discomfort, unpleasant taste), while only 3 patients on K-712 reported slight dyspepsia. The number of relapses was significantly lower in the K-712-treated group as compared to the itraconazole-group (22 vs 39, p less than 0.05). Moreover, the former group showed a significantly decreased number of cases resistant or dose-dependent susceptible as compared to group A (p less than 0.05 vs itraconazole) and the same occurred for the occurrence of non-albicans species (group A 64.1 percent vs group B 31.8 percent, p less than 0.05). The overall mycological cure at the end of the 2-year study showed a comparable benefit between the two groups. From these data it appears that the present antifungal phytonutrient is equally effective as itraconazole in the overall treatment of RVVC over a 2-year follow-up, but yielding a significantly better prophylactic effect and also maintenance benefit with lower relapse rate, antifungal susceptibility and growth of azole-resistant species. PMID:24152852

Chopra, V; Marotta, F; Kumari, A; Bishier, M P; He, F; Zerbinati, N; Agarwal, C; Naito, Y; Tomella, C; Sharma, A; Solimene, U

2013-01-01

180

Anidulafungin pharmacokinetics and microbial response in neutropenic mice with disseminated candidiasis.  

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Candidemia is often fatal, especially in patients with persistent neutropenia. New therapies are needed. We performed 24-h pharmacodynamic studies to compare the efficacies of anidulafungin, fluconazole, and amphotericin B in neutropenic mice with disseminated candidiasis caused by one of three strains of Candida glabrata. Anidulafungin produced a maximal fungal kill (E(max)) of 1.4 to 1.9 log(10) CFU/g in kidneys and was not influenced by resistance to either fluconazole or amphotericin B. Fluconazole produced an E(max) of 1.3 log(10) CFU/g in mice infected with fluconazole-susceptible C. glabrata, but the E(max) was 0 for mice infected with a C. glabrata strain that had a fluconazole MIC of >/=32 mg/liter. Amphotericin B achieved an E(max) of 4.2 log(10) CFU/g in mice infected with amphotericin B-susceptible C. glabrata, but the E(max) was 0 for mice infected with a C. glabrata strain with an amphotericin B MIC of 2 mg/liter. In all instances, anidulafungin's maximal microbial kill was superior to that of fluconazole. Next, we performed a 96-h anidulafungin pharmacokinetic-pharmacodynamic study. Anidulafungin exhibited delayed peak concentrations in kidneys compared to those in serum, after which the concentrations declined, with a serum terminal half-life of 21.6 (+/-4.6) h. This was accompanied by a persistent 96-h decrease in the kidney fungal burden after treatment with a single anidulafungin dose of >/=8 mg/kg of body weight. This pharmacokinetic-pharmacodynamic picture of anidulafungin persistence in tissues and the resultant persistent fungal decline should be exploited to improve the efficacy of anidulafungin therapy for candidemia. PMID:16954319

Gumbo, Tawanda; Drusano, George L; Liu, Weiguo; Ma, Lei; Deziel, Mark R; Drusano, Michael F; Louie, Arnold

2006-11-01

 
 
 
 
181

Pharmacokinetic optimization of the treatment of oral candidiasis with fluconazole: studies with a suspension.  

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An open crossover study was performed in 12 healthy subjects to investigate the pharmacokinetics in saliva and plasma of a 100 mg oral dose of fluconazole, administered as either a capsule or as a suspension, the latter being used to rinse the mouth and retained for 2 min before being swallowed. In terms of fluconazole plasma concentrations the capsule and the suspension were essentially bioequivalent. While the saliva concentrations of fluconazole after capsule administration reached their peak at 3.0 +/- 0.8 micrograms/ml 4 h after dosage, administration of the suspension resulted in a mean peak concentration of 551.1 +/- 425.6 micrograms/ml 5 min after ingestion. The saliva concentrations decreased gradually after ingestion of the suspension, but were higher for 4 h than the corresponding levels from the capsule. The area under the curve (AUC) from 0 to 96 h of fluconazole in saliva was 227.7 +/- 73.8 h micrograms/ml after the suspension, compared to 123.5 +/- 25.5 h micrograms/ml after the capsule, indicating that the total drug exposure to the oral mucosa by the salivary route was enhanced more than 80% with use of the suspension. Four h after administration of the suspension, saliva and plasma concentrations of fluconazole were in equilibrium, at a saliva: plasma ratio of around 1.2. Taken together, the present results suggest that the treatment of oral candidiasis with fluconazole may be optimized by use of an oral suspension, as this delivers pharmacologically active levels of the drug to the site of infection by both topical and systemic routes. PMID:7796709

Laufen, H; Yeates, R A; Zimmermann, T; de los Reyes, C

1995-01-01

182

Patient preferences and treatment safety for uncomplicated vulvovaginal candidiasis in primary health care  

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Full Text Available Abstract Background Vaginitis is a common complaint in primary care. In uncomplicated candidal vaginitis, there are no differences in effectiveness between oral or vaginal treatment. Some studies describe that the preferred treatment is the oral one, but a Cochrane's review points out inconsistencies associated with the report of the preferred way that limit the use of such data. Risk factors associated with recurrent vulvovaginal candidiasis still remain controversial. Methods/Design This work describes a protocol of a multicentric prospective observational study with one year follow up, to describe the women's reasons and preferences to choose the way of administration (oral vs topical in the treatment of not complicated candidal vaginitis. The number of women required is 765, they are chosen by consecutive sampling. All of whom are aged 16 and over with vaginal discharge and/or vaginal pruritus, diagnosed with not complicated vulvovaginitis in Primary Care in Madrid. The main outcome variable is the preferences of the patients in treatment choice; secondary outcome variables are time to symptoms relief and adverse reactions and the frequency of recurrent vulvovaginitis and the risk factors. In the statistical analysis, for the main objective will be descriptive for each of the variables, bivariant analysis and multivariate analysis (logistic regression.. The dependent variable being the type of treatment chosen (oral or topical and the independent, the variables that after bivariant analysis, have been associated to the treatment preference. Discussion Clinical decisions, recommendations, and practice guidelines must not only attend to the best available evidence, but also to the values and preferences of the informed patient.

Hernández Susana

2011-01-01

183

Protocol for a randomised controlled trial of treatment of asymptomatic candidiasis for the prevention of preterm birth [ACTRN12610000607077  

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Full Text Available Abstract Background Prevention of preterm birth remains one of the most important challenges in maternity care. We propose a randomised trial with: a simple Candida testing protocol that can be easily incorporated into usual antenatal care; a simple, well accepted, treatment intervention; and assessment of outcomes from validated, routinely-collected, computerised databases. Methods/Design Using a prospective, randomised, open-label, blinded-endpoint (PROBE study design, we aim to evaluate whether treating women with asymptomatic vaginal candidiasis early in pregnancy is effective in preventing spontaneous preterm birth. Pregnant women presenting for antenatal care The study protocol draws on the usual antenatal care schedule, has been pilot-tested and the intervention involves only a minor modification of current practice. Women who agree to participate will self-collect a vaginal swab and those who are culture positive for Candida will be randomised (central, telephone to open-label treatment or usual care (screening result is not revealed, no treatment, routine antenatal care. Outcomes will be obtained from population databases. A sample size of 3,208 women with Candida colonisation (1,604 per arm is required to detect a 40% reduction in the spontaneous preterm birth rate among women with asymptomatic candidiasis from 5.0% in the control group to 3.0% in women treated with clotrimazole (significance 0.05, power 0.8. Analyses will be by intention to treat. Discussion For our hypothesis, a placebo-controlled trial had major disadvantages: a placebo arm would not represent current clinical practice; knowledge of vaginal colonisation with Candida may change participants' behaviour; and a placebo with an alcohol preservative may have an independent affect on vaginal flora. These disadvantages can be overcome by the PROBE study design. This trial will provide definitive evidence on whether screening for and treating asymptomatic candidiasis in pregnancy significantly reduces the rate of spontaneous preterm birth. If it can be demonstrated that treating asymptomatic candidiasis reduces preterm births this will change current practice and would directly impact the management of every pregnant woman. Trial registration Australian New Zealand Clinical Trials Registry ACTRN12610000607077

Rickard Kristen R

2011-03-01

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Susceptibilidad antifúngica de Candida albicans recuperadas de pacientes con SIDA y candidiasis orofaríngea y esofágica: Experiencia con Etest® Antifungal susceptibility testing of Candida albicans isolates from AIDS patients with oropharyngeal and esophageal candidiasis: Experience with Etest®  

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Full Text Available Background: Oropharyngeal candidiasis (OPC and esophageal candidiasis (EPC are frequent complications in AIDS patients. The use of Fluconazole, an effective and a low toxicity drug, has been associated to the emergency of secondary resistant strains. For this reason, in vitro antifungal susceptibility tests are necessary to predict a therapeutic failure. Etest® is an easy to perform alternative test, that has showed a good agreement with the broth microdilution reference method (NCCLS, document M27-A. Aim: To measure the susceptibility of C. albicans isolates from AIDS patients complicated with OPC and EPC to Amphotericin B (AmB and Fluconazole (Flu using Etest®. Material and methods: Twenty strains from 20 AIDS patients were studied. AmB was tested in RPMI 1640 agar and Flu in Casitone agar. Results: All studied strains showed minimal inhibitory concentrations (MICs 256 mg/mL was isolated from a patient previously treated with Flu. Conclusions: In AIDS patients with OPC and EPC, the susceptibility to Flu of the isolates should be screened, to detect resistant strains. Etest®; is a reliable alternative in these cases, for laboratories that cannot use the reference method (Rev Méd Chile 2003; 131: 515-19.

Cecilia Tapia P

2003-05-01

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Susceptibilidad antifúngica de Candida albicans recuperadas de pacientes con SIDA y candidiasis orofaríngea y esofágica: Experiencia con Etest® / Antifungal susceptibility testing of Candida albicans isolates from AIDS patients with oropharyngeal and esophageal candidiasis: Experience with Etest®  

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Full Text Available SciELO Chile | Language: Spanish Abstract in spanish [...] Abstract in english Background: Oropharyngeal candidiasis (OPC) and esophageal candidiasis (EPC) are frequent complications in AIDS patients. The use of Fluconazole, an effective and a low toxicity drug, has been associated to the emergency of secondary resistant strains. For this reason, in vitro antifungal susceptibi [...] lity tests are necessary to predict a therapeutic failure. Etest® is an easy to perform alternative test, that has showed a good agreement with the broth microdilution reference method (NCCLS, document M27-A). Aim: To measure the susceptibility of C. albicans isolates from AIDS patients complicated with OPC and EPC to Amphotericin B (AmB) and Fluconazole (Flu) using Etest®. Material and methods: Twenty strains from 20 AIDS patients were studied. AmB was tested in RPMI 1640 agar and Flu in Casitone agar. Results: All studied strains showed minimal inhibitory concentrations (MICs) 256 mg/mL) was isolated from a patient previously treated with Flu. Conclusions: In AIDS patients with OPC and EPC, the susceptibility to Flu of the isolates should be screened, to detect resistant strains. Etest®; is a reliable alternative in these cases, for laboratories that cannot use the reference method (Rev Méd Chile 2003; 131: 515-19).

Cecilia, Tapia P; Patricia, González A; Angélica, Pereira A; Jorge, Pérez G; Luis M, Noriega R; Elizabeth, Palavecino R.

186

?-Glucan Induces Reactive Oxygen Species Production in Human Neutrophils to Improve the Killing of Candida albicans and Candida glabrata Isolates from Vulvovaginal Candidiasis  

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Vulvovaginal candidiasis (VVC) is among the most prevalent vaginal diseases. Candida albicans is still the most prevalent species associated with this pathology, however, the prevalence of other Candida species, such as C. glabrata, is increasing. The pathogenesis of these infections has been intensely studied, nevertheless, no consensus has been reached on the pathogenicity of VVC. In addition, inappropriate treatment or the presence of resistant strains can lead to RVVC (vulvovaginal candidiasis recurrent). Immunomodulation therapy studies have become increasingly promising, including with the ?-glucans. Thus, in the present study, we evaluated microbicidal activity, phagocytosis, intracellular oxidant species production, oxygen consumption, myeloperoxidase (MPO) activity, and the release of tumor necrosis factor ? (TNF-?), interleukin-8 (IL-8), IL-1?, and IL-1Ra in neutrophils previously treated or not with ?-glucan. In all of the assays, human neutrophils were challenged with C. albicans and C. glabrata isolated from vulvovaginal candidiasis. ?-glucan significantly increased oxidant species production, suggesting that ?-glucan may be an efficient immunomodulator that triggers an increase in the microbicidal response of neutrophils for both of the species isolated from vulvovaginal candidiasis. The effects of ?-glucan appeared to be mainly related to the activation of reactive oxygen species and modulation of cytokine release. PMID:25229476

Bonfim-Mendonca, Patricia de Souza; Ratti, Bianca Altrao; Godoy, Janine da Silva Ribeiro; Negri, Melyssa; de Lima, Nayara Cristina Alves; Fiorini, Adriana; Hatanaka, Elaine; Consolaro, Marcia Edilaine Lopes; de Oliveira Silva, Sueli; Svidzinski, Terezinha Inez Estivalet

2014-01-01

187

?-glucan induces reactive oxygen species production in human neutrophils to improve the killing of Candida albicans and Candida glabrata isolates from vulvovaginal candidiasis.  

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Vulvovaginal candidiasis (VVC) is among the most prevalent vaginal diseases. Candida albicans is still the most prevalent species associated with this pathology, however, the prevalence of other Candida species, such as C. glabrata, is increasing. The pathogenesis of these infections has been intensely studied, nevertheless, no consensus has been reached on the pathogenicity of VVC. In addition, inappropriate treatment or the presence of resistant strains can lead to RVVC (vulvovaginal candidiasis recurrent). Immunomodulation therapy studies have become increasingly promising, including with the ?-glucans. Thus, in the present study, we evaluated microbicidal activity, phagocytosis, intracellular oxidant species production, oxygen consumption, myeloperoxidase (MPO) activity, and the release of tumor necrosis factor ? (TNF-?), interleukin-8 (IL-8), IL-1?, and IL-1Ra in neutrophils previously treated or not with ?-glucan. In all of the assays, human neutrophils were challenged with C. albicans and C. glabrata isolated from vulvovaginal candidiasis. ?-glucan significantly increased oxidant species production, suggesting that ?-glucan may be an efficient immunomodulator that triggers an increase in the microbicidal response of neutrophils for both of the species isolated from vulvovaginal candidiasis. The effects of ?-glucan appeared to be mainly related to the activation of reactive oxygen species and modulation of cytokine release. PMID:25229476

Bonfim-Mendonça, Patricia de Souza; Ratti, Bianca Altrão; Godoy, Janine da Silva Ribeiro; Negri, Melyssa; Lima, Nayara Cristina Alves de; Fiorini, Adriana; Hatanaka, Elaine; Consolaro, Marcia Edilaine Lopes; de Oliveira Silva, Sueli; Svidzinski, Terezinha Inez Estivalet

2014-01-01

188

Levamisole Aids in Treatment of Refractory Oral Candidiasis in Two Patients with Thymoma Associated with Myasthenia Gravis: Report of Two Cases  

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Full Text Available Oral candidiasis is associated with defects in cell-mediated immunity and is commonamong patients undergoing cytotoxic chemotherapy, or corticosteroid or antibiotic therapy,and those patients seropositive for AIDS and HIV (human immunodeficiency virus. Thispaper demonstrates the important role of cell-mediated immunity in oral candidiasis in 2cases of thymoma associated with myasthenia gravis. Both suffered from recurrent oral candidiasisafter a thymectomy, radiotherapy, and chemotherapy. There was an initial goodresponse to conventional antifungal therapy, which later became refractory. Lymphocytesubset quantitation showed a T cell deficiency and a decreased CD4/CD8 ratio. Levamisole,an immunomodulator, or an immunopotentiating drug was added as adjunctive therapy incombination with oral nystatin treatment. Oral candidiasis responded favorably, and substantialrelief was obtained with a concurrent increase in T cells and the CD4/CD8 ratio.These findings clearly demonstrate a significant role of cell-mediated immunity in oral candidiasis,and that eradication of infection is dependent on the host defense mechanism.

Wei-Hao Lai

2002-09-01

189

[Effects of inhibitory activity on mycelial growth of Candida albicans and therapy for murine oral candidiasis by the combined use of terpinen-4-ol and a middle-chain fatty acid, capric acid].  

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The combined effect of terpinen-4-ol, the main component of tea tree oil, and capric acid against mycelial growth of Candida albicans and murine oral candidiasis was evaluated in vitro and in vivo. Mycelial growth of C. albicans was estimated by the Cristal violet method. Combination of these compounds revealed a potent synergistic inhibition of growth. Therapeutic efficacy of the combination was evaluated microbiologically in murine oral candidiasis, and its application of the compounds clearly demonstrated therapeutic activity. Based on these results, the combined agent of terpinen-4-ol and capric acid was discussed as a possible candidate for oral candidiasis therapy. PMID:23292030

Ninomiya, Kentaro; Hayama, Kazumi; Ishijima, Sanae; Takahashi, Miki; Kurihara, Junichi; Abe, Shigeru

2013-01-01

190

Micafungin: a review of its use in adults for the treatment of invasive and oesophageal candidiasis, and as prophylaxis against Candida infections.  

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Intravenous micafungin (Mycamine; Fungard), an echinocandin, inhibits the synthesis of 1,3-beta-D-glucan, an essential cell wall component in many fungi. It is approved in adults (focus of this review) and in neonates and paediatric patients (Pediatric Drugs [in press]) in the EU and elsewhere for the treatment of invasive candidiasis and oesophageal candidiasis, and as prophylactic treatment to prevent Candida infections in haematopoietic stem cell transplant (HSCT) recipients.Intravenous micafungin shows very good activity against clinically relevant isolates of Candida spp. Furthermore, the pharmacokinetic profile of micafungin permits once-daily treatment and means that it is associated with relatively few drug-drug interactions. However, like all of the echinocandins and all formulations of amphotericin B, micafungin must be given intravenously. In large, well designed clinical trials in adult patients (>or=16 years of age) with invasive candidiasis, intravenous micafungin was shown to be noninferior to intravenous caspofungin or liposomal amphotericin B. In similarly designed trials in adult patients with oesophageal candidiasis, intravenous micafungin was shown to be noninferior to fluconazole or caspofungin treatment. As prophylactic treatment in adult and paediatric patients who had undergone HSCT, micafungin was superior to fluconazole therapy in a large, well designed trial. Micafungin was generally well tolerated by participants in these clinical trials. Furthermore, it was as well tolerated as caspofungin and fluconazole, and better tolerated than liposomal amphotericin B. The position of micafungin relative to newer antifungal therapies, such as anidulafungin, voriconazole and posaconazole, remains to be fully determined. Thus, micafungin is an emerging option for the treatment of adult patients with invasive or oesophageal candidiasis, and as prophylaxis against Candida infections in HSCT recipients. PMID:18840009

Cross, Sarah A; Scott, Lesley J

2008-01-01

191

Low-dose ketoconazole-fluconazole combination versus fluconazole in single doses for the treatment of vaginal candidiasis  

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Full Text Available Background: Vaginal candidiasis (VC is one of the most common fungal diseases. Candida albicans is the most common causative fungus and has been isolated from more than 80% of specimens obtained from women with VC. Ketoconazole is the first orally active antifungal, the dosage for VC is 200 mg twice daily for 5 days. Fluconazole is the newer oral antifungal, its dosage for VC is a single oral dose of 150 mg. Since fluconazole 150 mg is considerably expensive, a single dose of 100 mg ketoconazole and 40 mg fluconazole in combination has been tested for the treatment of VC. The results showed that from 11 women with confirmed VC, 1-2 weeks after drug administration, the mycological culture was negative in 8 women, positive in 1 woman, and 2 woman lost to follow-up. This promising result led to the present study with the objective to confirm the efficacy and safety of the above combination in a formal clinical trial.Methods: A total of 165 female patients, aged 18 years or older, with the diagnosis of VC from clinical symptoms (pruritus or burning or excessive discharge and positive microscopic smear (pseudohyphae and/or yeast cells were randomized to receive a single dose of either keto-fluco combination (n = 85 or fluconazole (n = 80, and returnedfor follow-up visit on day 8.Results: Among these patients, 39 patients had negative baseline culture, leaving 126 patients eligible for efficacy evaluation. The mycological eradication in the keto-fluco group was 74.5% (41 patients from a total of 55 patients with available mycological culture, while that in the fluconazole group was 70.2% (40 patients from 57 patients with available culture and this difference was not significant. The clinical favorable response (clinical cure and clinical improvement in the keto-fluco arm (n = 60 was 98.3%, while that in the fluconazole group (n = 66 was 100%. Adverse events were found in 5 patients, 3 patients in the keto-fluco group (3/85 = 3.5% and 2 patients in the fluconazole group (2/80 = 2.5%.Conclusion: The present study showed that the efficacy and safety of ketoconazole 100 mg and fluconazole 40 mg combination was not inferior compared to fluconazole 150 mg in single doses for the treatment of vaginal candidiasis. (Med J Indones 2011; 20:205-11Keywords: fluconazole, low-dose ketoconazole-fluconazole combination, single dose, vaginal candidiasis

Jan Susilo

2011-08-01

192

Candida nivariensis as an etiologic agent of vulvovaginal candidiasis in a tertiary care hospital of New Delhi, India.  

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Candida nivariensis is a cryptic species, phenotypically indistinguishable from Candida glabrata and identified by molecular methods. Aside its isolation from broncho-alveolar lavage, we report for the first time the etiologic role of C. nivariensis in 4 patients with vulvovaginal candidiasis. Of 100 phenotypically identified C. glabrata isolates originating from vaginal swabs, 4 were identified as C. nivariensis by polymerase chain reaction and confirmed by sequencing. All of the C. nivariensis isolates exhibited white colonies on CHROMagar. Phylogenetic analysis revealed genotypic diversity in the C. nivariensis isolates originating from within or outside of India. Barring a solitary C. nivariensis isolate with MIC, 16 ?g/mL of fluconazole, the rest were susceptible to voriconazole, itraconazole, posaconazole, isavuconazole, amphotericin B, and echinocandins. The patient with high fluconazole MIC did not respond to fluconazole therapy. It is suggested that the prevalence of this species is likely to be much higher than apparent from the sporadic published reports. PMID:23537782

Sharma, Cheshta; Wankhede, Sandeep; Muralidhar, Sumathi; Prakash, Anupam; Singh, Pradeep K; Kathuria, Shallu; Kumar, Deepa Anil; Khan, Nilofar; Randhawa, Harbans S; Meis, Jacques F; Chowdhary, Anuradha

2013-05-01

193

Candida species in cutaneous candidiasis patients in the Guilan province in Iran; identified by PCR-RFLP method.  

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Due to the epidemiological alteration in distribution of Candida species as well as significant increasing trend of either intrinsic or acquired in resistance of some of these fungi, the precise identification of Candida species is necessary for effective antifungal therapy and also for prevention of nosocomial infections. PCR-RFLP method is indicated to be a reliable, rapid and simple technique which is able to differentiate the Candida species. In the present study, we applied this method to evaluate the distribution of Candida species in patients affected with cutaneous candidiasis in the Guilan province. 896 clinical cutaneous samples were collected from different parts of skin and nail of suspected patients referred to clinical centers all over the Guilan province during 24 months. Samples were examined directly with 15% KOH and cultured on fungal specific media. Genomic DNA was extracted and the restriction enzyme Msp1 was applied for polymorphism analysis. Totally, 47 yeast strains were successfully isolated from different clinical samples and identified by conventional as well as PCR-RFLP methods. The results indicated that Candida albicans (36.17%) was the most frequent species followed by C. parapsilosis (25.53%), C. tropicalis (19.14%), C. guilliermondii (14.89%), C. famata (2.12%) and C. krusei (2.12%). Female finger nails were the most common location to be affected by Candida species. In conclusion, PCR-RFLP method was successfully used for recognition of clinical Candida species within the Guilan province and obtained results revealed C. albicans as the predominant causative agent of cutaneous candidiasis. However, distribution of other Candida species did not completely consist with the reported distribution of Candida species in other parts of Iran with different climate to the Guilan province. PMID:24390951

Fallahi, Ali Akbar; Korbacheh, Parivash; Zaini, Farideh; Mirhendi, Hossein; Zeraati, Hojjat; Noorbakhsh, Fatemeh; Moazeni, Maryam; Andonian, Laris; Nazeri, Mehdi; Rezaie, Sassan

2013-01-01

194

Sexually transmitted infections, bacterial vaginosis, and candidiasis in women of reproductive age in rural Northeast Brazil: a population-based study  

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Full Text Available SciELO Brazil | Language: English Abstract in english Population-based data on sexually transmitted infections (STI), bacterial vaginosis (BV), and candidiasis reflect the epidemiological situation more accurately than studies performed in specific populations, but such data are scarce. To determine the prevalence of STI, BV, and candidiasis among wome [...] n of reproductive age from a resource-poor community in Northeast Brazil, a population-based cross sectional study was undertaken. All women from seven hamlets and the centre of Pacoti municipality in the state of Ceará, aged 12 to 49 years, were invited to participate. The women were asked about socio-demographic characteristics and genital symptoms, and thereafter examined gynaecologically. Laboratory testing included polymerase chain reaction (PCR) for human papillomavirus (HPV), ligase chain reaction (LCR) for Chlamydia trachomatis and Neisseria gonorrhoeae, ELISA for human immunodeficiency virus (HIV), venereal disease research laboratory (VDRL) and fluorescent treponema antibody absorption test (FTA-ABS) for syphilis, and analysis of wet mounts, gram stains and Pap smears for trichomoniasis, candidiasis, and BV. Only women who had initiated sexual life were included in the analysis (n = 592). The prevalences of STI were: HPV 11.7% (95% confidence interval: 9.3-14.7), chlamydia 4.5% (3.0-6.6), trichomoniasis 4.1% (2.7-6.1), gonorrhoea 1.2% (0.5-2.6), syphilis 0.2% (0.0-1.1), and HIV 0%. The prevalence of BV and candidiasis was 20% (16.9-23.6) and 12.5% (10.0-15.5), respectively. The most common gynaecological complaint was lower abdominal pain. STI are common in women in rural Brazil and represent an important health threat in view of the HIV pandemic.

Fabíola Araújo, Oliveira; Viola, Pfleger; Katrin, Lang; Jörg, Heukelbach; Iracema, Miralles; Francisco, Fraga; Anastácio Queiroz, Sousa; Marina, Stoffler-Meilicke; Ralf, Ignatius; Ligia Franco Sansigolo, Kerr; Hermann, Feldmeier.

2007-09-01

195

Treatment and prophylaxis of invasive candidiasis with anidulafungin, caspofungin and micafungin and its impact on use and costs - review of the literature  

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Abstract Invasive fungal infections are on the rise. Echinocandins are a relatively new class of antifungal drugs that act by inhibition of a key enzyme necessary for integrity of the fungal cell wall. Currently there are three available agents: caspofungin, micafungin and anidulafungin. While the individual echinocandin antifungals have a different spectrum of licensed indications, basically all of them are available for the treatment of candidemia and invasive candidiasis. ...

Mh, Wilke

2011-01-01

196

Candidíase laríngea isolada em paciente imunocompetente: relato de caso e revisão literária pertinente Isolated laryngeal candidiasis in a immunocompetent patient: a case report and a literature review  

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Full Text Available Através de revisão de literatura, confirma-se que infecção laríngea por cândida é uma entidade rara e usualmente associada a infecção pulmonar ou candidíase disseminada¹. Candidíase em laringe de forma isolada (C.L.I. é uma patologia ainda mais rara, e comumente relacionada a pacientes imunodeficientes². Sabe-se que à laringoscopia direta, a candidíase pode apresentar achados físicos pobres como simples hiperemia local ou mesmo leucoplasia, mimetizando patologias como DRGE até neoplasias, fazendo, pois, parte do diagnóstico diferencial. Encontramos e documentamos em nosso serviço um caso de infecção por cândida de forma isolada em laringe (C.L.I. em paciente imunocompetente. Havia comprometimento laríngeo importante, inclusive com lesão deformante em epiglote, simulando processo neoplásico. O diagnóstico foi estabelecido por videolaringoscopia e 2 biópsias da lesão encontrada, sendo os materiais obtidos submetidos a 2 estudos histopatológicos. Tomamos o cuidado de afastar síndromes imunodeficitárias, inclusive de etiologia viral, através de pesquisa sorológica e investigação sobre abuso de corticoesteróides ou antibióticos sistêmicos. Fizemos o follow-up do paciente "per" e pós tratamento com antifúngico sistêmico, acompanhando evolução e melhora através da endoscopia e sinais clínicos.After a literature revision it is confirmed that the larynx candidiasis is rare and usually associated with lungs infection or systemic candidiasis. The larynx isolated form is more rare and seldom associated to immunological disease. It is known that through endoscopic examination, the candidiasis of larynx can show a single local erythema or leucoplasy, simulating G.E.R.D. or even neoplasia, which are the main differential diagnosis. We reported in our hospital an immunocompetent patient with isolated laryngeal candidiasis. There was an important involvement of larynx with degenerative lesions on epyglote, simulating a neoplasic process. The diagnosis was confirmed by biopses and histophatologic analyses. We crossed off hypotheses corticosteroids and antibiotics abuse. We followed up during and after the treatment with antifungeal by the use of endoscopic and clinical improvement.

Paulo S. L. Perazzo

2004-04-01

197

Sexually transmitted infections, bacterial vaginosis, and candidiasis in women of reproductive age in rural Northeast Brazil: a population-based study  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: English Abstract in english Population-based data on sexually transmitted infections (STI), bacterial vaginosis (BV), and candidiasis reflect the epidemiological situation more accurately than studies performed in specific populations, but such data are scarce. To determine the prevalence of STI, BV, and candidiasis among wome [...] n of reproductive age from a resource-poor community in Northeast Brazil, a population-based cross sectional study was undertaken. All women from seven hamlets and the centre of Pacoti municipality in the state of Ceará, aged 12 to 49 years, were invited to participate. The women were asked about socio-demographic characteristics and genital symptoms, and thereafter examined gynaecologically. Laboratory testing included polymerase chain reaction (PCR) for human papillomavirus (HPV), ligase chain reaction (LCR) for Chlamydia trachomatis and Neisseria gonorrhoeae, ELISA for human immunodeficiency virus (HIV), venereal disease research laboratory (VDRL) and fluorescent treponema antibody absorption test (FTA-ABS) for syphilis, and analysis of wet mounts, gram stains and Pap smears for trichomoniasis, candidiasis, and BV. Only women who had initiated sexual life were included in the analysis (n = 592). The prevalences of STI were: HPV 11.7% (95% confidence interval: 9.3-14.7), chlamydia 4.5% (3.0-6.6), trichomoniasis 4.1% (2.7-6.1), gonorrhoea 1.2% (0.5-2.6), syphilis 0.2% (0.0-1.1), and HIV 0%. The prevalence of BV and candidiasis was 20% (16.9-23.6) and 12.5% (10.0-15.5), respectively. The most common gynaecological complaint was lower abdominal pain. STI are common in women in rural Brazil and represent an important health threat in view of the HIV pandemic.

Fabíola Araújo, Oliveira; Viola, Pfleger; Katrin, Lang; Jörg, Heukelbach; Iracema, Miralles; Francisco, Fraga; Anastácio Queiroz, Sousa; Marina, Stoffler-Meilicke; Ralf, Ignatius; Ligia Franco Sansigolo, Kerr; Hermann, Feldmeier.

198

Transmission of an Azole-Resistant Isogenic Strain of Candida albicans among Human Immunodeficiency Virus-Infected Family Members with Oropharyngeal Candidiasis  

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We report transmission of an azole-resistant, isogenic strain of Candida albicans in a human immunodeficiency virus (HIV)-infected family of two children with symptomatic oropharyngeal candidiasis and a mother with asymptomatic colonization over a 5-year period. These findings were confirmed by three different molecular epidemiology methods: interrepeat PCR, Southern hybridization with a C. albicans repetitive element 2 probe, and electrophoretic karyotyping. This study contributes to an evol...

Mu?ller, Frank-michael C.; Kasai, Miki; Francesconi, Andrea; Brillante, Beth; Roden, Maureen; Peter, Joanne; Chanock, Stephen J.; Walsh, Thomas J.

1999-01-01

199

Sexually transmitted infections, bacterial vaginosis, and candidiasis in women of reproductive age in rural Northeast Brazil: a population-based study  

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Full Text Available Population-based data on sexually transmitted infections (STI, bacterial vaginosis (BV, and candidiasis reflect the epidemiological situation more accurately than studies performed in specific populations, but such data are scarce. To determine the prevalence of STI, BV, and candidiasis among women of reproductive age from a resource-poor community in Northeast Brazil, a population-based cross sectional study was undertaken. All women from seven hamlets and the centre of Pacoti municipality in the state of Ceará, aged 12 to 49 years, were invited to participate. The women were asked about socio-demographic characteristics and genital symptoms, and thereafter examined gynaecologically. Laboratory testing included polymerase chain reaction (PCR for human papillomavirus (HPV, ligase chain reaction (LCR for Chlamydia trachomatis and Neisseria gonorrhoeae, ELISA for human immunodeficiency virus (HIV, venereal disease research laboratory (VDRL and fluorescent treponema antibody absorption test (FTA-ABS for syphilis, and analysis of wet mounts, gram stains and Pap smears for trichomoniasis, candidiasis, and BV. Only women who had initiated sexual life were included in the analysis (n = 592. The prevalences of STI were: HPV 11.7% (95% confidence interval: 9.3-14.7, chlamydia 4.5% (3.0-6.6, trichomoniasis 4.1% (2.7-6.1, gonorrhoea 1.2% (0.5-2.6, syphilis 0.2% (0.0-1.1, and HIV 0%. The prevalence of BV and candidiasis was 20% (16.9-23.6 and 12.5% (10.0-15.5, respectively. The most common gynaecological complaint was lower abdominal pain. STI are common in women in rural Brazil and represent an important health threat in view of the HIV pandemic.

Fabíola Araújo Oliveira

2007-09-01

200

Use of Green Fluorescent Protein and Reverse Transcription-PCR To Monitor Candida albicans Agglutinin-Like Sequence Gene Expression in a Murine Model of Disseminated Candidiasis  

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Candida albicans PALS-green fluorescent protein (GFP) reporter strains were inoculated into mice in a disseminated candidiasis model, and GFP production was monitored by immunohistochemistry and reverse transcription-PCR (RT-PCR). GFP production from the ALS1 and ALS3 promoters was detected immunohistochemically. ALS1, ALS2, ALS3, ALS4, and ALS9 transcription was detected by RT-PCR, further identifying ALS genes expressed in this model.

Green, Clayton B.; Zhao, Xiaomin; Hoyer, Lois L.

2005-01-01

 
 
 
 
201

Anti-candidal activity of Astragalus verus in the in vitro and in vivo guinea pig models of cutaneous and systemic candidiasis  

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Full Text Available This study was design to evaluate the anti-candidal activity of Astragalus verus Olivier, Fabaceae (Av. The GC/MS analysis of essential oils of Av showed that aqueous extract contains thymol while hexadecanoic acid, 1,2-benzenedicarboxylic acid, diisooctyl ester and phytol were found as major components of methanol and acetone extracts. The aqueous extract showed anti-candidal activity in the concentration 320 mg/mL using disc diffusion method and its minimum inhibitory concentration (MIC was 160 mg/mL. To induce cutaneous candidiasis, the dorsum of immunocompromised guinea pigs was infected with Candida albicans and animals were divided into five groups (n=5 for each: NC, received a vehicle; PC, received topical ketoconazole 2% and three other groups which received topical 10, 20 and 40% aqueous extract of Av. On ninth day postinfection, skins were cultured and colony forming unite per gram (CFU/g skin was recorded. Systemic candidiasis was obtained by intravenous inoculation of C. albicans, 4000 CFU/g body weight. Here, animals have been divided into five groups like cutaneous candidiasis but their medications have been delivered in drinking water for ten days before induction of infection. On second day postinfection, all internal tissues were taken for determining CFU/g tissue. The aqueous extract (40% prevented heavy burden of C. albicans in tissues and skin in oral and topical application, respectively. The results indicate that Av represents a potential source of anti-candidal drug.

Ali Mikaeili

2012-10-01

202

Artemisia princeps Pamp. Essential oil and its constituents eucalyptol and ?-terpineol ameliorate bacterial vaginosis and vulvovaginal candidiasis in mice by inhibiting bacterial growth and NF-?B activation.  

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To investigate the inhibitory effects of Artemisia princeps Pamp. (family Asteraceae) essential oil (APEO) and its main constituents against bacterial vaginosis and vulvovaginal candidiasis, their antimicrobial activities against Gardnerella vaginalis and Candida albicans in vitro and their anti-inflammatory effects against G. vaginalis-induced vaginosis and vulvovaginal candidiasis were examined in mice. APEO and its constituents eucalyptol and ?-terpineol were found to inhibit microbe growths. ?-Terpineol most potently inhibited the growths of G. vaginalis and C. albicans with MIC values of 0.06 and 0.125?% (v/v), respectively. The antimicrobial activity of ?-terpineol was found to be comparable to that of clotrimazole. Intravaginal treatment with APEO, eucalyptol, or ?-terpineol significantly decreased viable G. vaginalis and C. albicans numbers in the vaginal cavity and myeloperoxidase activity in mouse vaginal tissues compared with controls. These agents also inhibited the expressions of proinflammatory cytokines (IL-1 ?, IL-6, TNF- ?), COX-2, iNOS, and the activation of NF- ?B and increased expression of the anti-inflammatory cytokine IL-10. In addition, they inhibited the expressions of proinflammatory cytokines and the activation of NF- ?B in lipopolysaccharide-stimulated peritoneal macrophages, and ?-terpineol most potently inhibited the expressions of proinflammatory cytokines and NF- ?B activation. Based on these findings, APEO and its constituents, particularly ?-terpineol, ameliorate bacterial vaginosis and vulvovaginal candidiasis by inhibiting the growths of vaginal pathogens and the activation of NF- ?B. PMID:21830186

Trinh, Hien-Trung; Lee, In-Ah; Hyun, Yang-Jin; Kim, Dong-Hyun

2011-12-01

203

In vitro/in vivo performance of different complexes of itraconazole used in the treatment of vaginal candidiasis  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: English Abstract in portuguese A maioria das novas entidades químicas e muitas moléculas de fármacos existentes apresenta fraca solubilidade em água, o que pode limitar seu uso potencial no desenvolvimento de formulações com biodisponibilidade ideal. Uma das abordagens para melhorar a solubilidade de um fármaco pouco solúvel em á [...] gua e, eventualmente, a sua biodisponibilidade é a complexação com agentes como o ácido húmico (HA), ácido fúlvico (FA), ?-ciclodextrina (?-CD), 2-hidroxipropil-?-ciclodextrina (HP-?-CD) e cafeína (Caff). O presente trabalho baseia-se no uso desses agentes para preparar diferentes complexos e suas avaliações in vitro/in vivo. Todos os complexos foram avaliados quanto à eficiência de complexação por modelação molecular, análise conformacional, calorimetria de varredura diferencial (DSC), difração de raios-X (XRD), ressonância magnética nuclear (RMN) e espectroscopia de massas. Além disso, os complexos foram avaliados in vivo, em ratas, no tocante à sua eficácia no tratamento de candidíase vaginal. Entre os cinco complexos testados, o complexo de ácido fúlvico-itraconazol foi o que apresentou melhor solubilidade, bem como melhor eficácia in vivo e, portanto, pode ser explorado para o desenvolvimento de uma formulação comercial para o tratamento de candidíase vaginal. Abstract in english A large majority of new chemical entities and many existing drug molecules exhibit poor aqueous solubility, which may limit their potential use in developing drug formulations, with optimum bioavailability. One of the approaches to improve the solubility of a poorly water soluble drug and eventually [...] its bioavailability is complexation with agents like humic acid (HA), fulvic acid (FA), ?-cyclodextrin (?-CD), 2-hydroxypropyl-?-cyclodextrin (HP-?-CD) and caffeine (Caff). The current work emphasized at employing these agents to prepare different complexes and their in vitro/in vivo assessment. All the complexes evaluated for their complexation efficiency and authenticated by molecular modeling; conformational analysis, differential scanning calorimetry (DSC), X-ray diffraction (XRD), nuclear magnetic resonance (NMR) and mass spectroscopy. Furthermore, the complexes were assessed in an in vivo, rat vaginal model for their efficacy in treatment of vaginal candidiasis. Amongst the five tested complexes, fulvic acid-itraconazole complex yielded better solubility as well as in vivo efficacy and therefore may further be explored for developing a commercial formulation for treating vaginal candidiasis.

Mohammad Aamir, Mirza; Mohammad Akhlaquer, Rahman; Sushama, Talegaonkar; Zeenat, Iqbal.

204

In vitro/in vivo performance of different complexes of itraconazole used in the treatment of vaginal candidiasis  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: English Abstract in portuguese A maioria das novas entidades químicas e muitas moléculas de fármacos existentes apresenta fraca solubilidade em água, o que pode limitar seu uso potencial no desenvolvimento de formulações com biodisponibilidade ideal. Uma das abordagens para melhorar a solubilidade de um fármaco pouco solúvel em á [...] gua e, eventualmente, a sua biodisponibilidade é a complexação com agentes como o ácido húmico (HA), ácido fúlvico (FA), ?-ciclodextrina (?-CD), 2-hidroxipropil-?-ciclodextrina (HP-?-CD) e cafeína (Caff). O presente trabalho baseia-se no uso desses agentes para preparar diferentes complexos e suas avaliações in vitro/in vivo. Todos os complexos foram avaliados quanto à eficiência de complexação por modelação molecular, análise conformacional, calorimetria de varredura diferencial (DSC), difração de raios-X (XRD), ressonância magnética nuclear (RMN) e espectroscopia de massas. Além disso, os complexos foram avaliados in vivo, em ratas, no tocante à sua eficácia no tratamento de candidíase vaginal. Entre os cinco complexos testados, o complexo de ácido fúlvico-itraconazol foi o que apresentou melhor solubilidade, bem como melhor eficácia in vivo e, portanto, pode ser explorado para o desenvolvimento de uma formulação comercial para o tratamento de candidíase vaginal. Abstract in english A large majority of new chemical entities and many existing drug molecules exhibit poor aqueous solubility, which may limit their potential use in developing drug formulations, with optimum bioavailability. One of the approaches to improve the solubility of a poorly water soluble drug and eventually [...] its bioavailability is complexation with agents like humic acid (HA), fulvic acid (FA), ?-cyclodextrin (?-CD), 2-hydroxypropyl-?-cyclodextrin (HP-?-CD) and caffeine (Caff). The current work emphasized at employing these agents to prepare different complexes and their in vitro/in vivo assessment. All the complexes evaluated for their complexation efficiency and authenticated by molecular modeling; conformational analysis, differential scanning calorimetry (DSC), X-ray diffraction (XRD), nuclear magnetic resonance (NMR) and mass spectroscopy. Furthermore, the complexes were assessed in an in vivo, rat vaginal model for their efficacy in treatment of vaginal candidiasis. Amongst the five tested complexes, fulvic acid-itraconazole complex yielded better solubility as well as in vivo efficacy and therefore may further be explored for developing a commercial formulation for treating vaginal candidiasis.

Mohammad Aamir, Mirza; Mohammad Akhlaquer, Rahman; Sushama, Talegaonkar; Zeenat, Iqbal.

2012-12-01

205

EPICO 2.0 PROJECT. Development of educational therapeutic recommendations using the DELPHI technique on invasive candidiasis in critically ill adult patients in special situations.  

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Introduction. Although there has been an improved management of Invasive Candidiasis in the last decade, still controversial issues remain, especially in different therapeutic critical care scenarios. Objectives. We sought to identify the core clinical knowledge and to achieve high agreement recommendations required to care for critically ill adult patients with Invasive Candidiasis for antifungal treatment in special situations and different scenarios. Methods. Second Prospective Spanish survey reaching consensus by the Delphi technique, conducted anonymously by electronic e-mail in the first phase to 23 national multidisciplinary experts in invasive fungal infections from five national scientific societies including Intensivists, Anesthesiologists, Microbiologists, Pharmacologists and Infectious disease specialists, answering 30 questions prepared by a coordination group after a strict review of literature in the last five years. The educational objectives spanned four categories, including peritoneal candidiasis, immunocompromised patients, special situations and organ failures. The agreement among panellists in each item should be higher than 75% to be selected. In a second phase, after extracting recommendations from the selected items, a meeting was heldwith more than 60 specialists in a second round invited to validate the preselectedrecommendations. Measurements and Main Results. In the first phase, 15 recommendations were preselected (peritoneal candidiasis (3), immunocompromised patients (6), special situations (3) and organ failures (3)). After the second round the following 13 were validated: Peritoneal candidiasis (3): Source control and early adequate antifungal treatment is mandatory; empirical antifungal treatment is recommended in secondary nosocomial peritonitis with Candidaspp colonization risk factors and in tertiary peritonitis. Immunocompromised patients (5): Consider hepatotoxicity and interactions before starting antifungal treatment with azoles in transplanted patients; treat candidemia in neutropenic adult patients with antifungal drugs at least 14 days after the first negative blood culture and until normalization of neutrophil count is achieved. Caspofungin, if needed, is the echinocandin with most scientific evidence to treat candidemia in neutropenic adult patients; Caspofungin is also the first choice drug to treat febrile candidemia; in neutropenic patients with candidemia remove catheter. Special situations (2): In moderate hepatocelular failure, patients with invasive candidiasis use echinocandins (preferably low doses of anidulafungin and caspofungin) and try to avoid azoles; in case of possible interactions review all of the drugs involved and preferably use Anidulafungin. Organ failures (3): Echinocandins are the safest antifungal drugs; reconsider the use of azoles in patients under renal replacement therapy; all of the echinocandins are accepted for the treatment of patients under continuous renal replacement therapy and do not require dosage adjustment. Conclusions. Treatment of Invasive Candidiasis in ICU patients requires a broad range of knowledge and skills as summarized in our recommendations. These recommendations may help to optimize the therapeutic management of these patients in special situations and different scenarios and improve their outcome based on the DELPHI methodology. PMID:25229375

Zaragoza, R; Ferrer, R; Maseda, E; Llinares, P; Rodríguez, A

2014-09-01

206

Association between symptomatic vulvovaginal candidiasis and HIV RNA levels in plasma and genital secretions among women on HAART  

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Full Text Available SciELO South Africa | Language: English Abstract in english BACKGROUND: Genital tract (GT) inflammation plays a major role in HIV transmission. We aimed to determine the association between symptomatic vulvovaginal candidiasis (VVC) and HIV RNA levels in plasma and GTs of HIV-infected women on highly active antiretroviral therapy (HAART). METHOD: Women with [...] VVC on HAART were recruited from a primary healthcare clinic in KwaZulu-Natal Province, South Africa, between June 2011 and December 2011. VVC was diagnosed clinically, supported by Gram staining and culture of genital secretions. HIV RNA load was determined by reverse transcription polymerase chain reaction. CD4+ counts were obtained from patients' medical records. RESULTS: Plasma HIV RNA was detected in 42 of 60 (70%) patients on HAART. The mean duration (± standard deviation) on HAART for these patients was 4.2 (±1.6) months v. 10.7 (±1.4) months for the remaining 18 patients (p10 000 copies/ml (p=0.032) and genital absolute counts of neutrophils >10 cells/5 high microscopic fields (p=0.007). CONCLUSION: Given that the majority of women had recently initiated HAART (allowing a high rate of detectable plasma HIV RNA), there was insufficient evidence to conclude that VVC was predictive of high plasma HIV RNA levels. It is more likely that this cohort of immunosuppressed women were prone to develop VVC. Plasma HIV loads and local genital inflammation were predictors of genital HIV detectability.

T, Apalata; W H, Carr; B, Longo-Mbenza; W A, Sturm; P, Moodley.

207

Genetic relatedness among vaginal and anal isolates of Candida albicans from women with vulvovaginal candidiasis in north-east Brazil.  

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Vulvovaginal candidiasis (VVC) is one of the most common causes of vaginitis and affects about 75?% of women of reproductive age. In order to better understand the epidemiology and pathogenesis of this disease, we evaluated genetic relatedness among 62 clinical isolates of Candida albicans sequentially obtained from the anus and vagina of patients with sporadic and recurrent VVC. Evaluation of patients' demographic and clinical data, direct examination, and colony forming units (c.f.u.) counts of vaginal and anal samples were also performed. The genotypes of strains were determined with ABC genotyping and Randomly Amplified Polymorphic DNA (RAPD). Genotype A was the most prevalent (93.6?%), followed by genotype C (6.4?%), whereas genotype B was not found. We found the maintenance of the same ABC genotype, regardless of the body site of each patient. Most of the vaginal strains suffered microevolution, whereas most of the anal strains were replaced during the period of study. Vaginal and anal isolates of C. albicans obtained simultaneously from the same patient showed the same ABC genotype and high genetic similarity as determined by RAPD. Genotype A seemed to be dominant in both vaginal and anal isolates of patients with VVC. Our results corroborate the hypothesis that there are 'substrains' of the C. albicans vaginal clone successfully established, which dominate in an apparently random manner over the course of time. It is suggested that the anal reservoir constitutes a possible source for vaginal infection in most of the cases. PMID:25187602

Araújo Paulo de Medeiros, Mariana; Vieira de Melo, Ana Patrícia; Gonçalves, Sarah Santos; Milan, Eveline Pipolo; Chaves, Guilherme Maranhão

2014-11-01

208

A Supplement Based on Zn-Enriched Virgin Coconut Oil as an Antifungal agent for Vaginal Candidiasis Patients  

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Full Text Available This research was conducted to investigate the amount of Candida albicans in vaginal secretion of Vaginal Candidiasis patients administered with Zn-enriched virgin coconut oil. Thirty respondents were selected based on several criteria as follows: the number of C. albicans colonies in the vaginal secretion was more than 105 cfu.ml-1, voluntary, healthy, willing to sign the informed consent and resided in Purwokerto. In Group A, 10 women were administered 2 tablespoons per day of Zn-enriched virgin coconut oil. In Group B, 10 women were administered 1 tablespoon per day of Zn-enriched virgin coconut oil; and in Group C, 10 women served as control group. Vaginal secretions were taken 3 times, before intervention (at baseline time, at 1 month and 2 months after intervention. Samples were taken by collecting vaginal secretions from the vaginal proximal region using a sterile cotton bud, which was then put into a tube containing sterile carrier media. The vaginal secretions were tested for the number of total C. albicans using Pour Plate Method. Two months after treatment, the number of colonies decreased from 4.4x106 to 2.5x106 cfu ml-1 (p=0.03 in Group A. There was no significant difference in the number of colonies between Group A and Group B, the number of C. albicans colonies was still above the normal range. Therefore, the recommended dosage of intervention with Zn-enriched virgin coconut oil is one tablespoon a day.

HERY WINARSI

2008-08-01

209

Mannose-binding lectin codon 54 gene polymorphism and vulvovaginal candidiasis: a systematic review and meta-analysis.  

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Mannose-binding lectin (MBL) plays a key role in the human innate immune response. It has been shown that polymorphisms in the MBL2 gene, particularly at codon 54 (variant allele B; wild-type allele designated as A), impact upon host susceptibility to Candida infection. This systematic review and meta-analysis were performed to assess the association between MBL2 codon 54 genotype and vulvovaginal candidiasis (VVC) or recurrent VVC (RVVC). Studies were searched in MEDLINE, SCOPUS, and ISI Web of Science until April 2013. Five studies including 704 women (386 cases and 318 controls) were part of the meta-analysis, and pooled ORs were calculated using the random effects model. For subjects with RVVC, ORs of AB versus AA and of BB versus AA were 4.84 (95% CI 2.10-11.15; P for heterogeneity = 0.013; I(2) = 68.6%) and 12.68 (95% CI 3.74-42.92; P for heterogeneity = 0.932, I(2) = 0.0%), respectively. For subjects with VVC, OR of AB versus AA was 2.57 (95% CI 1.29-5.12; P for heterogeneity = 0.897; I (2) = 0.0%). This analysis indicates that heterozygosity for the MBL2 allele B increases significantly the risk for both diseases, suggesting that MBL may influence the women's innate immunity in response to Candida. PMID:25143944

Nedovic, Bojan; Posteraro, Brunella; Leoncini, Emanuele; Ruggeri, Alberto; Amore, Rosarita; Sanguinetti, Maurizio; Ricciardi, Walter; Boccia, Stefania

2014-01-01

210

A STUDY ON PREVALENCE OF PULMONARY CANDIDIASIS AMONG TUBERCULOSIS PATIENTS AND USE OF CHROMAGAR IN IDENTIFICATION OF CANDIDA SPECIES  

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Full Text Available Introduction: In recent years, fungal infections are on the rise due to various predisposing factors such as long term administration of antibiotics, use of steroids, pulmonary tuberculosis, immunosuppressive drugs and HIV infection. When host resistance is lowered, these opportunistic fungi may become fatal. Candida albicans was the most important pathogen causing pulmonary candidiasis. In recent times, there is increase in incidence of non-albicans Candida. Identification to the species level becomes mandatory in the selection of appropriate antifungal agents. Aim: To find out the prevalence of Candida co-infection among pulmonary tuberculosis patients and to identify the species of Candida using CHROMagar. Materials & Methods: A total of 107 smear positive pulmonary tuberculosis patients were included in this study. Two consecutive sputum samples were collected and subjected to gram staining. Only those samples which showed pus cells with budding yeast cells and pseudohyphae in direct gram stain were cultured on Sabouraud’s dextrose agar (SDA with gentamycin. The Candida grown was identified and speciated based on the color produced on CHROMagar Candida. Results: Out of 21 Candida isolates, 14 were C. albicans (66.7%, 2 were C. tropicalis (9.5%, 2 were C.krusei (9.5%, 2 were C. parapsilosis (9.5% and one was C. glabrata (4.8%. Conclusion: The secondary fungal infections are associated with persistence of lung symptoms inspite of successful completion of antituberculous therapy. Hence adequate measures need to be taken for the early identification and treatment of these opportunistic infections.

S Mathavi

2014-05-01

211

Association between symptomatic vulvovaginal candidiasis and HIV RNA levels in plasma and genital secretions among women on HAART  

Scientific Electronic Library Online (English)

Full Text Available SciELO South Africa | Language: English Abstract in english BACKGROUND: Genital tract (GT) inflammation plays a major role in HIV transmission. We aimed to determine the association between symptomatic vulvovaginal candidiasis (VVC) and HIV RNA levels in plasma and GTs of HIV-infected women on highly active antiretroviral therapy (HAART). METHOD: Women with [...] VVC on HAART were recruited from a primary healthcare clinic in KwaZulu-Natal Province, South Africa, between June 2011 and December 2011. VVC was diagnosed clinically, supported by Gram staining and culture of genital secretions. HIV RNA load was determined by reverse transcription polymerase chain reaction. CD4+ counts were obtained from patients' medical records. RESULTS: Plasma HIV RNA was detected in 42 of 60 (70%) patients on HAART. The mean duration (± standard deviation) on HAART for these patients was 4.2 (±1.6) months v. 10.7 (±1.4) months for the remaining 18 patients (p10 000 copies/ml (p=0.032) and genital absolute counts of neutrophils >10 cells/5 high microscopic fields (p=0.007). CONCLUSION: Given that the majority of women had recently initiated HAART (allowing a high rate of detectable plasma HIV RNA), there was insufficient evidence to conclude that VVC was predictive of high plasma HIV RNA levels. It is more likely that this cohort of immunosuppressed women were prone to develop VVC. Plasma HIV loads and local genital inflammation were predictors of genital HIV detectability.

T, Apalata; W H, Carr; B, Longo-Mbenza; W A, Sturm; P, Moodley.

2014-02-01

212

An open-label study of anidulafungin for the treatment of candidaemia/invasive candidiasis in Latin America.  

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Incidence and mortality of candidaemia/invasive candidiasis (C/IC) is relatively high in Latin America versus North America and Europe. To assess efficacy and safety of intravenous (IV) anidulafungin in Latin American adults with documented C/IC. All patients in this open-label study received initial IV anidulafungin with optional step-down to oral voriconazole after 5 days; total treatment duration was 14-42 days. The primary endpoint was global response (clinical + microbiological response) at end of treatment (EOT); missing/indeterminate responses were failures. The study enrolled 54 patients; 44 had confirmed C/IC within 96 h before study entry and comprised the modified intent-to-treat population. Global response at EOT was 59.1% (95% CI: 44.6, 73.6), with 13 missing/indeterminate assessments. Thirty-day all-cause mortality was 43.1%. Fourteen patients (31.8%) were able to step-down to oral voriconazole; these patients had lower baseline acute physiological assessment and chronic health evaluation (APACHE) II scores and were less likely to have solid tumours or previous abdominal surgery. Anidulafungin was generally well tolerated with few treatment-related adverse events. Anidulafungin was associated with relatively low response rates influenced by a high rate of missing/indeterminate assessments and mortality comparable to other recent candidaemia studies in Latin America. In a subset of patients with lower APACHE II scores, short-course anidulafungin followed by oral voriconazole was successful. PMID:23710653

Nucci, Marcio; Colombo, Arnaldo L; Petti, Marco; Magana, Martin; Abreu, Paula; Schlamm, Haran T; Sanchez, Sonia P

2014-01-01

213

Candidíase vulvovaginal: sintomatologia, fatores de risco e colonização anal concomitante Vulvovaginal candidiasis: symptomatology, risk factors and concomitant anal colonization  

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Full Text Available OBJETIVO: analisar pacientes com candidíase vulvovaginal quanto a sintomatologia, fatores de risco e resultados da cultura anal, identificar a freqüência de Candida albicans e não C. albicans e correlacionar as colonizações anal e vaginal. MÉTODOS: foram incluídas 99 pacientes com suspeita clínica de candidiase vulvovaginal, procedentes de Natal, RN, atendidas entre maio de 2003 e maio de 2005, perfazendo-se o total de 294 coletas. O material clínico, colhido por zaragatoas, foi semeado em CHROMagar Candida®. As leveduras foram identificadas pelo método clássico, além da prova de crescimento a 42 e 45ºC e da prova do caldo Sabouraud hipertônico. A sintomatologia, fatores de risco e colonização anal foram analisados de acordo com a positividade ou negatividade para Candida spp. As culturas positivas para C. albicans nos dois sítios foram comparadas com outros resultados encontrados. Para análise estatística utilizou-se o teste do chi2, com correção de Yates e o teste exato de Fisher. RESULTADOS: a espécie mais frequente foi C. albicans em 69% dos casos. Uso de roupas íntimas justas e/ou sintéticas, presença de doenças alérgicas, ocorrência de prurido, leucorréia e hiperemia apresentaram associação com a positividade vaginal para Candida spp. A chance de uma paciente com colonização anal positiva de apresentar positividade vaginal concomitante foi 2,8 e 4,9 vezes maior, respectivamente, para Candida spp e C. albicans. A chance de uma paciente com cultura anal positiva para C. albicans de apresentar resultado vaginal positivo foi 3,7 vezes maior quando comparada a espécies não C. albicans. CONCLUSÕES: C. albicans foi a espécie mais comum, tendo sido observada associação da positividade vaginal para Candida spp com uso de roupas justas e/ou sintéticas, doenças alérgicas, prurido, leucorréia e eritema (pPURPOSE: to analyze patients with vulvovaginal candidiasis with respect to risk factors, symptomatology and results of anal culture, to identify the frequency of species of Candida albicans and non-C. albicans, and to correlate anal and vaginal colonization. METHODS: a total of 99 patients were included with suspected vulvovaginal candidiasis, from Natal, Brazil, between May 2003 and May 2005, totalling 294 collections. The clinical material, obtained by vaginal and anal swabs, was seeded on CHROMagar Candida®. The yeasts were identified using the classic method, in addition to the growth test at 42º and 45ºC and the Hypertonic Saboraud broth test. Symptomatology, risk factors and anal colonization were assessed according to positive or negative culture for Candida spp. The cultures positive for C. albicans at the two sites were compared with other results encountered. Yates’ chi2 test and Fisher’s exact test were used for statistical analysis. RESULTS: the most frequent was C. albicans in 69% of the cases. Wearing tight and/or synthetic underclothing, the presence of allergic diseases, the occurrence of itching, leukorrhea and hyperemia showed a significant association with positive culture for Candida spp in the vagina. The chance of a patient with positive anal colonization to present with concomitant positive vaginal colonization was 2.8 and 4.9 times greater for Candida spp and C. albicans, respectively. The risk of a patient with anal culture positive for C. albicans to present with positive vaginal colonization was 3.7 times greater when compared to non-C. albicans species. CONCLUSIONS: the most common species was C. albicans, and a relevant association between vaginal cultures positive for Candida spp and the use of tight and/or synthetic underclothing, allergic diseases, the occurrence of pruritus, leukorrhea and erythema was observed (p<0.05. Positive anal colonization concomitant with vaginal colonization was significant, suggesting possible vaginal contamination from the anus.

Antônio Arildo Reginaldo de Holanda

2007-01-01

214

Candidíase vulvovaginal: sintomatologia, fatores de risco e colonização anal concomitante / Vulvovaginal candidiasis: symptomatology, risk factors and concomitant anal colonization  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: Portuguese Abstract in portuguese OBJETIVO: analisar pacientes com candidíase vulvovaginal quanto a sintomatologia, fatores de risco e resultados da cultura anal, identificar a freqüência de Candida albicans e não C. albicans e correlacionar as colonizações anal e vaginal. MÉTODOS: foram incluídas 99 pacientes com suspeita clínica d [...] e candidiase vulvovaginal, procedentes de Natal, RN, atendidas entre maio de 2003 e maio de 2005, perfazendo-se o total de 294 coletas. O material clínico, colhido por zaragatoas, foi semeado em CHROMagar Candida®. As leveduras foram identificadas pelo método clássico, além da prova de crescimento a 42 e 45ºC e da prova do caldo Sabouraud hipertônico. A sintomatologia, fatores de risco e colonização anal foram analisados de acordo com a positividade ou negatividade para Candida spp. As culturas positivas para C. albicans nos dois sítios foram comparadas com outros resultados encontrados. Para análise estatística utilizou-se o teste do chi2, com correção de Yates e o teste exato de Fisher. RESULTADOS: a espécie mais frequente foi C. albicans em 69% dos casos. Uso de roupas íntimas justas e/ou sintéticas, presença de doenças alérgicas, ocorrência de prurido, leucorréia e hiperemia apresentaram associação com a positividade vaginal para Candida spp. A chance de uma paciente com colonização anal positiva de apresentar positividade vaginal concomitante foi 2,8 e 4,9 vezes maior, respectivamente, para Candida spp e C. albicans. A chance de uma paciente com cultura anal positiva para C. albicans de apresentar resultado vaginal positivo foi 3,7 vezes maior quando comparada a espécies não C. albicans. CONCLUSÕES: C. albicans foi a espécie mais comum, tendo sido observada associação da positividade vaginal para Candida spp com uso de roupas justas e/ou sintéticas, doenças alérgicas, prurido, leucorréia e eritema (p Abstract in english PURPOSE: to analyze patients with vulvovaginal candidiasis with respect to risk factors, symptomatology and results of anal culture, to identify the frequency of species of Candida albicans and non-C. albicans, and to correlate anal and vaginal colonization. METHODS: a total of 99 patients were incl [...] uded with suspected vulvovaginal candidiasis, from Natal, Brazil, between May 2003 and May 2005, totalling 294 collections. The clinical material, obtained by vaginal and anal swabs, was seeded on CHROMagar Candida®. The yeasts were identified using the classic method, in addition to the growth test at 42º and 45ºC and the Hypertonic Saboraud broth test. Symptomatology, risk factors and anal colonization were assessed according to positive or negative culture for Candida spp. The cultures positive for C. albicans at the two sites were compared with other results encountered. Yates’ chi2 test and Fisher’s exact test were used for statistical analysis. RESULTS: the most frequent was C. albicans in 69% of the cases. Wearing tight and/or synthetic underclothing, the presence of allergic diseases, the occurrence of itching, leukorrhea and hyperemia showed a significant association with positive culture for Candida spp in the vagina. The chance of a patient with positive anal colonization to present with concomitant positive vaginal colonization was 2.8 and 4.9 times greater for Candida spp and C. albicans, respectively. The risk of a patient with anal culture positive for C. albicans to present with positive vaginal colonization was 3.7 times greater when compared to non-C. albicans species. CONCLUSIONS: the most common species was C. albicans, and a relevant association between vaginal cultures positive for Candida spp and the use of tight and/or synthetic underclothing, allergic diseases, the occurrence of pruritus, leukorrhea and erythema was observed (p

Antônio Arildo Reginaldo de, Holanda; Ana Cristina Santos, Fernandes; Christiane Medeiros, Bezerra; Maria Ângela Fernandes, Ferreira; Manoel Reginaldo Rocha de, Holanda; Julita de Campos Pipolo, Holanda; Eveline Pipolo, Milan.

215

Anti-candidal activity of Astragalus verus in the in vitro and in vivo guinea pig models of cutaneous and systemic candidiasis  

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Full Text Available SciELO Brazil | Language: English Abstract in english This study was design to evaluate the anti-candidal activity of Astragalus verus Olivier, Fabaceae (Av). The GC/MS analysis of essential oils of Av showed that aqueous extract contains thymol while hexadecanoic acid, 1,2-benzenedicarboxylic acid, diisooctyl ester and phytol were found as major compo [...] nents of methanol and acetone extracts. The aqueous extract showed anti-candidal activity in the concentration 320 mg/mL using disc diffusion method and its minimum inhibitory concentration (MIC) was 160 mg/mL. To induce cutaneous candidiasis, the dorsum of immunocompromised guinea pigs was infected with Candida albicans and animals were divided into five groups (n=5 for each): NC, received a vehicle; PC, received topical ketoconazole 2% and three other groups which received topical 10, 20 and 40% aqueous extract of Av. On ninth day postinfection, skins were cultured and colony forming unite per gram (CFU/g) skin was recorded. Systemic candidiasis was obtained by intravenous inoculation of C. albicans, 4000 CFU/g body weight. Here, animals have been divided into five groups like cutaneous candidiasis but their medications have been delivered in drinking water for ten days before induction of infection. On second day postinfection, all internal tissues were taken for determining CFU/g tissue. The aqueous extract (40%) prevented heavy burden of C. albicans in tissues and skin in oral and topical application, respectively. The results indicate that Av represents a potential source of anti-candidal drug.

Ali, Mikaeili; Isaac, Karimi; Tayebeh, Shamspur; Babak, Gholamine; Masoud, Modaresi; Ali, Khanlari.

216

Anti-candidal activity of Astragalus verus in the in vitro and in vivo guinea pig models of cutaneous and systemic candidiasis  

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Full Text Available SciELO Brazil | Language: English Abstract in english This study was design to evaluate the anti-candidal activity of Astragalus verus Olivier, Fabaceae (Av). The GC/MS analysis of essential oils of Av showed that aqueous extract contains thymol while hexadecanoic acid, 1,2-benzenedicarboxylic acid, diisooctyl ester and phytol were found as major compo [...] nents of methanol and acetone extracts. The aqueous extract showed anti-candidal activity in the concentration 320 mg/mL using disc diffusion method and its minimum inhibitory concentration (MIC) was 160 mg/mL. To induce cutaneous candidiasis, the dorsum of immunocompromised guinea pigs was infected with Candida albicans and animals were divided into five groups (n=5 for each): NC, received a vehicle; PC, received topical ketoconazole 2% and three other groups which received topical 10, 20 and 40% aqueous extract of Av. On ninth day postinfection, skins were cultured and colony forming unite per gram (CFU/g) skin was recorded. Systemic candidiasis was obtained by intravenous inoculation of C. albicans, 4000 CFU/g body weight. Here, animals have been divided into five groups like cutaneous candidiasis but their medications have been delivered in drinking water for ten days before induction of infection. On second day postinfection, all internal tissues were taken for determining CFU/g tissue. The aqueous extract (40%) prevented heavy burden of C. albicans in tissues and skin in oral and topical application, respectively. The results indicate that Av represents a potential source of anti-candidal drug.

Ali, Mikaeili; Isaac, Karimi; Tayebeh, Shamspur; Babak, Gholamine; Masoud, Modaresi; Ali, Khanlari.

1035-10-01

217

Serum Antibody Signature Directed against Candida albicans Hsp90 and Enolase Detects Invasive Candidiasis in Non-Neutropenic Patients.  

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Invasive candidiasis (IC) adds significantly to the morbidity and mortality of non-neutropenic patients if not diagnosed and treated early. To uncover serologic biomarkers that alone or in combination could reliably detect IC in this population, IgG antibody-reactivity profiles to the Candida albicans intracellular proteome were examined by serological proteome analysis (SERPA) and data mining procedures in a training set of 24 non-neutropenic patients. Despite the high interindividual molecular heterogeneity, unsupervised clustering analyses revealed that serum 22-IgG antibody-reactivity patterns differentiated IC from non-IC patients. Univariate analyses further highlighted that 15 out of the 22 SERPA-identified IgG antibodies could be useful candidate IC biomarkers. The diagnostic performance of one of these candidates (anti-Hsp90 IgG antibodies) was validated using an ELISA prototype in a test set of 59 non-neutropenic patients. We then formulated an IC discriminator based on the combined immunoproteomic fingerprints of this and another SERPA-detected and previously validated IC biomarker (anti-Eno1 IgG antibodies) in the training set. Its consistency was substantiated using their ELISA prototypes in the test set. Receiver-operating-characteristic curve analyses showed that this two-biomarker signature accurately identified IC in non-neutropenic patients and provided better IC diagnostic accuracy than the individual biomarkers alone. We conclude that this serum IgG antibody signature directed against C. albicans Hsp90 and Eno1, if confirmed prospectively, may be useful for IC diagnosis in non-neutropenic patients. PMID:25377742

Pitarch, Aida; Nombela, César; Gil, Concha

2014-11-01

218

Measurement of T-Cell-Derived Antigen Binding Molecules and Immunoglobulin G Specific to Candida albicans Mannan in Sera of Patients with Recurrent Vulvovaginal Candidiasis  

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Immunoglobulin G (IgG) and T-cell-derived antigen binding molecules (TABM) specific to whole Candida extract and to Candida-derived mannans prepared by both the cetryltrimethylammonium bromide (CTAB) and alkaline degradation (PEAT) methods were measured in the sera of women with vulvovaginal candidiasis and controls. In the patients there were significantly higher levels of IgG to both CTAB and PEAT mannans and of TABM to CTAB mannan. TABM specific to CTAB mannan was purified from the serum o...

Little, Colin H.; Georgiou, George M.; Marceglia, Alex; Ogedgebe, Henry; Cone, Robert E.; Mazza, Danielle

2000-01-01

219

Candidíase laríngea isolada em paciente imunocompetente: relato de caso e revisão literária pertinente / Isolated laryngeal candidiasis in a immunocompetent patient: a case report and a literature review  

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Full Text Available SciELO Brazil | Language: Portuguese Abstract in portuguese Através de revisão de literatura, confirma-se que infecção laríngea por cândida é uma entidade rara e usualmente associada a infecção pulmonar ou candidíase disseminada¹. Candidíase em laringe de forma isolada (C.L.I.) é uma patologia ainda mais rara, e comumente relacionada a pacientes imunodeficie [...] ntes². Sabe-se que à laringoscopia direta, a candidíase pode apresentar achados físicos pobres como simples hiperemia local ou mesmo leucoplasia, mimetizando patologias como DRGE até neoplasias, fazendo, pois, parte do diagnóstico diferencial. Encontramos e documentamos em nosso serviço um caso de infecção por cândida de forma isolada em laringe (C.L.I.) em paciente imunocompetente. Havia comprometimento laríngeo importante, inclusive com lesão deformante em epiglote, simulando processo neoplásico. O diagnóstico foi estabelecido por videolaringoscopia e 2 biópsias da lesão encontrada, sendo os materiais obtidos submetidos a 2 estudos histopatológicos. Tomamos o cuidado de afastar síndromes imunodeficitárias, inclusive de etiologia viral, através de pesquisa sorológica e investigação sobre abuso de corticoesteróides ou antibióticos sistêmicos. Fizemos o follow-up do paciente "per" e pós tratamento com antifúngico sistêmico, acompanhando evolução e melhora através da endoscopia e sinais clínicos. Abstract in english After a literature revision it is confirmed that the larynx candidiasis is rare and usually associated with lungs infection or systemic candidiasis. The larynx isolated form is more rare and seldom associated to immunological disease. It is known that through endoscopic examination, the candidiasis [...] of larynx can show a single local erythema or leucoplasy, simulating G.E.R.D. or even neoplasia, which are the main differential diagnosis. We reported in our hospital an immunocompetent patient with isolated laryngeal candidiasis. There was an important involvement of larynx with degenerative lesions on epyglote, simulating a neoplasic process. The diagnosis was confirmed by biopses and histophatologic analyses. We crossed off hypotheses corticosteroids and antibiotics abuse. We followed up during and after the treatment with antifungeal by the use of endoscopic and clinical improvement.

Paulo S. L., Perazzo; Luiz Ricardo L., Martin; Milton Pamponet da Cunha, Moura; Max Adrian M., Melo; Márcio da Silva, Carvalho.

220

Enzymatic activity profile of a Brazilian culture collection of Candida albicans isolated from diabetics and non-diabetics with oral candidiasis.  

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The secretion of hydrolytic enzymes is a fundamental virulence factor of Candida albicans to develop disease. The objective of this study was to characterise the virulence of 148 clinical isolates of C. albicans from oral candidiasis by assessing the expression of phospholipase (PL) and secreted aspartyl proteinase (SAP). Isolates were obtained from healthy subjects (HS) and diabetics (DOC) and non-diabetics with oral candidiasis (NDOC). An aliquot (5 ?l) of each cell suspension was inoculated on PL and SAP agar plates and incubated. Enzymes secretion was detected by the formation of an opaque halo around the colonies and enzymatic activity (PZ) was determined by the ratio between colony diameter and colony diameter plus the halo zone. Statistical comparisons were made by a one-way anova followed by Tukey's post hoc test (? = 0.05). The clinical sources of C. albicans had significant effect (P < 0.001) on the PZ values of both enzymes. For PL, clinical isolates from NDOC and DOC had highest enzymatic activity than those from HS (P < 0.05), with no significant differences between them (P = 0.506). For SAP, C. albicans from NDOC showed the lower enzymatic activity (P < 0.001). There were no significant differences between isolates from HS and DOC (P = 0.7051). C. albicans isolates from NDOC and DOC patients showed an increased production of PL. PMID:24329754

Sanitá, Paula Volpato; Zago, Chaiene Evelin; Pavarina, Ana Cláudia; Jorge, Janaina Habib; Machado, Ana Lúcia; Vergani, Carlos Eduardo

2014-06-01

 
 
 
 
221

Quantitative expression of the Candida albicans secreted aspartyl proteinase gene family in human oral and vaginal candidiasis.  

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A quantitative real-time RT-PCR system was established to identify which secreted aspartyl proteinase (SAP) genes are most highly expressed and potentially contribute to Candida albicans infection of human epithelium in vitro and in vivo. C. albicans SC5314 SAP1-10 gene expression was monitored in organotypic reconstituted human epithelium (RHE) models, monolayers of oral epithelial cells, and patients with oral (n=17) or vaginal (n=17) candidiasis. SAP gene expression was also analysed in Deltasap1-3, Deltasap4-6, Deltaefg1 and Deltaefg1/cph1 mutants to determine whether compensatory SAP gene regulation occurs in the absence of distinct proteinase gene subfamilies. In monolayers, RHE models and patient samples SAP9 was consistently the most highly expressed gene in wild-type cells. SAP5 was the only gene significantly upregulated as infection progressed in both RHE models and was also highly expressed in patient samples. Interestingly, the SAP4-6 subfamily was generally more highly expressed in oral monolayers than in RHE models. SAP1 and SAP2 expression was largely unchanged in all model systems, and SAP3, SAP7 and SAP8 were expressed at low levels throughout. In Deltasap1-3, expression was compensated for by increased expression of SAP5, and in Deltasap4-6, expression was compensated for by SAP2: both were observed only in the oral RHE. Both Deltasap1-3 and Deltasap4-6 mutants caused RHE tissue damage comparable to the wild-type. However, addition of pepstatin A reduced tissue damage, indicating a role for the Sap family as a whole in inducing epithelial damage. With the hypha-deficient mutants, RHE tissue damage was significantly reduced in both Deltaefg1/cph1 and Deltaefg1, but SAP5 expression was only dramatically reduced in Deltaefg1/cph1 despite the absence of hyphal growth in both mutants. This indicates that hypha formation is the predominant cause of tissue damage, and that SAP5 expression can be hypha-independent and is not solely controlled by the Efg1 pathway but also by the Cph1 pathway. This is believed to be the first study to fully quantify SAP gene expression levels during human mucosal infections; the results suggest that SAP5 and SAP9 are the most highly expressed proteinase genes in vivo. However, the overall contribution of the Sap1-3 and Sap4-6 subfamilies individually in inducing epithelial damage in the RHE models appears to be low. PMID:18957581

Naglik, Julian R; Moyes, David; Makwana, Jagruti; Kanzaria, Priya; Tsichlaki, Elina; Weindl, Günther; Tappuni, Anwar R; Rodgers, Catherine A; Woodman, Alexander J; Challacombe, Stephen J; Schaller, Martin; Hube, Bernhard

2008-11-01

222

Etiología de la candidiasis vulvovaginal recidivante en la Atención Primaria de Salud en Santa Catarina, Brasil / Etiology of recurrent vulvovaginal candidiasis in the National Health System in Santa Catarina, Brazil / Etiologia da candidíase vulvovaginal recorrente na Atenção Primária à Saúde em Santa Catarina, Brasil  

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Full Text Available SciELO Argentina | Language: Spanish Abstract in portuguese O objetivo do presente trabalho foi destacar as características epidemiológicas que possam subsidiar a Atenção Primária à Saúde (APS) em mulheres portadoras de candidíase vulvovaginal (CVV) e candidíase vulvovaginal recorrente (CVVR), a partir de estudos realizados em três municípios do sul do Brasi [...] l. Através do exame micológico da secreção vaginal de 300 mulheres com suspeita clínica de CVV ou CVVR foram identificadas as espécies prevalentes de Candida, correlacionando os achados com os principais fatores de risco mencionados na literatura. Foram detectadas leveduras em 90 (30%) dos casos, resultando as espécies mais frequentes C. albicans (61,1%), C. krusei (16,7%), C. tropicalis (6,7%), C. glabrata (4,4%) e Candida spp. (11,1%). Nos casos de CVVR, C. albicans foi a espécie mais encontrada, com uma prevalência superior à observada nos casos de CVV. C. krusei apareceu como a segunda espécie mais prevalente em todas as amostras, ressaltando a importância do diagnóstico em nível de espécie, devido à resistência intrínseca ao fluconazol. As informações epidemiológicas deste estudo são úteis para que os gestores da Atenção Primária à Saúde (APS) e os profissionais da Saúde Pública possam ter subsídios adicionais para atuar preventivamente nos casos de candidíases vulvovaginais. Abstract in spanish El objetivo del presente trabajo fue destacar las características epidemiológicas que puedan subsidiar la Atención Primaria de Salud (APS) en mujeres portadoras de candidiasis vulvovaginal (CVV) y candidiasis vulvovaginal recidivante (CVVR), a partir de estudios realizados en tres municipios del sur [...] de Brasil. A través del examen micológico de la secreción vaginal de 300 mujeres con sospecha clínica de CVV o CVVR se identificaron las especies prevalentes de Candida, correlacionándose los hallazgos con los principales factores de riesgo mencionados en la literatura. Fueron confirmadas levaduras en 90 (30%) casos, resultando las especies más frecuentes C. albicans (61,1%), C. krusei (16,7%), C. tropicalis (6,7%), C. glabrata (4,4%) y Candida spp. (11,1%). En los casos de CVVR, C. albicans fue la especie más encontrada, con una prevalencia superior a la observada en la CVV. C. krusei apareció como la segunda especie más prevalente en todas las muestras, resaltando la importancia del diagnóstico a nivel de especie, dada la resistencia intrínseca al fluconazol. Las informaciones epidemiológicas del estudio son útiles para que los gestores de la Atención Primaria de Salud (APS) y los profesionales de la Salud puedan tener subsidios adicionales para actuar preventivamente en el caso de candidiasis vulvovaginales. Abstract in english The main purpose of this work was to highlight epidemiological characteristics serving as subsidies to health promotion activities for vulvovaginal candidiasis (VVC) and recurrent vulvovaginal candidiasis (RVVC) by the national health system, in three cities in southern Brazil. Through the mycologic [...] al examination of vaginal secretions of 300 women with clinical suspicion of VVC or RVVC, Candida-prevalent species were identified and they were correlated with the main risk factors mentioned in the literature. Yeasts were confirmed in 90 (30%) cases, resulting in C. albicans 61.1%, C. krusei 16.7%, C. tropicalis 6.7%, C. glabrata 4.4% and others 11.1%. C. albicans was the species most commonly found in cases of RVVC, with levels higher than the prevalence of the species in the VVC. C. krusei prevailed as the second most prevalent species in both samples, emphasizing the importance of diagnosing the species level, due to its intrinsic resistance to fluconazole. The epidemiological information of the study is useful for managers of the National Health Care System, as well as direct health professionals, who can have new subsidies to act preventively against vulvovaginal candidiasis.

Rangeli, Basso; Nelci, Lopes da Silva; Karina, Braccini Pereira; Adelina, Mezzari; Alexandre, Meneghello Fuentefria.

223

Etiología de la candidiasis vulvovaginal recidivante en la Atención Primaria de Salud en Santa Catarina, Brasil Etiologia da candidíase vulvovaginal recorrente na Atenção Primária à Saúde em Santa Catarina, Brasil Etiology of recurrent vulvovaginal candidiasis in the National Health System in Santa Catarina, Brazil  

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Full Text Available El objetivo del presente trabajo fue destacar las características epidemiológicas que puedan subsidiar la Atención Primaria de Salud (APS en mujeres portadoras de candidiasis vulvovaginal (CVV y candidiasis vulvovaginal recidivante (CVVR, a partir de estudios realizados en tres municipios del sur de Brasil. A través del examen micológico de la secreción vaginal de 300 mujeres con sospecha clínica de CVV o CVVR se identificaron las especies prevalentes de Candida, correlacionándose los hallazgos con los principales factores de riesgo mencionados en la literatura. Fueron confirmadas levaduras en 90 (30% casos, resultando las especies más frecuentes C. albicans (61,1%, C. krusei (16,7%, C. tropicalis (6,7%, C. glabrata (4,4% y Candida spp. (11,1%. En los casos de CVVR, C. albicans fue la especie más encontrada, con una prevalencia superior a la observada en la CVV. C. krusei apareció como la segunda especie más prevalente en todas las muestras, resaltando la importancia del diagnóstico a nivel de especie, dada la resistencia intrínseca al fluconazol. Las informaciones epidemiológicas del estudio son útiles para que los gestores de la Atención Primaria de Salud (APS y los profesionales de la Salud puedan tener subsidios adicionales para actuar preventivamente en el caso de candidiasis vulvovaginales.O objetivo do presente trabalho foi destacar as características epidemiológicas que possam subsidiar a Atenção Primária à Saúde (APS em mulheres portadoras de candidíase vulvovaginal (CVV e candidíase vulvovaginal recorrente (CVVR, a partir de estudos realizados em três municípios do sul do Brasil. Através do exame micológico da secreção vaginal de 300 mulheres com suspeita clínica de CVV ou CVVR foram identificadas as espécies prevalentes de Candida, correlacionando os achados com os principais fatores de risco mencionados na literatura. Foram detectadas leveduras em 90 (30% dos casos, resultando as espécies mais frequentes C. albicans (61,1%, C. krusei (16,7%, C. tropicalis (6,7%, C. glabrata (4,4% e Candida spp. (11,1%. Nos casos de CVVR, C. albicans foi a espécie mais encontrada, com uma prevalência superior à observada nos casos de CVV. C. krusei apareceu como a segunda espécie mais prevalente em todas as amostras, ressaltando a importância do diagnóstico em nível de espécie, devido à resistência intrínseca ao fluconazol. As informações epidemiológicas deste estudo são úteis para que os gestores da Atenção Primária à Saúde (APS e os profissionais da Saúde Pública possam ter subsídios adicionais para atuar preventivamente nos casos de candidíases vulvovaginais.The main purpose of this work was to highlight epidemiological characteristics serving as subsidies to health promotion activities for vulvovaginal candidiasis (VVC and recurrent vulvovaginal candidiasis (RVVC by the national health system, in three cities in southern Brazil. Through the mycological examination of vaginal secretions of 300 women with clinical suspicion of VVC or RVVC, Candida-prevalent species were identified and they were correlated with the main risk factors mentioned in the literature. Yeasts were confirmed in 90 (30% cases, resulting in C. albicans 61.1%, C. krusei 16.7%, C. tropicalis 6.7%, C. glabrata 4.4% and others 11.1%. C. albicans was the species most commonly found in cases of RVVC, with levels higher than the prevalence of the species in the VVC. C. krusei prevailed as the second most prevalent species in both samples, emphasizing the importance of diagnosing the species level, due to its intrinsic resistance to fluconazole. The epidemiological information of the study is useful for managers of the National Health Care System, as well as direct health professionals, who can have new subsidies to act preventively against vulvovaginal candidiasis.

Rangeli Basso

2012-09-01

224

Candidíase sistêmica com localização encefálica: estudo anátomo-clínico de cinco casos Septicaemia candidiasis with cerebral involvement: a report of five cases  

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Full Text Available Nas septicemias por Candida, a localização encefálica é rara, e apenas quatro casos isolados foram publicados no Brasil. Os AA. apresentam cinco observações anátomo-clínicas de candidíase do sistema nervoso central, diagnosticadas somente pela autópsia. Quatro dos pacientes eram adultos e apenas uma criança foi estudada. Todos eram portadores de uma ou mais doenças de base e foram submetidos à terapêutica antibiótica múltipla e prolongada. Os sintomas neurológicos eventualmente atribuíveis à infecção fúngica limitaram-se a convulsões em um caso e rigidez de nuca em outro. Em nenhum as lesões assumiram gravidade suficiente para serem responsabilizadas como causa imediata da morte. Revelaram-se múltiplas e microscópicas em três pacientes, com caráter exsudativo e granulomatoso; macroscópicas em um caso, com aspecto necro-hemorrágico. Na criança, dois granulomas apenas foram observados. O agente etiológico foi identificado como Candida, nos cortes histológicos, pela técnica de impregnação argêntica de Grocott. Os autores discutem a patogênese e a anatomia patológica da candidíase sistêmica, bem como seu diagnóstico clínico-laboratorial e a terapêutica. Os achados clínicos e an átomo-patológicos dos presentes casos são analisados à luz da literatura, enfatizando que a incidência de monilíase sistêmica no Brasil deve ser muito superior ao sugerido pela escassa casuística nacional.Central nervous system involvement in Candida septicaemia is rare and not more than four cases have been published in Brazil. Five new cases of systemic candidiasis with cerebral lesions are reported. All patients (four adults and a child had serious underlying diseases and were submitted to heavy long-term antibiotic therapy with multiple drugs. Seizures in one case and neck stiffness in another were the only neurologic signs that could be attributed to candidiasis. In no case were the lesions severe enough to be considered an immediate cause of death. In three patients, no macroscopic changes were evident in the brain, but microabscesses and granulomata were observed on microscopical examination; another patient had two gross areas with necrotic and haemorrhagic appearance in the cerebral hemispheres; the child had only two microscopic granulomata. The aetiological agent was demonstrated by Grocott's methenamine silver technique in all cases. Involvement of organs other than the central nervous system could be demonstrated in three autopsies. Discussion is confined mainly to such aspects as the contributory factors in the pathogenesis of systemic candidiasis as well as the marked rise in the incidence of this condition in the past few decades. It is suggested that the frequence of monilial septicaemia in Brazil may be far more serious than apparent from the scarcity of reported cases.

Luciano de Souza Queiroz

1976-03-01

225

Candidíase sistêmica com localização encefálica: estudo anátomo-clínico de cinco casos / Septicaemia candidiasis with cerebral involvement: a report of five cases  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: Portuguese Abstract in portuguese Nas septicemias por Candida, a localização encefálica é rara, e apenas quatro casos isolados foram publicados no Brasil. Os AA. apresentam cinco observações anátomo-clínicas de candidíase do sistema nervoso central, diagnosticadas somente pela autópsia. Quatro dos pacientes eram adultos e apenas uma [...] criança foi estudada. Todos eram portadores de uma ou mais doenças de base e foram submetidos à terapêutica antibiótica múltipla e prolongada. Os sintomas neurológicos eventualmente atribuíveis à infecção fúngica limitaram-se a convulsões em um caso e rigidez de nuca em outro. Em nenhum as lesões assumiram gravidade suficiente para serem responsabilizadas como causa imediata da morte. Revelaram-se múltiplas e microscópicas em três pacientes, com caráter exsudativo e granulomatoso; macroscópicas em um caso, com aspecto necro-hemorrágico. Na criança, dois granulomas apenas foram observados. O agente etiológico foi identificado como Candida, nos cortes histológicos, pela técnica de impregnação argêntica de Grocott. Os autores discutem a patogênese e a anatomia patológica da candidíase sistêmica, bem como seu diagnóstico clínico-laboratorial e a terapêutica. Os achados clínicos e an átomo-patológicos dos presentes casos são analisados à luz da literatura, enfatizando que a incidência de monilíase sistêmica no Brasil deve ser muito superior ao sugerido pela escassa casuística nacional. Abstract in english Central nervous system involvement in Candida septicaemia is rare and not more than four cases have been published in Brazil. Five new cases of systemic candidiasis with cerebral lesions are reported. All patients (four adults and a child) had serious underlying diseases and were submitted to heavy [...] long-term antibiotic therapy with multiple drugs. Seizures in one case and neck stiffness in another were the only neurologic signs that could be attributed to candidiasis. In no case were the lesions severe enough to be considered an immediate cause of death. In three patients, no macroscopic changes were evident in the brain, but microabscesses and granulomata were observed on microscopical examination; another patient had two gross areas with necrotic and haemorrhagic appearance in the cerebral hemispheres; the child had only two microscopic granulomata. The aetiological agent was demonstrated by Grocott's methenamine silver technique in all cases. Involvement of organs other than the central nervous system could be demonstrated in three autopsies. Discussion is confined mainly to such aspects as the contributory factors in the pathogenesis of systemic candidiasis as well as the marked rise in the incidence of this condition in the past few decades. It is suggested that the frequence of monilial septicaemia in Brazil may be far more serious than apparent from the scarcity of reported cases.

Luciano de Souza, Queiroz; Anamarli, Nucci; J. Lopes de, Faria.

1976-03-01

226

First characterization of Candida albicans by random amplified polymorphic DNA method in Nicaragua and comparison of the diagnosis methods for vaginal candidiasis in Nicaraguan women  

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Full Text Available A total of 106 women with vaginitis in Nicaragua were studied. The positive rate for the identification of Candida species was 41% (44 positive cultures out of 106 women with vaginitis. The sensitivity of microscopic examination of wet mount with the potassium hydroxide (KOH was 61% and 70% with Gram's stain when using the culture of vaginal fluid as gold standard for diagnosis of candidiasis. Among the 44 positives cultures, isolated species of yeast from vaginal swabs were C. albicans (59%, C. tropicalis (23%, C. glabrata (14% and C. krusei (4%. This study reports the first characterization of 26 C. albicans stocks from Nicaragua by the random amplified polymorphic DNA method. The genetic analysis in this small C. albicans population showed the existence of linkage disequilibrium, which is consistent with the hypothesis that C. albicans undergoes a clonal propagation.

Martha Darce Bello

2002-10-01

227

Quantification of Candida albicans Actin mRNA by the LightCycler System as a Means of Assessing Viability in a Model of Cutaneous Candidiasis  

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The LightCycler system (two-step reverse transcription-PCR–fluorescent hybridization [LC RT-PCR–FH]) was used to quantify Candida albicans actin mRNA as a means of assessing its viability in a reconstituted skin model of cutaneous candidiasis following the application of an antimycotic. A 192-bp ACT exon fragment was ligated into the pCR2.1 plasmid vector, and dilutions of the cloned insert (pACT; 4.092 kb) were used as the standard reference template. The LC RT-PCR–FH system could detect 1 fg of pACT, equivalent to 2.2 copies of the plasmid. The ACT exon-based PCR primers and FH probes were C. albicans specific, and electrophoretic analysis of the LC RT-PCR–FH assay product showed a 174-bp band in agarose gel. The number of copies of C. albicans ACT mRNA per milligram of tissue decreased with increasing amounts of amorolfine applied to a C. albicans-infected skin model, showing a reduction in viability. Detection and quantification of ACT mRNA in tissue by the LC RT-PCR–FH assay corresponded with cultural isolation of C. albicans from samples. The ACT mRNA-targeted LC RT-PCR–FH assay represents a sensitive, specific, rapid, and quantitative means of assessing the viability of C. albicans in infected tissue. This method may also be useful in evaluating the therapeutic efficacies of antifungal drugs in the treatment of various forms of candidiasis and other fungal diseases. PMID:11574561

Okeke, Charles N.; Tsuboi, Ryoji; Ogawa, Hideoki

2001-01-01

228

Prospective survey of (1?3)-beta-D-glucan and its relationship to invasive candidiasis in the surgical intensive care unit setting.  

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Non-culture-based diagnostic strategies are needed for diagnosing invasive candidiasis (IC). We evaluated serial serum (1?3)-?-d-glucan (BG) levels in patients in the surgical trauma intensive care unit (SICU) patients with clinical evidence of IC. Serum samples from patients admitted to the SICU for a minimum of 3 days were collected twice weekly and analyzed for BG by using a Fungitell kit with a positive cutoff of ? 80 pg/ml. Diagnosis of IC was done using a set of predefined and validated clinical practice-based criteria. A total of 57 patients consented to participate and were enrolled. The median ICU stay was 16 days (range, 3 to 51). A total of 14 of 57 (25%) false positives were observed in the first sample (ICU day 3) and, overall, 73% of the day 3 samples had higher BG levels than subsequent samples. On the date of clinical diagnosis of IC, the sensitivity of a positive BG for identifying invasive candidiasis was 87%, with a 73% specificity. In patients with evidence of IC, the median BG value was significantly higher than those without evidence of IC (171 versus 48 pg/ml, P = 0.02), respectively. In the three patients with proven IC, BG was detected 4 to 8 days prior to diagnosis. BG serum detection may be a useful tool to aid in the early diagnosis of IC in SICU patients, particularly after day 3 and in patients with at least two positive samples drawn several days apart. Elevated BG levels within the first 3 days need to be further characterized. PMID:21048005

Mohr, John F; Sims, Charles; Paetznick, Victor; Rodriguez, Jose; Finkelman, Malcolm A; Rex, John H; Ostrosky-Zeichner, Luis

2011-01-01

229

Prospective Survey of (1->3)-?-d-Glucan and Its Relationship to Invasive Candidiasis in the Surgical Intensive Care Unit Setting?  

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Non-culture-based diagnostic strategies are needed for diagnosing invasive candidiasis (IC). We evaluated serial serum (1?3)-?-d-glucan (BG) levels in patients in the surgical trauma intensive care unit (SICU) patients with clinical evidence of IC. Serum samples from patients admitted to the SICU for a minimum of 3 days were collected twice weekly and analyzed for BG by using a Fungitell kit with a positive cutoff of ?80 pg/ml. Diagnosis of IC was done using a set of predefined and validated clinical practice-based criteria. A total of 57 patients consented to participate and were enrolled. The median ICU stay was 16 days (range, 3 to 51). A total of 14 of 57 (25%) false positives were observed in the first sample (ICU day 3) and, overall, 73% of the day 3 samples had higher BG levels than subsequent samples. On the date of clinical diagnosis of IC, the sensitivity of a positive BG for identifying invasive candidiasis was 87%, with a 73% specificity. In patients with evidence of IC, the median BG value was significantly higher than those without evidence of IC (171 versus 48 pg/ml, P = 0.02), respectively. In the three patients with proven IC, BG was detected 4 to 8 days prior to diagnosis. BG serum detection may be a useful tool to aid in the early diagnosis of IC in SICU patients, particularly after day 3 and in patients with at least two positive samples drawn several days apart. Elevated BG levels within the first 3 days need to be further characterized. PMID:21048005

Mohr, John F.; Sims, Charles; Paetznick, Victor; Rodriguez, Jose; Finkelman, Malcolm A.; Rex, John H.; Ostrosky-Zeichner, Luis

2011-01-01

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A double-blind comparative study of the safety and efficacy of caspofungin versus micafungin in the treatment of candidiasis and aspergillosis.  

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The safety and efficacy profile of caspofungin and micafungin in Japanese patients with fungal infections were directly compared in this prospective, randomized, double-blind study. The proportion of patients who developed significant drug-related adverse event(s) (defined as a serious drug-related adverse event or a drug-related adverse event leading to study therapy discontinuation) was compared in 120 patients [caspofungin 50 mg, or 50 mg following a 70-mg loading dose on Day 1 (hereinafter, 70/50 mg) group: 60 patients; micafungin 150 mg: 60 patients]. The overall response rate was primarily evaluated in the per-protocol set (PPS) population. The proportion of patients who developed significant drug-related adverse events was 5.0 % (3/60) in the caspofungin group and 10.0 % (6/60) in the micafungin group [95 % confidence interval (CI) for the difference: -15.9 %, 5.2 %]. The favorable overall response in the PPS population for patients with esophageal candidiasis, invasive candidiasis, and chronic pulmonary aspergillosis including aspergilloma was 100.0 % (6/6), 100.0 % (3/3), and 46.7 % (14/30) in the caspofungin group, and 83.3 % (5/6), 100.0 % (1/1), and 42.4 % (14/33) in the micafungin group, respectively. In Japanese patients with Candida or Aspergillus infections, there was no statistical difference in the safety between caspofungin and micafungin. Consistent with other data on these two agents, the efficacy of caspofungin and micafungin was similar. PMID:23052987

Kohno, S; Izumikawa, K; Yoshida, M; Takesue, Y; Oka, S; Kamei, K; Miyazaki, Y; Yoshinari, T; Kartsonis, N A; Niki, Y

2013-03-01

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Susceptibility of Germfree Phagocyte Oxidase- and Nitric Oxide Synthase 2-Deficient Mice, Defective in the Production of Reactive Metabolites of Both Oxygen and Nitrogen, to Mucosal and Systemic Candidiasis of Endogenous Origin  

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Mice deficient for phagocyte oxidase (Phox) and nitric oxide synthase 2 (NOS2) (gp91phox?/?/NOS2?/?), defective in the production of both reactive oxygen intermediates (ROI) and reactive nitrogen intermediates (RNI), were used to investigate the role of phagocytic cells during mucosal and systemic candidiasis of endogenous origin. The alimentary tracts of germfree mice were colonized with Candida albicans wild type or each of two hyphal signaling-defective mutants (efg1/efg1 and efg1/...

Balish, Edward; Warner, Thomas F.; Nicholas, Peter J.; Paulling, Emily E.; Westwater, Caroline; Schofield, David A.

2005-01-01

232

Treatment and prophylaxis of invasive candidiasis with anidulafungin, caspofungin and micafungin and its impact on use and costs - review of the literature  

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Full Text Available Abstract Invasive fungal infections are on the rise. Echinocandins are a relatively new class of antifungal drugs that act by inhibition of a key enzyme necessary for integrity of the fungal cell wall. Currently there are three available agents: caspofungin, micafungin and anidulafungin. While the individual echinocandin antifungals have a different spectrum of licensed indications, basically all of them are available for the treatment of candidemia and invasive candidiasis. Antifungal treatment modalities basically include in therapy for suspected or proven infection and prophylaxis. All three drugs are comparatively expensive. Therefore a systematic review of the literature was performed to investigate the following aspects: • General aspects of cost-effectiveness in the treatment of invasive fungal infections • Cost-effectiveness of the treatment with the above-mentioned antifungals • Cost-effectiveness in two settings: therapy and prophylaxis Early initiation of antifungal therapy, adjustment after availability of microbiological results, duration of therapy, success and occurrence of severe complications (e.g renal failure are the most important cost drivers in antifungal therapy. Considering the specific antifungals, for caspofungin the best evidence for cost-effectiveness is found in treatment of invasive candidiasis and in empiric therapy of suspected infections. Favourable economic data are available for micafungin as a cost-effective alternative to LAmB for prophylaxis in patients with hematopoietic stem cell transplantation (HSCT. For anidulafungin, cost-effectiveness was demostrated in a pharmacoeconomic model. Net savings - yet not significant - were observed in a retrospective chart review of 234 patients. Generally, however, most analyses are still based on pharmacoeconomic modelling rather than direct analysis of trial data or real-life clinical populations. As an overall conclusion, using caspofungin, micafungin, or anidulafungin is not more expensive than using other established therapies. Micafungin has proven to be cost-effective in prophylaxis if the local fungal epidemiology indicates a high level of resistance to fluconazole. Switch strategies involving early initiation of broadly active therapy with switch to cheaper alternatives according to microbiology results and clinical status and early initiation of an appropriate therapy have been proven to be cost-efficient independent of the antifungal agent.

Wilke MH

2011-04-01

233

Avaliação clínica e laboratorial do gel da Uncaria tomentosa (Unha de Gato) sobre candidose oral / Clinical and laboratorial evaluation of Uncaria tomentosa (Cat's Claw) gel on oral candidiasis  

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Full Text Available SciELO Brazil | Language: Portuguese Abstract in portuguese Na odontologia, a fitoterapia já vem sendo utilizada com sucesso há vários anos. Trata-se de um meio terapêutico que apresenta como vantagem sobre as medicações alopáticas o fato de apresentar reações adversas mínimas. A Uncaria tomentosa é uma planta indígena da floresta Amazônica e de outras áreas [...] tropicais da América do Sul e Central. Tem aplicação no tratamento de diversas patologias, entre elas a candidose. Este trabalho avalia clínico e laboratorialmente a ação do gel da Uncaria tomentosa em pacientes portadores de candidose na cavidade oral. Foram selecionados 20 pacientes que apresentaram clínico e laboratorialmente infecção pelo Candida. Os mesmos foram divididos em 2 grupos. O grupo-teste (Uncaria tomentosa/Imuno-Max Gel), composto por 10 pacientes, foi orientado a utilizar o gel da Uncaria tomentosa, sobre as lesões na cavidade oral, 3x ao dia por um período de 14 dias. O grupo-controle (Miconazol/Daktarin Gel) utilizou a medicação da mesma forma prescrita para o grupo-teste. Após o período de tratamento, os pacientes retornaram para nova avaliação clínica e laboratorial. A Uncaria tomentosa mostrou ser um fitofármaco promissor na odontologia, apresentando vantagem sobre o miconazol de não ter provocado reações adversas nos pacientes, uma vez que, 40% dos pacientes do grupo-controle, apresentaram reações indesejáveis. Abstract in english In dentistry, the phytotherapy is already being used successfully for some years now. It is about a promising therapeutical way in the pharmaceutical field, having as advantage on pharmacotherapy medications the fact to present minimum adverse reactions. The Uncaria tomentosa is an aboriginal plant [...] of the Amazonian forest and other tropical areas of the South and Central America. It has application in the treatment of several pathologies, including candidiasis. This work evaluates, clinical and laboratorial, the action of the Uncaria tomentosa gel in the oral cavity candidiasis patients. Twenty patients which presented clinical and laboratorial signs of Candida infection were selected. They were divided in 2 groups. The test-group (Uncaria tomentosa/IMUNO-MAX Gel), with 10 patients, was told to use the Uncaria tomentosa gel, on the oral cavity injuries, 3 times a day for a period of 14 days. The control-group (Miconazol/DAKTARIN Gel) used the prescribed medication in the same way of the test-group. After the treatment period, the patients returned for a new clinical and laboratorial evaluation. The Uncaria tomentosa showed to be a promising phytotherapeutical medication in dentistry, in the field of the anti-fungi treatment, presenting as advantage on the Miconazol not causing adverse reactions in the patients, once 40% of the control-group patients showed undesirable reactions.

Leonardo Costa de Almeida, Paiva; Rodrigo Alves, Ribeiro; Jozinete Vieira, Pereira; Neuza Maria Cavalcante, Oliveira.

2009-06-01

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Etiologia dos casos de candidíase cutânea atendidos no serviço de micologia da Universidade Federal Fluminense, Brasil / Etiology of cutaneous candidiasis cases seen at the mycology service of the Universidade Federal Fluminense, Brazil / Etiología de casos de candidiasis cutánea atendidos en el servicio de micología de la Universidad Federal Fluminense, Brasil  

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Full Text Available SciELO Venezuela | Language: Portuguese Abstract in portuguese Neste trabalho foram estudadas 64 amostras oriundas de 56 pacientes com suspeita clínica de candidíase cutânea, coletadas de novembro de 2008 a agosto de 2009, no serviço de Diagnóstico Micológico Humano e Veterinário do Departamento de Microbiologia e Parasitologia, Instituto Biomédico da Universid [...] ade Federal Fluminense. Foram isoladas espécies de Candida em 58 amostras de 51 pacientes, trinta e oito mulheres e treze homens, com a seguinte distribuição: 15 C. parapsilosis, 11 C. famata, 9 C. albicans, 7 C. haemulonii, 5 C. ciferrii, 4 C. guilliermondii, 4 C. lipolytica e 3 C . tropicalis. As onicomicoses representaram mais de 75% das manifestações clínicas. Nos casos em que não foi Candida isolada como o agente etiológico, foram identificados dois Cryptococcus laurentii, um Trichosporon mucoides e um Trichosporon asahii. Este trabalho é uma contribuição para o entendimento da etiologia de candidíase cutânea no serviço de Micologia da Universidade Federal Fluminense. Abstract in spanish En este trabajo se estudiaron 64 muestras procedentes de 56 pacientes con sospecha clínica de candidiasis cutánea, recolectadas entre noviembre de 2008 a agosto de 2009 en el servicio de Diagnóstico Micológico Humano y Veterinario del Departamento de Microbiología y Parasitología, Instituto Biomédic [...] o de la Universidad Federal Fluminense. Se aislaron especies del género Candida en 58 muestras de 51 pacientes, treinta y ocho mujeres y trece hombres, con la siguiente distribución: 15 C. parapsilosis, 11 C. famata, 9 C. albicans, 7 C. haemulonii, 5 C. ciferrii, 4 C. guilliermondii, 4 C. lipolytica y 3 C . tropicalis. Las onicomicosis representaron más del 75% de las manifestaciones clínicas. En los casos donde no se aisló Candida como agente etiológico se identificaron dos Cryptococcus laurentii, un Trichosporon mucoides y un Trichosporon asahii. Este trabajo es una contribución al conocimiento de la etiología de la candidiasis cutánea en el Servicio de Micología de la Universidad Federal Fluminense. Abstract in english This work corresponds to the study of 64 samples from 56 patients with clinical suspicion of cutaneous candidiasis, collected between November 2008 and August 2009 at the Human and Veterinarian Diagnostic Service of the Department of Microbiology and Parasitology of the Instituto Biomédico of the Un [...] iversidad Federal Fluminense, Brazil. Candida genus species were isolated in 58 samples from 51 patients (38 women and 13 men), with the following distribution: C. parapsilosis 15, C. famata 11, C. albicans 9, C. haemulonii 7, C. guilliermondii 4, C. ciferrii 5, C. lipolytica 4, and C. tropicalis 3. Onicomycoses represented over 75% of the clinical manifestations. In cases where Candida was not isolated as etiologic agent, two Cryptococcus laurentii, one Trichosporum mucoides, and one Trichosporum asahii were identified. This work is a contribution to the knowledge of the etiology of cutaneous candidiasis at the Mycology Service of the Universidade Federal Fluminense.

Leonardo, Silva Barbedo; Simone Cristina, Pereira Brito; Fabíola Cristina, de Oliveira Kegele; Jânio, Alves Cordeiro; Jeferson, Carvalhaes de Oliveira; Diana Bridon, da Graça Sgarbi.

235

Etiologia dos casos de candidíase cutânea atendidos no serviço de micologia da Universidade Federal Fluminense, Brasil / Etiology of cutaneous candidiasis cases seen at the mycology service of the Universidade Federal Fluminense, Brazil / Etiología de casos de candidiasis cutánea atendidos en el servicio de micología de la Universidad Federal Fluminense, Brasil  

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Full Text Available SciELO Venezuela | Language: Portuguese Abstract in portuguese Neste trabalho foram estudadas 64 amostras oriundas de 56 pacientes com suspeita clínica de candidíase cutânea, coletadas de novembro de 2008 a agosto de 2009, no serviço de Diagnóstico Micológico Humano e Veterinário do Departamento de Microbiologia e Parasitologia, Instituto Biomédico da Universid [...] ade Federal Fluminense. Foram isoladas espécies de Candida em 58 amostras de 51 pacientes, trinta e oito mulheres e treze homens, com a seguinte distribuição: 15 C. parapsilosis, 11 C. famata, 9 C. albicans, 7 C. haemulonii, 5 C. ciferrii, 4 C. guilliermondii, 4 C. lipolytica e 3 C . tropicalis. As onicomicoses representaram mais de 75% das manifestações clínicas. Nos casos em que não foi Candida isolada como o agente etiológico, foram identificados dois Cryptococcus laurentii, um Trichosporon mucoides e um Trichosporon asahii. Este trabalho é uma contribuição para o entendimento da etiologia de candidíase cutânea no serviço de Micologia da Universidade Federal Fluminense. Abstract in spanish En este trabajo se estudiaron 64 muestras procedentes de 56 pacientes con sospecha clínica de candidiasis cutánea, recolectadas entre noviembre de 2008 a agosto de 2009 en el servicio de Diagnóstico Micológico Humano y Veterinario del Departamento de Microbiología y Parasitología, Instituto Biomédic [...] o de la Universidad Federal Fluminense. Se aislaron especies del género Candida en 58 muestras de 51 pacientes, treinta y ocho mujeres y trece hombres, con la siguiente distribución: 15 C. parapsilosis, 11 C. famata, 9 C. albicans, 7 C. haemulonii, 5 C. ciferrii, 4 C. guilliermondii, 4 C. lipolytica y 3 C . tropicalis. Las onicomicosis representaron más del 75% de las manifestaciones clínicas. En los casos donde no se aisló Candida como agente etiológico se identificaron dos Cryptococcus laurentii, un Trichosporon mucoides y un Trichosporon asahii. Este trabajo es una contribución al conocimiento de la etiología de la candidiasis cutánea en el Servicio de Micología de la Universidad Federal Fluminense. Abstract in english This work corresponds to the study of 64 samples from 56 patients with clinical suspicion of cutaneous candidiasis, collected between November 2008 and August 2009 at the Human and Veterinarian Diagnostic Service of the Department of Microbiology and Parasitology of the Instituto Biomédico of the Un [...] iversidad Federal Fluminense, Brazil. Candida genus species were isolated in 58 samples from 51 patients (38 women and 13 men), with the following distribution: C. parapsilosis 15, C. famata 11, C. albicans 9, C. haemulonii 7, C. guilliermondii 4, C. ciferrii 5, C. lipolytica 4, and C. tropicalis 3. Onicomycoses represented over 75% of the clinical manifestations. In cases where Candida was not isolated as etiologic agent, two Cryptococcus laurentii, one Trichosporum mucoides, and one Trichosporum asahii were identified. This work is a contribution to the knowledge of the etiology of cutaneous candidiasis at the Mycology Service of the Universidade Federal Fluminense.

Leonardo, Silva Barbedo; Simone Cristina, Pereira Brito; Fabíola Cristina, de Oliveira Kegele; Jânio, Alves Cordeiro; Jeferson, Carvalhaes de Oliveira; Diana Bridon, da Graça Sgarbi.

2013-06-01

236

Antifungal susceptibility patterns, in vitro production of virulence factors, and evaluation of diagnostic modalities for the speciation of pathogenic Candida from blood stream infections and vulvovaginal candidiasis.  

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Candida spp. have emerged as successful pathogens in both invasive and mucosal infections. Varied virulence factors and growing resistance to antifungal agents have contributed to their pathogenicity. We studied diagnostic accuracy of HiCrome Candida Differential Agar and Vitek 2 Compact system for identification of Candida spp. in comparison with species-specific PCR on 110 clinical isolates of Candida from blood stream infections (54, 49%) and vulvovaginal candidiasis (56, 51%). C. albicans (61%) was the leading pathogen in VVC, while C. tropicalis (46%) was prominent among BSIs. HiCrome Agar and Vitek 2 Compact had good measures of agreement (?) 0.826 and 0.895, respectively, in comparison with PCR. We also tested these isolates for in vitro production of proteinase, esterase, phospholipases, and biofilms. Proteinase production was more among invasive isolates (P = 0.017), while phospholipase production was more among noninvasive isolates (P = 0.001). There was an overall increase in the production of virulence factors among non-albicans Candida. Identification of clinical isolates of Candida up to species level either by chromogenic agar or by Vitek 2 Compact system should be routinely done to choose appropriate therapy. PMID:25110589

Tellapragada, Chaitanya; Eshwara, Vandana Kalwaje; Johar, Ruqaiyah; Shaw, Tushar; Malik, Nidhi; Bhat, Parvati V; Kamath, Asha; Mukhopadhyay, Chiranjay

2014-01-01

237

[Protective activity of S-PT84, a heat-killed preparation of Lactobacillus pentosus, against oral and gastric candidiasis in an experimental murine model].  

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The effect of S-PT84, a heat-killed preparation of Lactobacillus pentosus on growth of Candida albicans was examined in vitro and in vivo. The mycelial growth was effectively inhibited by S-PT84 and seemed to bind to the hyphae. We assessed the potential of S-PT84 for treatment of oral and gastric candidiasis using a murine model. When 2 mg of S-PT84 was administered three times into the oral cavity of orally Candida infected mice, the score of lesions on the tongue was improved on day 2. When 50 ?l and 200 ?l of S-PT84 (10 mg/ml) were administered three times into the oral cavity (0.5 mg × 3) and the stomach (2 mg × 3) of the same mouse model, the number of viable Candida cells in the stomach was reduced significantly on day 2. These findings suggest the possibility that S-PT84 has potential as a food ingredient supporting anti-Candida treatment, especially for Candida infection in the gastrointestinal tract. PMID:25231227

Hayama, Kazumi; Ishijima, Sanae; Ono, Yoshiko; Izumo, Takayuki; Ida, Masayuki; Shibata, Hiroshi; Abe, Shigeru

2014-01-01

238

Epidemiology and Outcomes of Invasive Candidiasis Due to Non-albicans Species of Candida in 2,496 Patients: Data from the Prospective Antifungal Therapy (PATH) Registry 2004-2008  

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This analysis describes the epidemiology and outcomes of invasive candidiasis caused by non-albicans species of Candida in patients enrolled in the Prospective Antifungal Therapy Alliance (PATH Alliance) registry from 2004 to 2008. A total of 2,496 patients with non-albicans species of Candida isolates were identified. The identified species were C. glabrata (46.4%), C. parapsilosis (24.7%), C. tropicalis (13.9%), C. krusei (5.5%), C. lusitaniae (1.6%), C. dubliniensis (1.5%) and C. guilliermondii (0.4%); 111 infections involved two or more species of Candida (4.4%). Non-albicans species accounted for more than 50% of all cases of invasive candidiasis in 15 of the 24 sites (62.5%) that contributed more than one case to the survey. Among solid organ transplant recipients, patients with non-transplant surgery, and patients with solid tumors, the most prevalent non-albicans species was C. glabrata at 63.7%, 48.0%, and 53.8%, respectively. In 1,883 patients receiving antifungal therapy on day 3, fluconazole (30.5%) and echinocandins (47.5%) were the most frequently administered monotherapies. Among the 15 reported species, 90-day survival was highest for patients infected with either C. parapsilosis (70.7%) or C. lusitaniae (74.5%) and lowest for patients infected with an unknown species (46.7%) or two or more species (53.2%). In conclusion, this study expands the current knowledge of the epidemiology and outcomes of invasive candidiasis caused by non-albicans species of Candida in North America. The variability in species distribution in these centers underscores the importance of local epidemiology in guiding the selection of antifungal therapy. PMID:24991967

Pfaller, Michael A.; Andes, David R.; Diekema, Daniel J.; Horn, David L.; Reboli, Annette C.; Rotstein, Coleman; Franks, Billy; Azie, Nkechi E.

2014-01-01

239

Anidulafungin versus caspofungin in a mouse model of candidiasis caused by anidulafungin-susceptible Candida parapsilosis isolates with different degrees of caspofungin susceptibility.  

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Candida parapsilosis isolates occasionally display resistance in vitro to echinocandins and cause breakthrough infections to echinocandins. The degree of the in vivo cross-resistance among echinocandins and the fitness loss associated with caspofungin (CAS) resistance of C. parapsilosis are not well studied. We compared the activities of CAS and anidulafungin (ANF), each given at 2 dosing schedules (high dose or low dose) in a nonneutropenic mouse model of invasive candidiasis (IC) caused by ANF-susceptible isolates of C. parapsilosis with different degrees of susceptibility to CAS (CAS resistant [CAS-R], MIC, >16 mg/liter; CAS intermediate [CAS-I], MIC, 4 mg/liter; and CAS susceptible [CAS-S], MIC, 2 mg/liter). We analyzed tissue fungal burden, histopathology, and weight loss patterns. Increasing CAS resistance was associated with reduced virulence of C. parapsilosis isolates (mortality rates for CAS-S versus CAS-I versus CAS-R, 100% versus 11.1% versus 0%, respectively; P < 0.001). High doses of either echinocandin were active against infection with the CAS-I isolate when assessed by fungal burden reduction and weight gain. In contrast to CAS-S and CAS-I isolates, there was no reduction in fungal burden in mice infected with the CAS-R isolate following treatment with either echinocandin, each given at a high or low dose. Nevertheless, mice infected with the CAS-R isolate had reduced disease severity following echinocandin treatment, suggesting that echinocandins have activity in vivo, even against echinocandin-resistant strains. A complex interplay of residual echinocandin activity, decreased virulence, and/or fitness of isolates with altered cell wall and possible immunomodulatory effects can be encountered in vivo during infection with CAS-resistant C. parapsilosis isolates. PMID:24145540

Dimopoulou, Dimitra; Hamilos, Georgios; Tzardi, Maria; Lewis, Russell E; Samonis, George; Kontoyiannis, Dimitrios P

2014-01-01

240

An Evaluation of Butoconazole Nitrate 2% Site Release® Vaginal Cream (Gynazole-1® Compared to Fluconazole 150 mg Tablets (Diflucan® in the Time to Relief of Symptoms in Patients With Vulvovaginal Candidiasis  

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Full Text Available Background. It is estimated that as many as 13 million cases of vulvovaginal infection occur in the United States annually, the majority of which are the result of Candida albicans infection. The symptoms of vulvovaginal infections are often painful and distressing to the patient. The objective of this study was to compare the time to symptomatic relief of vulvovaginal candidiasis (VVC with butoconazole nitrate 2% Site Release® vaginal cream (Gynazole-1® and oral fluconazole 150 mg tablets (Diflucan®.

Campbell K. Skokos

2005-01-01

 
 
 
 
241

Candidíase vulvovaginal: fatores predisponentes do hospedeiro e virulência das leveduras Vulvovaginal candidiasis: susceptibility factors of the host and virulence of the yeasts  

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Full Text Available INTRODUÇÃO: Leveduras do gênero Candida são patógenos oportunistas freqüentemente isolados das superfícies mucosas de indivíduos normais, mas podem levar ao desenvolvimento de infecções denominadas candidíases, que variam desde lesões superficiais até infecções disseminadas. OBJETIVOS: Ampliar os conhecimentos sobre candidíase vulvovaginal (CVV: infecção de vulva e vagina, causada por leveduras comensais que habitam a mucosa vaginal e candidíase vulvovaginal recorrente (CVVR: ocorrência de quatro ou mais episódios de CVV no período de 12 meses, bem como caracterizar e abordar o ponto de vista das influências do hospedeiro e dos fatores de virulência dos agentes causais da infecção, principalmente C. albicans, visando identificar a sua importância nessa patologia. Tanto fatores predisponentes locais como sistêmicos do hospedeiro podem contribuir para a invasão por Candida sp. Sua intensa multiplicação no canal vaginal é favorecida por uma série de fatores predisponentes abordados nesta revisão. Também tem sido postulado que existem diferenças na patogenicidade de isolados de Candida sp., não sendo o fungo apenas um participante passivo no processo infeccioso; com isso vários fatores de virulência têm sido propostos e são descritos. DISCUSSÃO E CONCLUSÕES: Este artigo de revisão bibliográfica buscou atualizar os profissionais da área da saúde em relação a CVV, CVVR, aspectos predisponentes do hospedeiro e virulência dos agentes causais, que são pouco conhecidos. Assim, a atualização e o conhecimento de conceitos básicos e clínicos relacionados com essa patologia são muito importantes para auxiliar o seu manejo pelos profissionais da área.INTRODUCTION: Vulvovaginal candidiasis (VVC is a vulva and vagina infection caused by comensal yeasts that inhabit the vaginal mucosa and eventually become patogenic, depending on host conditions. Eighty percent to 90% of the infections are due to C. albicans, and 10% to 20% to other species called non-C. albicans (C. tropicalis, C. glabrata, C. krusei, C. parapsilosis, C. pseudotropicalis, C. lusitaniae. C. glabrata is the second agent in frequency in VVC and yeasts of other genus can also cause this infection, as Saccahromyces cerevisiae, Rhodutorula sp. and Trichosporon sp. Besides host inherent factors, it has been postulated that differences exist in the patogenicity of different isolates of Candida sp. The fungus is not a mere passive participant in the infectious process, and a series of virulence factors has been proposed, but little was investigated in VVC. The objective of this work is to enlarge knowledge on VVC and RVVC, as well as to discuss the influences of host and virulence factors, aiming to identify their importance in this pathology. These aspects are of great importance for professionals that act in the area of women’s health.

Cassiana Aparecida Álvares

2007-10-01

242

Anidulafungin compared with fluconazole for treatment of candidemia and other forms of invasive candidiasis caused by Candida albicans: a multivariate analysis of factors associated with improved outcome  

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Full Text Available Abstract Background Candida albicans is the most common cause of candidemia and other forms of invasive candidiasis. Systemic infections due to C. albicans exhibit good susceptibility to fluconazole and echinocandins. However, the echinocandin anidulafungin was recently demonstrated to be more effective than fluconazole for systemic Candida infections in a randomized, double-blind trial among 245 patients. In that trial, most infections were caused by C. albicans, and all respective isolates were susceptible to randomized study drug. We sought to better understand the factors associated with the enhanced efficacy of anidulafungin and hypothesized that intrinsic properties of the antifungal agents contributed to the treatment differences. Methods Global responses at end of intravenous study treatment in patients with C. albicans infection were compared post-hoc. Multivariate logistic regression analyses were performed to predict response and to adjust for differences in independent baseline characteristics. Analyses focused on time to negative blood cultures, persistent infection at end of intravenous study treatment, and 6-week survival. Results In total, 135 patients with C. albicans infections were identified. Among these, baseline APACHE II scores were similar between treatment arms. In these patients, global response was significantly better for anidulafungin than fluconazole (81.1% vs 62.3%; 95% confidence interval [CI] for difference, 3.7-33.9. After adjusting for baseline characteristics, the odds ratio for global response was 2.36 (95% CI, 1.06-5.25. Study treatment and APACHE II score were significant predictors of outcome. The most predictive logistic regression model found that the odds ratio for study treatment was 2.60 (95% CI, 1.14-5.91 in favor of anidulafungin, and the odds ratio for APACHE II score was 0.935 (95% CI, 0.885-0.987, with poorer responses associated with higher baseline APACHE II scores. Anidulafungin was associated with significantly faster clearance of blood cultures (log-rank p p Conclusions In patients with C. albicans infection, anidulafungin was more effective than fluconazole, with more rapid clearance of positive blood cultures. This suggests that the fungicidal activity of echinocandins may have important clinical implications. Trial registration ClinicalTrials.gov: NCT00058682

Reisman Arlene L

2011-09-01

243

An unusual case: Renal candidiasis; Der besondere Fall: Renale Candidiasis  

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A 39-year old female patient suffering from congenital spastic tetraparesis, bilateral hip dysplasia and diabetes was hospitalized as an emergency because of violent pains in the right flank which emanated paravertebrally and into the pelvis. There was no fever or ague. The anamnesis included urolithiasis on the right side 5 years ago and an ileum conduit operation after a neurogenic disturbance of micturition 22 years ago. The sonographic pictures indicated no congestion of the kidneys. To exclude urolithiasis, a low-dose CT was carried out, followed by CT after application of a contrast medium. (orig.)

Pautz, Doerthe [Medizinische Hochschule Hannover (Germany). Inst. fuer Radiologie

2009-03-15

244

Oropharyngeal/Esophageal Candidiasis ("Thrush")  

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... Get email updates Contact Us: Centers for Disease Control and Prevention 1600 Clifton Rd Atlanta, GA 30333 800-CDC-INFO (800-232-4636) TTY: (888) 232-6348 Contact CDC–INFO Fungal Diseases Types of Diseases Aspergillosis Definition Symptoms People ...

245

Pulmonary candidiasis presenting as mycetoma  

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Full Text Available Candida is a saprophytic yeast that is frequently recovered from the respiratory tract. Most mycetoma lesions are due to Aspergillus species growing inside an existing cavity. The saprophytic nature of the Candida species in the human respiratory tract obscures diagnosis of Candida pulmonary infections. Only a few cases of mycetoma due to Can-dida have been reported. We report a case of mycetoma caused by Candida albicans in a diabetic immunocompromised tuberculous patient. Diagnosis was confirmed by biopsy and certain points strongly favoured the diagnosis. The patient was immunocompromised due to uncontrolled diabetes mellitus. Candida albicans was grown from bronchial and repeatedly from sputum samples and Candida antigen was positive from blood in high titre. There was a good clinical as well as radiological response to antifungal therapy and Candida antigen became negative. We emphasize that in the immunosuppressed host, a mycetoma-like lesion may be caused by Candida pulmonary infection.

Bachh Arshad

2008-01-01

246

An unusual case: Renal candidiasis  

International Nuclear Information System (INIS)

A 39-year old female patient suffering from congenital spastic tetraparesis, bilateral hip dysplasia and diabetes was hospitalized as an emergency because of violent pains in the right flank which emanated paravertebrally and into the pelvis. There was no fever or ague. The anamnesis included urolithiasis on the right side 5 years ago and an ileum conduit operation after a neurogenic disturbance of micturition 22 years ago. The sonographic pictures indicated no congestion of the kidneys. To exclude urolithiasis, a low-dose CT was carried out, followed by CT after application of a contrast medium. (orig.)

247

Thrush (Oral Candidiasis) in Adults  

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... People with diabetes or other glandular (endocrine) disorders Denture wearers People taking antibiotics Persons undergoing chemotherapy Drug ... by fever, chills, vomiting, or generalized illness, more immediate medical attention is warranted. Treatments Your Physician May ...

248

Comparison of two cleansing pastes for the removal of biofilm from dentures and palatal lesions in patients with atrophic chronic candidiasis  

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Full Text Available SciELO Brazil | Language: English Abstract in portuguese Foram comparadas duas pastas, específica para prótese total e convencional para dentes naturais, quanto à habilidade de remoção de biofilme e cura de lesões do palato em pacientes com Candidíase Atrófica Crônica. Avaliou-se também o grau de correlação entre biofilme e grau de eritema. Vinte e quatro [...] pacientes (45-80 anos) foram distribuídos em: a) pasta específica (produto experimental); b) pasta convencional (pasta dental Sorriso). Para ambos os grupos foram fornecidas escovas dentais de cerdas macias. Assuperfícies internas (próteses superiores) foram evidenciadas (fluoresceína 1%) e fotografadas (45º) em 4 visitas (0, 15, 30 e 60 dias). Os slides foram escaneados e as áreas (total e biofilme) foram medidas (software Image Tool). Sobre slides avaliou-se o grau de eritema empregando-se o Índice Tecidual de Prótese. Houve redução significativa (1%) dos níveis de biofilme (análise de variância) entre as primeiras (0 e 15 dias) e últimas visitas (45 e 60 dias) e dos escores de eritema (Kruskal-Wallis) da primeira para quarta vistita para ambas pastas. O teste de Mann-Whitney mostrou diferença estatística entre as pastas para os níveis de biofilme e igualdade estatística para os escores de eritema. Os valores de correlação entre níveis de biofilme e grau de eritema foram de 0,3801 (pasta específica) e 0,3678 (pasta convencional). A pasta específica mostrou-se efetiva, mostrando que é possível a manutenção da higiene de próteses totais com o uso regular de higienizador em forma de pasta. Abstract in english The efficacy of 2 oral hygiene products, an experimental toothpaste specific for complete denture cleansing and a regular standard toothpaste, was compared in terms of denture biofilm removal and cure of palatal lesions in patients with atrophic chronic candidiasis. The degree of correlation between [...] presence of biofilm and mucosa erythema was also evaluated. Twenty-four complete denture wearers (45-80 years old) were divided into 2 groups: experimental paste and standard toothpaste (Sorriso-Kolynos, Brazil). Both groups received soft toothbrushes. The internal surfaces of upper dentures were stained using 1% sodium fluorescein and photographed at a 45º angle at 0, 15, 30 and 60 days. The slides were scanned and the areas of interest (denture total area and biofilm area) were measured (Image Tool software). The degree of erythema was evaluated on slides according to the Prosthesis Tissue Index. There was a significant reduction (1%) in the degree of biofilm (ANOVA/Tukey) between the two initial visits (0 and 15 days) and the two final visits (30 and 60 days), and in the average erythema scores (Kruskal-Wallis) between 0 and 60 days, in both groups. The Mann-Whitney test showed a significant difference (1%) between pastes in terms of biofilm degree, but no difference was found for the erythema score. Correlation values between biofilm and erythema degree were 0.3801 (experimental paste) and (0.3678 (standard toothpaste). We may therefore conclude that the experimental product was efficient for the removal of denture plaque biofilm.

Marcela Cristina Damião, Andrucioli; Leandro Dorigan de, Macedo; Heitor, Panzeri; Elza Helena Guimarães, Lara; Helena de Freitas Oliveira, Paranhos.

249

Glossite rombóide mediana associada a candidíase esofagiana: uma possível relação etiológica com a Candida albicans Median rhomboid glossitis associated with esophagic candidiasis: a possible etiologic relation with Candida albicans  

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Full Text Available A glossite rombóide mediana é doença inflamatória que ocorre na superfície da língua. Apresenta-se como placa avermelhada ou vermelho-esbranquiçada no dorso da língua, na localização mediana. A etiologia é desconhecida. Acredita-se que possa haver relação com a má formação dos arcos branquiais durante a embriogênese. Fatores infecciosos relacionados à Candida albicans também são aventados. Os autores apresentam o caso clínico de uma paciente de 60 anos, com glossite rombóide mediana associada a esofagite candidiásica, ambas responsivas ao tratamento com itraconazol e fluconazol oral. Discute-se se a cândida não seria um dos fatores implicados na etiologia da doença lingual.Median rhomboid glossitis is an inflammatory disease involving the surface of the tongue. It develops clinically as an erythematous or white-erythematous area on the dorsal median surface of the tongue. Etiologic factors are unknown. One of the possible etiologic theories suggests a relation between median rhomboid glossitis and malformation of bronchial arches during embriogenesis. Candida albicans as an infectious etiologic factor has also been suggested. The study presents the case of a 60-year-old patient with median rhomboid glossitis associated with esophagic candidiasis. Both pathologies responded well to therapy with oral itraconazole and fluconazole. The authors argue in favor of the possibility of an etiologic relation between Candida albicans and median rhomboid glossitis .

Rubens Marcelo Souza Leite

2002-10-01

250

An Evaluation of Theraphy with Fluconazole 150 mg Tablets Compared to Fluconazole 150 mg Tablets Plus Dermoxen Lenitiva Cream in The Time to Reduce Simptomatology in Women with Vulvovaginal Candidiasis  

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Full Text Available Aim of the study. Authors investigated first of all the time to onset of ?rst relief of symptoms. Secondary measures included the time to overall relief of symptoms and the reoccurrence rate over the ?rst 45 days after the first visit. Methods. A randomized, open-label, parallel study evaluated 47 women with moderate to severe symptoms of Vulvo Vaginal Candidiasis (VVC. Patients were divided into two groups of treatment: group 1 followed a therapy with Fluconazole 150 mg tablets, while group 2 had a therapy based on Fluconazole 150 mg tablets coadjuvated by Dermoxen Lenitiva cream. Results. The time at which 50% of patients experienced ?rst relief of symptoms was 24.6 hours for Group 1, while for Group 2 it was 12.4 hours (P<0.05. There were signi?cant differences between the two groups in respect to the time of first relief of symptoms and reoccurrence of infection within 45 days of treatment. Conclusions. Combined treatment with Fluconazole 150 mg tablets and by Dermoxen Lenitiva cream provides statistically signi?cant improvement in the time of ?rst relief of symptoms, complete relief of symptoms and relapse time in the treatment of VVC compared to ?uconazole 150 mg tablets only.

Davide Carati

2014-06-01

251

A prospective two-year assessment of miconazole resistance in Candida spp. With repeated treatment with 0.25% miconazole nitrate ointment in neonates and infants with moderate to severe diaper dermatitis complicated by cutaneous candidiasis.  

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A petrolatum and zinc oxide-based ointment containing 0.25% miconazole nitrate is reported to be effective and well tolerated in the treatment of diaper dermatitis complicated by cutaneous candidiasis (DDCC). This prospective, multicenter, open-label, long-term, phase IV study investigated the potential resistance of Candida spp. to repeated topical use of 0.25% miconazole nitrate in infants age 15 months and younger with moderate to severe DDCC. For initial and recurring episodes of DDCC over the 2-year study period, subjects were treated with a 7-day course of 0.25% miconazole nitrate ointment (active components: miconazole nitrate 0.25%, zinc oxide 15%, and white petrolatum 81.35%) with a 7-day follow-up. Clinical and mycologic evaluations were conducted before treatment (day 0) and 7 days after treatment (day 14). Potential resistance to miconazole was defined using an arbitrary breakpoint of minimum inhibitory concentration of 2 ?g/mL. There was no evidence of resistance to miconazole in Candida spp. after single or repeated treatment courses of 0.25% miconazole nitrate ointment. For the initial episode of DDCC, 83 of 168 subjects (49.4%) achieved a clinical cure, 77 (45.8%) achieved a mycologic cure, and 49 (29.2%) achieved an overall cure (clinical and mycologic). The overall cure rate for recurrent episodes of DDCC was similar to or numerically greater than rates observed for the initial episode. Treatment of DDCC with 0.25% miconazole nitrate ointment was effective and generally well tolerated. No evidence of the development of resistance to miconazole in Candida spp. was observed. PMID:23675632

Blanco, Daisy; van Rossem, Koen

2013-01-01

252

Two Novel Gain-of-Function Mutations of STAT1 Responsible for Chronic Mucocutaneous Candidiasis Disease: Impaired Production of IL-17A and IL-22, and the Presence of Anti-IL-17F Autoantibody.  

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Heterozygous gain-of-function (GOF) mutations of STAT1 are responsible for chronic mucocutaneous candidiasis disease (CMCD), one of the primary immunodeficiency diseases characterized by susceptibility to mucocutaneous Candida infection. To date, 30 aa changes have been reported: 21 in the coiled-coil domain and 9 in the DNA-binding domain. In this study, we report two novel STAT1 GOF mutations of p.K278E in coiled-coil domain and p.G384D in DNA-binding domain in Japanese CMCD patients. Ectopic expression of these STAT1 mutants in HeLa cells was associated with increased phosphorylation of the mutant and the endogenous wild-type STAT1 due to impaired dephosphorylation, indicating heterodimers of the wild-type and mutant STAT1 cause impaired dephosphorylation, as did homodimers of the mutants. Because IL-17A production was not significantly reduced at least in one of the patients following PMA plus ionomycin stimulation, we further studied Th17-associated cytokines IL-17A, IL-17F, and IL-22 in response to more physiologically relevant stimulations. IL-17A and IL-22 production from PBMCs and CD4(+) cells was significantly reduced in four patients with STAT1 GOF mutations, including the previously reported R274Q in response to anti-CD3 plus anti-CD28 Abs or Candida stimulations. In contrast, IL-17F production was comparable to healthy controls in response to anti-CD3 plus anti-CD28 Abs stimulation. These results indicate impaired production of IL-17A and IL-22 rather than IL-17F was associated with the development of CMCD in these patients. Additionally, only the anti-IL-17F autoantibody was detected in sera from 11 of 17 patients with STAT1 GOF mutations, which may be useful as a marker for this disease. PMID:25288569

Yamazaki, Yasuhiro; Yamada, Masafumi; Kawai, Toshinao; Morio, Tomohiro; Onodera, Masafumi; Ueki, Masahiro; Watanabe, Nobuyuki; Takada, Hidetoshi; Takezaki, Shunichiro; Chida, Natsuko; Kobayashi, Ichiro; Ariga, Tadashi

2014-11-15

253

Vaginal Epithelial Cell-Derived S100 Alarmins Induced by Candida albicans via Pattern Recognition Receptor Interactions Are Sufficient but Not Necessary for the Acute Neutrophil Response during Experimental Vaginal Candidiasis  

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Vulvovaginal candidiasis (VVC), caused by Candida albicans, affects women worldwide. Animal and clinical studies suggest that the immunopathogenic inflammatory condition of VVC is initiated by S100 alarmins in response to C. albicans, which stimulate polymorphonuclear neutrophil (PMN) migration to the vagina. The purpose of this study was to extend previous in vitro data and determine the requirement for the alarmin S100A8 in the PMN response and to evaluate pattern recognition receptors (PRRs) that initiate the response. For the former, PMN migration was evaluated in vitro or in vivo in the presence or absence of S100 alarmins initiated by several approaches. For the latter, vaginal epithelial cells were evaluated for PRR expression and C. albicans-induced S100A8 and S100A9 mRNAs, followed by evaluation of the PMN response in inoculated PRR-deficient mice. Results revealed that, consistent with previously reported in vitro data, eukaryote-derived S100A8, but not prokaryote-derived recombinant S100A8, induced significant PMN chemotaxis in vivo. Conversely, a lack of biologically active S100A8 alarmin, achieved by antibody neutralization or by using S100A9?/? mice, had no effect on the PMN response in vivo. In PRR analyses, whereas Toll-like receptor 4 (TLR4)- and SIGNR1-deficient vaginal epithelial cells showed a dramatic reduction in C. albicans-induced S100A8/S100A9 mRNAs in vitro, inoculated mice deficient in these PRRs showed PMN migration similar to that in wild-type controls. These results suggest that S100A8 alarmin is sufficient, but not necessary, to induce PMN migration during VVC and that the vaginal PMN response to C. albicans involves PRRs in addition to SIGNR1 and TLR4, or other induction pathways. PMID:24478092

Yano, Junko; Palmer, Glen E.; Eberle, Karen E.; Peters, Brian M.; Vogl, Thomas; McKenzie, Andrew N.

2014-01-01

254

Candidíase oral e leucoplasia pilosa como marcadores de progressão da infecção pelo HIV em pacientes brasileiros / Oral candidiasis and hairy leukoplakia as progression markers of HIV infection in Brazilian patients  

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Full Text Available SciELO Brazil | Language: Portuguese Abstract in portuguese Candidíase oral (CO) e leucoplasia pilosa (LP) são importantes indicadores da progressão da infecção pelo vírus da imunodeficiência humana (HIV) para o quadro de AIDS, principalmente em locais onde exames específicos são inacessíveis. OBJETO: Relacionar CO e LP ao número de células CD4+ e à carga vi [...] ral (CV) em pacientes brasileiros HIV-positivos, confirmando-as como marcadores clínicos confiáveis de progressão da doença. FORMA DE ESTUDO: Coorte longitudinal. CASUÍSTICA E MÉTODO: Avaliamos prospectivamente 124 pacientes HIV-positivos, isentos de terapia antiretroviral. Todos foram submetidos a exame ORL, dosagem de células CD4+ e CV, sendo divididos em dois grupos: P e A, de acordo com a presença ou ausência de CO e LP. Depois de seis meses, os pacientes do grupo A foram subdivididos nos subgrupos P6 (presença de lesões) e A6. Dosamos novamente CD4+ e carga viral. Os resultados foram analisados estatisticamente. RESULTADOS: No grupo P (43 pacientes, 28 CO e 15 LP) a contagem de células CD4+ foi menor e a carga viral maior em relação ao grupo A (p Abstract in english Oral candidiasis (OC) and hairy leukoplakia (HL) are important markers of HIV (Human Imunodeficiency syndrome) infection progression for AIDS, mainly in locals where specific tests are inacessible. AIM: to intertwine OC and HL to CD4+ counting and to viral charge (VC) on HIV positive brazilian patie [...] nts, confirming them as trustworthy clinical markers of the disease progression. STUDY DESIGN: Longitudinal cohort. MATERIAL AND METHOD: we have prospectively evaluated 124 HIV+ patients not in use of antiretroviral therapy. All of them have undertaken otorrhinolaringologic examination and CD4+ and VC counting, being divided in two groups: P and A, accordingly to presence or absence of OC and HL. After six months, patients belonging to the A group were re-divided on groups P6 (presence of lesions) and A6 (absence of lesions). Again, CD4+ and VC were counted. The results were statistically evaluated. RESULTS: on the P group, (43 patients, 28 OC, 15 HL) the CD4+ counting was smaller with greater viral charge when compared to A group (P

Ivan Dieb, Miziara; Adriana da Silva, Lima; Rodrigo Antonio Cataldo de la, Cortina.

255

Treatment and Outcomes of Oral Candidiasis  

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... Get email updates Contact Us: Centers for Disease Control and Prevention 1600 Clifton Rd Atlanta, GA 30333 800-CDC-INFO (800-232-4636) TTY: (888) 232-6348 Contact CDC–INFO Fungal Diseases Types of Diseases Aspergillosis Definition Symptoms People ...

256

Treatment and Outcomes of Genital / Vulvovaginal Candidiasis  

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... Get email updates Contact Us: Centers for Disease Control and Prevention 1600 Clifton Rd Atlanta, GA 30333 800-CDC-INFO (800-232-4636) TTY: (888) 232-6348 Contact CDC–INFO Fungal Diseases Types of Diseases Aspergillosis Definition Symptoms People ...

257

Mucocutaneous candidiasis or psoriasis? A case report  

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Full Text Available

BACKGROUND: Pustular psoriasis is a rare form of psoriasis in childhood. The prevalence of psoriasis in various parts of the world varies from 0.1% to 3% and the most frequently observed variant is the plaque type, followed by the guttate psoriasis.

CASE REPORT: A 4-year-old boy with a history of repeated self-limited arthritis, onycholysis, recurrent erythematous skin, diaper rash, fever and pustular lesions, had several hospital admissions with no benefits. After a 2-year delay in the diagnosis, he was treated as a case of pustular psoriasis which was shown by skin biopsy.

KEY WORDS: Pustular psoriasis, arthritis, children.

Shahnaz Armin

2007-06-01

258

Candidíase oral e leucoplasia pilosa como marcadores de progressão da infecção pelo HIV em pacientes brasileiros Oral candidiasis and hairy leukoplakia as progression markers of HIV infection in Brazilian patients  

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Full Text Available Candidíase oral (CO e leucoplasia pilosa (LP são importantes indicadores da progressão da infecção pelo vírus da imunodeficiência humana (HIV para o quadro de AIDS, principalmente em locais onde exames específicos são inacessíveis. OBJETO: Relacionar CO e LP ao número de células CD4+ e à carga viral (CV em pacientes brasileiros HIV-positivos, confirmando-as como marcadores clínicos confiáveis de progressão da doença. FORMA DE ESTUDO: Coorte longitudinal. CASUÍSTICA E MÉTODO: Avaliamos prospectivamente 124 pacientes HIV-positivos, isentos de terapia antiretroviral. Todos foram submetidos a exame ORL, dosagem de células CD4+ e CV, sendo divididos em dois grupos: P e A, de acordo com a presença ou ausência de CO e LP. Depois de seis meses, os pacientes do grupo A foram subdivididos nos subgrupos P6 (presença de lesões e A6. Dosamos novamente CD4+ e carga viral. Os resultados foram analisados estatisticamente. RESULTADOS: No grupo P (43 pacientes, 28 CO e 15 LP a contagem de células CD4+ foi menor e a carga viral maior em relação ao grupo A (pOral candidiasis (OC and hairy leukoplakia (HL are important markers of HIV (Human Imunodeficiency syndrome infection progression for AIDS, mainly in locals where specific tests are inacessible. AIM: to intertwine OC and HL to CD4+ counting and to viral charge (VC on HIV positive brazilian patients, confirming them as trustworthy clinical markers of the disease progression. STUDY DESIGN: Longitudinal cohort. MATERIAL AND METHOD: we have prospectively evaluated 124 HIV+ patients not in use of antiretroviral therapy. All of them have undertaken otorrhinolaringologic examination and CD4+ and VC counting, being divided in two groups: P and A, accordingly to presence or absence of OC and HL. After six months, patients belonging to the A group were re-divided on groups P6 (presence of lesions and A6 (absence of lesions. Again, CD4+ and VC were counted. The results were statistically evaluated. RESULTS: on the P group, (43 patients, 28 OC, 15 HL the CD4+ counting was smaller with greater viral charge when compared to A group (P<0.001. After 6 months, 15 of the 81 patients from the A group were excluded as they have initiated antiretroviral therapy. Eighteen patients (11 OC and 7 HL were included on the P6 group. The others, who were free of lesions, were allocated on the A6 group. Again, CD4+ counting on the P6 group was smaller compared to the A6 group (P<0.001. The opposite occurred to the viral charge. DISCUSSION AND CONCLUSIONS: OC and HL indicate CD4+ counting below 300 cells/mm³ and increased VC, thus being trustable clinical markers of the disease progression.

Ivan Dieb Miziara

2004-06-01

259

Associação entre cultura de secreção vaginal, características sociodemográficas e manifestações clínicas de pacientes com diagnóstico de candidíase vulvovaginal / Association between vaginal secretion culture, socio-demographic characteristics and clinical manifestations of patients with vulvovaginal candidiasis  

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Full Text Available SciELO Brazil | Language: Portuguese Abstract in portuguese OBJETIVO: Investigar a etiologia, o perfil epidemiológico de pacientes com candidíase vulvovaginal (CVV) e possíveis fatores predisponentes. MÉTODOS: Secreção vaginal das pacientes foi semeada em ágar Sabouraud e amostras de leveduras foram isoladas e identificadas por Polymerase Chain Reaction (PCR [...] ). Dados demográficos, clínicos e fatores predisponentes foram obtidos por meio de questionário. Para análise estatística, foram utilizados os testes t de Student, Fischer e do ?², com auxílio do software Statistical Package for the Social Sciences (SPSS), com nível de significância de 5%. RESULTADOS: Foram avaliadas 69 pacientes, com idade entre 15 e 52 anos, predominando mulheres brancas (79,7%), com escolaridade de nível superior completo (58%), casadas (56,5%) e com vida sexual ativa (97,1%). Dentre elas, 34,8% eram gestantes, 7,2% diabéticas, 1,4% soropositivas para AIDS e 36,2% usavam anticoncepcional oral. Antibioticoterapia recente foi citada por 13% das pacientes, uso de antifúngico por 5,8% e de antitricomonas por 1,4%. Uso de corticosteroides foi relatado por 2,9% das participantes e de antineoplásicos, por 1,4%. Fluxo vaginal e prurido foram as principais queixas apresentadas, respectivamente, por 97,1 e 73,9% das pacientes, seguido de ardência (63,8%) e hiperemia (63,8%). Quando presente, o fluxo foi majoritariamente branco (88,1%) ou grumoso (86,6%). O diagnóstico foi confirmado pela cultura em 55 (79,7%) pacientes, sendo 4 casos de infecção mista. A espécie prevalente foi C. albicans, seguida por um caso de C. glabrata, que foi encontrada em mais duas pacientes em associação com C. albicans. Nas outras duas infecções polimicrobianas, C. lusitaniae foi isolada com C. albicans. CONCLUSÕES: Embora a positividade da cultura tenha sido alta e os dados clínicos de CVV sejam característicos, a sintomatologia não é patognomônica. C. albicans é a espécie prevalente, mas deve-se atentar para a ocorrência de outras espécies na etiologia de CVV, como a emergência de C. lusitaniae. Abstract in english PURPOSE: To investigate the etiology and the epidemiological profile of patients with vulvovaginal candidiasis (VVC) and predisposing factors. METHODS: Vaginal secretions were streaked in Sabouraud agar and yeast samples were isolated and identified by Polymerase Chain Reaction (PCR). Demographic an [...] d clinical data were obtained with a questionnaire. For statistical analysis, the Student's t-test, the ?² and Fischer tests were applied as needed using the Statistical Package for Social Sciences (SPSS) software, with the level of significance set at 5%. RESULTS: Sixty-nine patients aged from 15 to 52 years were evaluated. They were predominantly white (79.7%), with higher education (58%), married (56.5%) and sexually active (97.1%). Among them, 34.8% were pregnant, 7.2% diabetic, 1.4% seropositive for AIDS, and 36.2% were using oral contraceptives. Recent antibiotic therapy was mentioned by 13% of the patients, and antifungal or anti-trichomonas therapy was mentioned by 5.8 and 1.4% of the patients, respectively. Corticosteroid use was reported by 2.9% and antineoplastic by 1.4%. Vaginal discharge and itching were the main complaints (97.1 and 73.9%), followed by burning (63.8%) and erythema (63.8%). When present, the vaginal flow was predominantly white (88.1%) or lumpy (86.6%). The diagnosis was confirmed by culture in 55 (79.7%) patients, with mixed infections in 4 patients. The most prevalent species was C. albicans, followed by C. glabrata (one monoinfection and two mixed infections with C. albicans). C. lusitaniae and C. albicans were also identified in mixed infections (two patients). CONCLUSION: Despite the high culture positivity and clinical data characteristic of VVC, the symptoms were not pathognomonic. C. albicans is the most prevalent species, but other species are also involved in VVC etiology, such as the emergence of C. lusitaniae.

Márcio Tavares, Rodrigues; Ana Carolina, Gonçalves; Mariana Carolina Tocantins, Alvim; Didier Silveira, Castellano Filho; Juliana Barroso, Zimmermmann; Vânia Lúcia da, Silva; Cláudio Galuppo, Diniz.

2013-12-01

260

Associação entre cultura de secreção vaginal, características sociodemográficas e manifestações clínicas de pacientes com diagnóstico de candidíase vulvovaginal / Association between vaginal secretion culture, socio-demographic characteristics and clinical manifestations of patients with vulvovaginal candidiasis  

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Full Text Available SciELO Brazil | Language: Portuguese Abstract in portuguese OBJETIVO: Investigar a etiologia, o perfil epidemiológico de pacientes com candidíase vulvovaginal (CVV) e possíveis fatores predisponentes. MÉTODOS: Secreção vaginal das pacientes foi semeada em ágar Sabouraud e amostras de leveduras foram isoladas e identificadas por Polymerase Chain Reaction (PCR [...] ). Dados demográficos, clínicos e fatores predisponentes foram obtidos por meio de questionário. Para análise estatística, foram utilizados os testes t de Student, Fischer e do ?², com auxílio do software Statistical Package for the Social Sciences (SPSS), com nível de significância de 5%. RESULTADOS: Foram avaliadas 69 pacientes, com idade entre 15 e 52 anos, predominando mulheres brancas (79,7%), com escolaridade de nível superior completo (58%), casadas (56,5%) e com vida sexual ativa (97,1%). Dentre elas, 34,8% eram gestantes, 7,2% diabéticas, 1,4% soropositivas para AIDS e 36,2% usavam anticoncepcional oral. Antibioticoterapia recente foi citada por 13% das pacientes, uso de antifúngico por 5,8% e de antitricomonas por 1,4%. Uso de corticosteroides foi relatado por 2,9% das participantes e de antineoplásicos, por 1,4%. Fluxo vaginal e prurido foram as principais queixas apresentadas, respectivamente, por 97,1 e 73,9% das pacientes, seguido de ardência (63,8%) e hiperemia (63,8%). Quando presente, o fluxo foi majoritariamente branco (88,1%) ou grumoso (86,6%). O diagnóstico foi confirmado pela cultura em 55 (79,7%) pacientes, sendo 4 casos de infecção mista. A espécie prevalente foi C. albicans, seguida por um caso de C. glabrata, que foi encontrada em mais duas pacientes em associação com C. albicans. Nas outras duas infecções polimicrobianas, C. lusitaniae foi isolada com C. albicans. CONCLUSÕES: Embora a positividade da cultura tenha sido alta e os dados clínicos de CVV sejam característicos, a sintomatologia não é patognomônica. C. albicans é a espécie prevalente, mas deve-se atentar para a ocorrência de outras espécies na etiologia de CVV, como a emergência de C. lusitaniae. Abstract in english PURPOSE: To investigate the etiology and the epidemiological profile of patients with vulvovaginal candidiasis (VVC) and predisposing factors. METHODS: Vaginal secretions were streaked in Sabouraud agar and yeast samples were isolated and identified by Polymerase Chain Reaction (PCR). Demographic an [...] d clinical data were obtained with a questionnaire. For statistical analysis, the Student's t-test, the ?² and Fischer tests were applied as needed using the Statistical Package for Social Sciences (SPSS) software, with the level of significance set at 5%. RESULTS: Sixty-nine patients aged from 15 to 52 years were evaluated. They were predominantly white (79.7%), with higher education (58%), married (56.5%) and sexually active (97.1%). Among them, 34.8% were pregnant, 7.2% diabetic, 1.4% seropositive for AIDS, and 36.2% were using oral contraceptives. Recent antibiotic therapy was mentioned by 13% of the patients, and antifungal or anti-trichomonas therapy was mentioned by 5.8 and 1.4% of the patients, respectively. Corticosteroid use was reported by 2.9% and antineoplastic by 1.4%. Vaginal discharge and itching were the main complaints (97.1 and 73.9%), followed by burning (63.8%) and erythema (63.8%). When present, the vaginal flow was predominantly white (88.1%) or lumpy (86.6%). The diagnosis was confirmed by culture in 55 (79.7%) patients, with mixed infections in 4 patients. The most prevalent species was C. albicans, followed by C. glabrata (one monoinfection and two mixed infections with C. albicans). C. lusitaniae and C. albicans were also identified in mixed infections (two patients). CONCLUSION: Despite the high culture positivity and clinical data characteristic of VVC, the symptoms were not pathognomonic. C. albicans is the most prevalent species, but other species are also involved in VVC etiology, such as the emergence of C. lusitaniae.

Márcio Tavares, Rodrigues; Ana Carolina, Gonçalves; Mariana Carolina Tocantins, Alvim; Didier Silveira, Castellano Filho; Juliana Barroso, Zimmermmann; Vânia Lúcia da, Silva; Cláudio Galuppo, Diniz.

 
 
 
 
261

Correlação entre os resultados laboratoriais e os sinais e sintomas clínicos das pacientes com candidíase vulvovaginal e relevância dos parceiros sexuais na manutenção da infecção em São Paulo, Brasil Relationship of laboratory results with clinical signs and symptoms of patients with vulvovaginal candidiasis and the significance of the sexual partners for the maintenance of the infection  

Directory of Open Access Journals (Sweden)

Full Text Available OBJETIVO: relacionar as leveduras identificadas aos sinais e sintomas clínicos das pacientes com candidíase vulvovaginal e investigar a importância dos parceiros sexuais na reincidência da infecção. MÉTODOS: foi desenvolvido estudo prospectivo de julho de 2001 a julho de 2003 com uma amostra de mulheres residentes na Grande São Paulo. Foram avaliadas 179 pacientes com suspeita clínica de vaginite fúngica, com idade entre 18 e 65 anos. Os critérios para exclusão foram: gravidez, comprometimento imunológico intrínseco e extrínseco, incluindo AIDS, diabetes, imunossupressão, pacientes em terapia com corticosteróides, antibióticos ou hormônios, em pós-menopausa, em uso de dispositivo intra-uterino e duchas vaginais ou espermicidas. Amostras de secreções vaginais ou da glande dos parceiros sexuais de pacientes com vaginite de repetição foram coletadas para microscopia e cultura de fungos. Colônias fúngicas isoladas em CHROMagar Candida foram identificadas por provas clássicas. O teste exato de Fisher foi usado para correlacionar o quadro clínico com as leveduras isoladas das pacientes. RESULTADOS: os sinais e sintomas clínicos mais relevantes na candidíase vulvovaginal foram prurido e corrimento, seguidos por eritema e edema, estatisticamente independente do agente etiológico. Leveduras foram diagnosticadas por microscopia direta em 77 pacientes com vulvovaginites, sendo obtidos 40 cultivos de Candida spp. Candida albicans (70%, C. glabrata (20%, C. tropicalis (7,5% e C. guilliermondii (2,5% foram identificadas. As leveduras prevalentes nos parceiros foram C. albicans e C. glabrata. As mesmas espécies foram detectadas nas companheiras e parceiros em 87% dos casos. CONCLUSÕES: as vulvovaginites fúngicas foram mais freqüentes em mulheres entre 18 e 34 anos de idade. Não foi observada correlação entre as espécies de leveduras detectadas e a sintomatologia clínica. Os parceiros sexuais podem ser importantes reservatórios de Candida spp e estar relacionados à manutenção da candidíase vulvovaginal.PURPOSE: to relate yeasts identified by laboratory tests to clinical signs and symptoms in patients with vulvovaginal candidiasis, and to investigate the importance of the sexual partners in the recurrence of the infection. METHODS: from July 2001 to July 2003, a sample of 179 patients aged from 18 to 65 years old, with clinical suspicion of fungal vaginitis were analyzed in a prospective study in Great São Paulo. Exclusion criteria included: pregnancy, impaired intrinsic or extrinsic immune response (including Aids, diabetes or immunosuppression; patients undergoing corticosteroid, antibiotic or hormone therapy, in post menopause, with intrauterine device (IUD or making use of vaginal douches or spemicides. Samples of vaginal and penis secretions from partners of patients with relapse of vaginitis episodes were collected for microscopy and fungal culture. Fungal colonies isolated in CHROMagar Candida were identified by classical methods. Fisher's exact t-test was used to correlate the clinical picture with the yeasts isolated from patients. RESULTS: the most relevant clinical signs and symptoms were pruritus and vaginal discharge followed by erythema and edema, statistically independent from the etiological agent. Direct microscopy revealed yeasts in 77 patients with vulvovaginitis, and 40 Candida spp cultures were obtained. Candida albicans (70%, C. glabrata (20%, C. tropicalis (7,5% and C. guilliermondii (2,5% were identified. The yeasts prevalent in partners were C. albicans and C. glabrata. The same species were detected in female and male sex partners in 87% of the cases. CONCLUSIONS: fungal vulvovaginitis was more frequent in women between 18 and 34 years old. No correlation was observed between the species of yeast detected and clinical symptomatology. Sexual partners are important Candida spp reservoirs and may be related to the maintenance of the vulvovaginal candidiasis.

Humberto Fabio Boatto

2007-02-01

262

Evaluation of the supply of antifungal medication for the treatment of vaginal thrush in the community pharmacy setting: a randomized controlled trial / Evaluación del suministro de medicación antifúngica para el tratamiento de la candidiasis vaginal en la farmacia comunitaria: ensayo controlado aleatorizado  

Scientific Electronic Library Online (English)

Full Text Available SciELO Spain | Language: English Abstract in spanish Antecedentes: La Sociedad Farmacéutica de Australia ha desarrollado una "guía" para el suministro de varios medicamentos sin prescripción al público general. Se ha publicado poca investigación evaluando el efecto de estas guías sobre la provisión de medicación en la práctica de la farmacia. Objetivo [...] s: Evaluar el suministro apropiado de antifúngicos sin receta para el tratamiento de candidiasis vaginal en farmacias comunitarias, con y sin guía. Un objetivo secundario fue describir la evaluación y el consejo proporcionado a los pacientes cuando solicitaban esta medicación. Métodos: Se realizó un ensayo controlado aleatorizado donde dos pacientes simulados condujeron visitas a 100 farmacias comunitarias aleatoriamente seleccionadas en una región metropolitana. Se comparó una solicitud de un producto con fluconazol (antifúngico oral que tiene guía) con una solicitud de un producto con clotrimazol (un antifúngico tópico sin guía). Los mismos datos de los pacientes fueron usados en ambas solicitudes. Las medidas de resultados en las visitas fueron la adecuación del suministro y la remisión al médico. Resultados: Un total de un 16% (n=16) de las visitas produjeron resultados apropiados; 10% (n=5) de fluconazol comparadas con el 22% (n=11) de clotrimazol (chi-square= 2,68, p=0,10). Hubo una diferencia significativa en el tipo de evaluación realizada por el personal de la farmacia entre las visitas del fluconazol y del clotrimazol. La solicitud de clotrimazol produjo un aumento significativo en la frecuencia de la evaluación de la causa de la solicitud (chi-square = 8,57, p=0,003), localización de los síntomas (chi-square= 8,27, p=0,004), e historia previa (chi-square = 5,09, p=0,02). Conclusiones: En general la práctica fue pobre, con la mayoría de las farmacias suministrando inadecuadamente la medicación antifúngica. Se requieren nuevas estrategias para mejorar la práctica actual de las farmacias comunitarias en el suministro de antifúngicos sin receta para la candidiasis vaginal. Abstract in english Background: The Pharmaceutical Society of Australia have developed "guidance" for the supply of several medicines available without prescription to the general public. Limited research has been published assessing the effect of these guidelines on the provision of medication within the practice of p [...] harmacy. Objectives: To assess appropriate supply of non-prescription antifungal medications for the treatment of vaginal thrush in community pharmacies, with and without a guideline. A secondary aim was to describe the assessment and counseling provided to patients when requesting this medication. Methods: A randomized controlled trial was undertaken whereby two simulated patients conducted visits to 100 randomly selected community pharmacies in a metropolitan region. A product-based request for fluconazole (an oral antifungal that has a guideline was compared to a product-based request for clotrimazole (a topical antifungal without a guideline). The same patient details were used for both requests. Outcome measures of the visits were the appropriateness of supply and referral to a medical practitioner. Results: Overall 16% (n=16) of visits resulted in an appropriate outcome; 10% (n=5) of fluconozaole requests compared with 22% (n=11) of clotrimazole requests (chi-square=2.68, p=0.10). There was a difference in the type of assessment performed by pharmacy staff between visits for fluconazole and clotrimazole. A request for clotrimazole resulted in a significant increase in frequency in regards to assessment of the reason for the request (chi-square=8.57, p=0.003), symptom location (chi-square=8.27, p=0.004), and prior history (chi-square=5.09, p=0.02). Conclusions: Overall practice was poor, with the majority of pharmacies inappropriately supplying antifungal medication. New strategies are required to improve current practice of community pharmacies for provision of non-prescription antifungals in the treatment of va

Carl R., Schneider; Lyndal, Emery; Raisa, Brostek; Rhonda M., Clifford.

263

Evaluation of the supply of antifungal medication for the treatment of vaginal thrush in the community pharmacy setting: a randomized controlled trial / Evaluación del suministro de medicación antifúngica para el tratamiento de la candidiasis vaginal en la farmacia comunitaria: ensayo controlado aleatorizado  

Scientific Electronic Library Online (English)

Full Text Available SciELO Spain | Language: English Abstract in spanish Antecedentes: La Sociedad Farmacéutica de Australia ha desarrollado una "guía" para el suministro de varios medicamentos sin prescripción al público general. Se ha publicado poca investigación evaluando el efecto de estas guías sobre la provisión de medicación en la práctica de la farmacia. Objetivo [...] s: Evaluar el suministro apropiado de antifúngicos sin receta para el tratamiento de candidiasis vaginal en farmacias comunitarias, con y sin guía. Un objetivo secundario fue describir la evaluación y el consejo proporcionado a los pacientes cuando solicitaban esta medicación. Métodos: Se realizó un ensayo controlado aleatorizado donde dos pacientes simulados condujeron visitas a 100 farmacias comunitarias aleatoriamente seleccionadas en una región metropolitana. Se comparó una solicitud de un producto con fluconazol (antifúngico oral que tiene guía) con una solicitud de un producto con clotrimazol (un antifúngico tópico sin guía). Los mismos datos de los pacientes fueron usados en ambas solicitudes. Las medidas de resultados en las visitas fueron la adecuación del suministro y la remisión al médico. Resultados: Un total de un 16% (n=16) de las visitas produjeron resultados apropiados; 10% (n=5) de fluconazol comparadas con el 22% (n=11) de clotrimazol (chi-square= 2,68, p=0,10). Hubo una diferencia significativa en el tipo de evaluación realizada por el personal de la farmacia entre las visitas del fluconazol y del clotrimazol. La solicitud de clotrimazol produjo un aumento significativo en la frecuencia de la evaluación de la causa de la solicitud (chi-square = 8,57, p=0,003), localización de los síntomas (chi-square= 8,27, p=0,004), e historia previa (chi-square = 5,09, p=0,02). Conclusiones: En general la práctica fue pobre, con la mayoría de las farmacias suministrando inadecuadamente la medicación antifúngica. Se requieren nuevas estrategias para mejorar la práctica actual de las farmacias comunitarias en el suministro de antifúngicos sin receta para la candidiasis vaginal. Abstract in english Background: The Pharmaceutical Society of Australia have developed "guidance" for the supply of several medicines available without prescription to the general public. Limited research has been published assessing the effect of these guidelines on the provision of medication within the practice of p [...] harmacy. Objectives: To assess appropriate supply of non-prescription antifungal medications for the treatment of vaginal thrush in community pharmacies, with and without a guideline. A secondary aim was to describe the assessment and counseling provided to patients when requesting this medication. Methods: A randomized controlled trial was undertaken whereby two simulated patients conducted visits to 100 randomly selected community pharmacies in a metropolitan region. A product-based request for fluconazole (an oral antifungal that has a guideline was compared to a product-based request for clotrimazole (a topical antifungal without a guideline). The same patient details were used for both requests. Outcome measures of the visits were the appropriateness of supply and referral to a medical practitioner. Results: Overall 16% (n=16) of visits resulted in an appropriate outcome; 10% (n=5) of fluconozaole requests compared with 22% (n=11) of clotrimazole requests (chi-square=2.68, p=0.10). There was a difference in the type of assessment performed by pharmacy staff between visits for fluconazole and clotrimazole. A request for clotrimazole resulted in a significant increase in frequency in regards to assessment of the reason for the request (chi-square=8.57, p=0.003), symptom location (chi-square=8.27, p=0.004), and prior history (chi-square=5.09, p=0.02). Conclusions: Overall practice was poor, with the majority of pharmacies inappropriately supplying antifungal medication. New strategies are required to improve current practice of community pharmacies for provision of non-prescription antifungals in the treatment of va

Carl R., Schneider; Lyndal, Emery; Raisa, Brostek; Rhonda M., Clifford.

2013-08-01

264

Neonatal candidiasis in Venezuela: clinical and epidemiological aspects.  

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A prospective study of the clinical and epidemiological aspects of Candida spp. sepsis was performed to assess the frequency, etiology, and risk factors in the neonatology service of the Pediatrics Hospital "Dr. Elías Toro" (2002-2003). Forty four out of 128 neonatal intensive care patients, with clinical sepsis and suspected fungal etiology, were chosen randomly for this study. Infant blood, urine, gastrointestinal tract, oral and skin samples were cultured. Samples were also taken from health care worker hands and the environment. The antifungal susceptibility patterns of the isolates were evaluated. The prevalence of Candida spp. from the clinical samples was: C. albicans (72.06%), C. parapsilosis (13.24%), C. tropicalis (10.29 %), C. guilliermondii (2.94%), and C. glabrata (1.47%). Due to the similarity of the susceptibility pattern of some isolates from infants and health care workers, we speculate a horizontal nosocomial infection. Statistical analysis revealed the following significant risk factors associated with Candida spp. isolation: prolonged hospitalization (p neonates receiving empirical therapy with amphotericin B (0.5-1.0 mg/k/day) evolved satisfactorily. PMID:17061542

Hartung de Capriles, Claudia; Mata-Essayag, Sofía; Azpiróz, Amparo; Ponente, Adriana; Magaldi, Sylvia; Pérez, Celina; Roselló, Arantza; Colella, María Teresa; Machuca, Jensi

2005-01-01

265

Correlação entre os resultados laboratoriais e os sinais e sintomas clínicos das pacientes com candidíase vulvovaginal e relevância dos parceiros sexuais na manutenção da infecção em São Paulo, Brasil / Relationship of laboratory results with clinical signs and symptoms of patients with vulvovaginal candidiasis and the significance of the sexual partners for the maintenance of the infection  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: Portuguese Abstract in portuguese OBJETIVO: relacionar as leveduras identificadas aos sinais e sintomas clínicos das pacientes com candidíase vulvovaginal e investigar a importância dos parceiros sexuais na reincidência da infecção. MÉTODOS: foi desenvolvido estudo prospectivo de julho de 2001 a julho de 2003 com uma amostra de mulh [...] eres residentes na Grande São Paulo. Foram avaliadas 179 pacientes com suspeita clínica de vaginite fúngica, com idade entre 18 e 65 anos. Os critérios para exclusão foram: gravidez, comprometimento imunológico intrínseco e extrínseco, incluindo AIDS, diabetes, imunossupressão, pacientes em terapia com corticosteróides, antibióticos ou hormônios, em pós-menopausa, em uso de dispositivo intra-uterino e duchas vaginais ou espermicidas. Amostras de secreções vaginais ou da glande dos parceiros sexuais de pacientes com vaginite de repetição foram coletadas para microscopia e cultura de fungos. Colônias fúngicas isoladas em CHROMagar Candida foram identificadas por provas clássicas. O teste exato de Fisher foi usado para correlacionar o quadro clínico com as leveduras isoladas das pacientes. RESULTADOS: os sinais e sintomas clínicos mais relevantes na candidíase vulvovaginal foram prurido e corrimento, seguidos por eritema e edema, estatisticamente independente do agente etiológico. Leveduras foram diagnosticadas por microscopia direta em 77 pacientes com vulvovaginites, sendo obtidos 40 cultivos de Candida spp. Candida albicans (70%), C. glabrata (20%), C. tropicalis (7,5%) e C. guilliermondii (2,5%) foram identificadas. As leveduras prevalentes nos parceiros foram C. albicans e C. glabrata. As mesmas espécies foram detectadas nas companheiras e parceiros em 87% dos casos. CONCLUSÕES: as vulvovaginites fúngicas foram mais freqüentes em mulheres entre 18 e 34 anos de idade. Não foi observada correlação entre as espécies de leveduras detectadas e a sintomatologia clínica. Os parceiros sexuais podem ser importantes reservatórios de Candida spp e estar relacionados à manutenção da candidíase vulvovaginal. Abstract in english PURPOSE: to relate yeasts identified by laboratory tests to clinical signs and symptoms in patients with vulvovaginal candidiasis, and to investigate the importance of the sexual partners in the recurrence of the infection. METHODS: from July 2001 to July 2003, a sample of 179 patients aged from 18 [...] to 65 years old, with clinical suspicion of fungal vaginitis were analyzed in a prospective study in Great São Paulo. Exclusion criteria included: pregnancy, impaired intrinsic or extrinsic immune response (including Aids), diabetes or immunosuppression; patients undergoing corticosteroid, antibiotic or hormone therapy, in post menopause, with intrauterine device (IUD) or making use of vaginal douches or spemicides. Samples of vaginal and penis secretions from partners of patients with relapse of vaginitis episodes were collected for microscopy and fungal culture. Fungal colonies isolated in CHROMagar Candida were identified by classical methods. Fisher's exact t-test was used to correlate the clinical picture with the yeasts isolated from patients. RESULTS: the most relevant clinical signs and symptoms were pruritus and vaginal discharge followed by erythema and edema, statistically independent from the etiological agent. Direct microscopy revealed yeasts in 77 patients with vulvovaginitis, and 40 Candida spp cultures were obtained. Candida albicans (70%), C. glabrata (20%), C. tropicalis (7,5%) and C. guilliermondii (2,5%) were identified. The yeasts prevalent in partners were C. albicans and C. glabrata. The same species were detected in female and male sex partners in 87% of the cases. CONCLUSIONS: fungal vulvovaginitis was more frequent in women between 18 and 34 years old. No correlation was observed between the species of yeast detected and clinical symptomatology. Sexual partners are important Candida spp reservoirs and may be related to the maintenance of the vulvovaginal ca

Humberto Fabio, Boatto; Maria Sayonara de, Moraes; Alexandre Paulo, Machado; Manoel João Batista Castelo, Girão; Olga, Fischman.

2007-02-01

266

Candidiasis vulvovaginal en un grupo mujeres gestantes de Medellín Vulvovaginal candidiasis in a group of pregnant women from Medellín  

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Full Text Available Introducción. En la mujer embarazada, factores como la carga hormonal y los altos niveles de glucogéno favorecen la colonización y la infección vaginal por levaduras. Objetivo. Determinar la prevalencia de levaduras del género Candida, aisladas de muestras de flujo vaginal de un grupo de mujeres embarazadas de la ciudad de Medellín y evaluar la sensibilidad a los antifúngicos. Materiales y métodos. Estudio descriptivo en el cual se estudiaron 300 mujeres gestantes que acudieron a los programas de control prenatal de diferentes IPS de Medellín, en el período de febrero de 2006 a junio de 2007. Se determinó la prevalencia de Candida spp. mediante cultivo e identificación de las levaduras obtenidas, y se determinó la sensibilidad a fluconazol e itraconazol por el método comercial del ATB fungus. A las cepas en las que se evidenció crecimiento residual en fluconazol por dicho método, se les realizó antibiograma por los métodos avalados por el Clinical and Laboratory Standards Institute (CLSI microdilución M27-A y método de difusión en disco M-44P. Resultados. La prevalencia de Candida spp. fue de 33,3% (C. albicans, 77%; C. parapsilosis, 11%; C. tropicalis, 5%; C. glabrata, 3%; C. guillermondii, 2%; C. kefyr, 1%, y C. famata, 1%. Todos los aislamientos mostraron sensibilidad al fluconazol. Se halló resistencia al itraconazol en 9% de los aislamientos de C. albicans y en 100% de los de C. glabrata. El 2,5% de los aislamientos de C. albicans y el 100% de los de C. kefyr resultaron sensibles dependiente de la dosis a dicho antifúngico. Conclusiones. C. albicans fue la levadura más frecuentemente aislada de flujo vaginal, seguida por patógenos emergentes, como C. parapsilosis y C. tropicalis. En la población estudiada, las levaduras del género Candida son aún ampliamente sensibles a los antifúngicos. Se recomienda la identificación de la levadura a nivel de especie y hacer pruebas de sensibilidad en el caso de falla terapéutica y en infecciones recidivantes.During pregnancy, risk factors such as the high hormonal load and high levels of glucogen allow vaginal colonization and infection by yeasts. Objective: To determine the prevalence of Candida spp. isolated from samples of vaginal discharge from pregnant women in Medellín and to test their sensitivity to antimycotic agents. Materials and methods: Descriptive study in which 300 pregnant women were tested between February 2006 to June 2007. The prevalence of Candida spp. was determined by culture, the yeasts were identified, and the sensitivity to fluconazole and itraconazole was determined by the ATB fungus method; the strains with residual growth in fluconazole by such method were submitted to antibiogram by the methods approved by the CLSI. Results: The prevalence of Candida spp. was 33.3% (C. albicans, 77%. All the isolations showed sensitivity to fluconazole. Resistance to itraconazole was found in 9% of C. albicans isolates, and in 100% of C. glabrata; 2.5% of the isolates of C. albicans and 100% of C. kefyr resulted sensitive dose-dependent to such antymicotyc. Conclusions: C. albicans was the yeast most frequently isolated from vaginal discharge, followed by emergent pathogens such as C. parasilopsis and C. tropicalis. In the studied population, yeasts from the Candida gender were still very sensitive to antimycotic agets. It is recommended to identify the yeast to its gender and to perform sensitivity tests in case of therapeutic failure or in recurrent infections.

Clara María Duque

2009-03-01

267

Candida infection of the skin  

Science.gov (United States)

... Skin infection - yeast; Yeast infection - skin; Intertriginous candidiasis; Cutaneous candidiasis ... and yeast-like fungi (such as Candida ). In cutaneous candidiasis, the skin is infected with Candida fungi. ...

268

Relationship between clinical factors and severity of esophageal candidiasis according to Kodsi's classification.  

Science.gov (United States)

Severe Candida esophagitis (CE) may lead to development of strictures, hemorrhage, esophagotracheal fistula, and a consequent decrease in quality of life. Although the severity of CE has been classified based on macroscopic findings on endoscopy, the clinical significance remains unknown. The aim of the study was to elucidate the predictive clinical factors for endoscopic severity of CE. Patients who underwent upper endoscopy and answered questionnaires were prospectively enrolled. Smoking, alcohol, human immunodeficiency virus (HIV) infection, diabetes mellitus, chronic renal failure, liver cirrhosis, systemic steroids use, proton pump inhibitor use, H2 blocker use, and gastrointestinal (GI) symptoms were assessed on the same day of endoscopy. GI symptoms including epigastric pain, heartburn, reflux, hunger cramps, nausea, dysphagia, and odynophagia were assessed on a 7-point Likert scale. Endoscopic severity was classified as mild (Kodsi's grade I/II) or severe (grade III/IV). Of 1855 patients, 71 (3.8%) were diagnosed with CE (mild, n?=?48; severe, n?=?23). In the CE patients, 50.0% (24/48) in the mild group and 23.1% (6/23) in the severe group did not have any GI symptoms. In HIV-infected patients (n?=?17), a significant correlation was found between endoscopic severity and declining CD4 cell count (Spearman's rho?=?-0.90; P?Patients in the severe group experienced more epigastric pain (P?=?0.02), reflux symptoms (P?=?0.04), dysphagia (P?=?0.05), and odynophagia (P?

Asayama, N; Nagata, N; Shimbo, T; Nishimura, S; Igari, T; Akiyama, J; Ohmagari, N; Hamada, Y; Nishijima, T; Yazaki, H; Teruya, K; Oka, S; Uemura, N

2014-04-01

269

Drug resistance of yeasts isolated from oropharyngeal candidiasis in aids patients  

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Full Text Available Candida spp was isolated from 59 (68.60% out of eighty six samples of oral mucosa of AIDS patients. The identification, based or the production of a germ tube and chlamydospores, and on the assimilation and fermentation of carbohydrates, revealed 52 strains (88.13% of C. albicans, 4 (6.77% of C. tropicalis and 3 (5.08% of C. krusei. The susceptibility of these strains to amphotericin B, flucytosine, itraconazole, fluconazole and ketoconazole was determined using the agar dilution method. Comparing the minimum inhibitory concentration values found in the susceptibility test with the serum levels achieved by these drugs, only 8.47% and 5.08% of the yeasts strains proved to be resistant to amphotericin B and flucitosyne, respectively. A high frequency of strains resistant to azole derivatives (25.42%, to itraconazole, 45.76%, to ketoconazole and 66.10% to fluconazole was observed.

Silva Maria do Rosário Rodrigues

1998-01-01

270

Sonographic detection of intrarenal and intraarterial fungus balls in a preterm infant due to systemic candidiasis  

International Nuclear Information System (INIS)

Shortly after birth a preterm infant suffering from aspiration syndrome and subsequent Pseudomonas aeruginosa sepsis showed signs of renal insufficiency and mycotic infection: Yeast cells were identified in several urinalyses; there was also an increasing anti-Candida IgM antibody titer. At the same time sonographic examinations revealed an increasing echogenicity of the renal cortex and echogenic masses of variable size which did not cause acoustic shadows in both enlarged kidneys. A few days later, we found a right-sided hydronephrosis caused by an intraureteric prevesical mass of equal echogenicity. As we could observe sonographically, the aggressive antimycotic therapy was successful. Eleven weeks later there were signs of cardiac insufficiency. An angiographically demonstrated filling defect within the pulmonary artery showed the same sonographic findings as the previously found intrarenal masses. The baby underwent embolectomy and recovered. The thrombotic material contained yeast cells giving evidence of systemic Candidasis. Provided appropriate equipment is available, ultrasound today is an excellent non-invasive screening and followup method not only for echoencephalography, but also for more complicated neonatologic problems as seen here. The detailed observation of a changing echogenicity of the renal cortex and pelvis is important and often allows a decisive diagnostic clue before other radiological methods become conclusive. (orig.)conclusive. (orig.)

271

Vulvovaginal candidiasis in Mato Grosso, Brazil: pregnancy status, causative species and drugs tests  

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Full Text Available Causative agent in majority of VVC is Candida albicans, but infection due to non-C. albicans is common. Use of empiric antifungal therapy in Brazil due to syndromic management of vulvovaginitis could act as risk factor for increase resistance among VVC causative agents. From Mato Grosso patients, 160 with culture-proved among 404 women who had clinical symptoms of VVC, were enrolled in this study. 70 non-pregnant women and 90 pregnant women were included. Candida albicans was the most prevalent, representing 72.9% in the non-pregnant group and 92.3% in the pregnant group. Differences in species distribution were noted between the two groups, being C. parapsilosis the second more prevalent species among non-pregnant women. Susceptibility testing revealed high susceptibility to fluconazole (except for C. krusei, itraconazole, ketoconazole, and amphotericin B regardless the species (C. albicans, C. parapsilosis, C. tropicalis, C. glabrata, C. krusei analyzed.

Luciana Basili Dias

2011-12-01

272

Fatores associados à candidíase vulvovaginal: estudo exploratório / Risk factors for vulvovaginal candidiasis: an exploratory study  

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Full Text Available SciELO Brazil | Language: Portuguese Abstract in portuguese OBJETIVO: avaliar fatores de risco para candidíase vulvovaginal identificados ao exame e anamnese ginecológica, em amostra de conveniência. MÉTODO: estudo transversal, com amostra de conveniência, envolvendo todas as trabalhadoras (135) de uma indústria de confecção em Criciúma (SC), sintomáticas e [...] assintomáticas, no período de julho a setembro de 2002. Foi utilizada, como técnica de coleta dos dados, entrevista roteirizada investigando-se possíveis fatores de risco. O exame ginecológico detectou a presença ou não de sinais clínicos de vulvovaginites. Realizou-se cultura de secreção vaginal em meio de ágar Sabouraud para isolamento de Candida sp. Os dados foram processados e analisados no programa Epi-Info, versão 6.0. A medida de intensidade de associação usada foi a razão de prevalência. O intervalo de confiança adotado para inferência estatística foi de 95%. A análise multivariada dos dados foi realizada pelo programa SPSS versão 10.0, empregando-se modelo de regressão logística. RESULTADOS: os resultados mostraram que a prevalência da candidíase vulvovaginal foi de 19,3%. A freqüência de vulvovaginite diagnosticada pelo exame clínico foi de 17%, com sensibilidade de 38% e especificidade de 88%. O fator de risco significante para vulvovaginite por Candida nessa população foi a presença de ciclos menstruais regulares e para vulvovaginite clínica foi o uso de hormônios e idade entre 25 e 34 anos. CONCLUSÃO: a prevalência de candidíase vulvovaginal é alta entre mulheres consideradas hígidas e o fator de risco encontrado com significância estatística foi a presença de ciclos menstruais regulares, reforçando a importância de possível relação entre ciclo hormonal e esta infecção. Devido à limitação do presente estudo, esta possível associação, juntamente com outras, devem ser estudadas num futuro desenho de coorte com amostra de tamanho apropriado e medidas de níveis hormonais ao longo do ciclo menstrual. Abstract in english PURPOSE: to identify risk factors involved in Candida sp vulvovaginitis in an exploratory study using an intentional sample. METHODS: a cross-sectional study with a sample of 135 textile female workers living in Criciúma, South Brazil, between July and September 2002. Oral interview and physical exa [...] mination were performed by a single gynecologist and vaginal swabs were collected for culture and plated on Sabouraud agar. Epi-Info, version 6.0 was used to analyze the collected data. Prevalence ratios were calculated with a 95% confidence interval. A multivariable analysis of the data by logistic regression and data entry using the SPSS, version 10.0 computer program, was performed. RESULTS: the prevalence of Candida sp vulvovaginitis confirmed by culture in this sample was 19.3%. The prevalence of clinical vulvovaginitis was 17.0% (sensitivity of 38% and specificity of 88%). Significant risk factors for clinically manifest vulvaginitis were the use of hormones and age between 25-34 years and for culture-proven Candida sp vulvovaginitis, regular menstrual cycle. CONCLUSIONS: the overall prevalence of Candida sp vulvovaginitis was 19.3%. A regular menstrual cycle was the main risk factor for Candida sp vulvovaginitis showing the existence of a relationship between menstrual cycle and Candida sp vulvovaginitis. This finding should be better investigated by a cohort study with a larger sample and correlated with blood hormone levels throughout the menstrual cycle.

Maria Inês da, Rosa; Davi, Rumel.

273

Fatores associados à candidíase vulvovaginal: estudo exploratório Risk factors for vulvovaginal candidiasis: an exploratory study  

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Full Text Available OBJETIVO: avaliar fatores de risco para candidíase vulvovaginal identificados ao exame e anamnese ginecológica, em amostra de conveniência. MÉTODO: estudo transversal, com amostra de conveniência, envolvendo todas as trabalhadoras (135 de uma indústria de confecção em Criciúma (SC, sintomáticas e assintomáticas, no período de julho a setembro de 2002. Foi utilizada, como técnica de coleta dos dados, entrevista roteirizada investigando-se possíveis fatores de risco. O exame ginecológico detectou a presença ou não de sinais clínicos de vulvovaginites. Realizou-se cultura de secreção vaginal em meio de ágar Sabouraud para isolamento de Candida sp. Os dados foram processados e analisados no programa Epi-Info, versão 6.0. A medida de intensidade de associação usada foi a razão de prevalência. O intervalo de confiança adotado para inferência estatística foi de 95%. A análise multivariada dos dados foi realizada pelo programa SPSS versão 10.0, empregando-se modelo de regressão logística. RESULTADOS: os resultados mostraram que a prevalência da candidíase vulvovaginal foi de 19,3%. A freqüência de vulvovaginite diagnosticada pelo exame clínico foi de 17%, com sensibilidade de 38% e especificidade de 88%. O fator de risco significante para vulvovaginite por Candida nessa população foi a presença de ciclos menstruais regulares e para vulvovaginite clínica foi o uso de hormônios e idade entre 25 e 34 anos. CONCLUSÃO: a prevalência de candidíase vulvovaginal é alta entre mulheres consideradas hígidas e o fator de risco encontrado com significância estatística foi a presença de ciclos menstruais regulares, reforçando a importância de possível relação entre ciclo hormonal e esta infecção. Devido à limitação do presente estudo, esta possível associação, juntamente com outras, devem ser estudadas num futuro desenho de coorte com amostra de tamanho apropriado e medidas de níveis hormonais ao longo do ciclo menstrual.PURPOSE: to identify risk factors involved in Candida sp vulvovaginitis in an exploratory study using an intentional sample. METHODS: a cross-sectional study with a sample of 135 textile female workers living in Criciúma, South Brazil, between July and September 2002. Oral interview and physical examination were performed by a single gynecologist and vaginal swabs were collected for culture and plated on Sabouraud agar. Epi-Info, version 6.0 was used to analyze the collected data. Prevalence ratios were calculated with a 95% confidence interval. A multivariable analysis of the data by logistic regression and data entry using the SPSS, version 10.0 computer program, was performed. RESULTS: the prevalence of Candida sp vulvovaginitis confirmed by culture in this sample was 19.3%. The prevalence of clinical vulvovaginitis was 17.0% (sensitivity of 38% and specificity of 88%. Significant risk factors for clinically manifest vulvaginitis were the use of hormones and age between 25-34 years and for culture-proven Candida sp vulvovaginitis, regular menstrual cycle. CONCLUSIONS: the overall prevalence of Candida sp vulvovaginitis was 19.3%. A regular menstrual cycle was the main risk factor for Candida sp vulvovaginitis showing the existence of a relationship between menstrual cycle and Candida sp vulvovaginitis. This finding should be better investigated by a cohort study with a larger sample and correlated with blood hormone levels throughout the menstrual cycle.

Maria Inês da Rosa

2004-02-01

274

Vulvovaginal candidiasis in Mato Grosso, Brazil: pregnancy status, causative species and drugs tests  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: English Abstract in english Causative agent in majority of VVC is Candida albicans, but infection due to non-C. albicans is common. Use of empiric antifungal therapy in Brazil due to syndromic management of vulvovaginitis could act as risk factor for increase resistance among VVC causative agents. From Mato Grosso patients, 16 [...] 0 with culture-proved among 404 women who had clinical symptoms of VVC, were enrolled in this study. 70 non-pregnant women and 90 pregnant women were included. Candida albicans was the most prevalent, representing 72.9% in the non-pregnant group and 92.3% in the pregnant group. Differences in species distribution were noted between the two groups, being C. parapsilosis the second more prevalent species among non-pregnant women. Susceptibility testing revealed high susceptibility to fluconazole (except for C. krusei), itraconazole, ketoconazole, and amphotericin B regardless the species (C. albicans, C. parapsilosis, C. tropicalis, C. glabrata, C. krusei) analyzed.

Luciana Basili, Dias; Márcia de Souza Carvalho, Melhem; Maria Walderez, Szeszs; José, Meirelles Filho; Rosane Christine, Hahn.

275

Candidiasis of gastrointestinal tract at patients treated with antibiotics - prophylactic use of diet supplements  

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Full Text Available Introduction: Fungi may be present within human organism with no clinical symptoms of mycosis. Local bacterial flora and local environmental conditions in gastrointestinal tract prevent from colonization and spreading the Candida fungus. Antibiotics, namely those with a wide spectrum, cause quantitative decrease of local flora population, which disturbs proper defense mechanisms of an organism. Under such conditions, Candida fungi may reach improperly high concentrations in gastrointestinal tract gaining the ability to adherence, colonization, and dissemination. Goals and methods: Analysis of available literature references related to the influence of antibiotic therapy on gastrointestinal tract mycosis development. The poll performed among students of Lublin universities aimed at evaluating the frequency of antibiotic ingestion, conscious of respondents upon the influence of antibiotic therapy on gastrointestinal tract status, and prophylaxis application in a form of ingesting the protective drugs or diet supplements. Results: Taking antibiotics during last two years was declared by 76.1% of respondents (175 persons and - which is particularly alarming - 32.6% (75 persons of polled have not consulted it with any physician. Eighteen persons (7.8% of respondents took antibiotics 4 and more times a year, while 27% (62 persons at least once a year. Only 66% of polled (152 persons, including 72 students from University of Life Sciences - 53.7% and 80 persons from Medical University - 83.5% applied supportive treatment during antibiotic therapy. Conclusions: Applying antibiotic therapy is a common practice at present, namely taking drugs many times within a short period and with no consultations with any physician, is particularly alarming. The clinical data related to the fact that antibiotic use may invoke problems within gastrointestinal tract, were confirmed. Supportive use of diet supplements and protective drugs that recover a proper bacterial flora within digestive tract, may be helpful.

Ma?gorzata Kostecka

2011-03-01

276

A 16-year-old boy with emphysematous gastritis and oesophageal candidiasis.  

Science.gov (United States)

Emphysematous gastritis is a rare and frequently fatal condition caused by invasion of gas-forming bacteria into the gastric wall. There have only been a handful of reported cases in the paediatric population, and none of these have evidence of candidal infection or mucormycosis. Patients typically present with abdominal pain, vomiting, malaena and haematemesis. Risk factors for emphysematous gastritis are those that interfere with the natural barriers to infection in the stomach. Diagnosis is made on the basis of typical appearances on abdominal CT. Treatment is generally conservative with surgery reserved for failed medical management or later complications. Antimicrobial cover should be broad with a low threshold for antifungals. It is important to look for predisposing factors for this condition, perhaps including an assessment of the patient's immunocompetency. We present a 16-year-old boy with global developmental delay who presented with this condition associated with candidal infection. PMID:25213783

Yusef, Daniel; Waran, Ariane; Vamvakiti, Ekaterini

2014-01-01

277

Gene Polymorphisms in Pattern Recognition Receptors and Susceptibility to Idiopathic Recurrent Vulvovaginal Candidiasis  

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Conclusion. Genetic variation in TLR2 may significantly enhance susceptibility to RVVC by modulating host defense mechanisms against Candida. Additional studies are warranted to assess systematically the role of host genetic variation for susceptibility to RVVC.

MartinJaeger

2014-09-01

278

Bioadhesive vaginal tablets containing spray dried microspheres loaded with clotrimazole for treatment of vaginal candidiasis.  

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The aim of the present investigation was to prepare and evaluate novel bioadhesive vaginal tablets containing clotrimazole loaded microspheres in order to provide long-term therapeutic activity at the site of infection. Tablets were prepared by incorporating drug loaded microspheres and using bioadhesive polymers hydroxypropylmethylcellulose, sodium carboxymethylcellulose and Carbopol. Microspheres were prepared by the spray drying technique using Eudragit RS-100 and Eudragit RL-100. Microspheres were characterized by SEM, DSC, FTIR, particle size analysis and evaluated for percentage yield, drug loading, encapsulation efficiency and in vitro drug release. To achieve bioadhesion to the mucosal tissue, optimized microspheres were incorporated into bioadhesive tablets and were evaluated for in vitro drug release, in vitro and in vivo mucoadhesion. FTIR and DSC studies showed that no chemical interaction occurred between the drug and polymers. The sphericity factor indicated that the prepared microspheres were spherical. Formulation Mt6 indicated a controlled in vitro drug release and good bioadhesive strength. The in vivo images confirmed the bioadhesion and retention property of tablets up to 24 h. The results indicated that this drug delivery system can be explored for controlled intravaginal drug release. PMID:24152896

Gupta, Naresh Vishal; Natasha, Shirodker; Getyala, Anil; Bhat, Ramnath Sudeendra

2013-09-01

279

Formulation and Evaluation of in situ Gels Containing Clotrimazole for Oral Candidiasis  

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Gel dosage forms are successfully used as drug delivery systems to control drug release and protect the medicaments from a hostile environment. The main objective is to formulate and evaluate in situ oral topical gels of clotrimazole based on the concept of pH triggered and ion activated systems. The system utilizes polymers that exhibit sol-to-gel phase transition due to change in specific physico-chemical parameters. A pH triggered system consisting of carbopol 934P (0.2-1.4% w/v) and ion t...

Harish, N. M.; Prabhu, P.; Charyulu, R. N.; Gulzar, M. A.; Subrahmanyam, E. V. S.

2009-01-01

280

Formulation and evaluation of in situ gels containing clotrimazole for oral candidiasis  

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Full Text Available Gel dosage forms are successfully used as drug delivery systems to control drug release and protect the medicaments from a hostile environment. The main objective is to formulate and evaluate in situ oral topical gels of clotrimazole based on the concept of pH triggered and ion activated systems. The system utilizes polymers that exhibit sol-to-gel phase transition due to change in specific physico-chemical parameters. A pH triggered system consisting of carbopol 934P (0.2-1.4% w/v and ion triggered system using gellan gum (0.1-0.75% w/v along with hydroxylpropylmethylcelluose E50LV was used to prolong the release of clotrimazole (0.1% w/v. Formulations were evaluated for gelling capacity, viscosity, gel strength, bioadhesive force, spreadability, microbiological studies and in vitro release. The use of carbopol as in situ gel forming system was substantiated by the property to transform into stiff gels when the pH was raised, whereas in gellan gum this transformation occurred in the presence of monovalent/divalent cations. Effect of calcium carbonate and other process parameters optimized and found that increase in calcium ions produced stronger gels. The drug content, clarity, and pH of the formulation were found to be satisfactory. The viscosity was found to be in the range 5 to 85 centipoise for the sol, whereas for the gels it was up to 16000 centipoise. The formulation showed pseudoplastic flow with thixotrophy. The maximum gel strength (using texture analyzer and bioadhesion was found to be up to 6.5 g and 4 g, respectively. The optimized formulations were able to release the drug up to 6 h. The formulation containing gellan gum showed better sustained release compared to carbopol based gels.

Harish N

2009-01-01

 
 
 
 
281

[A new pharmaceutical concept for the therapy of oropharyngeal and esophageal candidiasis with fluconazole].  

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Administration of fluconazole capsules is of proven worth in the treatment of candidosis of the mucous membranes, particularly in immunocompromised patients. An additional topical effect on the course of oropharyngeal and oesophageal candidosis can be expected when fluconazole is administered as a suspension. For this reason a crossover pharmacokinetic study with 12 healthy volunteers was carried out, in which the concentrations of the antimycotic were measured in saliva and plasma, after oral administration of 100 mg fluconazole as either a capsule or as a suspension. The time-courses of the concentration of fluconazole after the two formulations were very similar in plasma, but significantly different in saliva. The mean Cmax for fluconazole in saliva was 551 micrograms/ml 5 min after ingestion of the suspension and 3 micrograms/ml 4 h after taking the capsule. Over the observation time (0-96 h) the concentration of the antimycotic in saliva was more than 80% higher with the suspension than with the capsule. PMID:8767284

Wildfeuer, A; Laufen, H; Yeates, R A; Zimmermann, T

1996-01-01

282

Comparison of antibody, antigen, and metabolite assays in rat models of systemic and gastrointestinal candidiasis.  

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We compared serial measurements of antibodies to mannan and to a cytoplasmic antigen (enzyme-linked immunosorbent assays), detection of mannan and an unidentified candidal antigen (latex agglutination), and assays of mannose and arabinitol (gas chromatographic assay of per-O-acetylated aldonitrile derivatives). In a high-inoculum intravascular-infection model, antimannan assays were consistently positive beginning on day 2 postinoculation, anti-cytoplasmic antigen assays followed the same tim...

Greenfield, R. A.; Troutt, D. L.; Rickard, R. C.; Altmiller, D. H.

1988-01-01

283

Comparison of the efficacy of combination and monotherapy with caspofungin and liposomal amphotericin B against invasive candidiasis.  

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The combination treatment was superior with 1mg/kg of doses of LAmB and CAS in terms of reducing the tissue fungal burden. Although with combination therapy the survival rates prolonged in all subgroups, no significant difference between the combination and monotherapies could be shown. Additional studies with a large number of cases are warranted to investigate the superiority of combination therapy.

Ozlem Tunger

2008-05-01

284

Pravastatin inhibits farnesol production in Candida albicans and improves survival in a mouse model of systemic candidiasis.  

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Candidemia remains a major cause of morbidity and mortality, especially in immunocompromised patients. A strategy of reducing virulence and virulence factors of Candida spp. is an attractive approach for the treatment of serious infections caused by these yeasts. Recently, farnesol has been reported to be a quorum-sensing autoinducer, as well as a virulence factor of C. albicans. In the present study, we examined the effects of pravastatin, a 3-hydroxy-3-methylglutaryl-CoA (HMG-CoA) reductase inhibitor on the in vitro production of farnesol. In addition, the synergistic effects of pravastatin with fluconazole (FLC) were examined in a mouse model of systemic infections. In vitro experiments demonstrated that pravastatin had synergistic activity with FLC as judged by fractional inhibitory concentration index (FICI) and suppression of farnesol production at sub-minimum inhibitory concentrations. Furthermore, significant improvement of survival in systemic infection models was shown with pravastatin supplementation. The survival benefits of pravastatin were correlated with reductions of fungal burden. These data suggest the potential of pravastatin as a supportive therapy against C. albicans infections. Synergistic antifungal activity and suppression of HMG-CoA reductase-associated Candida virulence factors, including farnesol, may explain, at least in part, the in vivo efficacy of pravastatin. PMID:21954955

Tashiro, Masato; Kimura, Soichiro; Tateda, Kazuhiro; Saga, Tomoo; Ohno, Akira; Ishii, Yoshikazu; Izumikawa, Koichi; Tashiro, Takayoshi; Kohno, Shigeru; Yamaguchi, Keizo

2012-05-01

285

Sonographic detection of intrarenal and intra-arterial fungus balls in a preterm infant due to systemic candidiasis  

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Shortly after birth a preterm infant suffering from aspiration syndrome and subsequent Pseudomonas aeruginosa sepsis showed signs of renal insufficiency and mycotic infection: yeast cells were identified in several urinalyses; there was also an increasing anti-candida IgM antibody titer. At the same time sonographic examinations revealed an increasing echogenicity of the renal cortex and echogenic masses of variable size which did not cause acoustic shadows in both enlarged kidneys. A few days later, we found a right-sided hydronephrosis caused by an intraureteric prevesical mass of equal echogenicity. As we could observe sonographically, the aggressive antimycotic therapy was successful. Eleven weeks later there were signs of cardiac insufficiency. An angiographically demonstrated filling defect, within the pulmonary artery, showed the same sonographic findings as the previously found intrarenal masses. The baby underwent embolectomy and recovered. The thrombotic material contained yeast cells giving evidence of systemic candidasis. Provided appropriate equipment is available, ultrasound today is an excellent non-invasive screening and followup method not only for echoencephalography, but also for more complicated neonatologic problems as seen here. The detailed observation of a changing echogenicity of the renal cortex and pelvis is important and often allows a decisive diagnostic clue before other radiological methods become conclusive.

Reither, M.; Schumacher, R.; Hagel, K.J.; Hering, F.

1983-10-01

286

In Vivo Efficacy of Anidulafungin against Mature Candida albicans Biofilms in a Novel Rat Model of Catheter-Associated Candidiasis?  

Science.gov (United States)

The present study demonstrates the efficacy of anidulafungin on mature Candida albicans biofilms in vivo. One hundred fifty-seven catheter fragments challenged with C. albicans were implanted subcutaneously in rats. After formation of biofilms, rats were treated with daily intraperitoneal injections of anidulafungin for 7 days. Catheters retrieved from treated animals showed reduced cell numbers compared to those retrieved from untreated and fluconazole-treated animals. Systemic administration of anidulafungin is promising for the treatment of mature C. albicans biofilms. PMID:20660685

Kucharikova, Sona; Tournu, Helene; Holtappels, Michelle; Van Dijck, Patrick; Lagrou, Katrien

2010-01-01

287

The PAV trial: Does lactobacillus prevent post-antibiotic vulvovaginal candidiasis? Protocol of a randomised controlled trial [ISRCTN24141277  

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Full Text Available Abstract Background Complementary and alternative medicines are used by many consumers, and increasingly are being incorporated into the general practitioner's armamentarium. Despite widespread usage, the evidence base for most complementary therapies is weak or non-existent. Post-antibiotic vulvovaginitis is a common problem in general practice, for which complementary therapies are often used. A recent study in Melbourne, Australia, found that 40% of women with a past history of vulvovaginitis had used probiotic Lactobacillus species to prevent or treat post-antibiotic vulvovaginitis. There is no evidence that this therapy is effective. This study aims to test whether oral or vaginal lactobacillus is effective in the prevention of post-antibiotic vulvovaginitis. Methods/design A randomised placebo-controlled blinded 2 × 2 factorial design is being used. General practitioners or pharmacists approach non-pregnant women, aged 18–50 years, who present with a non-genital infection requiring a short course of oral antibiotics, to participate in the study. Participants are randomised in a four group factorial design either to oral lactobacillus powder or placebo and either vaginal lactobacillus pessaries or placebo. These interventions are taken while on antibiotics and for four days afterwards or until symptoms of vaginitis develop. Women self collect a vaginal swab for culture of Candida species and complete a survey at baseline and again four days after completing their study medications. The sample size (a total of 496 – 124 in each factorial group is calculated to identify a reduction of half in post-antibiotic vulvovaginitis from 23%, while allowing for a 25% drop-out. An independent Data Monitoring Committee is supervising the trial. Analysis will be intention-to-treat, with two pre-specified main comparisons: (i oral lactobacillus versus placebo and (ii vaginal lactobacillus versus placebo.

Hurley Susan

2004-03-01

288

In vitro/in vivo performance of different complexes of itraconazole used in the treatment of vaginal candidiasis  

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A large majority of new chemical entities and many existing drug molecules exhibit poor aqueous solubility, which may limit their potential use in developing drug formulations, with optimum bioavailability. One of the approaches to improve the solubility of a poorly water soluble drug and eventually its bioavailability is complexation with agents like humic acid (HA), fulvic acid (FA), ?-cyclodextrin (?-CD), 2-hydroxypropyl-?-cyclodextrin (HP-?-CD) and caffeine (Caff). The...

Mohammad Aamir Mirza; Mohammad Akhlaquer Rahman; Sushama Talegaonkar; Zeenat Iqbal

2012-01-01

289

Amphotericin B liposomes with prolonged circulation in blood: in vitro antifungal activity, toxicity, and efficacy in systemic candidiasis in leukopenic mice  

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Pegylated amphotericin B (AmB) liposomes (PEG-AmB-LIP) were compared with laboratory-prepared nonpegylated AmB liposomes (AmB-LIP), a formulation with a lipid composition the same as that in AmBisome, as well as with industrially prepared AmBisome regarding their in vitro antifungal activities, toxicities, blood residence times, and therapeutic efficacies. Killing of Candida albicans (> 99.9%) during short-term (6-h) incubation ...

Etten, E. W. M.; Kate, M. T. Ten; Stearne, L. E. T.; Bakker-woudenberg, I. A. J. M.

1995-01-01

290

Disease: H01109 [KEGG MEDICUS  

Full Text Available H01109 Chronic mucocutaneous candidiasis (CMC); Familial candidiasis (CANDF) Chronic mucocutaneo ... yankar A, Toubiana J, Itan Y, Audry M, Nitschke P, Masson ... C, Toth B, Flatot J, Migaud M, Chrabieh M, Kochetk ...

291

Disease: H00363 [KEGG MEDICUS  

Full Text Available H00363 Candidiasis Candidiasis is a fungal infection with Candida species, predominantly with Ca ... H: D002177 Papadakis MA, Tierney LM (ed). [Current Medical ... Diagnosis & Treatment 2004, Forty-Third Edition] ( ...

292

Paracoccidioidomycosis  

Science.gov (United States)

... Aspergillosis Blastomycosis Candidiasis Coccidioidomycosis Cryptococcosis Histoplasmosis Mucormycosis Paracoccidioidomycosis Sporotrichosis Merck Manual > Patients & Caregivers > Infections > Fungal Infections 4 ...

293

Brazilian guidelines for the management of candidiasis - a joint meeting report of three medical societies: Sociedade Brasileira de Infectologia, Sociedade Paulista de Infectologia and Sociedade Brasileira de Medicina Tropical.  

Science.gov (United States)

Candida infections account for 80% of all fungal infections in the hospital environment, including bloodstream, urinary tract and surgical site infections. Bloodstream infections are now a major challenge for tertiary hospitals worldwide due to their high prevalence and mortality rates. The incidence of candidemia in tertiary public hospitals in Brazil is approximately 2.5 cases per 1000 hospital admissions. Due to the importance of this infection, the authors provide a review of the diversity of the genus Candida and its clinical relevance, the therapeutic options and discuss the treatment of major infections caused by Candida. Each topography is discussed with regard to epidemiological, clinical and laboratory diagnostic and therapeutic recommendations based on levels of evidence. PMID:23693017

Colombo, Arnaldo Lopes; Guimarães, Thaís; Camargo, Luis Fernando Aranha; Richtmann, Rosana; Queiroz-Telles, Flavio de; Salles, Mauro José Costa; Cunha, Clóvis Arns da; Yasuda, Maria Aparecida Shikanai; Moretti, Maria Luiza; Nucci, Marcio

2013-01-01

294

Comparison of Fluconazole and Clotrimazole in the Treatment of Acute Candida Albicans Vulvovaginitis  

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Objective: This study compared two antifungal drugs, fluconazole and clotrimazole for the treatment of vulvo vaginal candidiasis. "nMaterials and Methods: This randomized clinical trial was conducted on 120 women with vulvo vaginal candidiasis during a six month period. All patients answered a standard questionnaire containing questions about symptoms of vulvovaginal candidiasis and presence of vaginal discharge and signs of vulvar and vaginal inflammation were documented according to ph...

Atefe Namaki; Zahra Yekta; Kambiz Diba; Farzaneh Broomand; Fatemeh Bahadori

2008-01-01

295

Emergence of Resistance of Candida albicans to Clotrimazole in Human Immunodeficiency Virus-Infected Children: In Vitro and Clinical Correlations  

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Oropharyngeal candidiasis (OPC) is a common opportunistic infection in human immunodeficiency virus (HIV)-infected patients and other immunocompromised hosts. Clotrimazole troches are widely used in the treatment of mucosal candidiasis. However, little is known about the potential contribution of clotrimazole resistance to the development of refractory mucosal candidiasis. We therefore investigated the potential emergence of resistance to clotrimazole in a prospectively monitored HIV-infected...

Pelletier, Rene?; Peter, Joanne; Antin, Cynthia; Gonzalez, Corina; Wood, Lauren; Walsh, Thomas J.

2000-01-01

296

Diagnosis of superficial mycoses by direct microscopy - A statistical evaluation  

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A mycological study was undertaken in 250 cases of superficial mycotic infections, which included 210 cases of dermatophytosis, 18 cases of cutaneous candidiasis and 22 cases of tinea versicolor. The scrapings from all the cases were subjected to direct microscopic examination in 10% KOH solution and culture was done in case of candidiasis and dermatophytosis. Out of 250 cases direct microscopy was positive (KOH +ve) in 88 cases of dermatophytosis, 11 cases of candidiasis and al...

Mohanty J; Mohanty S; Sahoo R; Sahoo A; Ch, Prahara

1999-01-01

297

Esophageal strictures during treatment for acute lymphoblastic leukemia.  

LENUS (Irish Health Repository)

Esophageal stricture is a rare complication of paediatric cancer treatment that usually occurs after esophageal exposure to radiotherapy. We describe 4 cases of esophageal stricture during chemotherapy for acute lymphoblastic leukemia. All patients presented with refractory vomiting and were diagnosed with radiologic contrast studies. None of the patients had received radiotherapy. Esophageal candidiasis was seen in 2 patients but the remaining 2 patients had earlier systemic candidiasis. High-dose dexamethasone may predispose these children to both esophageal candidiasis and peptic esophagitis. The etiology of esophageal strictures during treatment for acute leukemia is likely to be multifactorial but systemic candidiasis may play a significant role.

Kelly, Kevin

2012-02-01

298

Candidemia, look at the eyes.  

Science.gov (United States)

Two patients with disseminated candidiasis are presented. The diagnosis was established by fundoscopy. Candida endophthalmitis can be the only manifestation of disseminated candidiasis. The role of fundoscopy in the management of candidemia is emphasized because it can provide evidence of disseminated disease. Every positive blood culture requires repeated fundoscopic examination. Early recognition is essential to prevent irreversible loss of vision. PMID:3258875

Piek, J J; Knot, E A; Schooneveld, M J; Rietra, P J

1988-01-01

299

Oesophageal candiasis in AIDS  

Digital Repository Infrastructure Vision for European Research (DRIVER)

With the explosion in the number of AIDS patients, many of these are likely to consult to otolaryngologists the head & neck is a rather common site to be affected. Sometimes only oesophageal candidiasis is the presenting feature as in the present case which is being reported show typical radiological appearance. the differential diagnosis and treatment of nesophageal candidiasis is briefly discussed

Yadav, S. P. S.; Ranga, Rupender K.; Singh, Jagat; Yadav, Rohtas

2003-01-01

300

Invasive fungal infections in newborns and current management strategies.  

Science.gov (United States)

Invasive fungal infections due to Candida are the third most common late-onset infection in infants born with birth weight neonates born with neonatal units where baseline rates of invasive candidiasis are more than 5%. PMID:23829639

Hundalani, Shilpa; Pammi, Mohan

2013-07-01

 
 
 
 
301

Vaginal yeast infection  

Science.gov (United States)

Yeast infection - vagina; Vaginal candidiasis; Monilial vaginitis ... Most women have a vaginal yeast infection at some time. Candida albicans is a common type of fungus. It is often found in small amounts in the ...

302

Vaginal Yeast Infections (For Parents)  

Science.gov (United States)

... treatment is simple and painless. What Is a Yeast Infection? A yeast infection, also known as candidiasis ( ... you can be treated appropriately. Do Guys Get Yeast Infections? Guys can get an infection of the ...

303

HIV and AIDS  

Medline Plus

Full Text Available ... 200 or less • He or she has a serious infection or cancer because the immune system could ... warts. Progressive multifocal leukoencephalopathy, or PML, is a serious brain infection. Infections caused by fungi include: • Candidiasis • ...

304

HIV and AIDS  

Medline Plus

Full Text Available ... Progressive multifocal leukoencephalopathy, or PML, is a serious brain infection. Infections caused by fungi include: • Candidiasis • Cryptococcal ... inflammation of the membranes and fluid around the brain and spinal cord. Infections caused by parasites include: • ...

305

Genetics Home Reference: Job syndrome  

Science.gov (United States)

... the body's cells and tissues. Changes in this gene alter the structure and function of the STAT3 protein, ... recessive ; bacteria ; bone density ; candidiasis ; cell ; DNA ; eczema ; gene ; ... inflammation ; inheritance ; joint ; mutation ; nervous system ; osteopenia ; pattern of ...

306

Genetic Diversity Among Candida albicans Isolates Associated with Vertical Transmission in Preterm Triplets.  

Science.gov (United States)

We report a case of congenital candidiasis in triplets, in the context of premature labor at 25 weeks gestation, without symptomatic vaginitis or chorioamnionitis. All three infants died as a result of prematurity, aggravated by systemic candidiasis. Multi-locus sequence typing confirmed vertical transmission of Candida albicans from the mother to the triplets and revealed a slight diversity among the strains isolated from the neonates. PMID:25151365

Hoarau, Gautier; Bougnoux, Marie-Elisabeth; Fily, Antoine; François, Nadine; Loridant, Séverine; Jawhara, Samir; d'Enfert, Christophe; Poulain, Daniel; Sendid, Boualem

2014-10-01

307

Review of the pharmacology and clinical studies of micafungin  

Digital Repository Infrastructure Vision for European Research (DRIVER)

Micafungin, like other members of the echinocandin class, has a unique mechanism of action that inhibits the synthesis of 1,3-?-D glucans in the fungal cell wall. It has been approved for treatment of esophageal candidiasis, invasive candidiasis including candidemia, and for prophylaxis of Candida infections in patients undergoing hematopoietic stem cell transplantation. Although efficacy and safety have also been demonstrated in pediatric populations, micafungin is approved for this indicat...

Bormann, Alison M.; Morrison, Vicki A.

2009-01-01

308

Sensitivity of Vaginal Isolates of Candida to Eight Antifungal Drugs Isolated From Ahvaz, Iran  

Digital Repository Infrastructure Vision for European Research (DRIVER)

Backgrounds: Candida vaginitis is a common fungal infection among adult women and it has been estimated that 75% of all adult women experience at least one period of vulvovaginal candidiasis in their lifetime. Several predisposing factors, such as diabetes mellitus,using contraceptive, pregnancy, and broad-spectrum antibiotics are reported as main risk factors for the infection. While, the main etiologic agent of vulvovaginal candidiasis is Candida albicans, more antifungal resistance has bee...

Zahra Salehei; Zahra Seifi; Ali Zarei Mahmoudabadi

2012-01-01

309

Efficiency of lyticase (bacterial enzyme) in experimental candidal vaginitis in mice.  

Science.gov (United States)

Lyticase (a bacterial enzyme) was tested as a new antimycotic drug. Of all objects studied, Cellulomonas cellulans AC-870 strain proved to be most productive for this enzyme. A technology for lyticase isolation and purification was proposed. An experimental model of recurrent vaginal candidiasis was created. The model includes combined antibiotic and estradiol therapy. Antimycotic effect of lyticase on the model of recurrent vaginal candidiasis in mice was demonstrated. PMID:21165431

Sachivkina, N P; Kravtsov, E G; Wasileva, E A; Anokchina, I V; Dalin, M V

2010-11-01

310

The influence of microbiota of kefir grains on the survival and growth of the fungus Candida albicans in milk  

Digital Repository Infrastructure Vision for European Research (DRIVER)

In the past two decades we have been noticing an increased manifestation of an invasive yeast infection candidiasis, which presents a huge health problem all over the world. In order to prevent and heal candidiasis, we should also consider a healthy diet that includes kefir as well. Therefore, this diploma thesis focuses on the influence of kefir on the growth and reproduction of Candida albicans. The diploma thesis consists of two parts, theoretical and empirical part. In the theoretical ...

Trunk, Mateja

2013-01-01

311

Echinocandins: A ray of hope in antifungal drug therapy  

Directory of Open Access Journals (Sweden)

Full Text Available Invasive fungal infections are on the rise. Amphotericin B and azole antifungals have been the mainstay of antifungal therapy so far. The high incidence of infusion related toxicity and nephrotoxicity with amphotericin B and the emergence of fluconazole resistant strains of Candida glabrata egged on the search for alternatives. Echinocandins are a new class of antifungal drugs that act by inhibition of ? (1, 3-D- glucan synthase, a key enzyme necessary for integrity of the fungal cell wall. Caspofungin was the first drug in this class to be approved. It is indicated for esophageal candidiasis, candidemia, invasive candidiasis, empirical therapy in febrile neutropenia and invasive aspergillosis. Response rates are comparable to those of amphotericin B and fluconazole. Micafungin is presently approved for esophageal candidiasis, for prophylaxis of candida infections in patients undergoing hematopoietic stem cell transplant (HSCT and in disseminated candidiasis and candidemia. The currently approved indications for anidulafungin are esophageal candidiasis, candidemia and invasive candidiasis. The incidence of infusion related adverse effects and nephrotoxicity is much lower than with amphotericin B. The main adverse effect is hepatotoxicity and derangement of serum transaminases. Liver function may need to be monitored. They are, however, safer in renal impairment. Even though a better pharmacoeconomical choice than amphotericin B, the higher cost of these drugs in comparison to azole antifungals is likely to limit their use to azole resistant cases of candidial infections and as salvage therapy in invasive aspergillosis rather than as first line drugs.

Grover Neeta

2010-01-01

312

Anidulafungin: an evidence-based review of its use in invasive fungal infections  

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Full Text Available Susan L. Davis, Jose A. VazquezHenry Ford Hospital, Wayne State University College of Pharmacy, Wayne State University School of Medicine, Detroit, Michigan, USAIntroduction: Anidulafungin is a new echinocandin antifungal agent with indications for use in esophageal candidiasis and candidemia. The mortality and morbidity associated with fungal infections in healthcare facilities necessitates the development of new treatment options for these diseases.Aims: This review assesses the pharmacology and evidence for the use of anidulafungin in the treatment of serious fungal infections.Evidence review: There is substantial evidence that anidulafungin is a potent antifungal agent with activity against a broad range of fungal species. Likewise, evidence supports that anidulafungin is a well-tolerated antifungal agent. Clinical studies provide sufficient evidence for regulatory approval for esophageal candidiasis and candidemia, and limited evidence suggests that anidulafungin may be superior to fluconazole for candidemia and invasive candidiasis. The introduction of anidulafungin into clinical practice adds a third option for therapy in the echinocandin class. Research into its efficacy in other fungal infections is ongoing, and further studies into the impact of anidulafungin on economic outcomes will be beneficial.Place in therapy: Current evidence supports the use of anidulafungin in the management of candidemia, esophageal candidiasis, and invasive candidiasis, as demonstrated by the successful results in large multicenter clinical trials.Key words: anidulafungin, candidemia, candidiasis, echinocandins, evidence, review, treatment

Susan L. Davis

2008-07-01

313

Anidulafungin in the treatment of invasive fungal infections  

Directory of Open Access Journals (Sweden)

Full Text Available Kathryn Sabol, Tawanda GumboUniversity of Texas Southwestern Medical Center, Dallas, TX, USAAbstract: More antifungal agents have reached clinical use in the past two decades than at any other time. The echinocandins have been a welcome addition to this group, with the latest being anidulafungin. There are several lines of evidence to support anidulafungin’s role as primary therapy for the treatment of invasive candidiasis in non-neutropenic patients, and as alternative therapy to fluconazole in patients with esophageal candidiasis with azole intolerance or triazole-resistant Candida. Pharmacokinetic–pharmacodynamic studies in animals have demonstrated superior efficacy, defined as maximal microbial kill, when compared to fluconazole, regardless of the fluconazole susceptibility of the Candida species. These studies, as well as dose-effect studies in patients, also support the currently recommended dose of anidulafungin. A well designed randomized controlled trial has demonstrated anidulafungin’s efficacy in patients with invasive candidiasis. In this paper, we argue that anidulafungin may be preferable to fluconazole for the treatment of candidemia. However, as of yet, the difference between anidulafungin and the other two licensed echinocandins as first-line therapy for invasive candidiasis is unclear. On the other hand, there is insufficient evidence as of yet to support first-line use of anidulafungin in patients with neutropenia or aspergillosis.Keywords: anidulafungin, pharmacokinetics-pharmacodynamics, efficacy, candidiasis

Kathryn Sabol

2008-03-01

314

Diagnosis of superficial mycoses by direct microscopy - A statistical evaluation  

Directory of Open Access Journals (Sweden)

Full Text Available A mycological study was undertaken in 250 cases of superficial mycotic infections, which included 210 cases of dermatophytosis, 18 cases of cutaneous candidiasis and 22 cases of tinea versicolor. The scrapings from all the cases were subjected to direct microscopic examination in 10% KOH solution and culture was done in case of candidiasis and dermatophytosis. Out of 250 cases direct microscopy was positive (KOH +ve in 88 cases of dermatophytosis, 11 cases of candidiasis and all cases of tinea versicolor. Culture for dermatophytes and candida species in SDA medium were positive in 76 and 9 cases respectively. The diagnostic sensitivity, specificity, positive predictive value, negative predictive value and the overall efficiency of the direct microscopy in the diagnosis of superficial mycotic infections were calculated to be 89.41%, 83.90%, 76.76%, 93.02% and 85.96% respectively.

Mohanty J

1999-01-01

315

Fungal infections today: size of the problem and focus on the initial cost of therapy with echinocandin  

Directory of Open Access Journals (Sweden)

Full Text Available Three candins had been approved for the treatment of invasive candidiasis (IC: caspofungin, micafungin, and anidulafungin. Different drugs are associated with different needs for dose adjustment which might affect the total cost. A Spanish economic analysis estimated the budget impact of caspofungin, micafungin and anidulafungin in the treatment of 100 patients with invasive candidiasis from the perspective of the Spanish hospital pharmacy setting. It has demonstrated that patients treated with anidulafungin did not required dose adjustment unlike caspofungin and micafungin, and the use of anidulafungin in the treatment of adult non-neutropenic patients with invasive candidiasis is a cost saving treatment option, from the pharmacy department perspective in Spain. The aim of this study was to estimate the initial costs of therapy with caspofungin, micafungin, and anidulafungin in the perspective of the Italian hospital setting.

Mario Venditti

2010-06-01

316

Clinico-Mycological Study Of Superficial Fungal Infection In Children In An Urban Clinic In Kolkata  

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Full Text Available Seventy children up to the age of 12 years who were suffering from dermatophytosis, candidiasis or pityriasis versicolor were studied clinically and mycologically. Dermatophytosis was the major group, which constituted 52.86% of children. It was followed by candidiasis that constituted 40% of children and pityriasis versicolor was the least, being 7.14% of children. Amongst the clinical types of dermatophytosis, tinea capitis was the commonest (32.43% followed by tinea corporis (27.03%. Candidial intertrigo was the commonest (42.86% from of candidiasis, followed by diaper dermatitis (32.14%. Most susceptible age group was school going children. Peak incidence of infection was during the months of June to September. T rubrum was the commonest dermatophyte isolated in culture. C. albicans was the most common species of candida isolated in culture.

Barbhuiya Joyashree Nath

2002-01-01

317

[Antifungal activity and clinical efficacy of micafungin sodium (Funguard)].  

Science.gov (United States)

Micafungin sodium (MCFG) is a new lipopeptide antifungal agent of the echinocandin class. MCFG inhibits 1,3-beta-glucan synthesis in C. albicans and A. fumigatus in a non-competitive manner and has antifungal activity against both Aspergillus and Candida species. In neutropenic mouse models of disseminated candidiasis and pulmonary aspergillosis, the efficacy of MCFG was superior to that of fluconazole and itroconazole, but comparable to that of amphotericin B. The efficacy and safety of MCFG were investigated in 70 patients with deep-seated mycosis caused by Candida and Aspergillus species. The overall clinical response rates were 57.1% in aspergillosis and 78.6% in candidiasis. The incidence of adverse events related to micafungin was 17.9 %, and there was no dose-related occurrence of any adverse events. The results from this study indicated that micafungin was effective against aspergillosis and candidiasis, with no tolerability problems. PMID:14501170

Ikeda, Fumiaki

2003-10-01

318

[Antifungal activity and clinical efficacy of micafungin (funguard)].  

Science.gov (United States)

Micafungin (MCFG) is a new lipopeptide antifungal agent of the echinocandin class. MCFG inhibits 1,3-beta-D-glucan synthesis in C. albicans and A. fumigatus in a non-competitive manner, and has antifungal activity against both Aspergillus and Candida species. In neutropenic mouse models of disseminated candidiasis and pulmonary aspergillosis, the efficacy of MCFG was superior to that of fluconazole and itraconazole, but comparable to that of amphotericin B. The efficacy and safety of MCFG were investigated in 70 patients with deep-seated mycosis caused by Candida and Aspergillus species. The overall clinical response rates were 57.1% in aspergillosis and 78.6% in candidiasis. The incidence of adverse events related to micafungin was 17.9%, and there was no dose-related occurrence of any adverse events. The results from this study indicated that micafungin was effective in aspergillosis and candidiasis, with no tolerability problems. PMID:16282962

Ikeda, Fumiaki

2005-01-01

319

High-dose caspofungin salvage in a very-low-birth-weight infant with refractory candidemia  

Directory of Open Access Journals (Sweden)

Full Text Available Candidiasis is one of the most common causes of late-onset infection among very-low-birth-weight infants (VLBW in most neonatal intensive care units and is associated with significant morbidity and mortality. Standard therapy consists of the administration of amphotericin B, amphotericin B complex, and fluconazole. In many cases, candidiasis is not easily eradicated, despite the administration of these drugs. We report our experience of the addition of high-dose caspofungin to the conventional antifungal drugs in a VLBW infant with refractory candidemia.

Eun Sun Seo

2010-02-01

320

BIOTECHNOLOGICAL DESCRIPTION OF TECHNOLOGIES FOR OBTAINING OF ANTIGENS OF CANDIDA GENUS FUNGI  

Directory of Open Access Journals (Sweden)

Full Text Available To develop the vaccine against candidal infection the various biotechnological methods for obtaining antigens of Candida genus fungi have been considered in the article. To obtain antigens for the prevention and treatment of candidiasis researchers use different types and parts of fungi of the genus Candida. Methods of preparation of antigens also vary widely including chemical, physical and physico-chemical techniques. Of all possible variants development and research of a dead and subunit vaccine based on C. albicans and C. tropicalis fungi that are the main causative agents of candidiasis have been chosen for further study.

Rybalkin ?.V

2014-06-01

 
 
 
 
321

[Superficial mucocutaneous mycosis].  

Science.gov (United States)

Superficial mycosis are very common. The frequency in France is 10 to 15% of the population. The reason for the high incidence of this disease is the change of the moral values, rise in promiscuity and increase sports activities. The agents responsible are divided in four groups. Dermatophytes involve keratin of the skin, hairs and nails but never the mucous membranes. They can cause glabrous skin lesion, tinea corporis, tinea capitis or onychomycosis. Yeast are divided in two groups: the candidiasis and Malassezia furfur, the etiologic agent of pityriasis versicolor. Oral mucosa candidiasis is very common in HIV infected patients. PMID:8949492

Schmutz, J L; Barbaud, A; Contet-Audonneau, N

1996-09-01

322

Cutaneous Manifestation of Pediatric AIDS  

Directory of Open Access Journals (Sweden)

Full Text Available Cutaneous disorders are the most common manifestation of HIV infection in both children and adults. The spectrum of these manifestations includes infections, neoplasm, drug reactions, nonspecific exanthemas and skin changes associated with nutritional deficits. Mucocutaneous candidiasis, herpetic gingivostomatitis and severe bacteriemia.

P Alizadeh Taheri

2002-08-01

323

Oat cell carcinoma of the esophagus: Unusual radiological appearances  

International Nuclear Information System (INIS)

Primary oat cell carcinoma of the esophagus is a very rare tumour. The radiographic appearance of the three cases described in this paper are unusual because they resemble benign lesions such as leiomyoma, fibrous polyp and candidiasis. It would be interesting to investigate whether such an unusual appearance is common for this neoplasm. (orig.)

324

Interdigital erosions - tinea pedis?  

Science.gov (United States)

Interdigital erosions are frequently due to tinea pedis. However, other infectious conditions, such as candidiasis, erythrasma or bacterial infections, can generate lesions that cannot be differentiated at the clinical level. Microbiological tests are therefore necessary. This clinical case shows a man with interdigital lesions of 10 months of evolution that are not responding to antifungal treatment. PMID:23210102

Orgaz-Molina, Jacinto; Orgaz-Molina, Maria Carmen; Cutugno, Marilena; Arias-Santiago, Salvador

2012-10-01

325

Dermatomycoses In Diabetics - A Clinical Study  

Directory of Open Access Journals (Sweden)

Full Text Available Two hundred diabetics including 153 non- insulin dependent diabetes mellitus and 47 insulin dependent diabetes mellitus patients, were screened for mycoses. Candidiasis was the commonest mycoses, followed by dermatophtoses and pityriasis versicolor. The fasting blood glucose level was observed to be higher in candidialsis compared to other mycoses.

Parthiban K

1998-01-01

326

Candida species isolation in peristomal skin in patients with abdominal stomas and correlation to clinical signs: a descriptive pilot study.  

Science.gov (United States)

The reported prevalence of candidiasis in peristomal skin varies greatly. Very few studies exist that correlate the clinical findings around the peristomal skin to the mycology. In this study, the authors report on Candida species prevalence, clinical correlation, and mycology. PMID:25325226

Morales-Mendoza, Yamilett; Fernández-Martínez, Ramón; Fabián-Victoriano, Ma Rosy; Contreras-Ruiz, José; Vásquez-Del-Mercado, Elsa; de Lourdes Suárez-Roa, Maria; Arenas-Guzman, Roberto

2014-11-01

327

Management of vaginitis.  

Science.gov (United States)

Common infectious forms of vaginitis include bacterial vaginosis, vulvovaginal candidiasis, and trichomoniasis. Vaginitis also can occur because of atrophic changes. Bacterial vaginosis is caused by proliferation of Gardnerella vaginalis, Mycoplasma hominis, and anaerobes. The diagnosis is based primarily on the Amsel criteria (milky discharge, pH greater than 4.5, positive whiff test, clue cells in a wet-mount preparation). The standard treatment is oral metronidazole in a dosage of 500 mg twice daily for seven days. Vulvovaginal candidiasis can be difficult to diagnose because characteristic signs and symptoms (thick, white discharge, dysuria, vulvovaginal pruritus and swelling) are not specific for the infection. Diagnosis should rely on microscopic examination of a sample from the lateral vaginal wall (10 to 20 percent potassium hydroxide preparation). Cultures are helpful in women with recurrent or complicated vulvovaginal candidiasis, because species other than Candida albicans (e.g., Candida glabrata, Candida tropicalis) may be present. Topical azole and oral fluconazole are equally efficacious in the management of uncomplicated vulvovaginal candidiasis, but a more extensive regimen may be required for complicated infections. Trichomoniasis may cause a foul-smelling, frothy discharge and, in most affected women, vaginal inflammatory changes. Culture and DNA probe testing are useful in diagnosing the infection; examinations of wet-mount preparations have a high false-negative rate. The standard treatment for trichomoniasis is a single 2-g oral dose of metronidazole. Atrophic vaginitis results from estrogen deficiency. Treatment with topical estrogen is effective. PMID:15606061

Owen, Marion K; Clenney, Timothy L

2004-12-01

328

ETUDE PHENOTYPIQUE E T MOLECULAIRE DES CA NDIDOSES VULVO - VAGINALES CHEZ DES P ATIENTES AU MAROC.  

Directory of Open Access Journals (Sweden)

Full Text Available In vulvovaginal pathology, vaginal candidiasis is the most common etiologies. Candida albicans is involved in more than 75% in this pathology. Our study included 151 vaginal swabs from women atMedical center of the Institute Pasteur in Morocco. Each vaginal swab was exanimated by direct test and culture on specific media.Out 151 samples 18 were positive (11.9% by direct examination. However, culture results showed that 29/151(19.2%positive cases. The identification of positivecultures showed that Candida albicans is present in 21 cases 72%(21/29 of vaginal candidiasis followed byCandida glabrata with a frequency of 24% (7/29, andCandida tropicalis with a frequency of 3.4 % (1/29 .The clinical symptoms were essentially theleucorrhea, itching and sensation of burning.The most age range affected by vaginalcandidiasis is between 22 and 37 years.Our result showed that the prevalence of vaginal candidiasis was 19% in Moroccan patient with a predominance ofCandida albicans and a sharp increase invaginal candidiasis due to non albicans species.These results will have an impact on thediagnosis and treatement of vaginal candidisis in Morocco.

H. BOURA

2013-02-01

329

Terconazole Cream for Non-Candida albicans Fungal Vaginitis: Results of a Retrospective Analysis  

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Full Text Available Objective: Although it is FDA-approved for use in vulvovaginal candidiasis caused by non-Candida albicans species, terconazole cream has not been been studied in patients with these infections. We sought to assess the clinical and mycological efficacy of terconazole cream in women with non-C. albicans vaginitis.

M. Velma Weitz

2000-01-01

330

Is incidental recovery of yeast from enteric pathogen stool cultures obtained from hospitalized patients clinically significant?  

Directory of Open Access Journals (Sweden)

Full Text Available A matched case-control study was conducted to investigate gastrointestinal colonization with yeast as a predictor of invasive candidiasis (IC in patients who underwent an enteric pathogen test. No significant association was detected between gastrointestinal colonization and IC. However, gastrointestinal colonization with yeast was associated with increased antimicrobial exposure and median length of hospitalization.

Elizabeth D. Hermsen

2011-03-01

331

Oral fungal infections.  

Science.gov (United States)

Candidiasis is the most common oral fungal infection diagnosed in humans. Candidiasis may result from immune system dysfunction or as a result of local or systemic medical treatment. Because oral candidiasis is generally a localized infection, topical treatment methods are the first line of therapy, especially for the pseudomembranous and erythematous variants. Patients with dental prostheses should also be advised to disinfect the prosthesis routinely during the candidal treatment period, because the prosthesis may serve as a source of reinfection. Additionally, patients should be advised that oral hygiene aids, such as toothbrushes and denture brushes, may also be contaminated and should be discarded or disinfected. A disinfecting solution of equal parts of hydrogen peroxide and water may be used. Likewise, 2% chlorhexidine gluconate solution may be used asa disinfecting solution for dental prostheses and oral hygiene aids. Occasionally the clinician encounters a more resistant form of oral candidiasis such as the hyperplastic variant or a variant that does not respond to topical therapy. Appropriate systemic therapy should be employed for the treatment of these infections. Additionally, a biopsy should be undertaken in individuals with the hyperplastic variant of Candida because there is some degree of risk for malignant transformation. Deep fungal infections should be managed in association with appropriate medical specialists to rule out other systemic involvement. The dental health care provider plays an important part in the diagnosis and management of fungal disease, and therefore clinicians should be aware of the presenting signs and symptoms or oral fungal disease. PMID:15567360

Muzyka, Brian C

2005-01-01

332

Cutaneous Manifestation of Pediatric AIDS  

Digital Repository Infrastructure Vision for European Research (DRIVER)

Cutaneous disorders are the most common manifestation of HIV infection in both children and adults. The spectrum of these manifestations includes infections, neoplasm, drug reactions, nonspecific exanthemas and skin changes associated with nutritional deficits. Mucocutaneous candidiasis, herpetic gingivostomatitis and severe bacteriemia.

Alizadeh Taheri, P.; Sm, Rohani

2002-01-01

333

Comparison of Fluconazole and Clotrimazole in the Treatment of Acute Candida Albicans Vulvovaginitis  

Directory of Open Access Journals (Sweden)

Full Text Available Objective: This study compared two antifungal drugs, fluconazole and clotrimazole for the treatment of vulvo vaginal candidiasis. "nMaterials and Methods: This randomized clinical trial was conducted on 120 women with vulvo vaginal candidiasis during a six month period. All patients answered a standard questionnaire containing questions about symptoms of vulvovaginal candidiasis and presence of vaginal discharge and signs of vulvar and vaginal inflammation were documented according to physical examination. Two swabs of vaginal discharge were obtained for each woman, one for direct smear, another for culture. The culture medium was Sabouraud Dextrose Agar (SDA. Patients were randomized into two groups of clotrimazole (vaginal cream for 7 days and 150 mg fluconazole in a single dose. Clinical and paraclinical responses were calculated."nResults: Clinical improvement occurred in 96 cases (80%. This value was 86.7% and 73.3%for clotrimazole and fluconazole, respectively (P-value=0.04. Paraclinical response on tenth day of treatment was observed in 87 patients (72.5%. This value was 66.7% and 78.3%for clotrimazole and fluconazole groups, respectively (P-value=0.110. Mean days of treatment was 4.06 ±1.30 days for clotrimazole and 2.70 ±0.78 days for fluconazole (p value =0.031."nConclusion: Most of the clinical and paraclinical responses to the drugs used for the treatment of vulvo vaginal candidiasis are in the favour of fluconazole.

Atefe Namaki

2008-12-01

334

Epidemiology and antifungal susceptibilities of yeasts causing vulvovaginitis in a teaching hospital.  

Science.gov (United States)

Vulvovaginal candidiasis is one of the most common mycosis. However, the information about antifungal susceptibilities of the yeasts causing this infection is scant. We studied 121 yeasts isolated from 118 patients with vulvovaginal candidiasis. The isolates were identified by phenotypic and molecular methods, including four phenotypic methods described to differentiate Candida albicans from C. dubliniensis. Antifungal susceptibility testing was performed according to CLSI documents M27A3 and M27S4 using the drugs available as treatment option in the hospital. Diabetes, any antibacterial and amoxicillin treatment were statistically linked with vulvovaginal candidiasis, while oral contraceptives were not considered a risk factor. Previous azole-based over-the-counter antifungal treatment was statistically associated with non-C.albicans yeasts infections. The most common isolated yeast species was C. albicans (85.2 %) followed by C. glabrata (5 %), Saccharomyces cerevisiae (3.3 %), and C. dubliniensis (2.5 %). Fluconazole- and itraconazole-reduced susceptibility was observed in ten and in only one C. albicans strains, respectively. All the C. glabrata isolates showed low fluconazole MICs. Clotrimazole showed excellent potency against all but seven isolates (three C. glabrata, two S. cerevisiae, one C. albicans and one Picchia anomala). Any of the strains showed nystatin reduced susceptibility. On the other hand, terbinafine was the less potent drug. Antifungal resistance is still a rare phenomenon supporting the use of azole antifungals as empirical treatment of vulvovaginal candidiasis. PMID:25005365

Gamarra, Soledad; Morano, Susana; Dudiuk, Catiana; Mancilla, Estefanía; Nardin, María Elena; de Los Angeles Méndez, Emilce; Garcia-Effron, Guillermo

2014-10-01

335

20 CFR Appendix 1 to Subpart P of... - Listing of Impairments  

Science.gov (United States)

...dioxide pressure (or tension) (PCO2), and...more accurately, a test site should be selected...signs of fever, headache, focal neurologic...positive serology test. (iv) Candidiasis...signs of fever, headache, focal neurologic...positive serology test.(iv)...

2010-04-01

336

Sexually transmitted infections and reproductive tract infections in female sex workers  

Directory of Open Access Journals (Sweden)

Full Text Available The present study was conducted in 300 female sex workers (FSWs from Surat city in 2005-2006. Vaginal swabs, endocervical swabs and serum samples were collected from each of these FSWs. Vaginal samples were screened for bacterial vaginosis (BV, candidiasis and Trichomonas vaginalis . Endocervical swabs were screened for gonococcal infection. Serological tests for human immunodeficiency virus (HIV, hepatitis B surface antigen (HBsAg and syphilis were performed. From a total of 300 FSWs, BV was detected in 40 (13.33%, trichomoniasis in six (2%, candidiasis in 31 (10.33%, HIV seropositivity in 35 (11.66%, HBsAg reactivity in 10 (3.33% and rapid plasma regain (RPR reactivity in 20 (6.66% cases. RPR-positive serum samples were confirmed by the treponema pallidum hemaglutination test. Gonococcal infection was not found in any of the FSWs. Of the total of 35 HIV-positive patients, 20 patients had associated coinfection. Of the 35 HIV-seropositive FSWs, BV was detected in six (17.14%, candidiasis in six (17.14%, syphilis in five (14.28% and HBsAg in two (5.71%. One (2.85% HIV-positive FSW was positive for both candidiasis and syphilis.

Shethwala Nimisha

2009-04-01

337

Nutrition and Its Relationship to Autism.  

Science.gov (United States)

Discusses the relationship between food allergies and sensitivities and autism. Information is provided on two dietary problems (candidiasis and gluten/casein intolerance) and case histories of two three-year-old children with autism are provided to illustrate each of the problems. Diet and vitamin therapy interventions are also described.…

Adams, Lynn; Conn, Susan

1997-01-01

338

The Effect of Candida Albicans Systemic Infection on Matrix Metalloproteinases in Breast Cancer Bearing Balb/c Mice  

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Full Text Available Breast cancer patients are susceptible to infections such as candidiasis. Due to the importance and the role of matrix metalloproteinases (MMP in breast cancer progression and its correlation with tumor metastasis, we analyzed the serum level of MMPs -2, -3, -9 and tissue inhibitor of matrix metalloproteinase-1 (TIMP-1 in breast cancer bearing mice in the presence of systemic Candida albicans infection.Female BALB/c mice were divided into 4 groups: group I had tumor + candidiasis; group II, tumor only; group III, candidiasis only and group IV as negative control. Tumor tissue was separated from stock breast cancer bearing mice and transplanted subcutaneously into the groups I and II mice. Two weeks after tumor transplantation, groups I and III were infected with Candida albicans by intravenous injection. One week after systemic infection, the sera of the experimental groups were prepared and analyzed with ELISA for MMP-2, -3, -9 and TIMP-1 levels.The results showed that the levels of MMP-3, MMP-9 and TIMP-1 were increased in groups I, II and III, as compared to the control group. However, the level of MMP-2 was decreased in mice infected with Candida albicans and in infected mice bearing tumor.These data suggest that candidiasis may have a positive effect on tumor progression and metastasis.

Fatemeh Hajari-Taheri

2013-03-01

339

Identification of a novel STAT3 mutation in a patient with hyper-IgE syndrome  

DEFF Research Database (Denmark)

Here we describe a patient with hyper-IgE syndrome presenting with recurrent staphylococcal abscesses, pneumonia, and chronic mucocutaneous candidiasis, and report the identification of a novel STAT3 mutation at amino acid position 621, which has not previously been described. In addition, we review the immunological, infectious, and genetic features of hyper-IgE syndrome.

Mogensen, Trine H; Jakobsen, Marianne

2013-01-01

340

38 CFR 4.88b - Schedule of ratings-infectious diseases, immune disorders and nutritional deficiencies.  

Science.gov (United States)

...intermittent diarrhea, and on approved medication(s), or; minimum rating with T4 cell count less than 200, or Hairy Cell Leukoplakia, or Oral Candidiasis 30 Following development of definite medical symptoms, T4 cell of 200 or more and less...

2010-07-01

 
 
 
 
341

Chronic Fatigue Syndrome: Names and Claims  

Science.gov (United States)

... fatigue, including CFS during the 1950s to 1970s. Chronic Epstein-Barr Virus (EBV) — The virus that causes mononucleosis was thought to persist in the body. Multiple Chemical Sensitivity Syndrome — Many people (and ... candidiasis (or chronic yeast infection) Back to top ...

342

[Clinical epidemiology of fungal infection in diabetes].  

Science.gov (United States)

It is well-known that diabetes is a risk for infection. According to our analysis of the cause of death in 221 diabetic patients over 10 years, infection and pneumonia accounted for 22% of all deaths. Diabetes may increase the risk of mycotic infections; however, few data are available on the prevalence of fungal infections in diabetic patients. The purpose of this paper was to analyze the clinical epidemiology of fungal infections in diabetic patients. Onychomycosis, oral candidiasis and vulvovaginal candidiasis are observed frequently in diabetic patients. Urinary tract candidiasis in diabetic patients frequently develops into systemic candidiasis and fungus ball formation in the kidney. An estimated 50-75% of cases of rhinocerebral mucomycosis occur in diabetic patients, and ketoacidosis is thought to be the most likely predisposing factor. Invasive otitis externa is almost exclusively found in diabetic patients, and generally caused by Pseudomonas. This has been described secondary to Aspergillus in diabetic patients. Regarding cryptococcosis in non-AIDS patients, approximately 10 to 20% of these patients have diabetes. Clinicians must be aware of mycotic infection in diabetic patients with infectious disease. PMID:19069086

Higa, Mariko

2008-12-01

343

Vulvovaginitis: correlación con factores predisponentes, aspectos clínicos y estudios microbiológicos / Vulvovaginitis: correlation with predisposing factors, clinical manifestations and microbiological studies  

Scientific Electronic Library Online (English)

Full Text Available SciELO Argentina | Language: Spanish Abstract in spanish Las vaginitis (V) y vaginosis bacterianas (VB) constituyen uno de los principales motivos de consultas ginecológicas. El objeto de este trabajo fue analizar muestras de flujos vaginales para identificar la etiología infecciosa y su relación con factores predisponentes asociados (dispositivos intraut [...] erinos, anticonceptivos orales, preservativos y antibióticos previos), y con signos y síntomas. Entre el 1/11/01 y el 30/10/03 se realizó un estudio de corte transversal con 400 mujeres en edad reproductiva y no embarazadas, en un rango de edad de 15 a 55 años. En el laboratorio se analizó el contenido vaginal mediante examen en fresco, coloraciones (Gram y Giemsa) y cultivo. Interpretación: 1) normales (sin alteraciones manifiestas y sin detección de los agentes infecciosos estudiados), 2) infecciosos (con alteraciones manifiestas): vaginosis bacteriana (VB), candidiasis vaginal (CV) y tricomoniasis (TC), 3) desequilibrio de la ecología vaginal (con alteraciones intermedias) (D). Los resultados obtenidos fueron: 1) normales, 209 (52,2%); 2) infecciosos, 115 (28,8%), los que incluyeron: VB, 13,5%; CV, 12,5%; TC, 2,8%; y 3) desequilibrio de la ecología vaginal, 76 (19%). La vaginosis bacteriana y los desequilibrios de la flora se asociaron con la utilización de dispositivos intrauterinos, y la candidiasis con el uso de anticonceptivos orales y tratamiento antibiótico previo. Las pacientes con candidiasis vaginal y tricomoniasis presentaron mayor porcentaje de síntomas. Abstract in english Vaginitis (V) and bacterial vaginosis (BV) are one of the most common reasons the middle class patient has to consult a gynaecologist. The purpose of this work is to analyse samples of vaginal fluid targeting the infection etiology and its relationship to related factors: (intrauterine devices, cont [...] raceptive pills, condoms, use of antibiotics), symptoms and signs. From November 1, 2001 to October 30, 2003, a cross-section study was carried out of 400 nonpregnant, sexually active women in an age range of 15 to 55. Vaginal secretions were analysed by Gram and Giemsa stains and culturing was used. Interpreting: (1) normal - no observable changes, absence of the infecting agents studied here; (2) infected - changes observed: bacterial vaginosis, vaginal candidiasis (CV) and trichomoniasis (TC) and (3) imbalance in vagina ecology, with medium alterations (D). Results obtained: (1) normal: 209 (52.2%); infected: 115 (28.8%) including 13.5%VB, 12.5% CV, 2.8% TC, and (3) 76 (19%) with imbalance of vagina ecology. Bacterial vaginosis and flora imbalance were related to the use of intrauterine devices, and candidiasis to contraceptive pills and previous antibiotic use. The number of symptoms increased in patients with vaginal candidiasis and trichomoniasis.

S., Fosch; N., Fogolín; E., Azzaroni; N., Pairetti; L., D´Ana; H., Minacori; I., Tita; M., Redona; G., Gribaudo.

2006-12-01

344

Vulvovaginitis: correlación con factores predisponentes, aspectos clínicos y estudios microbiológicos Vulvovaginitis: correlation with predisposing factors, clinical manifestations and microbiological studies  

Directory of Open Access Journals (Sweden)

Full Text Available Las vaginitis (V y vaginosis bacterianas (VB constituyen uno de los principales motivos de consultas ginecológicas. El objeto de este trabajo fue analizar muestras de flujos vaginales para identificar la etiología infecciosa y su relación con factores predisponentes asociados (dispositivos intrauterinos, anticonceptivos orales, preservativos y antibióticos previos, y con signos y síntomas. Entre el 1/11/01 y el 30/10/03 se realizó un estudio de corte transversal con 400 mujeres en edad reproductiva y no embarazadas, en un rango de edad de 15 a 55 años. En el laboratorio se analizó el contenido vaginal mediante examen en fresco, coloraciones (Gram y Giemsa y cultivo. Interpretación: 1 normales (sin alteraciones manifiestas y sin detección de los agentes infecciosos estudiados, 2 infecciosos (con alteraciones manifiestas: vaginosis bacteriana (VB, candidiasis vaginal (CV y tricomoniasis (TC, 3 desequilibrio de la ecología vaginal (con alteraciones intermedias (D. Los resultados obtenidos fueron: 1 normales, 209 (52,2%; 2 infecciosos, 115 (28,8%, los que incluyeron: VB, 13,5%; CV, 12,5%; TC, 2,8%; y 3 desequilibrio de la ecología vaginal, 76 (19%. La vaginosis bacteriana y los desequilibrios de la flora se asociaron con la utilización de dispositivos intrauterinos, y la candidiasis con el uso de anticonceptivos orales y tratamiento antibiótico previo. Las pacientes con candidiasis vaginal y tricomoniasis presentaron mayor porcentaje de síntomas.Vaginitis (V and bacterial vaginosis (BV are one of the most common reasons the middle class patient has to consult a gynaecologist. The purpose of this work is to analyse samples of vaginal fluid targeting the infection etiology and its relationship to related factors: (intrauterine devices, contraceptive pills, condoms, use of antibiotics, symptoms and signs. From November 1, 2001 to October 30, 2003, a cross-section study was carried out of 400 nonpregnant, sexually active women in an age range of 15 to 55. Vaginal secretions were analysed by Gram and Giemsa stains and culturing was used. Interpreting: (1 normal - no observable changes, absence of the infecting agents studied here; (2 infected - changes observed: bacterial vaginosis, vaginal candidiasis (CV and trichomoniasis (TC and (3 imbalance in vagina ecology, with medium alterations (D. Results obtained: (1 normal: 209 (52.2%; infected: 115 (28.8% including 13.5%VB, 12.5% CV, 2.8% TC, and (3 76 (19% with imbalance of vagina ecology. Bacterial vaginosis and flora imbalance were related to the use of intrauterine devices, and candidiasis to contraceptive pills and previous antibiotic use. The number of symptoms increased in patients with vaginal candidiasis and trichomoniasis.

S. Fosch

2006-12-01

345

Vulvovaginitis: correlación con factores predisponentes, aspectos clínicos y estudios microbiológicos / Vulvovaginitis: correlation with predisposing factors, clinical manifestations and microbiological studies  

Scientific Electronic Library Online (English)

Full Text Available SciELO Argentina | Language: Spanish Abstract in spanish Las vaginitis (V) y vaginosis bacterianas (VB) constituyen uno de los principales motivos de consultas ginecológicas. El objeto de este trabajo fue analizar muestras de flujos vaginales para identificar la etiología infecciosa y su relación con factores predisponentes asociados (dispositivos intraut [...] erinos, anticonceptivos orales, preservativos y antibióticos previos), y con signos y síntomas. Entre el 1/11/01 y el 30/10/03 se realizó un estudio de corte transversal con 400 mujeres en edad reproductiva y no embarazadas, en un rango de edad de 15 a 55 años. En el laboratorio se analizó el contenido vaginal mediante examen en fresco, coloraciones (Gram y Giemsa) y cultivo. Interpretación: 1) normales (sin alteraciones manifiestas y sin detección de los agentes infecciosos estudiados), 2) infecciosos (con alteraciones manifiestas): vaginosis bacteriana (VB), candidiasis vaginal (CV) y tricomoniasis (TC), 3) desequilibrio de la ecología vaginal (con alteraciones intermedias) (D). Los resultados obtenidos fueron: 1) normales, 209 (52,2%); 2) infecciosos, 115 (28,8%), los que incluyeron: VB, 13,5%; CV, 12,5%; TC, 2,8%; y 3) desequilibrio de la ecología vaginal, 76 (19%). La vaginosis bacteriana y los desequilibrios de la flora se asociaron con la utilización de dispositivos intrauterinos, y la candidiasis con el uso de anticonceptivos orales y tratamiento antibiótico previo. Las pacientes con candidiasis vaginal y tricomoniasis presentaron mayor porcentaje de síntomas. Abstract in english Vaginitis (V) and bacterial vaginosis (BV) are one of the most common reasons the middle class patient has to consult a gynaecologist. The purpose of this work is to analyse samples of vaginal fluid targeting the infection etiology and its relationship to related factors: (intrauterine devices, cont [...] raceptive pills, condoms, use of antibiotics), symptoms and signs. From November 1, 2001 to October 30, 2003, a cross-section study was carried out of 400 nonpregnant, sexually active women in an age range of 15 to 55. Vaginal secretions were analysed by Gram and Giemsa stains and culturing was used. Interpreting: (1) normal - no observable changes, absence of the infecting agents studied here; (2) infected - changes observed: bacterial vaginosis, vaginal candidiasis (CV) and trichomoniasis (TC) and (3) imbalance in vagina ecology, with medium alterations (D). Results obtained: (1) normal: 209 (52.2%); infected: 115 (28.8%) including 13.5%VB, 12.5% CV, 2.8% TC, and (3) 76 (19%) with imbalance of vagina ecology. Bacterial vaginosis and flora imbalance were related to the use of intrauterine devices, and candidiasis to contraceptive pills and previous antibiotic use. The number of symptoms increased in patients with vaginal candidiasis and trichomoniasis.

S., Fosch; N., Fogolín; E., Azzaroni; N., Pairetti; L., D´Ana; H., Minacori; I., Tita; M., Redona; G., Gribaudo.

346

Biological properties of aureobasidin A, a cyclic depsipeptide antifungal antibiotic.  

Science.gov (United States)

Aureobasidin A (AbA) is a novel cyclic depsipeptide antifungal antibiotic. The antifungal activity of AbA was studied in vitro and in vivo in comparison with clinically effective antifungal agents, amphotericin B and fluconazole. AbA was highly active in vitro against many pathogenic fungi, including Candida albicans, Cryptococcus neoformans, Blastomyces dermatitidis and Histoplasma capsulatum. The activity was superior to amphotericin B in most cases. AbA exhibited fungicidal action toward growing cultures of C. albicans. It was highly tolerated by mice and showed good efficacy in the treatment of murine systemic candidiasis when given orally or subcutaneously. AbA's fungicidal action in mice with candidiasis was more effective than fluconazole and amphotericin B. PMID:8226319

Takesako, K; Kuroda, H; Inoue, T; Haruna, F; Yoshikawa, Y; Kato, I; Uchida, K; Hiratani, T; Yamaguchi, H

1993-09-01

347

Sertaconazole: pharmacology of a gynecological antifungal agent.  

Science.gov (United States)

Sertaconazole is a broad spectrum antifungal agent with excellent activity against yeasts, dermatophytes and opportunistic fungi. In addition to this antifungal efficacy, it has a good safety profile, sustained cutaneous retention, and low systemic absorption, all of which make it ideal for topical applications. In this study, the pharmacological properties of sertaconazole related to the treatment of vaginal fungi, in particular vulvovaginal candidiasis, are reviewed. As with all other infectious processes, the interacting components are infectious microorganism, host and drug. The following properties of sertaconazole have been investigated in pre-clinical studies: its in vitro spectrum of activity and potency against causative agents and accompanying factors in vaginal infection; its mechanism of action, whether it acts on the pathogenic properties of the microorganism; if it affects host defense mechanisms and how its antifungal activity is manifested in vivo in experimental candidiasis in the mouse. PMID:11118563

Palacín, C; Tarragó, C; Ortiz, J A

2000-12-01

348

Trends in frequency and in vitro antifungal susceptibility patterns of Candida isolates from women attending the STD outpatients clinic of a tertiary care hospital in Northern Italy during the years 2002-2007.  

Science.gov (United States)

Vulvovaginal candidiasis is a common mucosal infection caused by saprophytic and opportunistic yeasts belonging to the Candida genus. 518 vaginal swabs, with positive fungal culture were collected from unselected women attending the Sexually Transmitted Disease clinic of an Italian tertiary care hospital over a six year period to determine the pathogen prevalence in vulvovaginal candidiasis and to evaluate in vitro the antifungal susceptibilities of yeast recovered by Sensititre YeastOne antifungal panel plates according to CLSI document M27-A2. The isolates belonging to the genus Candida were 495 (95.5%) with Candida albicans percentage equal to 61.2%. Voriconazole was highly active (MIC50 0.008; MIC90 0.5 microg/ml), regardless of the species tested. On the contrary, fluconazole susceptibility was based upon the species. The intrinsic resistance to fluconazole of C. krusei was confirmed. PMID:19579700

Asticcioli, Sara; Sacco, Laura; Daturi, Rossana; Matti, Cecilia; Nucleo, Elisabetta; Zara, Francesca; Pagani, Laura

2009-04-01

349

Rapid Molecular Diagnosis for Candida species Using PCR-RFLP  

Directory of Open Access Journals (Sweden)

Full Text Available Rapid identification of Candida species in clinical laboratory is becoming increasingly important since the incidence of Candidiasis continues to rise as the hospital surveys show. Molecular techniques utilizing amplification of target DNA provide quick and precise methods for diagnosis and identification of Candida species. In this study, using universal primers, the ITS1-ITS4 region was amplified. The restriction enzyme MspI digests this region and was used to identify of C. albicans, C. glabrata, C. krusei, C. tropicalis and C. guilliermondii. Electrophoretically, ribosomal DNA of C. guilliermondii produced three bands whereas the other species gave two bands upon digestion. Accordingly these enzymes behave as valuable application tools in molecular diagnosis of Candida species in Candidiasis maladies and can be substituted with the classical diagnosis of the pathogen.

S.A. Ayatollahi Mousavi

2007-01-01

350

X-Plate Technology: a new method for detecting fluconazole resistance in Candida species.  

Science.gov (United States)

Candida species are responsible for many opportunistic fungal infections. Fluconazole is a well-tolerated antifungal drug, commonly used in the treatment of candidiasis. However, with fluconazole resistance ever increasing, rapid detection and antifungal susceptibility testing of Candida is imperative for proper patient treatment. This paper reports a cost-effective, simple and rapid chromogenic agar dilution method for simultaneous Candida species identification and fluconazole susceptibility testing. The results obtained by X-Plate Technology were in absolute concordance with standard microbroth dilution assays. Analysis of 1383 clinical patient samples with suspected vulvovaginal candidiasis revealed that this technology was able to detect and speciate the Candida isolate and determine the fluconazole susceptibility. The prevalence and susceptibility profiles of the clinical isolates using this method were highly similar to published reports using the microbroth dilution method. PMID:23378559

Chadwick, Sean G; Schuyler, Jessica A; Vermitsky, John-Paul; Adelson, Martin E; Mordechai, Eli; Gygax, Scott E

2013-05-01

351

Echinocandins for candidemia: a rational choice  

Directory of Open Access Journals (Sweden)

Full Text Available Among antifungal drugs, echinocandins (micafungin, caspofungin and anidulafungin represent a rational choice for the first-line therapy of candidemia/invasive candidiasis in critically ill patients. Among other properties characterizing echinocandins, it’s important to emphasize the broad spectrum of activity, the fungicidal activity against the majority of Candida spp., and the activity against the biofilm. Furthermore, echinocandins show greater efficacy than conventional amphotericin B and fluconazole, and similar efficacy to liposomal amphotericin B (but they are less toxic. Finally, echinocandins are recommended at the highest level of evidence (AI for the treatment of invasive candidiasis by IDSA and ESCMID guidelines.http://dx.doi.org/10.7175/rhc.v4i2s.872

Francesco Menichetti

2013-08-01

352

In vitro effects of glycyrrhetinic acid on the growth of clinical isolates of Candida albicans.  

Science.gov (United States)

Compounds derived from Glycyrrhiza glabra L. root have been used widely for centuries for their numerous therapeutic properties. The present study aimed to test the in vitro activity against Candida albicans strains of the compound 18-beta glycyrrhetinic acid (18-beta GA), derived from the root of Glycyrrhiza species. This antimicrobial activity was assessed using the National Committee for Clinical Laboratory Standards (NCCLS) method on C. albicans strains that were isolated from patients with recurrent vulvovaginal candidiasis (RVVC). The in vitro growth of the C. albicans strains was markedly reduced, in a pH-dependent manner, by relatively low doses (6.2 microg/mL) of 18-beta GA. The results demonstrate that 18-beta GA is a promising biological alternative for the topical treatment of recurrent vulvovaginal candidiasis (RVVC). PMID:19067381

Pellati, Donatella; Fiore, Cristina; Armanini, Decio; Rassu, Mario; Bertoloni, Giulio

2009-04-01

353

Inhibitors of the Glyoxylate Cycle Enzyme ICL1 in Candida albicans for Potential Use as Antifungal Agents  

Science.gov (United States)

Candida albicans is an opportunistic pathogen that causes candidiasis in humans. In recent years, metabolic pathways in C. albicans have been explored as potential antifungal targets to treat candidiasis. The glyoxylate cycle, which enables C. albicans to survive in nutrient-limited host niches and its. Key enzymes (e.g., isocitrate lyase (ICL1), are particularly attractive antifungal targets for C. albicans. In this study, we used a new screening approach that better reflects the physiological environment that C. albicans cells experience during infection to identify potential inhibitors of ICL. Three compounds (caffeic acid (CAFF), rosmarinic acid (ROS), and apigenin (API)) were found to have antifungal activity against C. albicans when tested under glucose-depleted conditions. We further confirmed the inhibitory potential of these compounds against ICL using the ICL enzyme assay. Lastly, we assessed the bioavailability and toxicity of these compounds using Lipinski's rule-of-five and ADMET analysis. PMID:24781056

Cheah, Hong-Leong; Lim, Vuanghao; Sandai, Doblin

2014-01-01

354

Fixed drug eruption resulting from fluconazole use: a case report  

Directory of Open Access Journals (Sweden)

Full Text Available Abstract Introduction Fluconazole is a widely used antifungal agent with a possible side effect of fixed drug eruption. However, this adverse drug effect is absent from the reported list of possible side effects of fluconazole. We are presenting a rare case in our report. Case presentation A 25-year-old Iranian woman developed fixed drug eruptions on different sites of her body after taking five doses of fluconazole to treat vaginal candidiasis. A positive patch test, positive oral challenge test and skin biopsy were all found to be consistent with fixed drug eruption. Conclusion Fluconazole is a widely prescribed drug, used mainly to treat candidiasis. Fixed drug eruption as a possible side effect of Fluconazole is not well known and thus, the lesions may be misdiagnosed and mistreated. Based on our findings, which are consistent with a number of other practitioners, we recommend adding fixed drug eruption to the list of possible side effects of fluconazole.

Tavallaee Mahkam

2009-07-01

355

Extensive mucosal erosion and sloughing of tongue: a hitherto unknown complication of topical clotrimazole preparation.  

Science.gov (United States)

Clotrimazole, a broad-spectrum imidazole antimycotic, is a widely-used prescription as well as an over-the-counter drug for treatment of mucosal (oral, vulvovaginal) candidiasis and dermatophytes. An extremely safe and well-tolerated drug, its safety profile has been well-explored in researches and trials. The commonest complaints are almost always non-serious-pruritus, rashes, paraesthesia (stinging/burning sensation) and erythema on topical applications, and nausea, vomiting, unpleasant taste sensation and elevated liver enzymes on oral preparations (troches). However, mucosal ulceration on topical clotrimazole preparation has not been reported in literature before. We present here the first documentation of extensive bilateral erosions and necrosis of tongue involving the mucosa, submucosa and musculature on application of one percent weight/volume clotrimazole mouth paint in a 27-year-old immunocompetent woman who presented with oral candidiasis. PMID:23591311

Dutta, Mainak; Ghatak, Soumya; Biswas, Gautam; Sinha, Ramanuj

2013-01-01

356

Successful voriconazole treatment of invasive pulmonary aspergillosis in a patient with acute biphenotypic leukemia  

Digital Repository Infrastructure Vision for European Research (DRIVER)

A 23-year old woman with acute biphenotypic leukemia (ABL) complained of chest pain with cough, high fever and hemoptysis during induction chemotherapy, although she had been treated with anti-biotics and micafungin. We made a clinical diagnosis of invasive pulmonary aspergillosis (IPA) based on a consolidation in the right upper lung field on a chest radiograph as well as a high level of serum beta-D-glucan (with no evidence of tuberculosis and candidiasis). We changed her treatment from ...

Hirano, Teiichi; Imai, Kiyotoshi; Kagawa, Kumiko; Miyazono, Takayoshi; Kiyama, Yoshio; Ogasawara, Masahiro; Kobayashi, Koichiro; Kobayashi, Naoki; Tanimoto, Mitsune; Kasai, Masaharu

2009-01-01

357

Impaired TH17 cell differentiation in subjects with autosomal dominant hyper-IgE syndrome  

Digital Repository Infrastructure Vision for European Research (DRIVER)

The autosomal dominant hyper-IgE syndrome (HIES, ‘Job's syndrome’) is characterized by recurrent and often severe pulmonary infections, pneumatoceles, eczema, staphylococcal abscesses, mucocutaneous candidiasis, and abnormalities of bone and connective tissue1,2. Mutations presumed to underlie HIES have recently been identified in stat3, the gene encoding STAT3 (signal transducer and activator of transcription 3) (refs 3, 4). Although impaired production of interferon-? and tumour-necros...

Milner, Joshua D.; Brenchley, Jason M.; Laurence, Arian; Freeman, Alexandra F.; Hill, Brenna J.; Elias, Kevin M.; Kanno, Yuka; Spalding, Christine; Elloumi, Houda Z.; Paulson, Michelle L.; Davis, Joie; Hsu, Amy; Asher, Ava I.; O Shea, John; Holland, Steven M.

2008-01-01

358

Measurement of Serum d-Arabinitol/Creatinine Ratios for Initial Diagnosis and for Predicting Outcome in an Unselected, Population-Based Sample of Patients with Candida Fungemia?  

Digital Repository Infrastructure Vision for European Research (DRIVER)

d-Arabinitol (DA) is a useful diagnostic marker for candidiasis in patients with neutropenia and other high-risk groups, but its use in unselected patients with a broad range of underlying diseases and conditions has not been studied. We used an automated enzymatic fluorometric assay to measure serum DA/creatinine ratios (DA/cr's) in 30 healthy adults, 100 hospitalized controls without Candida fungemia, and 83 patients from a study of all Candida fungemias in Connecticut between October 1998 ...

Yeo, Siew Fah; Huie, Sharon; Sofair, Andre N.; Campbell, Sheldon; Durante, Amanda; Wong, Brian

2006-01-01

359

Cancer drugs inhibit morphogenesis in the human fungal pathogen, Candida albicans  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: English Abstract in english Candida infections are very common in cancer patients and it is a common practice to prescribe antifungal antibiotics along with anticancer drugs. Yeast to hyphal form switching is considered to be important in invasive candidiasis. Targeting morphogenetic switching may be useful against invasive ca [...] ndidiasis. In this study, we report the antimorphogenetic properties of thirty cancer drugs.

Madhushree M, Routh; Nitin M, Chauhan; S Mohan, Karuppayil.

2013-09-01

360

Depresión Mayor y Salud Oral: Rol de los Fármacos Antidepresivos Major Depression and Oral Health: Role of Antidepressants Medications  

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La mayoría de los fármacos antidepresivos, así como otras drogas usadas en el manejo de los cuadros depresivos son hiposalivantes. La disminución del flujo salival produce alteraciones en los tejidos blandos y duros de la cavidad oral. Las principales patologías que se han descrito asociadas a hiposialia son las caries dentarias, la candidiasis oral y en algún grado la gingivitis y periodontitis. Adicionalmente, estas patologías pueden verse exacerbadas por el abandono de los hábitos ...

Gonzalo Rojas; René Latorre; Ana Verónica Ortega

2000-01-01

 
 
 
 
361

In Vitro Activity of Caspofungin against Candida albicans Biofilms  

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Most manifestations of candidiasis are associated with biofilm formation on biological or inanimate surfaces. Candida albicans biofilms are recalcitrant to treatment with conventional antifungal therapies. Here we report on the activity of caspofungin, a new semisynthetic echinocandin, against C. albicans biofilms. Caspofungin displayed potent in vitro activity against sessile C. albicans cells within biofilms, with MICs at which 50% of the sessile cells were inhibited well within the drug's ...

Bachmann, Stefano P.; Vandewalle, Kacy; Ramage, Gordon; Patterson, Thomas F.; Wickes, Brian L.; Graybill, John R.; Lo?pez-ribot, Jose? L.

2002-01-01

362

In Vivo Efficacy of Anidulafungin and Caspofungin against Candida glabrata and Association with In Vitro Potency in the Presence of Sera?  

Digital Repository Infrastructure Vision for European Research (DRIVER)

In vitro studies have demonstrated that anidulafungin has greater potency than caspofungin against Candida glabrata. However, data from in vivo studies demonstrating that it has superior efficacy are lacking. The objective of this study was to compare the activities of anidulafungin and caspofungin against C. glabrata in a murine model of disseminated candidiasis. Two clinical C. glabrata isolates were used, including one with reduced caspofungin susceptibility. MICs were determined by broth ...

Wiederhold, Nathan P.; Najvar, Laura K.; Bocanegra, Rosie; Molina, Destiny; Olivo, Marcos; Graybill, John R.

2007-01-01

363

Susceptibility testing of Candida albicans isolated from oropharyngeal mucosa of HIV+ patients to fluconazole, amphotericin B and Caspofungin: killing kinetics of caspofungin and amphotericin B against fluconazole resistant and susceptible isolates Teste de suscetibilidade de Candida albicans isoladas da mucosa orofaringeana de pacientes HIV+, ao fluconazol, anfotericcina B e caspofungina: cinética de morte de caspofungina e anfotericina B contra isolados fluconazol resistentes e suscetíveis  

Digital Repository Infrastructure Vision for European Research (DRIVER)

A clear understanding of the pharmacodynamic properties of antifungal agents is important for the adequate treatment of fungal infections like candidiasis. For certain antifungal agents, the determination of Minimal Fungicidal Concentration (MFC) and time kill curve could be clinically more relevant than the determination of the Minimal Inhibitory Concentration (MIC). In this study, MIC and MFC to fluconazole, amphotericin B and caspofungin against C. albicans isolates and the killing pattern...

Janine de Aquino Lemos; Carolina Rodrigues Costa; Crystiane Rodrigues de Araújo; Souza, Lu?cia Kioko Hasimoto E.; Maria do Rosário Rodrigues Silva

2009-01-01

364

Genital tract infections among HIV-infected pregnant women in Malawi, Tanzania and Zambia  

Digital Repository Infrastructure Vision for European Research (DRIVER)

The aim of this study was to compare the prevalence and factors associated with genital tract infections among HIV-infected pregnant women from African sites. Participants were recruited from Blantyre and Lilongwe, Malawi; Dar es Salaam, Tanzania; and Lusaka, Zambia. Genital tract infections were assessed at baseline. Of 2627 eligible women enrolled, 2292 were HIV-infected. Of these, 47.8% had bacterial vaginosis (BV), 22.4% had vaginal candidiasis, 18.8% had trichomoniasis, 8.5% had genital ...

Aboud, S.; Msamanga, G.; Read, J. S.; Mwatha, A.; Chen, Y. Q.; Potter, D.; Valentine, M.; Sharma, U.; Hoffmann, I.; Taha, T. E.; Goldenberg, R. L.; Fawzi, W. W.

2008-01-01