Zusammenfassung. Bei 14 Sporotrichose‐Patienten (sieben Kinder und sieben Erwachsene) wurden Taschenwärmer, Infrarot‐und langwellige Infrarotstrahlung zur Behandlung eingesetzt. Neun Sporotrichose‐Läsionen gehörten zum Typ der fixierten Hautverletzung, fünf waren Lymphgewebsverletzungen; sechs waren im Gesicht und acht auf den Extremitäten lokalisiert. Vier Patienten wurden mit Taschenwärmern behandelt, fünf mit Infrarotstrahlung und weitere fünf mit Langwellen‐Infrarotstrahlung. Die mit Taschenwärmern behandelten Läsionen waren Gesichtsverletzungen bei Kindern. Infrarot‐und Langwellen‐Infrarotstrahlung wurde bei drei Kindern und sieben Erwachsenen eingesetzt. Dabei handelt es sich um zwei Gesichtsverletzungen und zwei Lasionen an den Extremitäten. Bei den Infrarotbehandlungen war die applizierte Wärmemenge groUßer als bei Taschenwärmern; eine tägliche Behandlung von 15 min war ausreichend zur Erzielung zufriedenstellender Resultate. Die Anwendung der Infrarotstrahlung ist jedoch bei Kindern und im Gesicht schwierig, und zwei bis drei Behandlungen von je 40 min/Woche führte nicht zu zufriedenstellenden Resultaten. Im Vergleich zur Taschenwärmer‐Behandlung konnte bei den Infrarotbehandlungen die Behandlungszeit um drei Viertel verkürzt werden. Summary. We used pocket warmers and infrared and far infrared rays to treat 14 cases of sporotrichosis, 7 in children and 7 in adults. There were 9 cases of the fixed cutaneous type and 5 of the lymphocutaneous type; 6 were located on the face and 8 on the limbs. Four cases were treated with pocket warmers, 5 with infrared rays, and 5 with far infrared rays. All lesions treated with pocket warmers were facial lesions in children; infrared and far infrared ray treatments were used in 3 children and 7 adults, 2 on facial lesions and 8 on lesions on the extremities. In treatments with infrared and far infrared rays, the amount of heat was greater than with the pocket warmers, and one 15‐min treatment daily was sufficient to yield satisfactory results, but this method is difficult to use on children and on the face, and 40‐min treatments two or three times a week proved unsatisfactory. Infrared and far infrared ray treatments allow the length of a single treatment to be reduced by three‐quarters, in comparison with one pocket warmer treatment.
Summary. Eighteen adult white male patients with cutaneous sporotrichosis were treated with itraconazole following different daily dose schemes. Cure was obtained in all cases after periods of 15–75 days (median 44 days) with total doses between 3.1 and 14.8 g (median 8.4 g). No serious side effects were observed and no relapses occurred in the follow‐up period of between 1 and 26 months (median 14.7). These results show that itraconazole represents a safe and effective drug for the treatment of sporotrichosis. Comparison with other studies leads us to consider a daily dose of 200 mg as the most appropriate. A concomitant warming of the affected limbs should be recommended. Zusammenfassung. Achtzehn männliche Erwachsene weißer Hautfarbe mit kutaner Sporotrichose wurden nach unterschiedlichen Dosierungsschemata mit Itraconazol behandelt. Eine Heilung wurde in allen Fällen nach einer Behandlungsdauer zwischen 15 und 75 d (Mittel 44 d) mit Gesamtdosen von 3.1 bis 14.8 g (Mittel 8.4 g) erzielt. Bedeutsame Nebenwirkungen wurden nicht beobachtet. In der Nachbeobachtungszeit, die mit einem Mittel von 14.7 Monaten zwischen einem und 26 Monaten lag, traten keine Rück‐fälle auf. Die Ergebnisse belegen, daß Itraconazol ein sicher wirksames Medikament für die Behandlung der Sporotrichose darstellt. Unter Einbeziehung der Ergebnisse anderer Studien erscheint uns eine tägliche Itraconazol‐Dosis von 200 mg als am günstigsten. Eine gleichzeitige Erwärmung der befallenen Gliedmaßen wird empfohlen.
The first three human cases of rickettsiosis caused by Rickettsia conorii in Montevideo, Uruguay were described in 1990. All of them showed an initial papulosquamous lesion on the scalp from a canine tick bite (Amblyomma triste). At the same time, fever and regional adenopathies were observed. Serological diagnosis was made by the indirect IgM immunofluorescent technique on glass smears of R. conorii (Biomerieux Laboratories, France). All patients had a benign disease course after been treated with oral tetracyclines. Other authors later developed clinical and serological studies for R. conorii rickettsiosis in a nearby county, confirming our original findings. The tache noir and a light exanthema were also noticed. We have seen several similar cases since that date. Most of them were from rural areas, and two presented with the classical tache noir and a maculopapular rash with severe symptomatology. A. triste, a South American tick with deep anthropophilia, appears as the usual transmitting vector of the disease in the country. A review of the literature reveals a very intriguing absence of similar cases in the Americas including the USA. New studies are necessary to resolve this issue. The possibility that a new species of rickettsia responsible for the disease in Uruguay is also considered.
A case of mycotic bovine nasal granuloma in a 10 year-old Jersey cow, produced by Drechslera halodes is presented. Histopathological sections showed abundant hyaline and pigmented extra and intracellular fungal structures together with a polymorphic cellular granuloma formed by neutrophils, lymphocytes, plasmocytes, histiocytes and giant cells of the Langhans type. It is the first case of mycotic bovine nasal granuloma recognized in Uruguay although this disease seems to be frequent according to the opinion of veterinarian specialists. Another similar clinical case also in a Jersey cow from the same dairy house with an intense cellular infiltrate rich in eosinophils without granulomatous image, together with extracellular hyaline and fuliginous fungal forms, is also referred for comparative purposes. Geotrichum sp. was isolated. The need of an early diagnosis and treatment of the disease is stressed.
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