Focus on Fungal Infections: Introduction and Comprehensive Summary

Anaissie, Elias; Rinaldi, Michael C.; Sarosi, George A.

doi:10.1093/clinids/14.supplement_1.s1

Cited by 3 publications

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“…In recent years several antifungal agents have become available. These include liposomal amphotericin B and the triazoles, fluconazole and SCH 39304 [9–11]. While amphotericin B is active against the majority of fungal infections, the agent appears to have limited activity against T. cutaneum .…”

Section: Discussionmentioning

confidence: 99%

Case Reports. Isolation of two Trichosporon cutaneum strains from urine

Gökahmetoğlu¹,

Koç²,

Nas

2002

Mycoses

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Section: Discussionmentioning

confidence: 99%

Case Reports. Isolation of two Trichosporon cutaneum strains from urine

Gökahmetoğlu¹,

Koç²,

Nas

2002

Mycoses

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“…In recent years, several antifungal agents have become available. These include liposomal amphotericin B and the triazoles fluconazole and SCH 39304 (2,4,5). In the present work, we evaluated these antifungal agents and the role of combination antifungal chemotherapy in the treatment of disseminated murine trichosporonosis.…”

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confidence: 99%

Comparative efficacies of amphotericin B, triazoles, and combination of both as experimental therapy for murine trichosporonosis

Anaissie

Hachem

Karyotakis

et al. 1994

Antimicrob Agents Chemother

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We assessed the activities of amphotericin B deoxycholate, liposomal amphotericin B, fluconazole, and SCH 39304 against 10 strains of Trichosporon beigelii in mice with hematogenous infections. Cyclophosphamideimmunosuppressed CF1 male mice were challenged intravenously with a lethal inoculum of T. beigelii (5 x 106 conidia per mouse) and were assigned to different treatment groups or were left untreated. Amphotericin B deoxycholate (1 mg/kg of body weight and liposomal amphotericin B (1, 5, and 10 mg/kg) were given parenteraily once daily. Escalating doses (5, 10, and 20 mg/kg/day) of fluconazole and SCH 39304 were tested.We also compared the activity of amphotericin B deoxycholate plus fluconazole (1 and 10 mg/kg/day, respectively) with that of each agent alone. Fluconazole significantly prolonged the survival of mice infected with each of the 10 strains tested. Amphotericin B deoxycholate achieved various responses, improving the outcomes in mice infected with seven of the strains. Liposomal amphotericin B was not more effective than amphotericin B deoxycholate against the two strains tested. Both fluconazole and SCH 39304 reduced the kidney fungal counts in a dose-dependent pattern, with SCH 39304 being more active than fluconazole against one of the two strains tested. The activity of the combination of amphotericin B deoxycholate plus fluconazole appeared to be superior to that of either agent alone, especially in reducing the kidney fungal burden.Fluconazole is more active than amphotericin B deoxycholate against experimental murine trichosporonosis.Trichosporon beigelii is increasingly recognized as a fungal opportunistic pathogen. Infection with this pathogen is frequently disseminated and carries a high mortality rate, particularly in the setting of immunosuppression (3, 6-11, 13, 16-26, 28, 32). The treatment of choice for disseminated trichosporonosis remains to be established. While amphotericin B is active against a variety of fungal infections, the agent appears to have limited activity against T. beigelii (32). In recent years, several antifungal agents have become available. These include liposomal amphotericin B and the triazoles fluconazole and SCH 39304 (2,4,5). In the present work, we evaluated these antifungal agents and the role of combination antifungal chemotherapy in the treatment of disseminated murine trichosporonosis. We sought to determine whether triazoles were as efficacious as amphotericin B deoxycholate and whether liposomal amphotericin B was superior to amphotericin B deoxycholate. Additionally, we tried to determine whether a dose response to triazole therapy was present and whether the combination of a triazole with amphotericin B was associated with antagonism.MATERLIALS AND METHODS Animals. Outbred CF1 male mice (average weight, 25 g; Harlan Breeding Laboratories, Indianapolis, Ind.) were used. All mice were housed in standard boxes with corncob bedding and were given food and water ad libitum. Five mice were housed in each box.Organisms and culture conditions. Ten T. be...

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“…Mucormycosis is described in diabetics, hematological and other malignancies, organ transplantation, immunosuppression and steroid therapy, iron overload and desferrioxamine therapy, AIDS patients, intravenous drug abusers and malnutrition. 3 In COVID-19 patients, factors which facilitate the spores of mucorales to cause infection are many. Spores germinate to produce hyphae that invade the blood vessels and adjacent tissue, this blocks the blood flow to the tissues causing extensive infarction and necrosis.…”

Section: Discussionmentioning

confidence: 99%

Covid-19 associated mucormycosis

Radha

Afroz²,

Prasad³

et al. 2022

IJPO

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: Corona virus disease-2019 (COVID-19) is associated with various opportunistic, bacterial, and fungal infections. High risk groups include people with diabetes especially diabetic ketoacidosis, solid organ transplantation, long-term systemic corticosteroid use, and iron overload. Many cases of mucormycosis were reported worldwide. Mucormycosis is an invasive fungal infection with high morbidity and mortality. Early diagnosis and treatment with appropriate anti-fungals lead to improved outcomes. The aim of this study is to establish the factors associated with mucormycosis in a COVID-19 setting, like comorbidities and treatment protocols for treatment of COVID-19. The histological patterns and tissue reactions to mucormycosis also were studied. In patients with ongoing COVID-19 infection and in a post COVID-19 scenario, we studied the biopsy findings of mucormycosis in various sites like rhino-orbital, lung, gastric and trachea. Material for this study is from a tertiary care hospital in South India. Patient age ranged from 30 years to 74 years. Mean age of the patients was 51 years. Male to female ratio was 1:1.1. Tissue from sino- nasal mucosa, peri orbital tissue, exenterated eyeball, lung tissue and tissue from rare sites like gastric and tracheal mucosal lesions were also included in this study. Tissue was fixed in 10% buffered formalin. Routine Haematoxylin and Eosin(H&E) stains were done. Gomori’s Methenamine silver (GMS) stains were done on all cases. Tissue was submitted for fungal cultures in all the cases.Total of twenty-three cases were diagnosed as mucormycosis based on the morphology and special stains in this analysis. Histology revealed areas of infarction in all cases with neutrophilic infiltration. Granulomatous reaction was seen in seven cases and melanin pigment was seen in two cases. 100% of patients were diabetics. There was neutrophilia in 100% of cases. Lymphopenia was seen in 85.7%, C-Reactive Protein (CRP) was elevated in 100% of cases.Ferritin was done in 14 patients and D-dimer was done in 17 patients and in all patients, these were elevated. All patients were treated with steroids according to the treatment protocol for COVID-19, Remdesivir was given in 72.7% of cases and second immunomodulator drugs like Tocilizumab in four cases and Baricitinib in one case.Mucormycosis is an emerging problem with COVID-19. It is important to carefully monitor blood glucose levels and take into account underlying medical conditions of patients before initiation of steroid therapy. Early recognition of symptoms and early diagnosis has a better outcome in patients with mucormycosis associated with COVID-19 infection.

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Focus on Fungal Infections: Introduction and Comprehensive Summary

Cited by 3 publications

References 0 publications

Case Reports. Isolation of two Trichosporon cutaneum strains from urine

Case Reports. Isolation of two Trichosporon cutaneum strains from urine

Comparative efficacies of amphotericin B, triazoles, and combination of both as experimental therapy for murine trichosporonosis

Covid-19 associated mucormycosis

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