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1.
Rev. Nac. (Itauguá) ; 16(3): 221-228, sep-dec 2024.
Article in Spanish | LILACS-Express | LILACS | ID: biblio-1572651

ABSTRACT

RESUMEN La paracoccidioidomicosis es una micosis profunda sistémica, endémica en algunos países de Latinoamérica, de presentación clínica es de evolución aguda/subaguda, en nuestro país es el principal diagnóstico diferencial de la tuberculosis pulmonar. Se describe el caso clínico de un hombre de 48 años, procedente de zona rural, inmunocompetente, que se presentó clínicamente por dificultad respiratoria, pérdida de peso de forma progresiva y lesiones en mucosas oral; como hallazgos radiológicos presentó infiltrados reticulares bilaterales. Desde el punto de vista micológico se evidenció la presencia del microorganismo en diversas muestras biológicas: biopsias de lesiones orofaríngeas y estudio micológico del esputo. Se realizó tratamiento dirigido con antimicótico intravenoso presentando buena respuesta al mismo con mejoría clínica.


ABSTRACT Paracoccidioidomycosis is a deep systemic mycosis, endemic in some Latin American countries, with an acute/subacute clinical presentation. In our country, it is the main differential diagnosis of pulmonary tuberculosis. We describe the clinical case of a 48-year-old man from a rural area, immunocompetent, who presented clinically with respiratory distress, progressive weight loss and lesions in the oral mucosa; as radiological findings, he presented bilateral reticular infiltrates. From a mycological point of view, the presence of the microorganism was evidenced in various biological samples: biopsies of oropharyngeal lesions and mycological study of sputum. Targeted treatment with intravenous antifungals was performed, presenting a good response to it with clinical improvement.

2.
Acta méd. costarric ; 65(2): 77-84, abr.-jun. 2023. tab
Article in Spanish | LILACS, SaludCR | ID: biblio-1556682

ABSTRACT

Resumen Objetivo. Analizar la susceptibilidad in vitro de aislamientos de Candida spp. provenientes de onicomicosis obtenidos entre 2016 y 2019, para contribuir con el conocimiento sobre la necesidad o no de realizar pruebas de susceptibilidad a los microorganismos aislados antes de prescribir el tratamiento. Métodos. El estudio consistió en identificar 23 aislamientos de Candida spp. utilizando el sistema automatizado Vitek2® (bioMérieux, Francia). Se determinó la susceptibilidad in vitro de estos aislamientos ante dos antifúngicos tópicos (amorolfina y ciclopirox) y dos antifúngicos sistémicos (fluconazol e itraconazol) por el método de microdilución en caldo M27-A3 del Instituto Estándares para el Laboratorio Clínico (CLSI por sus siglas en inglés) de los Estados Unidos de América. Resultados. La mayoría de los aislamientos correspondieron a Candida parapsilosis (34,8 %), seguido por C. albicans (30,3 %), C. guilliermondii (17,4 %), C. tropicalis (8,7 %), C. dubliniensis (4,4 %) y C. krusei (4,4 %). No se encontraron diferencias estadísticamente significativas entre las CIMs de los diferentes antifúngicos y en promedio hubo susceptibilidad para todos los antifúngicos analizados. Sin embargo, para fluconazol se encontró un aislamiento con CIM alta de C. guilliermondii y un aislamiento resistente de C. parapsilosis. Conclusiones. Las directrices internacionales recomiendan pruebas de susceptibilidad para Candida spp. de hemocultivos o tejidos tras infecciones sistémicas. En todas las demás candidiasis se identifica la especie y se revisan sus patrones de susceptibilidad en la literatura. Por lo tanto, es de importancia conocer que aislamientos de onicomicosis de Candida no-albicans, especialmente de C. guilliermondii y C. parapsilosis, presentan una susceptibilidad disminuida a ciertos antifúngicos que se utilizan como tratamiento, por lo que se recomienda realizar pruebas de susceptibilidad en caso de no tener una buena respuesta al tratamiento en casos de onicomicosis por estas levaduras.


Abstract Aim. The purpose of this investigation was to determine the in vitro susceptibility patterns of Candida spp. isolated from onychomycosis, in order to contribute with strategies for optimal clinical laboratory management of patients with onychomycosis infected with these yeasts. Methods . A total of 23 isolates of Candida spp. were identified with the automatized system Vitek®2 (system bioMérieux, France). In vitro susceptibility patterns were evaluated with two topic antifungals (amorolfine and ciclopirox) and two systemic antifungals (fluconazole and itraconazole) using the Clinical Laboratory and Standards Institute (CLSI) broth microdilution M27-A3 guidelines. Results . Most of the isolates were identified as Candida parapsilosis (34,8 %), followed by C. albicans (30,3 %), C. guilliermondii (17,4 %), C. tropicalis (8,7 %), C. dubliniensis (4,4 %) and C. krusei (4,4 %). There were no statistically significant differences among the MICs of the antifungals tested. However, there was one isolate of C. guilliermondii with high MIC for fluconazole and one fluconazole resistant isolate of C. parapsilosis. Conclusions. Susceptibility tests are only recommended internationally for Candida spp. isolated from blood stream or tissue in systemic infections. In every other candidiasis there is only a species identification, while its susceptibility pattern for treatment is reviewed in literature. Therefore, it is important to report that Candida no-albicans isolates from onychomycosis, especially C. guilliermondii and C. parapsilosis, have a reduced susceptibility to some antifungals commonly used for treatment. According to the obtained in vitro results, we recommend performing antifungal susceptibility testing in those cases of onychomycosis caused by Candida spp. no responsive to treatment.


Subject(s)
Candida/drug effects , Antifungal Agents/analysis , In Vitro Techniques
3.
Indian J Pathol Microbiol ; 2023 Mar; 66(1): 196-198
Article | IMSEAR | ID: sea-223419

ABSTRACT

Systemic mycosis raging endemic, histoplasmosis has an increasing incidence with the advent of HIV-AIDS. The authors report a case of vertebra-medullar histoplasmosis mimicking tuberculous spondylodiscitis in a patient without proven immunosuppression. This was a patient who spent 3 years in a highly endemic area. He presented with signs of transverse myelitis. MRI of the lumbar spine showed a para-vertebral tumor lesion that partially infiltrated the spinal cord. The positive diagnosis of histoplasmosis was made by histomorphology, and symptoms were reduced with administration of itraconazole. These findings show the need for a proper coding of the management of patients living or having stayed in histoplasmosis endemic areas, whether they are immunocompromised or not.

4.
Article | IMSEAR | ID: sea-223167

ABSTRACT

Background: Onychomycosis accounts for 20–40% of all nail disorders. It is difficult to cure with resistance to anti-fungal drugs, their side effects and drug interactions limiting treatment options. Itraconazole is a widely accepted oral medication used for onychomycosis while fractional CO2 laser along with a topical anti-fungal has shown promising results for nail plate clearance in onychomycosis. Aim: To compare the efficacy of fractional CO2 laser with 1% terbinafine cream versus itraconazole in the management of onychomycosis. Methods: A prospective, randomised, single-centre, two-arm, parallel-group interventional study was conducted at Command Hospital Air Force, Bangalore. Onychomycosis cases confirmed by KOH mount/culture-positive were included. Patients were randomly divided into two groups. Group A received 4 sessions of fractional CO2 laser every fourth week with twice-daily application of 1% terbinafine cream; Group B received one-week pulse therapy with capsule itraconazole once every four-week for three pulses. The response was assessed by Onychomycosis Severity Index, a validated onychomycosis assessment scale, at baseline and at six months. Results: Group A had 50 patients with a total of 98 nails. Clinical improvement was seen in 83/98 (84.7%) nails. The average reduction in Onychomycosis Severity Index was 8.65 (P < 0.05). Group B had 50 patients with a total of 136 nails. Clinical improvement was seen in 104/136 (76.5%) nails. The average reduction in Onychomycosis Severity Index was 7.37 (P < 0.05). Both groups showed statistically significant improvement measured by ‘Reduction in Onychomycosis Severity Index’ at six months; however, there was no significant difference between the two arms. Limitations: The main limitations of the study are the small sample size and lack of long-term follow-up to assess recurrence of infection. Conclusion: Fractional CO2 laser with 1% terbinafine cream is an effective and safe method for inducing nail clearance in onychomycosis and has efficacy similar to itraconazole pulse therapy.

5.
Chinese Journal of Dermatology ; (12): 438-440, 2023.
Article in Chinese | WPRIM | ID: wpr-994496

ABSTRACT

Objective:To compare the efficacy and safety of oral terbinafine versus itraconazole in the treatment of pediatric tinea capitis.Methods:From January 2021 to December 2021, a randomized clinical trial was conducted among 53 children with tinea capitis in Beijing Children′s Hospital. These patients were randomly divided into 2 groups by using a random number table: terbinafine group treated with oral terbinafine at different doses (weight <20 kg, dose: 62.5 mg/d; weight 20 - 40 kg, dose: 125 mg/d; weight >40 kg, dose: 250 mg/d), while itraconazole group treated with oral itraconazole at doses of 3 - 5 mg·kg -1·d -1. Statistical analysis was performed using the SPSS 23.0 software, and enumeration data were compared between groups by using chi-square test or Fisher′s exact test. Results:Totally, 27 patients were treated with oral terbinafine, including 17 with tinea alba and 10 with kerion; 26 were treated with oral itraconazole, including 17 with tinea alba and 9 with kerion. After treatment, 14 (51.85%) patients were cured in the terbinafine group, including 5 with tinea alba and 9 with kerion, while 25 (96.15%) were cured in the itraconazole group, including 16 with tinea alba and 9 with kerion. The response rate was significantly higher in the itraconazole group than in the terbinafine group ( χ2 = 13.37, P < 0.001) . Conclusion:The efficacy of itraconazole was superior to that of terbinafine in the treatment of pediatric tinea alba, but their efficacy was equivalent in the treatment of pediatric kerion.

6.
Chinese Journal of Dermatology ; (12): 415-420, 2023.
Article in Chinese | WPRIM | ID: wpr-994499

ABSTRACT

To report the first case of chronic disseminated paracoccidioidomycosis in China. A 49-year-old male patient presented with papules and nodules of the skin for 1 year, and papules and ulcers on the oral mucosa for 2 months. Skin examination showed the edema of the left foot, multiple crusting ulcers on the sole of the left foot, ulcers with a granular base in the interdigital regions between the third and fourth toes as well as fourth and fifth toes of the left foot, accompanied by punctate hemorrhage and exudation; there were multiple papules, nodules, and plaques on the dorsum and medial side of the left foot and the left knee, with ulcers and crusts in the center; 2 papules were observed on the left wrist, and 1 papule on the left upper lip with a crusted surface; red plaques with ulcers and punctate hemorrhage were observed on the gingival mucosa, buccal mucosa, labial mucosa, and palate, and the lesions mainly occurred on the left side. Ultrasonography of superficial lymph nodes showed bilateral cervical and supraclavicular lymph node enlargement, which was more obvious on the left side. Computed tomography of the chest and abdomen showed diffuse miliary nodular shadows, and cordlike, cloudy flocculent and nodular high-density shadows in both lungs, as well as obvious thickening of the left adrenal gland in the abdomen. Yeast cells were observed by immunofluorescent staining of biopsy tissues from the oral mucosa and left lower limb. Histopathological examination of biopsy tissues from the oral mucosa and left lower limb showed granulomatous inflammation, and refractive double-membrane yeast cells could be observed inside or outside the multinucleated giant cells, without or with a single bud or multiple buds; periodic acid-Schiff staining and hexamine silver staining of the above biopsy tissues were positive. Fungal culture of the left lower limb lesion in Sabouraud dextrose agar medium at 25℃ and 37℃ both yielded fungal hyphae. Metagenomics sequencing of the oral mucosal tissue and alveolar lavage fluid indicated the infection with Paracoccidioides brasiliensis. The diagnosis of chronic disseminated paracoccidioidomycosis was confirmed. After 1-month oral treatment with itraconazole capsules at a dose of 400 mg/d, the lesions on the skin and oral mucosa markedly improved, and computed tomography imaging of the lung and left adrenal gland also showed obvious improvement. The dose of itraconazole was reduced to 200 mg/d after 3 months. The patient′s condition further improved during a 10-month follow-up.

7.
Article in English | WPRIM | ID: wpr-997709

ABSTRACT

@#Sporotrichosis is a fungal infection caused by Sporothrix, a thermally dimorphic fungus that affects humans and animals. It is most commonly associated with cutaneous and subcutaneous tissue exposed to fungus-containing soil, moss, or organic material. Sporotrichosis is challenging to diagnose because it can mimic various other dermatological diseases. Thus, as demonstrated in this case, the importance of making a diagnosis based on history and a thorough physical examination, as misdiagnosis can delay proper treatment. A 53-year-old Malay woman presented with bilateral thumb swelling that had been treated with two courses of antibiotics but had failed, resulting in disease progression. Clinical suspicion of lymphocutaneous sporotrichosis was made based on history, physical examination, and investigations finding. The patient was started on an empirical course of Itraconazole 200mg twice daily, and the lesions responded well.

8.
Article in Chinese | WPRIM | ID: wpr-990894

ABSTRACT

Objective:To prepare water-soluble graphene-based itraconazole antifungal eye drops and evaluate its antifungal activity against Fusarium solani. Methods:By oxidative modification of graphene and modification of polymer materials, water-soluble graphene oxide-modified polyethylene glycol (GO-PEG) composites were prepared.The composites were characterized by scanning electron microscopy, zeta potential, and Raman spectroscopy.The antifungal drug itraconazole was loaded onto the GO-PEG vector by solvent evaporation method, and itraconazole eye drops were obtained.The drug loading of itraconazole eye drops was measured using a UV and visible spectrophotometer.The antifungal effect in vitro was assessed by the microdilution method and light microscopy. Results:Scanning electron microscopy showed that GO-PEG had a two-dimensional nanosheet structure and many wrinkles.The zeta potential of GO-PEG was -42.40 mV.Raman spectroscopy showed that the ID/ IG of GO-PEG was 1.003.Using the water-soluble GO-PEG vector, a maximum itraconazole concentration of 10 mg/ml was achieved with a 10 000-fold increase in apparent solubility (10 mg/ml vs 0.001 mg/ml). The antifungal results showed that the minimum inhibitory concentration of itraconazole eye drops against Fusarium solani was approximately 1.88 μg/ml, but the GO-PEG vector has no significant antifungal activity against Fusarium solani. Conclusions:GO-PEG achieves effective loading and solubilization of itraconazole, demonstrating an in vitro inhibitory effect on Fusarium solani.

9.
Arq. bras. oftalmol ; Arq. bras. oftalmol;86(6): e20230062, 2023. graf
Article in English | LILACS-Express | LILACS | ID: biblio-1520206

ABSTRACT

ABSTRACT Ocular sporotrichosis involving adnexa can present in 4 types: granulomatous conjunctivitis, dacryocystitis, Parinaud oculoglandular syndrome, and bulbar conjunctivitis. The incidence of ocular sporotrichosis has increased in regions with high incidence rates of sporotrichosis. We present a series of three cases of ocular involvement by the fungus Sporothrix species, including its manifestations, approaches, and relevance in areas where sporotrichosis has considerable incidence rates.


RESUMO A esporotricose ocular envolvendo anexos pode se apresentar de quatro formas: conjuntivite granulomatosa, dacriocistite, Síndrome Oculoglandular de Parinaud e conjuntivite bulbar. A esporotricose ocular, apesar de incomum, tem aumentado em regiões com alta incidência de esporotricose. Apresentamos uma série de três casos de envolvimento ocular pelo fungo Sporothrix sp.: suas manifestações, abordagem e sua relevância em áreas com alta incidência de esporotricose.

10.
Surg. cosmet. dermatol. (Impr.) ; 15: e20220154, 2023.
Article in Portuguese | LILACS-Express | LILACS | ID: biblio-1438476

ABSTRACT

Cromoblastomicose é uma infecção granulomatosa crônica causada por fungos dematiáceos, com apresentações clínicas variadas, que podem representar um desafio terapêutico. Neste relato, apresentamos um caso de cromoblastomicose em forma localizada, de longa evolução, em paciente idoso, resistente a terapêuticas medicamentosas prévias, tratado com sucesso pela associação entre um método físico e tratamento farmacológico sistêmico, o que permitiu o uso de dose reduzida do medicamento.


Chromoblastomycosis is a chronic granulomatous infection caused by dematiaceous fungi with varied clinical presentations, which may represent a therapeutic challenge. In this report, we present a case of chromoblastomycosis in a localized form, with a long evolution, in an elderly patient, resistant to previous drug therapies, successfully treated by the association of a physical method with systemic pharmacological treatment, which allowed the use of a reduced dose of the drug

11.
Zhonghua fu chan ke za zhi ; Zhonghua fu chan ke za zhi;(12): 601-607, 2022.
Article in Chinese | WPRIM | ID: wpr-956683

ABSTRACT

Objective:To test the antibiotic susceptibility of vulvovaginal candidiasis pathogenic strains to 5 antifungal drugs commonly used in clinic.Methods:A total of 1 200 vulvovaginal candida patients from 23 gynecological and family planning outpatient departments in China were enrolled. Their vaginal secretions were collected for candida strain isolation and species identification. According to Clinical and Laboratory Standards Institute (CLSI) M27-S3, the sensitivity of 1 200 strains to clotrimazole, fluconazole, miconazole, itraconazole and nystatin was tested.Results:(1) The sensitivity and resistance of 1 200 vulvovaginal candidiasis pathogens to 5 antifungal drugs were statistically different ( χ2=3 513.201, P<0.01). (2) All strains had higher sensitivity to nystatin [99.92% (1 199/1 200)], followed by miconazole [92.25% (1 107/1 200)] and clotrimazole [87.17% (1 046/1 200)]. All strains had higher resistance to fluconazole [69.17% (830/1 200)], while itraconazole was 50.83% (610/1 200). (3) There was no significant difference between candida albicans and non-candida albicans in drug sensitivity to nystatin ( P=0.315) and miconazole ( P=0.425). (4) Candida albicans and non-candida albicans showed different sensitivity to clotrimazole, fluconazole and itraconazole, respectively. Compared with non-candida albicans, candida albicans showed higher sensitivity to clotrimazole [susceptibility rate: 73.01% (165/226) vs 90.45% (881/974); P<0.001] and higher resistance to fluconazole [resistance rate: 50.88% (115/226) vs 73.41% (715/974); P<0.001]. Although the drug sensitivity of itraconazole was not high, the susceptibility rate of candida albicans to itraconazole was slightly higher than that of non-candida albicans [37.68% (367/974) vs 23.89% (54/226)], and the drug resistance rate was lower [49.28% (480/974) vs 57.52% (130/226)]. Conclusions:The sensitivity of 1 200 strains of candida to 5 antifungal drugs is significantly different, the sensitivity rate of nystatin, miconazole and clotrimazole are higher, but the resistance rate of fluconazole and itraconazole are higher. The sensitivity of candida albicans and non-candida albicans to the same drug is also significantly different. It is suggested that in clinical diagnosis and treatment, we should pay attention to the identification of candida and drug sensitivity test, so as to select antifungal drugs rationally.

12.
Mem. Inst. Oswaldo Cruz ; 117: e220089, 2022. tab, graf
Article in English | LILACS-Express | LILACS | ID: biblio-1406000

ABSTRACT

BACKGROUND Black fungi of the Herpotrichiellaceae family are agents of chromoblastomycosis and phaeohyphomycosis. There are few therapeutic options for these infections and it is common to associate antifungal drugs in their treatment. OBJECTIVES To investigate the Medicines for Malaria Venture (MMV) Pathogen Box® for possible compounds presenting synergism with antifungal drugs used to treat black fungal infections. METHODS An initial screening of the Pathogen Box® compounds was performed in combination with itraconazole or terbinafine at sub-inhibitory concentrations against Fonsecaea pedrosoi. Hits were further tested against eight Herpotrichiellaceae using the checkerboard method. FINDINGS No synergism was observed with terbinafine. MMV687273 (SQ109) and MMV688415 showed synergism with itraconazole against F. pedrosoi. Synergism of these compounds was confirmed with some black fungi by the checkerboard method. SQ109 and itraconazole presented synergism for Exophiala dermatitidis, F. pedrosoi, F. monophora and F. nubica, with fungicidal activity for F. pedrosoi and F. monophora. MMV688415 presented synergism with itraconazole only for F. pedrosoi, with fungicidal activity. The synergic compounds had high selectivity index values when combined with itraconazole. MAIN CONCLUSIONS These compounds in combination, particularly SQ109, are promising candidates to treat Fonsecaea spp. and E. dermatitidis infections, which account for most cases of chromoblastomycosis and phaeohyphomycosis.

13.
Braz. J. Pharm. Sci. (Online) ; 58: e20152, 2022. tab, graf
Article in English | LILACS | ID: biblio-1403756

ABSTRACT

Abstract Sporothrix spp. are the major dimorphic fungus associated with a type of subcutaneous mycosis, sporotrichosis. The limitation of antifungal availability and the past reports of in vitro resistance of Sporothrix spp. clinical isolates makes it important to search for new compounds with antifungal activities. In this study, we therefore evaluate the in vitro activities of complexes coordinated with Co(II) and cobalt chloride hexahydrate against clinical isolates of Sporothrix spp. Broth microdilution test was performed as per M38-A2 from CLSI (2008) in duplicate for 31 clinical isolates of Sporothrix spp. (27 S. brasiliensis e 04 S. schenckii stricto sensu). The antifungal activities of the complexes coordinated with Co(II) and cobalt chloride hexahydrate were detected at a concentration range of 32-128 µg/mL for all isolates. None of the compounds demonstrated any cytotoxicity (to macrophage cells) at the concentration of 200 µg/mL. The activity against Sporothrix spp. recorded in this study instigate the continuity of experimental studies with Co(II) to search for the mechanisms of antifungal action as well as to evaluate its interaction with the commercial antifungal drugs.


Subject(s)
In Vitro Techniques/instrumentation , Macrophages/classification , Sporotrichosis/drug therapy , Sporothrix/classification , Pharmaceutical Preparations/administration & dosage , Chlorides/agonists , Fungi
14.
Acta méd. costarric ; 63(1)mar. 2021.
Article in Spanish | LILACS, SaludCR | ID: biblio-1383354

ABSTRACT

Resumen Objetivo: Analizar la susceptibilidad de N. dimidiatum ante el efecto combinado de itraconazol y terbinafina. Métodos: Se determinó la concentración mínima inhibitoria y la concentración inhibitoria fraccionada in vitro, mediante el método del tablero de ajedrez, a 15 aislamientos clínicos provenientes de onicomicosis de diferentes pacientes, todos positivos por N. dimidiatum. Se prepararon ensayos por duplicado con diluciones combinadas de los antifúngicos y se evaluó el efecto de ambos fármacos. Resultados: La concentración mínima inhibitoria promedio de solo itraconazol aplicado a los aislamientos fue de 30,83 μg/mL y de 4,49 μg/mL combinado con terbinafina. La concentración mínima inhibitoria promedio de solo terbinafina fue de 0,33 μg/mL y de 0,07 μg/mL combinada con itraconazol. Hay diferencias estadísticamente significativas entre las concentraciones mínimas inhibitorias promedio de los antifúngicos analizados en solitario respecto de las concentraciones mínimas inhibitorias combinadas; para itraconazol (t = 2,958; gl = 14; p = 0,01) y (t = 4,721; gl = 14; p < 0,001) para terbinafina. El uso combinado evidenció 40 % de sinergismo. Conclusiones: La combinación itraconazol-terbinafina presentó un efecto sinérgico total para inhibir el crecimiento de N. dimidiatum; esto ofrece una alternativa terapéutica en el tratamiento de las onicomicosis.


Abstract Aim: Study the combined susceptibility patterns of Neoscytalidium dimidiatum to the effect of Itraconazole and Terbinafine. Background: The Minimum Inhibitory Concentration and Fractional Inhibitory Concentration were determined in vitro by the chessboard method for 15 clinical isolates of onychomycosis, from different patients, all positives for N. dimidiatum. Duplicated trials were prepared with combined dilutions of antifungals and the effect of both drugs was evaluated. Results: The average Minimum Inhibitory Concentration of Itraconazole when applied alone for the isolates was 30.83 μg/mL and 4.49 μg/mL when combined with Terbinafine. The average Minimum Inhibitory Concentration of Terbinafine alone was 0.33 μg/mL and 0.07 μg/mL when combined with Itraconazole. Statistically significant differences were found between the average Minimum Inhibitory Concentrations of the antifungals analyzed alone versus the Minimum Inhibitory Concentrations obtained by mixing both compounds. That is for Itraconazole (t = 2,958; gl = 14; p = 0,01) and (t = 4,721; gl = 14; p <0,001) for Terbinafine. Combined use showed 40 % synergism. Conclusions: The Itraconazole-Terbinafine combination had synergistic effect to inhibit the growth of N. dimidiatum, which offers a therapeutic alternative in the treatment of onychomycoses caused by this fungus.


Subject(s)
Onychomycosis/drug therapy , Itraconazole/therapeutic use , Terbinafine/therapeutic use , Costa Rica
15.
An. bras. dermatol ; An. bras. dermatol;96(2): 231-233, Mar.-Apr. 2021. graf
Article in English | LILACS | ID: biblio-1248728

ABSTRACT

Abstract Sporotrichosis is a subcutaneous mycosis caused by dimorphic fungi of the genus Sporothrix. The authors report a case of fixed cutaneous sporotrichosis with therapeutic failure after 18 months of itraconazole and terbinafine associated with cryosurgery. The patient was cured after the introduction of saturated potassium iodide solution. Sporothrix brasiliensis was the identified species, presenting a susceptibility profile to itraconazole and terbinafine. This fact suggests that therapeutic failure is probably related to the host-fungus interaction rather than drug resistance. It is possible that the immunomodulatory action of the saturated potassium iodide solution may have played an important role in curing this patient.


Subject(s)
Sporotrichosis/drug therapy , Sporothrix , Potassium Iodide/therapeutic use , Itraconazole , Antifungal Agents/therapeutic use
16.
Arq. bras. med. vet. zootec. (Online) ; 73(2): 431-437, Mar.-Apr. 2021. ilus
Article in English | LILACS, VETINDEX | ID: biblio-1248922

ABSTRACT

Tracheal fungal infections in horses are rare. This case report describes surgical and clinical management of a filly with a Curvularia sp. infection within the trachea and skin that caused severe intraluminal granulomas and cutaneous nodules, respectively. The patient was successfully treated with itraconazole and surgical excision.(AU)


Infecções fúngicas traqueais em equinos são raras. Este relato de caso descreve condutas clínicas e cirúrgicas em uma égua com infecção por Curvularia sp. na traqueia e na pele, causando granulomas intraluminais severos e nódulos cutâneos, respectivamente. O animal foi tratado com sucesso com itraconazol e exérese cirúrgica.(AU)


Subject(s)
Animals , Tracheitis/veterinary , Itraconazole/therapeutic use , Phaeohyphomycosis/veterinary , Curvularia , Granuloma/veterinary , Horses/surgery
17.
Einstein (São Paulo, Online) ; 19: eRC5488, 2021. tab, graf
Article in English | LILACS | ID: biblio-1249741

ABSTRACT

ABSTRACT Histoplasmosis is an infection caused by the dimorphic fungus Histoplasma capsulatum. The disease is endemic in several regions of tropical and temperate climate. The fungus presents opportunistic behavior, causing widespread infection in immunocompromised patients, resulting from complication of primary pulmonary infection, due to exogenous reinfection or reactivation of a quiescent source. In immunocompetent individuals, approximately 95% of pulmonary infections are asymptomatic. However, prolonged exposure to high amount spores may lead to acute or chronic lung infection. Due to the low amount of inoculum, primary cutaneous histoplasmosis caused by traumatic implantation is extremely rare and effectively treated with triazoles. Thus, the present study aims to report a case of primary cutaneous histoplasmosis that is difficult to treat in an immunocompetent patient, and to review the literature on the incidence of drug-resistant Histoplasma capsulatum strains in clinical practice.


RESUMO A histoplasmose é uma infecção causada pelo fungo dimórfico Histoplasma capsulatum. A doença é endêmica em diversas regiões de clima tropical e temperado. O fungo apresenta comportamento oportunístico, causando infecção disseminada em pacientes imunocomprometidos, resultante da complicação da infecção pulmonar primária, por reinfecção exógena ou reativação de um foco quiescente. Em indivíduos imunocompetentes, cerca de 95% das infecções pulmonares são assintomáticas. No entanto, a exposição prolongada à quantidade elevada de esporos pode levar à infecção pulmonar aguda ou crônica. Devido à baixa quantidade de inóculo, a histoplasmose cutânea primária causada por implantação traumática é extremamente rara e efetivamente tratada com triazóis. Assim, o presente estudo tem como objetivos relatar um caso de histoplasmose cutânea primária de difícil tratamento em paciente imunocompetente, e revisar a literatura a respeito da incidência de cepas de Histoplasma capsulatum resistentes aos fármacos utilizados na prática clínica.


Subject(s)
Humans , Histoplasmosis/drug therapy , Histoplasma
18.
Article | IMSEAR | ID: sea-209430

ABSTRACT

roduction: The recent prevalence of dermatophytosis in India ranges from 36.6 to 78.4%. Itraconazole is commonly usedsystemic antifungal to treat dermatophytosis.Objective: The objective of the present study was to evaluate the effectiveness and safety of itraconazole given 100 mg twicedaily for the treatment of dermatophytosis.Materials and Methods: The present retrospective questionnaire-based survey was done, wherein dermatologists and generalphysicians were given survey questionnaire. Data analysis up to 4 weeks of treatment with itraconazole was considered forthis study. Efficacy evaluation was considered as percentage of patients achieving clinical cure.Results: A total of 150 doctors completed the survey involving 1100 patients. Out of 1100 patients, 341 patients (31%)responded well to topical therapy alone and were considered as clinically cured as per medical records. In remaining patientswho did not respond well to topical monotherapy, itraconazole was found to be added in 652 patients as 100 mg twice daily for4 weeks. Of these, 456 patients (70%) responded well to therapy in 4 weeks and were considered as clinically cured. Amongthe topical antifungals coprescribed with itraconazole, luliconazole was most commonly prescribed (49%). On comparison ofclinical cure rates in patients who received topical antifungal monotherapy (31%) and itraconazole cotherapy (70%), it was foundthat itraconazole cotherapy was better and the difference between the two therapies was statistically significant (P = 0.001).Conclusion: From the findings of the present analysis, clinical cure rates obtained with itraconazole were more than satisfactory.Although the standard duration of therapy ranges from 1 to 2 weeks, long-term treatment is warranted and that is with topicalantifungals and other supportive measures.

19.
Article | IMSEAR | ID: sea-200580

ABSTRACT

Background: Fungal infections of the skin were the 4th most common skin disease in 2010 affecting 984 million people. An estimated 20-25% of the world抯 population has some form of fungal infection. Dermatophytes are fungi that cause superficial infections of the skin, commonly referred to as tinea infections.Methods: This was a prospective and an observational study conducted from February 2018 to January 2019 in Dermatology Department. Prescriptions included all newly diagnosed patients with cutaneous fungal infection of both sex who attended dermatology OPD. Factors considered were sociodemographic parameters, the disease encountered and number of patients in each group and number of patients who received antifungal therapy (oral and topical) etc.Results: 1000 prescriptions were analysed of patients between 18 to 65 years of age with cutaneous fungal infections. There were a greater number of males (57.4%) than females (42.6%). The average number of antifungal drugs prescribed per prescription was 2.33. Majority of the patients were prescribed itraconazole (82.30%) followed by terbinafine (9.70%) and fluconazole (8.0%).Conclusions: The most common oral antifungal drug used was itraconazole. Ketoconazole and Terbinafine were the most commonly used topical agents respectively.

20.
An. bras. dermatol ; An. bras. dermatol;95(2): 241-243, Mar.-Apr. 2020. graf
Article in English | LILACS, ColecionaSUS | ID: biblio-1130855

ABSTRACT

Abstract Sporotrichosis is a deep mycosis of subacute or chronic evolution, caused by the dimorphic fungus of the genus Sporothrix. The treatment is carried out with antifungal orally or intravenously. Therapeutic success can be affected by several factors, such as altered gastrointestinal physiology by surgery. More and more patients are submitted to bariatric surgeries and the literature for the alterations of the absorption of medications in this context is very scarce. We intend to contribute to a better understanding with this case report of cutaneous-lymphatic sporotrichosis in a patient after bariatric surgery without response to itraconazole treatment, even at high doses.


Subject(s)
Humans , Female , Adult , Sporotrichosis/drug therapy , Itraconazole/therapeutic use , Bariatric Surgery/adverse effects , Antifungal Agents/therapeutic use , Sporotrichosis/pathology , Treatment Failure , Gastrointestinal Absorption
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