Lamisil versus clotrimazole in the treatment of vulvovaginal candidiasis

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 terbinafme [Lamisil] on Candida vaginitis versus clotrimazole. 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. 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. Our results show that vaginal cream, 1% Lamisil, could be suggested as a first-line treatment in vulvovaginal candidiasis

Occurrence of fungi in dialysis water system and dialysis solution in dialysis centers in Ahvaz, Iran

The aims of the present study were to examine the water and dialysate for determining the diversity, occurrence, and distribution of fungi in hemodialysis centers of Ahvaz Jundishapur University of Medical Sciences. One hundred and sixty eight water samples from dialysis machines, and dialysis solution were collected. The samples were cultured on Sabouraud's dextrose agar and incubated at room temperature. Our study demonstrated that various fungi were present in the water system in haemodialysis centers. Totally, eight genera of filamentous fungi and three genera of yeasts and yeast-likes were identified. The most common filamentous fungi were Fusarium, Peniditium and Aspergittlus, whereas, Candida tropicalis was the most frequently isolated yeast. The water supply for hemodialysis units could be contaminated with several fungal species that occur during piping into kidney machine. In addition, contamination with fungi due to contact with plastic materials in kidney machine pipes is more considerable. For minimizing the exposure of patients suffering from chronic renal insufficiency to contaminated water sources, water distribution systems should also be monitored for mycological contamination. In addition dialysate solutions should also be kept for preventing fungal contaminations

[Molecular detection of phospholipase B3 as an effective factor in virulence of Aspergillus fumigatus]

Phospholipases are the major component of all eukaryotic bilayer cell membranes. and serve as a scaffold for membranes proteins. Phospholipases are a class of ubiquitous enzymes that have estrase activity and due to their ability to lyses of cell membrane can play an important role for pathogenicity of microrganisims. During this study using degenerate primers based on homologous amino acid sequences of some fungi phospholipase B [PLB], detection of Aspergillus fumigatus PLB3 was carried out. After DNA extraction of A. fumigatus, A. niger, Fusarium venonatum and Aurobasidium pullulans PCR reaction was carried out using degenerate primers. Predicted 2100 bp product from A. fumigatus was cloned in pGEMT-Easy vector and then transformed into E. coli Top 10 F' competent cell for extraction of cloned DNA fragment. Sequence analysis of 2100 bp fragments using BLASTX software were revealed a high homology to published PLB sequences from other fungi. Phylogenic tree analysis of PLB3 gene shows that PLB and potential PLB analogues like lysophospholipase are contained in a large cluster of the PLB family. A. fumigatus PLB gene is more closely related to A. oryzae, A. niger, Penicillium chrysogenum and Neurospora crassa than other fungi. Also, sequence availability of full length PLB3 gene represents a noteworthy breakthrough in the study of this opportunistic pathogen and function of PLB3 gene in pathogenesis of A. fumigates. Detection of PLB3 gene can be lead to preparing vaccine, blocker and laboratory marker for recognition of PLB3 gene products either in patient body or clinical samples

Conjunctival mycoflora in patients presenting to eye ward of Imam Khomeini hospital, Ahvaz

To investigate the incidence of fungal mycoflora of conjunctiva in patients attending teaching department of ophthalmology, Imam Khomeini Hospital, Ahvaz, Iran. One hundred and seventy two swabs were collected from the conjunctiva of patients attending to eye ward of the hospital during autumn 2007 to summer 2008. Swabs were cultured on Sabouraud's Dextrose Agar and incubated at ambient temperature for one week. Eleven patients were positive for saprophytic fungi. The most common saprophytic fungus was Cladopsporium [four cases]. Other filamentous fungi were Drechslera [one case], Alternaria [one case], Fusarium [one case] and Epicoccum [one case]. In addition, three isolates of yeasts include Cryptococcus, Candida albicans and Rhodotorula rubra were also isolated from patients. There was a remarkable presence of fungi in the conjunctiva of patients. The environmental conditions, the socioeconomic status and personal poor hygienic conditions, led to the high incidence of conjunctival fungus isolation [6.4%]. The incidence was much higher in males [72.7%] as [27.3%] in females

Clinical study of candida vaginitis in Ahvaz, Iran and susceptibility of agents to topical antifungal

To evaluate etiological agents of vaginal candidiasis in Ahvaz, Iran. In addition, susceptibility isolates were also considered against topical anti fungal agents. Cotton swabs were used for sampling from vaginal lesions and inoculated on CHRO Magar Candida. Cultured media were incubated at 37°C for 2-4 days aerobically. Colonies producing a green coloration were presumptively identified as Candida. albicans. C. glabrata produced pink colonies on CHRO Magar Candida. One hundred vaginal isolates of Candida were sub-cultured on SDA and incubated at 37°C. A suspension of isolates containing 1x106 - 5x106 cfu/ml was used for susceptibility tests. Clotrimazole, miconazole and nystatin disks were used for determine of susceptibility. Prevalence of Candida among the 300 women enrolled was found to be 49%. Recurrent and acute vaginal candidiasis were 48.3% and 51.7% respectively. C. albicans was the most common species among the isolates followed by C. glabrata, C. dubliniensis and Candida species. Antifungal susceptibility testing in our study revealed that none of the Candida isolates tested were resistant to tested antifungal. However, isolates were susceptible to clotrimazole followed by miconazole and nystatin. Candida vaginitis is more prevalent among women in Ahvaz and the most common agent is C. albicans. In addition our isolates were sensitive to clotrimazole followed by miconazole and nystatin

Tinea incognito due to epidermophyton floccosum

Tinea incognito is a cutaneous infection with atypical clinical characteristics. Disease is usually caused by administration of steroids. We describe a 25-year-old man who presented with local lesion in groin being treated with corticosteroid. Epidermophyton floccosum, an anthropophilic species, was identified by mycological examinations, direct and culture

Isolation of dermatophytes and related keratinophilic fungi from the two public parks in Ahvaz

Fungi found in soil and the variation and prevalence in each area depends on environmental and nutritional conditions. Considering the importance of soil in transmission of diseases, this study aims at assessing the frequency of dermatophytes and related keratinophilic fungi, potentially pathogenic fungi in various samples collected from two public parks in Ahvaz, SW Iran. Five hundred samples were collected from different parts of the Zoo and Laleh parks in Ahvaz. The fungal flora was analyzed in different samples for the presence of dermatophytes and keratinophilic fungi by hair baiting technique. Specimens were contained soil, carpet pad technique from the walls of the cages, and animals' residues. The samples were cultured on Sabouraud's dextrose agar, containing chloramphenicol and cyclohexamide, and incubated at 25-27°C for 4-5 weeks aerobically. Isolates were identified by colony morphology, slide cultures, and differentiation tests. Most of the isolated dermatophytcs were collected from the soil of the Zoo park. The most common keratinophilic fungus was Chrysosporium [5]. Other species were Trichophyton mentagrophytes [3], T. verrucosum [2], T. schoenleinii [1] and M. gypseum [1]. The results demonstrated that dermatophytes and related keratinophilic fungi of Ahvaz is somewhat different from that in other parts of Iran. This may be due to the different climatic conditions prevailing. Considering, the fact that most of the potential pathogenic fungi were isolated from the Zoo park, where there are wilds and domestic animals

Extensive tinea corporis due to Trichophyton rubrum on the trunk

In the present cases we describe two normal patients who developed extensive tinea corporis that was complicated by multiple subcutaneous papules and pustule caused by Trichophyton rubrum. This form of dermatophytosis has only rarely been described. Two 18 and 20-year-old men were examined for tinea corporis. Direct KOH preparations from skin scrapings showed septate branching mycelium and arthroconidia in both patients. T. rubrum was also identified in cultures

Isolation Of fungi from housefly [Musca Domestica] in Ahwaz, Iran

The objective of this study was isolation of fungi on external surface of houseflies collected from Ahwaz, Iran. The fungal spores of the external surface of 275 house-flies [Musca domestica] were collected from Ahwaz, Iran. The flies were captured and rinsed in a solution of 1% sodium hypochlorite for three minutes and twice in sterile distilled water for 1min. The group of ten flies was transferred to a 0.85% saline solution. 0.1ml of this solution was transferred to Sabouraud's dextrose agar [SDA]. The plates were kept at room temperature to allow appearance of the fungal colonies. In this study 1295 fungal colonies were identified. The main fungi isolated were species of Aspergillus, Penicillium, Yeasts, Cladosporium and Fusarium. Also, 2 dermatophytes were recovered including Microsporum gypseum and Trichophyton mentagrophytes. Our study demonstrated that house-fly is a carrier for fungal spores

Clinical characteristics and mycology of cutaneous candidiasis in Ahwaz [Iran]

To study clinical characteristics and mycology of cutaneous candidiasis in Ahwaz [Iran]. Four hundered sixty one patients were examined for cutaneous candidiasis over a period of 4 years from different medical mycology laboratories in Ahwaz. Skin scrapings, nail clippings and swabs were obtained from the lesions of 461 subjects. Samples were prepared by KOH, Gram and methylene blue techniques. The samples were also cultured on Sabouraud's dextrose agar with chloramphenicol [SC] and kept at 37°C for one week. Isolates were identified based on germ tube test, production chlamydoconidia in cornmeal agar, growing at 45°C and API 20 C AUX kits. 257 patients 179 female and 78 male [55.7%] were observed to have candidiasis. Onychomycosis [64.2%] was the most common form of candidiasis, followed by groin candidiasis 21% and toenail candidiasis [14.8%]. Candida albicans [49.4%] was most common isolate from patients. Cutaneous candidiasis is an important candida infection in women at the ages of 21-40 years in Ahwaz and C. albicans is the commonest etiologic agent

In vitro synergism between miconazole and griseofulvin against candida species

To find the synergistic effect between miconazole and griseofulvin on common human Candida. A serial dilution of miconazole and griseofulvin in Yeast Nitrogen Base [YNB] was prepared in test tubes. 5011 of standardized suspension of yeasts was inoculated into each test tube and incubated at 30°C for 24-48 hours. The antifungal activity of miconazole alone or with griseofulvin was measured in vitro against 300 isolates of the Candida. Miconazole and griseofulvin in combination showed a Minimum inhibitory Concentration [MIC] of 6.7mg/l miconazole [M] and 20mg/l griseofulvin [G] for C. albicans, 13mg/I M and 20mg/I G for C. tropicalis, 4.9mg/I M and 20mg/I G for C. pseudotropicalis and 14.2mg/I M and 20mg/I G for C. parapsilosis. The combination of miconazole with griseofulvin resulted in synergistic activity [Fractional Inhibitory Concentration, FIC <0.82] against C. albicans in a microdilution checkerboard assay. FICs for other species were as follow: FIC <0.75 for C. tropicalis, FIC <0.86 for C. pseudotropicalis and FIC <0.79 for C. parapsilosis. These results suggest that combination of griseofulvin and miconazole regimens may reduce usual dosage of miconazole and it is helpful in the control of infections caused by Candida species

Myocological studies in 15 cases of otomycosis

Otomycosis is a subacute or acute superficial mycotic infection of the outer ear canal that is caused by opportunistic fungi. The infection is usually unilateral and characterized by inflammation, pruritus, scaling and severe discomfort such as suppuration and pain. In this study 15 patients [11 female and 4 male] with symptomatic otomycosis were confirmed by direct microscopy and cultures. The most common fungal pathogens were Aspergillus niger [8 cases] followed by A. flavus [2 cases], A. fumigatus, Penicillium Spp., Candida albicans, C. parapsilosis and Rhizopus Spp each 1 case

Phospholipid analogue distributions of Iranian isolates of candida

The aim of this study was to analyse polar lipids of Candida species isolated from Ahwaz [Iran] by Fast Atom Bombardment Mass Spectrometry [FAB MS]. Nine isolates of Candida Sp. were identified by growth at 45°C, production of chlamydoconidia on cornmeal agar, colonial colour on CHROMagar Candida, germ tube production and ID 32C kits. Then polar lipids were extracted from freeze-dried cultures and analysed using FAB MS. The most intense carboxylate and phospholipid molecular species anions were of m/z 281 C[18:1] and m/z 515 [PA 23:2]. However, the most intense carboxylate and phospholipid analogues in Candida parapsilosis were 292 [Un] and 555 [PA 26:3], which differed from other yeasts. Isolates were grouped by single linkage clustering based on correlation coefficient for strain pairs calculated with carboxylate and phospholipid molecular species distributions. FAB MS can differentiate the C. albicans based on analysis of polar lipid distributions. These findings support that differentiation between C. albicans and other species is possible based on polar lipids