Subject(s)
Bioterrorism/prevention & control , Public Health/standards , Anthrax/drug therapy , Anthrax/prevention & control , Bioterrorism/psychology , Bioterrorism/trends , Centers for Disease Control and Prevention, U.S./standards , Government , Humans , International Cooperation , Postal Service , Public Health/legislation & jurisprudence , Public Health/trends , Security Measures/organization & administration , Security Measures/trends , United StatesSubject(s)
Biotechnology/economics , Enzymes/chemistry , Enzymes/isolation & purification , Thermoplasma/genetics , Biotechnology/trends , Drug Industry/economics , Drug Industry/trends , Evolution, Molecular , Food Industry/economics , Food Industry/trends , Genome, Archaeal , Models, Chemical , TemperatureSubject(s)
Biotechnology , Genetic Engineering , Organisms, Genetically Modified , Public Opinion , European Union , HumansSubject(s)
Embryo, Mammalian/cytology , Research/legislation & jurisprudence , Stem Cells , Bioethical Issues , Cell Line , Ethics Committees , Female , Germany , Humans , PregnancySubject(s)
Anti-Bacterial Agents/chemical synthesis , Bacteria/drug effects , Drug Resistance, Microbial/genetics , Anti-Bacterial Agents/pharmacology , Anti-Bacterial Agents/therapeutic use , Bacteria/genetics , Bacterial Adhesion/drug effects , Cell Membrane/drug effects , Clinical Trials as Topic , Drug Design , Drug Industry , Humans , Oligonucleotides, Antisense/chemical synthesis , Oligonucleotides, Antisense/pharmacology , Oligonucleotides, Antisense/therapeutic use , United States , United States Food and Drug AdministrationABSTRACT
Depending on the aggressiveness of the pathogen and a patient's immunocompetence, fungal polypoid pansinusitis or allergic fungal sinusitis (AFS) may be a life-threatening disease. Apart from the clinical findings, its diagnosis is based on the demonstration of mucinous material with abundant eosinophils in the paranasal sinuses (indicating an allergic process), cultivation of the causative pathogen and immunocompetence of the patient. In a 20-year-old immigrant Sudanese woman, AFS due to Bipolaris (Drechslera) hawaiiensis was diagnosed. Because of intracranial extension, the disease had led to erosion of the cranial base and orbit with amaurosis on the right side and focal epilepsy. In addition to endonasal microsurgical pansinus operations, local irrigation therapy with amphothericin B was accompanied by systemic treatment with itraconazole after in vitro cultivation of the pathogen and determination of its sensitivities. Interdisciplinary management included a combination of endonasal surgery with debridement of infected tissues and wide drainage of the sinuses without removal of skull bone or the dural lesion in addition to specific antimycotic treatment. Injury to adjacent anatomical structures must be avoided in any case to prevent systemic or possibly lethal dissemination of infection.
