ABSTRACT
Phaeohyphomycosis is a diverse group of uncommon mycotic infections caused by dematiaceous fungi which appears to be increasing in incidence, particularly in transplant recipients. Alternaria is the most frequent isolated genus. Subcutaneous, pulmonary and disseminated disease are the most common sites of Alternaria infection in solid organ transplant recipients. We report the first case, to our knowledge, of a kidney transplant recipient with Alternaria alternata subcutaneous infection who was successfully treated with isavuconazole.
Subject(s)
Antifungal Agents/therapeutic use , Kidney Transplantation/adverse effects , Nitriles/therapeutic use , Phaeohyphomycosis/drug therapy , Pyridines/therapeutic use , Subcutaneous Tissue/microbiology , Triazoles/therapeutic use , Aged , Alternaria/immunology , Alternaria/isolation & purification , Humans , Immunocompromised Host , Kidney Failure, Chronic/surgery , Male , Phaeohyphomycosis/diagnosis , Phaeohyphomycosis/microbiology , Treatment OutcomeABSTRACT
Glucose intolerance and diabetes are becoming increasingly common in HIV-infected patients in the cART era. Many factors are associated with the development of diabetes in HIV-infected individuals who receive cART, one of which is the assumption of specific antiretroviral classes or agents. We describe a case in a 72-year-old Caucasian man with long-term HIV infection. We observed the development of unbalanced diabetes treated with insulin and metformin which improved when we replaced zidovudine with rilpivirine. This switch improved diabetes to such an extent that insulin suspension was required. In several countries zidovudine has long been used due to its low cost, although several side effects have been observed, especially in the long term. In this case, the switch to rilpivirine was shown to be able to improve the toxicity of zidovudine on glucose metabolism, representing a good option to be used.
Subject(s)
Anti-HIV Agents/therapeutic use , Diabetes Mellitus/chemically induced , Drug Substitution , HIV Infections/drug therapy , Reverse Transcriptase Inhibitors/adverse effects , Rilpivirine/therapeutic use , Zidovudine/adverse effects , Aged , Diabetes Mellitus/blood , Diabetes Mellitus/drug therapy , Glycated Hemoglobin/metabolism , Humans , MaleABSTRACT
A 39-year-old Ethiopian HIV-positive man with peripheral T-cell lymphoma developed Strongyloides stercoralis hyperinfection. The patient was initially treated with oral ivermectin for three weeks without response, most likely due to malabsorption because of concomitant paralytic ileus. Given the persistence of larvae in the body fluids, the worsening respiratory status and clinical malabsorption, veterinary parenteral formulation of ivermectin was administered. The very high plasma concentration of ivermectin achieved in the patient after parenteral administration led to a rapid improvement in his clinical condition and rapid disappearance of the parasite from biological samples, without any adverse reaction.
