ABSTRACT
Candida africana has been recovered principally as a causative agent of vulvovaginal candidiasis (VVC) from different countries, which is likely to be misidentified as the typical Candida albicans or Candida dubliniensis. The current study aimed to characterize C. albicans species complex obtained from VVC based on conventional and molecular assays. Furthermore, in vitro antifungal susceptibility testing was performed based on CLSI documents. Additionally, due to low knowledge concerning C. africana infections, we reviewed all published papers from 1991 to 2019. One hundred forty-four out of 287 patients were identified with Candida infection, among whom 151 isolates of Candida were obtained. Candida albicans 109 (72.1%), Candida glabrata 21 (13.9%), Candida krusei 8 (5.2%), Candida tropicalis 5 (3.3%), Candida africana 3 (1.9%), Candida parapsilosis 3 (1.9%) and C. dubliniensis 2 (1.3%) were isolated from patients. MIC results showed that C. africana isolates were susceptible to all tested antifungal drugs. Candida africana infections were more prevalent in Africa. One hundred fifteen (40.6%) of patients with C. africana candidiasis were from seven African countries, and Madagascar and Angola had the majority of cases. The epidemiological data, phenotypic, clinical features, ecologic similarity, and antifungal susceptibility profiles for better understanding of the pathogenic mechanisms and optimal treatment underlying non-CandidaalbicansCandida vulvovaginitis are highly recommended.
Subject(s)
Candida/isolation & purification , Candidiasis, Vulvovaginal/epidemiology , Candidiasis, Vulvovaginal/microbiology , Africa/epidemiology , Antifungal Agents/therapeutic use , Candida/classification , Candida/drug effects , Candidiasis, Vulvovaginal/drug therapy , Female , Geography , History, 20th Century , History, 21st Century , Humans , Madagascar/epidemiology , Microbial Sensitivity Tests , PrevalenceABSTRACT
In order to determine the frequency of acute renal failure (ARF) induced by drugs, to identify the agents responsible for it and to define its semiological characteristics, a prospective study was carried out between 1 October 1987 and 30 September 1988, in Sfax and southern Tunisia. Three Departments of Medicine and one Hemodialysis Center participated in this study. Twelve cases of drug-induced ARF were identified among the 73 cases of ARF reported, i.e., a frequency of 16%. Anti-inflammatory non-steroidal drugs (AINS) were implicated in 5 cases and antibiotics in 2. Symptoms of hypersensitivity were observed in 4 patients, 2/3 without oliguria. Renal insufficiency was usually marked: plasma creatinine was 523 +/- 425 mumol/l; proteinuria greater than 1 g/24 h was seen in 2 patients. Hypovolemia and/or hypotension (6 cases) and diabetes mellitus (4 patients) were found to favor ARF. Renal function returned to normal in 9 patients, whereas mild renal failure persisted in the remaining 3 patients. Drug-induced ARF occurs often. AINS are the most frequently incriminated agents and hypersensitivity symptoms without oliguria are the most common manifestations. Drug-induced ARF can be prevented by close monitoring of high-risk patients, i.e., those taking AINS.
Subject(s)
Acute Kidney Injury/chemically induced , Drug-Related Side Effects and Adverse Reactions , Aged , Anti-Bacterial Agents/adverse effects , Anti-Inflammatory Agents, Non-Steroidal/adverse effects , Contrast Media/adverse effects , Diuresis , Female , Humans , Iodine/adverse effects , Male , Middle Aged , Multicenter Studies as Topic , Prospective Studies , TunisiaABSTRACT
An unusual case of multiple cerebral tuberculomas is reported. The patient, a 19-year-old woman, presented with a 6-month history of raised intracranial pressure and cerebellar symptoms. CT scan disclosed a conglomerate of several ring-enhancing lesions within the cerebellar vermis and another homogeneously enhancing mass against the right occipital horn. Solid and ring-enhancing lesions are the main mode of presentation of cerebral tuberculomas. Although the patient had no history of systemic tuberculosis, this diagnosis was considered highly probable in this geographic area and was confirmed by pathological examination of the cerebellar mass, the excision of which was considered necessary. Antitubercular medications led to complete regression of the associated occipital lesion, as demonstrated by sequential CT scan examinations.
