ABSTRACT
We report a case of disseminated cutaneous Mycobacterium chelonae infection in a patient with head and neck cancer on salvage chemotherapy, including the epidermal growth factor receptor inhibitor cetuximab. Mycobacterium chelonae should be considered in the differential diagnosis of cutaneous infections in cancer patients receiving epidermal growth factor receptor inhibitors.
Subject(s)
Antineoplastic Agents/administration & dosage , Antineoplastic Agents/adverse effects , Head and Neck Neoplasms/complications , Head and Neck Neoplasms/drug therapy , Mycobacterium Infections, Nontuberculous/diagnosis , Mycobacterium chelonae/isolation & purification , Antibodies, Monoclonal/administration & dosage , Antibodies, Monoclonal/adverse effects , Antibodies, Monoclonal, Humanized , Biopsy , Cetuximab , Female , Histocytochemistry , Humans , Microscopy , Middle Aged , Mycobacterium Infections, Nontuberculous/microbiology , Skin/pathology , Skin Diseases, Bacterial/diagnosis , Skin Diseases, Bacterial/microbiologyABSTRACT
The effect of gentian violet against Candida albicans and non-Candida albicans biofilms formed on polymethylmethacrylate strips was evaluated using a dry weight assay and confocal laser scanning microscopy. The ability of gentian violet to inhibit Candida albicans germination was also assessed. Gentian violet activity against Candida biofilms was demonstrated by a reduction in dry weight, disruption of biofilm architecture, and reduced biofilm thickness. Additionally, gentian violet inhibited Candida germination in a concentration-dependent manner.
Subject(s)
Anti-Infective Agents, Local/pharmacology , Biofilms/drug effects , Candida albicans/drug effects , Candidiasis, Oral/microbiology , Gentian Violet/pharmacology , HIV Infections/microbiology , Candida albicans/isolation & purification , Candida albicans/physiology , Dose-Response Relationship, Drug , Humans , Microscopy, ConfocalABSTRACT
The use of inexpensive topical alternatives, e.g. oil of melaleuca (tea tree oil (TTO)), chlorhexidine (CHX), povidone iodine (PI) and gentian violet (GV), to treat oral candidiasis in human immunodeficiency virus (HIV)-infected patients has been proposed in resource-poor countries. However, pre-clinical studies comparing the antifungal activity of these agents are lacking. This study compared the minimal inhibitory concentrations (MICs) of TTO, GV, PI, CHX and fluconazole (FLZ) against 91 clinical Candida strains using Clinical and Laboratory Standard Institute (CLSI) methodology. Isolates were obtained from the oral cavity of acquired immune deficiency syndrome (AIDS) patients. Among the topical agents examined, GV showed the most potent activity against all Candida isolates tested (MIC range, MIC for 50% of the organisms (MIC(50)) and MIC for 90% of the organisms (MIC(90)) of 0.03-0.25 microg/mL, 0.06 microg/mL and 0.1 2microg/mL, respectively). CHX was 64 times less active than GV (MIC range, MIC(50) and MIC(90) of 0.5-16 microg/mL, 4 microg/mL and 8 microg/mL, respectively). The lowest antifungal activity was seen for PI (MIC(90)=0.25%). Moreover, GV, unlike the other topical agents tested, was fungicidal (minimum fungicidal concentration=1 microg/mL) against Candida albicans isolates (n=83). In addition, GV showed activity against FLZ-resistant C. albicans (n=3). The combination of GV and FLZ was not antagonistic and there was no interaction between the two compounds. GV possesses potent antifungal activity against FLZ-susceptible and -resistant Candida strains and is not antagonistic when used in combination with FLZ. In vivo evaluation is warranted.
