Cost-effective method for identification of dimorphic fungi.

Traditional methods to identify dimorphic fungi dictate that the mold be converted to the yeast phase at 35 to 37 degrees C. We present a time- and cost-saving method of confirming the identification of a dimorph by using special stains to demonstrate the yeast phase directly growing in the original clinical specimens.

Comparison of efficacy of topical and oral fluconazole treatment in experimental Aspergillus keratitis.

PURPOSE: To investigate the therapeutic role of topical and oral fluconazole treatment using a rabbit model of Aspergillus fumigatus keratitis. METHODS: Aspergillus fumigatus spores were injected into the corneal stroma of the right eye of 20 rabbits. Forty-eight hours later the rabbits were randomly divided into three groups. Group 1 rabbits (six) were treated with topical fluconazole (2 mg/ml, eight times daily), group 2 rabbits (seven) received oral fluconazole (37.5 mg/kg bid), and group 3 rabbits (seven) were untreated controls. The eyes were examined and photographed with a slit-lamp 2, 6, 10, 16, and 20 days after inoculation and an observer graded the corneas in a masked fashion. Corneal cultures were taken on days 2, 14, and 20 for fungus growth. RESULTS: At the beginning of treatment, the slit-lamp scores did not differ among three groups. However, on days 6, 10, 16, and 20 the treated groups had statistically significant lower scores compared to the untreated controls. No significant difference was observed between topical and oral treated groups at any examination point. All cultures were positive on day 2, but on days 16 and 20, there were significantly lower positive fungal cultures in both treatment groups compared to the control (p < 0.01, chi square test). CONCLUSION: Our study showed that both topical and oral fluconazole were effective in lessening the severity of fungal keratitis in a rabbit model and should be considered effective treatment alternatives in the therapy of Aspergillus fumigatus keratitis.

Serum LDH level as a clue to the diagnosis of histoplasmosis.

The purpose of this study was to determine whether serum lactate dehydrogenase (LDH) level could be used as an adjunct clinical marker to differentiate between histoplasmosis and Pneumocystis carinii pneumonia (PCP). In a retrospective, case-controlled study, 30 patients with a diagnosis of histoplasmosis (all but 1 with disseminated disease) were compared with 120 patients with PCP (33 patients with definitive PCP, 87 with presumed PCP). Groups were matched for CD4+ lymphocyte counts, sex, and year of diagnosis. The mean LDH level for patients with histoplasmosis was 1068 +/- 197 IU/L; for PCP, it was 375 +/- 23. An LDH level of more than 450 IU/L was 9.33 times more likely to be associated with a diagnosis of histoplasmosis than with PCP (odds ratio [OR], 9.33; 95% confidence interval [CI], 3.50-25.47; P < .01), and an LDH level of more than 600 IU/L was 9.41 times more likely to be so (OR, 9.41; 95% CI, 3.43-26.31; P < .01). An LDH level of 450 IU/L or greater had a sensitivity and specificity of 70% and 80%, respectively; a value of 600 IU/L or greater had sensitivity and specificity of 50% and 89%. Thus, serum LDH levels of 600 IU/L or greater are suggestive of histoplasmosis rather than PCP in appropriate clinical settings. Serum LDH may serve as an adjunct laboratory marker in the diagnosis of histoplasmosis. Elevated levels may prompt the physician to look for a diagnosis other than PCP early in the course of the illness.

Factores que afectan la prevalencia de dermatomicosis en dos localidades indigenas en Colombia / Factors affecting the prevalence of dermatomycosis in two indian reservoirs in Colombia

Esta encuesta es un esfuerzo para determinar la prevalencia de los dermatofitos en poblaciones indigenas colombianas y observar como influyen el clima y ciertos aspectos sociales sobre la distribucion de estos hongos patogenos. Se usaron metodos estandar para encuestas de campo a fin de estudiar y tomar muestras (cultivos, raspados, etc.) a 971 indigenas que viven en diversas zonas ecologicas del Putumayo, Colombia. En total se examinaron 391 adultos para tinea pedis y 580 ninos para tinea capitis. Mas de 60% de los adultos tenian signos positivos para tinea pedis. Sin embargo unicamente 4% para Candida albicans. La prevalencia para tinea capitis fue 1%. Solamente se aislaron 3 especies de dermatofitos (Trichophyton mentagrophytes, T. rubrum y Epidermophyton floccosum) como agentes de tinea pedis y 2 especies (Microsporum canis y M. gypseum) en tinea capitis. La baja prevalencia de tinea pedis se puede atribuir a que los indios andan descalzos. Se discute la importancia del uso de zapatos cerrados como un factor principal en la infecciones del pie. El clima juega un papel menor en la prevalencia de tinea pedis

La epidemiología de la paracoccidioidomicosis / Epidemiology of paracocciodioidomycosis

El artículo describe las características de la enfermedad y destaca la cantidad de factores y elementos que todavía permanecen ocultos en espera de una investigación más sutil (AU)

La epidemiología de la paracoccidioidomicosis / Epidemiology of paracocciodioidomycosis

El artículo describe las características de la enfermedad y destaca la cantidad de factores y elementos que todavía permanecen ocultos en espera de una investigación más sutil (AU)