RESUMO
Malaria is the most important parasitic infection in people, affecting 5-10% of the world's population with more than two million deaths a year. Whereas invasive bacterial infections are not uncommon during severe Plasmodium falciparum malaria, only a few cases of opportunistic fungal infections have been reported. Here, we present a fatal case of disseminated hyalohyphomycosis associated with acute P. falciparum malaria in a non-immune traveller, review the cases reported in the literature and discuss the theoretical foundations for the increased susceptibility of non-immune individuals with severe P. falciparum malaria to opportunistic fungal infections. Apart from the availability of free iron as sequelae of massive haemolysis, tissue damage, acidosis and measures of advanced life support, patients with complicated P. falciparum malaria also are profoundly immunosuppressed by the organism's interaction with innate and adaptive host immune mechanisms.
Assuntos
Malária Falciparum/complicações , Malária Falciparum/imunologia , Micoses/diagnóstico , Micoses/patologia , Plasmodium falciparum/patogenicidade , Encéfalo/patologia , Histocitoquímica , Humanos , Hospedeiro Imunocomprometido , Rim/patologia , Fígado/patologia , Pulmão/patologia , Microscopia , Miocárdio/patologia , Traqueia/patologiaRESUMO
Prompted by the worldwide surge in fungal infections, the past decade has witnessed a considerable expansion in antifungal drug research. New compounds have entered the clinical arena, and major progress has been made in defining paradigms of antifungal therapies. This article provides an up-to-date review on the clinical pharmacology, indications, and dosage recommendations of approved and currently investigational therapeutics for treatment of invasive fungal infections in adult and pediatric patients.
Assuntos
Antifúngicos/farmacologia , Antifúngicos/uso terapêutico , Proteínas Fúngicas , Micoses/tratamento farmacológico , Peptídeos Cíclicos , Peptídeos , Antibacterianos/classificação , Antibacterianos/metabolismo , Antibacterianos/farmacocinética , Antifúngicos/metabolismo , Desenho de Fármacos , Equinocandinas , Flucitosina/metabolismo , Flucitosina/farmacologia , Humanos , Hospedeiro Imunocomprometido , Estrutura Molecular , Micoses/prevenção & controle , Polienos/classificação , Polienos/farmacocinética , Triazóis/classificação , Triazóis/farmacocinéticaRESUMO
We present the case of a patient who presented with hypertrophic cardiomyopathy, generalized lymphadenopathy and serological evidence of African sleeping sickness (Trypanosoma gambiense). He made a full recovery after intravenous administration of eflornithine, a drug that is no longer distributed for antiparasitic indications for pharmacoeconomic reasons.
