acyclovir and Candidiasis

Concomitant herpetic and candidal esophagitis is a very rare disease that had not been reported in uremic patients. A 57-year-old woman receiving continuous ambulatory peritoneal dialysis (CAPD) therapy for 3 years was admitted due to CAPD-related peritonitis. Endoscopic examination was performed due to severe epigastralgia and upper gastrointestinal bleeding, and combined herpetic and candidal esophagitis was diagnosed. Intravenous acyclovir and fluconazole were prescribed and symptoms improved. The patient subsequently died due to progressive sepsis and respiratory failure. This is the first report of a dual infectious esophagitis in a uremic patient. Since infectious esophagitis may cause severe complications, early diagnosis and aggressive treatment are important.

Topics: Acyclovir; Antifungal Agents; Antiviral Agents; Candidiasis; Esophagitis; Fatal Outcome; Female; Fluconazole; Herpes Simplex; Humans; Middle Aged; Peritoneal Dialysis, Continuous Ambulatory; Sepsis; Uremia

New therapies and diseases causing immunosuppression have provoked new and devastating ocular diseases. The possible reasons for the vulnerability of the retina to opportunistic infections are discussed. The clinical patterns of disease caused by common opportunistic agents are described, and current treatment available is reviewed.

Topics: Acquired Immunodeficiency Syndrome; Acyclovir; Adult; Candidiasis; Chorioretinitis; Cytomegalovirus Infections; Eye Diseases; Herpes Simplex; Herpes Zoster; Humans; Immunity, Cellular; Immunosuppression Therapy; Infant, Newborn; Retina; Retinal Diseases; Retinal Vessels

Topics: Acyclovir; Adult; Boston; Candidiasis; Child; Cytomegalovirus; Cytomegalovirus Infections; Female; Ganciclovir; Humans; Immunization, Passive; Immunoglobulins; Immunoglobulins, Intravenous; Immunosuppressive Agents; Liver Transplantation; Male; Muromonab-CD3; Opportunistic Infections; Placebos; Pneumonia, Viral; Risk Factors; Treatment Outcome

Topics: Acyclovir; Aged; Antiviral Agents; Biopsy; Candidiasis; Diagnosis, Differential; Esophagitis; Esophagoscopy; Herpes Simplex; Humans; Inclusion Bodies, Viral; Male

Bloodstream infections (BSIs) and central line infections remain among the major causes of morbidity and mortality in transplant recipients because of prolonged neutropenia and mucosal damage. The objective of this study was to determine the frequency and outcome of bacterial and fungal isolates from patients undergoing allogeneic hematopoietic stem cell transplant.. This study was conducted at the Aga Khan University and Hospital's bone marrow transplant unit. All patients who underwent an allogeneic stem cell transplant with matched sibling/parent donor were included. The study period ranged from April 2004 to December 2012. Transplantation was performed according to institutional protocols. All patients were admitted in single rooms with positive pressure and high-efficiency particulate air filters. Ciprofloxacin, fluconazole, and valaciclovir were used for standard prophylaxis, which was started at the time of conditioning. All blood cultures were obtained at clinical suspicion of systemic infection, mainly documented as fever (temperature of >38.5°C). BSIs and line infections were defined as isolation of bacterial or fungal pathogen from at least one blood/central line culture.. In total, 101 of 108 patients developed febrile neutropenia. In the 101 patients, 245 documented febrile episodes occurred. There were 40 culture-positive episodes and 205 culture-negative episodes. Of these 40 culture-positive episodes, 22 patients had bloodstream isolates and 18 had central line isolates. The median ± standard deviation time of febrile neutropenia was day 7 ± 2 days (range: day -3 to day +13). The most common bloodstream isolate was Escherichia coli (n = 9) followed by Staphylococcus epidermidis (n = 5). One patient developed Fusarium infection. In central line infections, S. epidermidis was the most common organism (n = 8). In 2 patients with central venous catheters, Candida albicans was the isolate. Transplant-related mortality from sepsis occurred in 9.2%.. E.coli was mainly responsible for BSI, while gram-positive organisms dominated catheter-related febrile episodes. Transplant-related mortality due to sepsis was 9%.

Topics: Acyclovir; Adolescent; Adult; Anti-Infective Agents; Bacteremia; Candida albicans; Candidiasis; Catheterization, Central Venous; Catheters, Indwelling; Child; Child, Preschool; Ciprofloxacin; Developing Countries; Escherichia coli; Escherichia coli Infections; Febrile Neutropenia; Female; Fluconazole; Fungemia; Fusariosis; Fusarium; Hematopoietic Stem Cell Transplantation; Humans; Male; Middle Aged; Pakistan; Retrospective Studies; Staphylococcal Infections; Staphylococcus epidermidis; Valacyclovir; Valine; Virus Diseases; Young Adult

Topics: Acyclovir; Anti-Bacterial Agents; Antifungal Agents; Antimalarials; Antiviral Agents; Candidiasis; Child, Preschool; Clindamycin; Female; Herpes Simplex; Humans; Infant; Infant, Newborn; Intertrigo; Ketoconazole; Male; Staphylococcal Infections; Sulfamethoxazole; Trimethoprim

Topics: 2-Pyridinylmethylsulfinylbenzimidazoles; Acyclovir; Adolescent; Antifungal Agents; Antiviral Agents; Candidiasis; Esophagitis; Fluconazole; Herpes Simplex; Humans; Immunocompetence; Lansoprazole; Male; Omeprazole; Treatment Outcome

The main non-HIV presentations at the 1995 Interscience Conference on Antimicrobial Agents and Chemotherapy (ICAAC) are reviewed. Issues addressed vancomycin resistance, the use of antibiotics in overcoming drug resistance, two new classes of antibiotics that are active against resistant gram-positive bacteria, hepatitis A screening for low-risk prospective travelers to developing countries, a new antiviral agent (valaciclovir) for use against genital herpes, amphotericin B lipid therapy for invasive candidiasis, and cryptosporidium as a major cause of severe diarrhea.

Topics: Acyclovir; Amphotericin B; Anti-Bacterial Agents; Antifungal Agents; Antiviral Agents; Candidiasis; Cryptosporidium; Diarrhea; Drug Carriers; Drug Resistance, Microbial; Gram-Positive Bacteria; Hepatitis A; Herpes Genitalis; Valacyclovir; Valine; Vancomycin

Topics: Acyclovir; Adult; Aged; Aged, 80 and over; Agranulocytosis; Bacterial Infections; Breast Neoplasms; Candidiasis; Female; Herpes Zoster; Hodgkin Disease; Humans; Immunocompromised Host; Lymphoma, Non-Hodgkin; Male; Middle Aged; Neoplasms; Neutropenia

Topics: Acyclovir; Antifungal Agents; Antiviral Agents; Candidiasis; Dermatomycoses; Herpesviridae Infections; Humans; Imidazoles; Mycoses; Virus Diseases