amphotericin-b and Candidiasis--Chronic-Mucocutaneous

Topics: Amphotericin B; Antifungal Agents; Aspergillosis; Bone Marrow Transplantation; Candidiasis; Candidiasis, Chronic Mucocutaneous; Clinical Trials as Topic; Cryptococcosis; Double-Blind Method; Fluconazole; Humans; Itraconazole; Ketoconazole; Mucormycosis; Mycoses; Neutropenia; Nystatin; Primary Prevention; Recurrence; Retrospective Studies

Candida albicans causes debilitating, often azole-resistant, infections in patients with chronic mucocutaneous candidiasis (CMC). Amphotericin B (AMB) resistance is rare, but AMB use is limited by parenteral administration and nephrotoxicity. In this study, we evaluated cochleated AMB (CAMB), a new oral AMB formulation, in mouse models of oropharyngeal candidiasis (OPC) and vulvovaginal candidiasis (VVC) and in patients with azole-resistant CMC. OPC and VVC were modeled in

Topics: Amphotericin B; Animals; Antifungal Agents; Azoles; Candida albicans; Candidiasis; Candidiasis, Chronic Mucocutaneous; Candidiasis, Oral; Candidiasis, Vulvovaginal; Female; Humans; Mice

We report this rare case of cerebral phaeohyphomycosis in a previously healthy Chinese boy, who was found to have caspase recruitment domain family member 9 (CARD9) deficiency. Initial radiological features suggested a neoplastic cerebral lesion, while histopathological examination supplemented by internal transcribed sequencing (ITS) of cerebral tissue confirmed the diagnosis of phaeohyphomycosis. He was treated with intravenous (IV) liposomal amphotericin B and voriconazole, guided by plasma and cerebrospinal fluid (CSF) level monitoring at drug initiation. At the 1 year follow-up, the patient demonstrated near complete neurological and radiological recovery.

Topics: Administration, Intravenous; Amphotericin B; Antifungal Agents; Candidiasis, Chronic Mucocutaneous; CARD Signaling Adaptor Proteins; Cerebral Phaeohyphomycosis; Child; China; Humans; Male; Mutation, Missense; Radiography; Treatment Outcome; Voriconazole

Autoimmune polyendocrinopathy-candidiasis-ectodermal dystrophy (APECED) is a rare autosomal recessive disease caused by mutations in the AIRE gene. We report the case of a female patient with a 967-979del13 mutation in the AIRE gene. Her medical history included autoimmune hypoparathyroidism, Addison disease, and chronic mucocutaneous candidiasis. At the age of 40, she developed multiple white verrucous plaques on the oral mucosa. Histologically, the lesions appeared as moderately differentiated squamous cell carcinomas. The patient subsequently developed multiple local recurrences and therefore required repeated surgery. Notably, a higher incidence rate of oral and esophageal squamous cell carcinoma has been observed in this syndrome. However, the critical pathogenetic pathways implicated in squamous cell carcinoma development in APECED are far from being well understood.

Topics: Adult; Amphotericin B; Antifungal Agents; Candidiasis, Chronic Mucocutaneous; Carcinoma, Squamous Cell; Female; Humans; Nystatin; Polyendocrinopathies, Autoimmune

Autoimmune polyendocrinopathy-candidiasis-ectodermal dystrophy (APECED, APS-I) is exceptionally common in Finland. Most patients have chronic oral candidiasis since childhood. Thus, most patients receive repeated courses of antifungals throughout their life. Eleven of our patients (31.4%) have become colonized with Candida albicans with decreased sensitivity to fluconazole. A total of 43 isolates of C. albicans from 23 APECED patients isolated during the years 1994 to 2004 were divided into 2 groups: fluconazole-susceptible dose-dependent (MIC, 16-32 microg/mL, 18 isolates) and fluconazole-susceptible (MIC

Topics: Amphotericin B; Antifungal Agents; Azoles; Candida albicans; Candidiasis, Chronic Mucocutaneous; Drug Resistance, Fungal; Echinocandins; Finland; Fluconazole; Humans; Microbial Sensitivity Tests; Polyendocrinopathies, Autoimmune; Time Factors

Topics: Adult; Amphotericin B; Biopsy; Candidiasis, Chronic Mucocutaneous; Humans; Interferon-gamma; Intestinal Diseases; Itraconazole; Male; Prototheca; Treatment Outcome

6 months before admission a 21-year-old woman had developed anogenital condylomata acuminata (CA). Since early childhood she had been treated for primary hypoparathyroidism (PHPT) and recurrent mucocutaneous candidiasis. 5 years before admission corneal clouding had caused visual impairment. Recently, mainly truncal vitiligo with occipital poliosis had developed.. PHPT was confirmed (parathormone level 7.7 mg/l). In addition, liver transaminases were raised (GOT 105.8 U/l, GPT 145.6 U/l, gamma-GT 56.8 U/l), pointing to noninfectious hepatitis. An ACTH stress test could not exclude manifest adrenocortical insufficiency, and thyroid function was also normal. The Merieux Multitest indicated an anergy.. The constellation of test results suggested autoimmune polyglandular syndrome type I. The condylomata were treated by electrocautery and the intestinal candidiasis with amphotericin B suspension. Calcitriol capsules, 0.5 microgram, and calcium gluconate or lactate, 500 and 300 mg respectively, 3 times daily each, were given for the PHPT.. This case demonstrates a complex syndrome which can be recognized early by simple clinical tests. Early diagnosis prevents possible life-threatening complications.

Topics: Adult; Amphotericin B; Antifungal Agents; Anus Diseases; Calcitriol; Calcium Gluconate; Candidiasis, Chronic Mucocutaneous; Capsules; Condylomata Acuminata; Corneal Opacity; Drug Therapy, Combination; Electrocoagulation; Female; Humans; Hypoparathyroidism; Lactates; Polyendocrinopathies, Autoimmune; Scalp; Suspensions; Vaginal Diseases; Vitiligo

We reviewed the clinical course in 43 patients from eight medical centers who were given the diagnosis of chronic mucocutaneous candidiasis, a rare disorder of unknown cause that may occur in childhood. Recurrent or severe infections with organisms other than Candida were seen in 80% of the patients. There were nine cases of septicemia. Seven patients have died; six of these deaths were directly related to non-Candida infectious complications. Endocrine dysfunction, including Addison disease (11 patients) and hypothyroidism (9 patients), was seen in 19 of 43 patients. Immunologic studies failed to reveal a consistent abnormality, although two of five patients with reversed T4/T8 ratios are among those who have died. Ketoconazole was effective in controlling symptoms of candidiasis in most patients. The findings from this study indicate that non-Candida infections cause serious morbidity and may result in death in patients with chronic mucocutaneous candidiasis.

Topics: Adolescent; Amphotericin B; Autoimmune Diseases; Candidiasis; Candidiasis, Chronic Mucocutaneous; Child; Child, Preschool; Endocrine System Diseases; Family; Female; Flucytosine; Humans; Immunoglobulin A; Immunoglobulin G; Incidence; Infant; Infections; Ketoconazole; Lung Diseases; Male; Survival Rate

Topics: Adult; Amphotericin B; Candidiasis; Candidiasis, Chronic Mucocutaneous; Child; Female; Histoplasmosis; Humans; Ketoconazole; Male; Recurrence

A new antifungal agent, ketoconazole, has been added to the drugs available for the treatment of fungal infections. Ketoconazole has been shown to be effective in the treatment of mucocutaneous candidiasis with a reported 97% positive response rate. This drug may be administered orally to outpatients with a low risk of toxicity. Hepatitis has been reported as a possible complication of treatment. Infection relapse is the most significant posttherapeutic problem. Five patients suffering from mucocutaneous candidiasis after irradiation therapy are reported to have had favorable responses. The other available antifungal agents are reviewed and discussed.

Topics: Amphotericin B; Antifungal Agents; Candidiasis; Candidiasis, Chronic Mucocutaneous; Humans; Ketoconazole; Mycoses

Four cases of familial mucocutaneous candidiasis corresponding to two families were studied. In two of the cases (Family I), there were lesions in the mouth, vaginal mucosa, nails, palms and soles, with no other associated infections. In the other two cases (Family II) there were oral (glossitis with macroglossia), genital and inguinal folds lesions, associated to frequent bacterial infections (recurring forunculosis , pneumonia). The immunological study in the four cases showed overlapping results: anti-candida circulating antibodies at high dilutions, a negative or weakly positive candidine a negative TTL to candida in some of the cases, and not other abnormalities in T. lymphocytes. All of the cases became sensitive to DNCB. In two of them, there were low figures of ferritin (Family II); however, no improvement was obtained with an iron treatment. There were no endocrinological abnormalities in any case. All of the cases were cured with ketoconazole in a few months, and no relapse was found six months after the end of the treatment in one of them. A follow up could not be performed on the other three cases.

Topics: Adolescent; Adult; Amphotericin B; Candidiasis; Candidiasis, Chronic Mucocutaneous; Consanguinity; Female; Humans; Ketoconazole; Male; Nystatin; Pedigree

Topics: Amphotericin B; Candidiasis; Candidiasis, Chronic Mucocutaneous; Child, Preschool; Female; Humans

Five children (aged 11 to 19 years) with lifelong chronic mucocutaneous candidiasis had 12 episodes of esophageal and/or laryngeal candidiasis documented by endoscopy. Symptoms included hoarseness (8/12), dysphagia (6/12), and hemoptysis (1/12). There was poor correlation between oral lesions and esophageal or laryngeal involvement. On fiberoptic endoscopy, the esophagus was involved alone in four episodes (33%), the larynx in two episodes (17%), and both structures in six episodes (50%). In six of eight instances, the esophagram was nondiagnostic or markedly underestimated the extent of inflammation. Intravenous amphotericin B or miconazole resulted in the resolution of these infections for variable periods of time. Repeat endoscopy was used to follow the course of the disease. Aerosolized amphotericin B was effective on one occasion in clearing candidal lesions of the larynx and one small area of the left mainstem bronchus. Oral topical therapy was not beneficial. Since the signs and symptoms of laryngitis or esophagitis are often minimal or absent and complications, including strictures, may arise from chronic inflammation, periodic endoscopy and systemic therapy may be necessary.

Topics: Adolescent; Adult; Amphotericin B; Candidiasis; Candidiasis, Chronic Mucocutaneous; Child; Endoscopy; Esophagitis; Female; Humans; Laryngitis; Male

Topics: Administration, Cutaneous; Amphotericin B; Candidiasis, Chronic Mucocutaneous; Candidiasis, Cutaneous; Granuloma; Humans

Topics: Amphotericin B; Candidiasis; Candidiasis, Chronic Mucocutaneous; Granuloma; Humans

Topics: Achondroplasia; Amphotericin B; Bronchiectasis; Candidiasis, Chronic Mucocutaneous; Candidiasis, Cutaneous; Child; Granuloma; Humans; Injections, Intravenous; Nystatin; Organic Chemicals; Pathology

Topics: Amphotericin B; Candidiasis; Candidiasis, Chronic Mucocutaneous; Granuloma; Humans; Skin Diseases

Topics: Amphotericin B; Antifungal Agents; Candidiasis; Candidiasis, Chronic Mucocutaneous; Granuloma; Hypothyroidism; Medical Records