amphotericin-b and Cystitis

Fungal urinary tract infections (funguria) are rare in community medicine, but common in hospitals where 10 to 30% of urine cultures isolate Candida species. Clinical features vary from asymptomatic urinary tract colonization (the most common situation) to cystitis, pyelonephritis, or even severe sepsis with fungemia. The pathologic nature of funguria is closely related to host factors, and management depends mainly on the patient's underlying health status. Microbiological diagnosis of funguria is usually based on a fungal concentration of more than 10(3)/mm(3) in urine. No cutoff point has been defined for leukocyte concentration in urine. Candida albicans is the most commonly isolated species, but previous antifungal treatment and previous hospitalization affect both species and susceptibility to antifungal agents. Treatment is recommended only when funguria is symptomatic or in cases of fungal colonization when host factors increase the risk of fungemia. The antifungal agents used for funguria are mainly fluconazole and amphotericin B deoxycholate, because other drugs have extremely low concentrations in urine. Primary and secondary preventions are essential. The reduction of risk factors requires removing urinary catheters, limiting antibiotic treatment, and optimizing diabetes mellitus treatment.

Topics: Aged; Amphotericin B; Antifungal Agents; Candida albicans; Candidiasis; Cross Infection; Cystitis; Deoxycholic Acid; Drug Combinations; Female; Fluconazole; Fungemia; Fungi; Health Status; Hospital Mortality; Humans; Male; Mycoses; Primary Prevention; Pyelonephritis; Risk Factors; Urinary Catheterization; Urinary Tract Infections; Urine

Topics: Adult; Amphotericin B; Candidiasis; Child; Cystitis; Diagnosis, Differential; Humans; Infant, Newborn; Pyelonephritis; Therapeutic Irrigation; Urinary Catheterization

Topics: Adolescent; Cystitis; Fluconazole; Humans; Urinary Bladder

Topics: Administration, Intravesical; Adult; Amphotericin B; Candidiasis; Cystitis; Female; Humans; Pregnancy; Pregnancy Complications, Infectious

Topics: Administration, Intravesical; Amphotericin B; Candidiasis; Cystitis; Humans; Infant; Male

Spontaneous remission without any anti-cancer therapy in a 57-year-old woman with adult T-cell leukemia (ATL) is reported. The patient was referred to our department because of persistent cough and appearance of abnormal lymphocytes in the peripheral blood, and she was diagnosed as having chronic ATL. Eight months later, she was re-admitted because of cystitis, watery diarrhea and worsening of respiratory symptoms with an increase of ATL cells (WBC 31 x 10(9)/l with 56% ATL cells). Acute exacerbation of ATL was diagnosed. Interestingly, antibiotic therapy for the pulmonary and urinary tract infections brought about spontaneous reduction of the ATL cell count. Spontaneous remission of ATL continued for one year without chemotherapy. The role of infection as a trigger of acute exacerbation and spontaneous remission of ATL is discussed.

Topics: Amphotericin B; Ampicillin; Bone Marrow; Candidiasis; Cystitis; Diarrhea; Escherichia coli Infections; Female; Haemophilus Infections; Haemophilus influenzae; Humans; Leukemia, Prolymphocytic, T-Cell; Middle Aged; Remission, Spontaneous; Respiratory Tract Infections; T-Lymphocytes

Emphysematous cystitis is characterized by gas collection within the bladder wall and lumen. Often it is the result of aerobic urinary tract infections but it may be caused by gastrointestinal fistulas or iatrogenic surgical and diagnostic instrumentation. We report a case of emphysematous cystitis owing to Candida albicans with the incidental finding of emphysematous changes within the prostate gland.

Topics: Amphotericin B; Candidiasis; Cystitis; Emphysema; Humans; Ketoconazole; Male; Middle Aged; Prostatitis

Topics: Aged; Amphotericin B; Chronic Disease; Cystitis; Humans; Male; Mucorales; Mucormycosis; Urine

We report 4 cases of fungal cystitis. All patients had severe urgency, frequency and nocturia with sterile pyuria and microhematuria. Significant fungal growth was observed on routine blood agar cultur. Bladder biopsy was necessary to rule out tumor. Of the patients none responded to watchful waiting, 1 responded to intermittent daily bladder instillation of amphortericin B, 2 improved with oral 5-fluorocytosine, in addition to amphotericin B bladder instillations, and 1 required intravenous amphotericin B after unsuccessful response to 5-fluorocytosine and amphotericin B bladder treatments.

Topics: Amphotericin B; Candidiasis; Cystitis; Female; Flucytosine; Humans; Male; Middle Aged; Mycoses

Topics: Aged; Amphotericin B; Candida; Candidiasis; Cystitis; Humans; Male

Topics: Amphotericin B; Candida albicans; Candidiasis; Cystitis; Female; Flucytosine; Humans; Kidney Diseases; Male; Prostatitis; Urinary Catheterization; Urinary Tract Infections

Topics: Adult; Aged; Amphotericin B; Antibodies, Fungal; Candida albicans; Candidiasis; Cystitis; Female; Humans; Male; Middle Aged; Therapeutic Irrigation; Time Factors; Urinary Catheterization

Topics: Adolescent; Agar; Aged; Amphotericin B; Candida albicans; Candidiasis; Cystitis; Female; Humans; Male; Middle Aged; Urine

Topics: Amphotericin B; Anti-Bacterial Agents; Candida; Candidiasis; Cystitis; Humans; Male; Middle Aged; Urinary Bladder Calculi

Topics: Amphotericin B; Antifungal Agents; Candidiasis; Cystitis; Treatment Outcome