amphotericin-b and Diarrhea

Gastrointestinal basidiobolomycosis (GIB), a rare fungal infection associated with high mortality, has been reported worldwide mainly from tropical and subtropical regions of Asia, USA, and Latin America. The clinical manifestations are highly diverse and non-specific depending on the underlying disease, but fever, abdominal pain, weight loss, diarrhea, constipation and chills have been observed. There are no prominent risk factors for GIB but climatic conditions and life style are related to this infection in arid and semi-arid regions. Therefore timely diagnosis and early treatment is a challenge. Herein, we present an unusual case of gastrointestinal basidiobolomycosis in a 54-year-old male, initially misdiagnosed as colon cancer. After follow-up, no evidence of relapse and the patient was successfully cured by liposomal amphotericin B. In addition, the differential diagnosis and histopathological findings are discussed with a review of the literature.

Topics: Amphotericin B; Antifungal Agents; Colonic Neoplasms; Diagnosis, Differential; Diagnostic Errors; Diarrhea; Entomophthorales; Gastrointestinal Tract; Humans; Male; Middle Aged; Zygomycosis

Fungal infections of the gastrointestinal tract have risen to higher levels of prevalence in the past decade. Major factors accounting for this increase are social changes, such as the increased ease and frequency of travel, which exposes the individual to environmental conditions that may result in fungal infection; increasing use of antibiotic and hormonal medications by otherwise healthy persons; and improved therapy for other diseases, such as polychemotherapy of cancer with its immunosuppressive effects. Both noninvasive and invasive fungal disease of the intestinal tract in otherwise healthy individuals can be successfully treated. The invasive fungal infections in patients with severe prior underlying disease are often first diagnosed postmortem, but improvement in serologic techniques now offers a possibility of earlier diagnosis and therapeutic intervention.

Topics: Amphotericin B; Antifungal Agents; Candidiasis; Diarrhea; Enteritis; Histoplasmosis; Humans; Imidazoles; Immunosuppression Therapy; Ketoconazole; Miconazole; Mycoses; Neoplasms; Nystatin; Paracoccidioidomycosis; Piperazines; Sulfadiazine

Topics: Acetazolamide; Amphotericin B; Animals; Cholera; Cyclic AMP; Diarrhea; Dogs; Duodenum; Escherichia coli; Ethacrynic Acid; Fluorescent Antibody Technique; Gastrins; Humans; Intestinal Absorption; Intestinal Mucosa; Jejunum; Models, Biological; Peptides; Rabbits; Rats; Sodium; Toxins, Biological; Ultrafiltration; Zollinger-Ellison Syndrome

Topics: Adrenal Glands; Amphotericin B; Asthenia; Diarrhea; Fludrocortisone; Humans; Hydrocortisone; Itraconazole; Male; Middle Aged; Paracoccidioides; Paracoccidioidomycosis; Tomography, X-Ray Computed; Vomiting

A 3.5-month-old infant with undiagnosed underlying combined immunodeficiency presented with S. ceravisiae fungemia following treatment with S. boulardii containing probiotic preparation. This case highlights that the use of probiotics in sick patients may be fraught with danger.

Topics: Amphotericin B; Antifungal Agents; Caspofungin; Diarrhea; Humans; Immunocompromised Host; Immunologic Tests; Infant; Invasive Fungal Infections; Male; Probiotics; Saccharomyces cerevisiae; Treatment Outcome

Topics: Abdominal Pain; Aged; Amphotericin B; Antifungal Agents; Diagnosis, Differential; Diarrhea; Female; Fever; Histoplasma; Histoplasmosis; Humans

Topics: Amphotericin B; Animals; Animals, Newborn; Antifungal Agents; Diagnosis, Differential; Diarrhea; Drug Therapy, Combination; Female; Horse Diseases; Horses; Lung Diseases, Fungal; Minocycline; Paecilomyces

Histoplasmosis is an invasive mycosis caused by inhalation of the spores of dimorphic fungi Histoplasma capsulatum. The disease manifests in the lung as acute or chronic pulmonary histoplasmosis and in severe cases gets disseminated in multiple organs like skin, adrenal gland, central nervous system, lymph node, liver, spleen, bone marrow, and gastrointestinal tract. It occurs most commonly in immunodeficient patients like HIV-positive patients and transplant recipients, while immunocompetent hosts are affected rarely. In cases of gastrointestinal histoplasmosis, the samples are collected for culture and biopsy should be sent for histopathological examination for definitive diagnosis. We conducted a retrospective study of colonic biopsies performed in the department of gastroenterology in a tertiary care hospital of north India from January 2014 to December 2015. Five cases of colonic histoplasmosis were diagnosed on histopathology out of which 4 patients were from north India while 1 patient was from Myanmar. The patients presented with various complaints, including loose stools, diarrhea, altered bowel habits, and gastrointestinal bleeding. The prognosis is very good after early and aggressive treatment while the disease is fatal if it remains untreated. In our study, 2 patients died within few days of diagnosis due to delay in the diagnosis, dissemination, and associated complications. Other patients were started on amphotericin B deoxycholate and are under follow-up. An early diagnosis of gastrointestinal histoplasmosis is important as appropriate treatment leads to long-term survival while untreated cases are almost fatal.

Topics: Adult; Aged; Amphotericin B; Antifungal Agents; Biopsy; Colon; Colonoscopy; Deoxycholic Acid; Diarrhea; Drug Combinations; Female; Follow-Up Studies; Gastrointestinal Hemorrhage; Histoplasma; Histoplasmosis; Humans; India; Male; Middle Aged; Prognosis; Retrospective Studies; Time Factors

Topics: Amphotericin B; Antiprotozoal Agents; Diarrhea; Humans; Immunocompromised Host; Intestinal Mucosa; Leishmania donovani; Leishmaniasis, Visceral; Liver Transplantation; Macrophages; Male; Middle Aged; Postoperative Complications

Cases of visceral leishmaniasis (VL) in the course of human immunodeficiency virus (HIV) infection have regularly been recorded, mainly in southern Europe. HIV infection can increase the risk of VL development by 10-100 times in endemic areas. We describe the occurrence of this co-infection in 15 patients from Brazil. The mean age of the patients was 38 +/- 8.8 yr, with 86.6% males. The mean time between HIV diagnosis and the onset of visceral leishmaniasis was 44 +/- 39 mo. The main signs and symptoms presented at admission were splenomegaly (73%), weight loss (73%), cough (67%), fever (67%), asthenia (60%), and diarrhea (60%). The mean T CD4+ lymphocyte count was 173.7 +/- 225.6 cells/mm3, and viral load was 51,030 +/- 133,737/mm3. Treatment consisted of pentavalent antimonials (67% of cases). Most (87%) patients recovered from VL infection; death occurred in 1 patient due to septic shock. VL is an important opportunistic infection in HIV patients, which is potentially fatal, even when correct treatment is completed. Treatment should be done with pentavalent antimonials or amphotericin B in the case of relapse. Although there is no consensus, secondary prophylaxis should be considered in severe cases.

Topics: Adult; AIDS-Related Opportunistic Infections; Amphotericin B; Antiprotozoal Agents; Antiretroviral Therapy, Highly Active; Asthenia; Bone Marrow; Brazil; CD4 Lymphocyte Count; Cough; Diarrhea; Female; Fever; HIV Infections; Humans; Leishmaniasis, Visceral; Male; Meglumine; Meglumine Antimoniate; Middle Aged; Organometallic Compounds; Pancytopenia; Retrospective Studies; Splenomegaly; Time Factors; Weight Loss

Topics: Abdominal Pain; Adrenal Cortex Hormones; Adult; Amphotericin B; Antibodies, Monoclonal; Antifungal Agents; Biopsy; Colon; Colonoscopy; Crohn Disease; Diagnosis, Differential; Diagnostic Errors; Diarrhea; Hematologic Tests; Histoplasma; Histoplasmosis; Humans; Infliximab; Male; Necrosis

Fungal endocarditis in children is most commonly a complication of palliative or curative surgery for congenital heart disease, rheumatic valvulitis and prolonged indwelling central venous and umbilical catheters. We describe here the case of a 3-y-old patient with chronic diarrhoea and prolonged total parenteral alimentation who developed severe C. tropicalis endocarditis and was treated successfully using a liposomal preparation of amphotericin-B (AmBisome) without surgical intervention.

Topics: Amphotericin B; Antifungal Agents; Candida; Candidiasis; Child, Preschool; Chronic Disease; Diarrhea; Drug Carriers; Echocardiography; Endocarditis; Heart Atria; Humans; Liposomes; Male; Treatment Outcome

Penicillium marneffei is an opportunistic pathogen predominantly found in Southeast Asia. Systemic infection of Penicillium marneffei has protean manifestations including fever, weight loss, anaemia, skin lesions, and lymphadenopathy. We report a rare case of penicillium colitis in an AIDS patient who responded successfully to a course of amphotericin B therapy.

Topics: Adult; AIDS-Related Opportunistic Infections; Amphotericin B; Antifungal Agents; Colitis; Diagnosis, Differential; Diarrhea; Fever; Humans; Male; Mycoses; Penicillium

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

Of the 393 children who underwent BM autotransplantation in the pediatric oncology unit of the Institut Gustave Roussy between February 1979 and September 1991, 14 (3.56%) developed disseminated Candida infection within 3 months. This incidence was far lower than in other published series. Eleven of the 14 patients recovered from the infection, giving a far higher survival rate (78%) than among adult BM transplant recipients (usually < 30%). All 14 patients had four or more risk factors and persistent BM aplasia (median, 25 days); six had Candida tropicalis infection. Four cases of deep visceral involvement were documented, two of which were lethal. Clinical signs were relatively uniform and included secondary high-grade fever (> 40 degrees C) for 8 days; half the patients developed cardiovascular impairment, respiratory distress, neurological disturbances (altered consciousness or delirium) and severe diarrhoea, within as little as 10 days after transplantation. Blood cultures rapidly became positive after the onset of clinical signs and this permitted prompt treatment with a combination of amphotericin B and 5-fluorocytosine; in addition, central catheters were removed. Blood cultures became sterile within 4 days of treatment in 10 of the 14 cases. The generally favourable outcome in this series could be related to the young age of the patients, the absence of GVHD, the absence of total body irradiation in the conditioning regimen, and early antifungal treatment.

Topics: Adolescent; Amphotericin B; Bone Marrow Transplantation; Candidiasis; Child; Child, Preschool; Diarrhea; Female; Fever; Humans; Male; Neoplasms; Retrospective Studies; Treatment Outcome

The ability of viable and nonviable Saccharomyces boulardii to protect gnotobiotic mice from Clostridium difficile induced mortality was tested. With the exception of irradiated S. boulardii, which retained some activity, only viable yeast protected the mice from lethality. The survival of C. difficile infected mice was dependent on the dose of the yeast provided in the drinking water.

Topics: Amphotericin B; Animals; Bacterial Proteins; Bacterial Toxins; Cecum; Clostridioides difficile; Cytotoxins; Diarrhea; Disease Models, Animal; Enterocolitis, Pseudomembranous; Germ-Free Life; Mice; Saccharomyces

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

Flucytosine-associated diarrhea has been previously described in 6%-10% of patients receiving the drug. A potentially fatal ulcerating enterocolitis has been reported in 4 patients. In none of these reports has radiologic or pathologic data been presented. This report describes a case of flucytosine-associated ulcerating enteritis in which the small bowel x-ray demonstrated severe luminal narrowing, ulceration, and marked separation of loops of bowel. Ileal biopsy revealed an erosive enteritis with mucosal inflammatory infiltrate and disruption of the surface epithelium. Discontinuation of the drug resulted in total resolution of the clinical and radiologic abnormalities.

Topics: Aged; Amphotericin B; Biopsy; Cryptococcosis; Cytosine; Diarrhea; Flucytosine; Humans; Ileitis; Ileum; Male; Radiography; Ulcer

Topics: Amphotericin B; Animals; Anti-Bacterial Agents; Antitoxins; Cells, Cultured; Clostridium; Colitis, Ulcerative; Cricetinae; Cytotoxicity, Immunologic; Diarrhea; Enterocolitis, Pseudomembranous; Haplorhini; Humans; Infant, Newborn; Mice; Neomycin; Penicillins; Polymyxins; Rabbits; Streptomycin; Toxins, Biological

Topics: Amphotericin B; Ampicillin; Anaerobiosis; Bacillus; Bacteroides; Clostridium perfringens; Culture Media; Diarrhea; Enterococcus faecalis; Fungi; Humans; Methods; Microscopy, Electron; Proteus vulgaris; Streptomycin; Symbiosis; Time Factors; Trypanosoma cruzi

Topics: Amphotericin B; Biopsy; Colitis; Diarrhea; Histoplasma; Histoplasmosis; Humans; Intestinal Diseases; Male; Microscopy, Electron; Middle Aged; Mucous Membrane; Rectum

Topics: Amphotericin B; Arthritis, Infectious; Candidiasis; Dehydration; Diarrhea; Diet Therapy; Fructose; Galactose; Glucose; Humans; Infant; Malabsorption Syndromes; Mitosporic Fungi

Topics: Adult; Amphotericin B; Diabetes Complications; Diarrhea; Female; Humans; Potassium; Tetracycline