amphotericin-b and Escherichia-coli-Infections

Mucormycosis is a rare but aggressive fungal infection that predominantly affects immunocompromised patients. We report a case that highlights the importance of knowledge to enable prompt diagnosis and management of an otherwise fatal phenomenon.

Topics: Aged, 80 and over; Amphotericin B; Anemia, Aplastic; Antifungal Agents; Escherichia coli Infections; Fatal Outcome; Female; Humans; Immunocompromised Host; Mucormycosis; Necrosis; Rhizopus; Tongue; Triazoles

This is a case of mucormycosis complicated by necrotizing fasciitis in a renal transplant recipient on immunosuppressive therapy treated with posaconazole. Mucormycosis occurs most commonly as an opportunistic infection in the immunocompromised host. This patient, with predisposing risk factors for infection, including diabetes mellitus status post cadaveric renal transplantation on immunosuppressive therapy, is the first reported case of successful treatment of Mucor involving an extremity which was neither fatal nor required extremity amputation.

Topics: Alcaligenes; Amphotericin B; Amputation, Surgical; Antifungal Agents; Cefazolin; Combined Modality Therapy; Debridement; Diabetes Mellitus, Type 2; Diabetic Nephropathies; Drug Combinations; Drug Resistance, Multiple, Fungal; Escherichia coli Infections; Fatal Outcome; Fluconazole; Gangrene; Graft Rejection; Gram-Negative Bacterial Infections; Humans; Immunocompromised Host; Immunosuppressive Agents; Kidney Transplantation; Leg; Leg Ulcer; Male; Middle Aged; Mucor; Mucormycosis; Penicillanic Acid; Phosphatidylcholines; Phosphatidylglycerols; Piperacillin; Postoperative Complications; Pyrimidines; Renal Dialysis; Reoperation; Sepsis; Skin Transplantation; Tazobactam; Triazoles; Voriconazole

A 54-year-old farmer with moderate mitral valve regurgitation was admitted to hospital because of suspected infective endocarditis.. Echocardiography revealed a large mitral valve vegetation as the source of multifocal septic emboli to the central nervous system, spleen, mesenteric and femoro-popliteal arteries, eyes, and kidneys. Eventually an embolus removed from the femoro-popliteal artery and vegetations on the replaced mitral valve grew C. albicans.. Despite treatment with amphotericin B and valve replacement the patient died of septicemia due to E. coli.. Endocarditis due to C. albicans is commonly associated with severe complications. Diagnosis of this rare disease is often delayed because of negative blood cultures. Large cardiac vegetations and embolization of major arterial vessels should raise the suspicion of fungal endocarditis.

Topics: Amphotericin B; Candida albicans; Candidiasis; Echocardiography; Embolism; Endocarditis; Escherichia coli Infections; Fatal Outcome; Heart Valve Prosthesis; Humans; Male; Middle Aged; Mitral Valve; Mitral Valve Insufficiency; Sepsis

We report a case of Candida glabrata perinephric abscess in a patient with diabetes mellitus who recently underwent ureteropelvic surgery for lithiasic urinary tract obstruction. Surgical drainage and amphotericin B treatment led to resolution of the infection. C. glabrata urinary infection has become more prevalent over the last decade in immunocompromised patients. Drainage is indicated for development of a fungal abscess in the perinephric area. Most authors recommend administration of an antifungal adjuvant treatment.

Topics: Abscess; Aged; Amphotericin B; Anti-Bacterial Agents; Antifungal Agents; Candida; Candidiasis; Combined Modality Therapy; Diabetes Mellitus, Type 1; Drainage; Escherichia coli Infections; Female; Humans; Hypertension; Immunocompromised Host; Kidney Diseases; Postoperative Complications; Risk Factors; Serotyping; Urinary Calculi; Urinary Tract Infections

The recovery of Candida albicans along with bacteria from the abdomen in the setting of peritonitis is becoming increasingly common. It is not known whether the interactions between the fungal and bacterial elements of these infections are synergistic, competitive, or neutral. To study this question, we have examined the effects of both the addition of C. albicans to a solely bacterial infection caused by Escherichia coli and Bacteroides fragilis, and the deletion of various components of this system using directed antimicrobial therapy. In a mixed infection, both C. albicans and bacteria contributed to mortality, since only the combination of cefoxitin and amphotericin B improved survival (from 50% to 90%). The addition of C. albicans to the bacterial inoculum increased the recovery of abscesses, but only to the number seen with fungal infection alone, implying two fairly independent processes. Although the number of bacteria recovered from abscesses at 10 days postinfection was unchanged with the addition of fungi, the deletion of the bacterial component of mixed infections led to the overgrowth of C. albicans. We conclude that this model of mixed C. albicans/E. coli/B. fragilis peritonitis is best characterized as two nonsynergistic, parallel infections with incomplete competition, allowing the survival of all three organisms to eventual abscess formation.

Topics: Abscess; Amphotericin B; Animals; Bacteroides fragilis; Bacteroides Infections; Candida albicans; Candidiasis; Cefotetan; Cefoxitin; Clindamycin; Colony Count, Microbial; Drug Combinations; Escherichia coli; Escherichia coli Infections; Male; Mice; Mice, Inbred BALB C; Peritoneal Diseases; Peritonitis; Survival Rate

We evaluated the effects of amphotericin B (AmB) against Pseudomonas aeruginosa (P. aeruginosa) infection in mice. Pretreatment with 2 mg/kg of AmB 24 hours before infection significantly increased the survival rates of mice intraperitoneally infected with either P. aeruginosa or Escherichia coli. To evaluate the mechanism of this AmB-induced resistance to infection, we conducted a number of experiments. Peritoneal macrophages exposed in vitro to AmB showed superior bactericidal activity compared to that of control macrophages. Interleukin-1 production by peritoneal macrophages from mice pretreated with 2 mg/kg of AmB was significantly higher than that in control mice. Serum tumor necrosis factor level after intravenous injection of P. aeruginosa was also higher in mice pretreated with 2 mg/kg of AmB than in control mice. These data indicate that AmB induces resistance to P. aeruginosa in mice. Furthermore AmB-induced activation of peritoneal macrophages and their production of interleukin-1 and tumor necrosis factor appeared to play important roles in this phenomenon.

Topics: Amphotericin B; Animals; Drug Resistance, Microbial; Escherichia coli Infections; Interleukin-1; Macrophages; Male; Mice; Mice, Inbred ICR; Pseudomonas aeruginosa; Pseudomonas Infections

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

One hundred and ninety-five series of granulocyte transfusions in 144 patients were evaluated with respect to possible severe pulmonary toxicity from concomitant administration of granulocytes and amphotericin B. Dyspnea as a side effect of granulocyte transfusion was equally common among patients receiving amphotericin B and those in a matched control group not receiving amphotericin B. Granulocyte transfusions and amphotericin B were given simultaneously in 35 transfusion series, involving 32 patients. Respiratory deterioration, defined as the appearance of new pulmonary infiltrates on chest x-ray, occurred in 11 of these 35 episodes. Patients developing respiratory deterioration were similar to those not developing respiratory deterioration in age, diagnosis, disease status, duration of concomitant therapy, and outcome, but more often had positive fungal cultures as an indication for treatment (91% versus 58%; p = 0.1). In 8 patients, the episodes of respiratory deterioration were readily explained by congestive heart failure, by simultaneous bacteremia or fungemia, or by fungal pneumonia discovered at autopsy. One patient had a leukoagglutinin reaction (responsive to steroids) and the other 2 had unexplained, but reversible respiratory deterioration. We concluded that concomitant administration of granulocyte transfusions and amphotericin B is not associated with unexpected or rapidly fatal pulmonary toxicity and when appropriate, can be safely accomplished.

Topics: Adolescent; Adult; Aged; Agranulocytosis; Amphotericin B; Candidiasis; Child; Child, Preschool; Dyspnea; Escherichia coli Infections; Granulocytes; Humans; Lung; Middle Aged; Neutropenia; Pseudomonas Infections; Time Factors

One hundred consecutive subclavian catheter insertions were performed by the surgical house staff of Martland Hospital, Newark, New Jersey, over a ten month period. The only complications were three punctures of the subclavian artery and one systemic infection. The following conclusions were drawn from these data. Maintaining a closed intravenous system with minimal manipulation of the catheter is the most important factor in avoiding infectious complication. Neither the routine use of irrigation of the catheter with amphotericin B nor insertion of the catheter under strict aseptic conditions is necessary to minimize infectious complications. The morbidity related to insertion of the catheter can be kept to a minimum if the catheters are inserted by experienced personnel.

Topics: Amphotericin B; Asepsis; Catheterization; Emergencies; Escherichia coli Infections; Humans; Neoplasms; Parenteral Nutrition; Punctures; Sepsis; Subclavian Vein; Surgical Procedures, Operative; Surgical Wound Infection; Therapeutic Irrigation; Time Factors

Topics: Amphotericin B; Animals; Anti-Bacterial Agents; Anti-Infective Agents; Bacterial Infections; Candida albicans; Candidiasis; Escherichia coli; Escherichia coli Infections; Mice; Neomycin; Nystatin; Penicillins; Polymyxins; Staphylococcal Infections; Streptomycin; Tetracycline; Thiourea; Undecylenic Acids

Topics: Age Factors; Amphotericin B; Anti-Bacterial Agents; Cryptococcus; Escherichia coli Infections; Humans; Injections, Intravenous; Injections, Spinal; Intracranial Pressure; Leptospira; Meningitis; Meningitis, Haemophilus; Meningitis, Listeria; Meningitis, Meningococcal; Meningitis, Pneumococcal; Meningitis, Viral; Microbial Sensitivity Tests; Penicillins; Staphylococcal Infections; Streptococcal Infections; Streptomycin; Sulfonamides; Tuberculosis, Meningeal

Topics: Amphotericin B; Anti-Bacterial Agents; Antibiotic Prophylaxis; Enterobacter aerogenes; Escherichia coli Infections; Humans; Infant, Newborn; Proteus Infections; Pseudomonas Infections; Spinal Dysraphism; Staphylococcal Infections; Streptococcal Infections; Tetracycline

Topics: Amphotericin B; Anti-Bacterial Agents; Chloramphenicol; Colistin; Drug Resistance; Drug Resistance, Microbial; Endocarditis; Endocarditis, Bacterial; Enterobacter aerogenes; Enterobacteriaceae; Erythromycin; Escherichia coli Infections; Kanamycin; Penicillin G; Penicillins; Proteus Infections; Pseudomonas Infections; Ristocetin; Staphylococcal Infections; Streptococcal Infections; Streptomycin; Tetracycline; Vancomycin

Topics: Adolescent; Amphotericin B; Child; Diphtheria; Enterovirus Infections; Escherichia coli Infections; Humans; Infant; Otolaryngology; Phosphates; Pneumococcal Infections; Pseudomonas Infections; Staphylococcal Infections; Streptococcal Infections; Tetracycline