amphotericin-b and Genital-Diseases--Male

Topics: Acquired Immunodeficiency Syndrome; Amphotericin B; Female; Genital Diseases, Female; Genital Diseases, Male; Humans; Male; Mycoses; Urologic Diseases

Symptomatic involvement of the genitourinary tract as a manifestation of disseminated Coccidioides immitis infection is uncommon. We report a case of a colovesical fistula secondary to Coccidioides immitis infection and review the pertinent medical literature.

Topics: Adult; Amphotericin B; Coccidioidomycosis; Genital Diseases, Male; Humans; Hydronephrosis; Intestinal Fistula; Ketoconazole; Male; Prostatic Diseases; Sigmoid Diseases; Urinary Bladder Diseases; Urinary Bladder Fistula

Genitourinary fungal infections have become increasingly common in clinical practice. We review the literature on such infections, emphasizing recognition of fungal disease, predisposing factors, pathogenesis, and approaches to therapy.

Topics: Amphotericin B; Aspergillosis; Blastomycosis; Candidiasis; Coccidioidomycosis; Cryptococcosis; Female; Genital Diseases, Female; Genital Diseases, Male; Histoplasmosis; Humans; Infant, Newborn; Male; Mycoses; Urinary Tract Infections

Although fungal urinary tract infections occur less frequently than bacterial urinary tract infections their incidence has increased during the last several decades and their clinical importance to the urologist should not be underestimated. Herein the pertinent literature on fungal urinary tract infections is reviewed, with emphasis on the predisposing factors, pathogenesis, host defense mechanisms and the clinical spectrum of the disease. An approach to the evaluation of positive cultures and therapy is presented.

Topics: Amphotericin B; Animals; Candida; Candidiasis; Female; Flucytosine; Genital Diseases, Female; Genital Diseases, Male; Humans; Male; Mice; Mycoses; Urinary Tract Infections

Twenty-two strains of Trichosporon beigelii have been tested for susceptibility to imidazole compounds. Ten strains were isolated from untreated genital white piedra lesions and 12 were from the same patients following treatment failure with imidazole compounds. Agar dilution and disk elution methods were compared using two media: yeast nitrogen base and antibiotic assay medium 3 (Difco). Antifungal agents tested were econazole, miconazole, ketoconazole, clotrimazole, and amphotericin B in concentrations of 0.0625-32 micrograms/mL. The most consistent results occurred with antibiotic assay medium 3 and the agar dilution method giving minimal inhibitory concentrations between 0.0625 and 0.25 micrograms/mL. Using yeast nitrogen base agar, minimal inhibitory concentrations were higher ranging from 0.0625 to 2.0 micrograms/mL. End points of growth in the disk elution method were not clearly delineated and ranged from 0.0625 to 8.0 micrograms/mL. The distribution of minimal inhibitory concentrations obtained using different media and methods were compared by chi 2 analysis, and the medium was found to significantly change the minimal inhibitory concentrations. There was no difference in the susceptibility of strains of T. beigelii to imidazole compounds whether isolated before or after treatment. It was concluded that in vitro susceptibility of T. beigelii to imidazole compounds did not necessarily predict efficacy in vivo.

Topics: Amphotericin B; Clotrimazole; Culture Media; Econazole; Genital Diseases, Male; Hair; Humans; Imidazoles; Ketoconazole; Male; Miconazole; Microbial Sensitivity Tests; Mitosporic Fungi; Mycoses; Piedra; Scrotum; Trichosporon

Candidiasis often is the final insult to the critically ill patient. Flucytosine, an orally administered antifungal agent, was used in the treatment of 225 patients with genitourinary candidiasis. Criteria for treatment included clinical manifestations, high urine colony counts of Candida, serologic findings and in vitro sensitivity of Candida to flucytosine. Infection was eradicated in 212 patients (94 per cent), as determined by clinical and laboratory criteria. The only significant adverse drug effect was reversible agranulocytosis, which ccurred in 2 patients. Thirteen patients (6 per cent) required supplemental therapy with systemic or bladder irrigations of amphotericin B.

Topics: Agranulocytosis; Amphotericin B; Candidiasis; Cytosine; Female; Flucytosine; Genital Diseases, Female; Genital Diseases, Male; Humans; Male; Urinary Tract Infections

Topics: Amphotericin B; Chlamydia Infections; Chloramphenicol; Condylomata Acuminata; Female; gamma-Globulins; Genital Diseases, Female; Genital Diseases, Male; Herpes Zoster; Humans; Immunoglobulins; Lymphogranuloma Venereum; Male; Molluscum Contagiosum; Mumps; Mycoplasma Infections; Orchitis; Podophyllin; Tetracycline; Vaccination; Vaccinia; Virus Diseases

Cellulitis of the scrotum and penis is caused, in the majority of instances, by a beta hemolytic streptococci without a discernible portal of entry. Clostridium, occasionally, will result in this disease as a manifestation of a perirectal abscess. In either instance, fluid accumulates rapidly in the closed space between Colles' and Buck's fascia, producing intense swelling of the scrotum. If this compartment is not immediately decompressed by linear incisions, devascularization of the scrotal and penile skin will often occur, resulting in gangrene. Immediate treatment of the bacterial infection with penicillin also is essential. If gangrene does develop, radical debridement of the necrotic tissue as well as a wide margin of adjacent inflamed skin must be undertaken. Continual monitoring of the microflora of the debrided would is essential for the selection of the appropriate antibiotic against any secondary intruders. Coverage of the granulating would is accomplished when the would bacterial count is below 10-5 per gram of tissue.

Topics: Amphotericin B; Anti-Bacterial Agents; Antistreptolysin; Candida albicans; Candidiasis; Cellulitis; Debridement; Gangrene; Genital Diseases, Male; Humans; Immunity; Male; Middle Aged; Penile Diseases; Scrotum; Skin Diseases; Skin Transplantation; Streptococcal Infections; Transplantation, Autologous

In a retrospective study of 51 cases of systemic North American blastomycosis 11 patients were found to have genitourinary tract involvement, the prostate and epididymis being most commonly affected. Diagnosis was made by culture of the fungus from urine, abscess or prostate secretions, morphologic identification of the characteristic organism in urine or secretions, or histologic examination of tissue specimens. Treatment with amphotericin B reduced the mortality rate of 90 per cent to as low as 10 per cent. Long-term followup is necessary because of a relapse rate of 10 to 15 per cent.

Topics: Adult; Aged; Amphotericin B; Blastomycosis; Epididymitis; Genital Diseases, Male; Humans; Kidney Diseases; Male; Middle Aged; Penile Diseases; Potassium Iodide; Prostatic Diseases; Stilbamidines; Testicular Diseases

Topics: Aminosalicylic Acids; Amphotericin B; Blastomycosis; Coitus; Endometritis; Epididymis; Fallopian Tubes; Female; Genital Diseases, Female; Genital Diseases, Male; Humans; Isoniazid; Lung; Male; Middle Aged; Peritoneal Diseases; Prostatic Diseases; Radiography; Sexually Transmitted Diseases; Testicular Diseases; Urogenital System; Urologic Diseases; Uterine Diseases