amphotericin-b and Leg-Dermatoses

Cryptococcus neoformans is a common fungus found throughout the environment that causes opportunistic disease in immunocompromised individuals. Infection of humans with C neoformans usually manifests as lung disease through inhalation of spores or meningoencephalitis by involvement of the central nervous system. Rarely, dissemination in the form of cutaneous lesions can occur in individuals with long term immunosuppression. We present a patient with C. neoformans manifesting as cellulitis with focal segmental glomerulosclerosis treated with corticosteroids. Because of the mortality associated with disseminated cryptococcosis, early identification, especially of atypical cutaneous presentations is critical from a dermatological perspective.

Topics: Amphotericin B; Antifungal Agents; Cellulitis; Cryptococcosis; Cryptococcus neoformans; Cyclosporine; Fluconazole; Flucytosine; Fungemia; Glomerulosclerosis, Focal Segmental; Humans; Immunocompromised Host; Immunosuppressive Agents; Leg Dermatoses; Male; Middle Aged; Prednisone; Skin

A small hyperpigmented nodule 4 mm in diameter with a smaller satellite lesion was noted on the left hip 5 weeks after spontaneous birth of an otherwise unharmed 490 g female infant at 23 + 5 weeks of gestation. The mother had been treated with antibiotics for a clinically suspected amniotic infection syndrome. Aspergillus fumigatus was identified in both repeated swabs of the lesions and culture of the resected tissue. The infant received liposomal amphotericin B (3 mg/kg/day) for 8 days. No new lesions were noted thereafter. There was no evidence for a primary immunodeficiency.

Topics: Amphotericin B; Antifungal Agents; Aspergillosis; Aspergillus fumigatus; Female; Humans; Infant, Extremely Low Birth Weight; Infant, Newborn; Leg Dermatoses; Treatment Outcome

The authors report the clinical history of a patient having presented a cutaneous mucormycosis at the waning of a traumatic dilapidation post of the left lower limb. Mucormycosis is an opportunistic fungal infection due to fungi of the group of mucorales present in the environment. There are various clinical forms of the disease; it occurs generally in a predisposed environment. The diagnosis is based on the mycologic and pathologic examination. The therapeutic approach must be multidisciplinary; the vital and functional prognosis depends on early diagnosis and treatment.

Topics: Adult; Amphotericin B; Antifungal Agents; Humans; Leg Dermatoses; Male; Mucormycosis; Opportunistic Infections; Treatment Outcome

Existing systemic treatments for New World cutaneous leishmaniasis (CL) caused by Leishmania (vianna) braziliensis are unsatisfactory. Liposomal amphotericin B has been used extensively for the treatment of visceral leishmaniasis, but in few cases of CL, and an appropriate regimen for CL has not been described. We successfully treated a patient with multiple L. braziliensis CL lesions acquired in Belize. Liposomal amphotericin B (AmBisome) was given to our patient as an inpatient for seven daily doses of 3 mg kg(-1) day(-1) and then as an outpatient at 3 mg kg(-1) twice weekly for a further three weeks, a total of 40 mg kg(-1). Liposomal amphotericin offers a well-tolerated alternative to pentavalent antimony or amphotericin B deoxycholate for the systemic treatment of New World CL.

Topics: Adult; Amphotericin B; Animals; Antiprotozoal Agents; Humans; Leg Dermatoses; Leishmania braziliensis; Leishmaniasis, Cutaneous; Liposomes; Male

Topics: Aged; Amphotericin B; Antifungal Agents; Cellulitis; Cryptococcosis; Dermatomycoses; Female; Fluconazole; Flucytosine; Humans; Immunocompetence; Itraconazole; Leg Dermatoses

Topics: Amphotericin B; Blastomyces; Blastomycosis; Cytosine; Erythema; Facial Dermatoses; Flour; Humans; Leg Dermatoses; Male; Microscopy, Electron; Middle Aged; Spain; Spores, Fungal