amphotericin-b and Pemphigus

Pemphigus vulgaris is an autoimmune disease that mostly affects the mucosa and oral cavity. Candida species can invade the mucosal lesions of these patients and cause diseases. The aim of this study was to identify the fungal agents isolated from mucosal lesions and evaluate antifungal activity profile against the isolates. A total of 25 patients with pemphigus vulgaris with active oral lesions and 25 healthy people serving as a control group were included in this study. Identification of the fungal isolates was performed based on conventional methods and DNA sequence analysis of the internal transcribed spacer (ITS) rDNA gene region. The sequence results were deposited in the NCBI database using the Basic Local Alignment Search Tool. Antifungal activity of fluconazole, itraconazole, ketoconazole, posaconazole, econazole, and amphotericin B against the isolates were evaluated based on the CLSI M-44 A protocol. Oral candidiasis was detected in 20% of the patients. Candida species isolated from oral lesions of patients with pemphigus were identified as Candida albicans 22/25, Candida glabrata 2/25, and Candida dubliniensis 1/25. All of the isolates were sensitive to amphotericin and econazole, 96% to fluconazole and posaconazole, and 92% to ketoconazole and itraconazole. One patient showed a profile resistant to fluconazole, posaconazole, and ketoconazole, simultaneously. Ninety six percent of control group isolates were sensitive to six antifungals. Candida albicans was the most prevalent species isolated from oral lesions of patients with pemphigus vulgaris and the control group. Amphotericin B and econazole were the most effective antifungals against the isolates.

Topics: Adult; Amphotericin B; Antifungal Agents; Candida; Candidiasis, Oral; Disk Diffusion Antimicrobial Tests; Econazole; Female; Fluconazole; Humans; Itraconazole; Ketoconazole; Male; Pemphigus; Triazoles

To our knowledge, these are the first reports of bloodstream infections by Trichosporon inkin in patients with pemphigus.. Trichosporon inkin, a novel organism causing bloodstream infection, was detected in 2 patients with pemphigus. An elderly man with pemphigus foliaceus died despite treatment with liposomal amphotericin B, 3 mg/kg/d, and a young girl with pemphigus vulgaris responded to treatment with voriconazole, 8 mg/kg/d, for 24 days. One of the T inkin isolates had a minimal inhibitory concentration of 2 mg/L against amphotericin B, suggesting resistance to the drug.. Delayed suspicion of invasive infection by T inkin may result in a poor outcome in patients with severe forms of pemphigus. This opportunistic infection is highly refractory to conventional potent antifungal treatment.

Topics: Aged; Amphotericin B; Antifungal Agents; Child; Drug Resistance, Fungal; Fatal Outcome; Female; Humans; Male; Microbial Sensitivity Tests; Opportunistic Infections; Pemphigus; Severity of Illness Index; Trichosporon; Trichosporonosis; Voriconazole

Topics: Amphotericin B; Antifungal Agents; Cellulitis; Diabetes Mellitus, Type 2; Female; Hand Dermatoses; Histoplasma; Histoplasmosis; Humans; Hypothyroidism; Immunocompromised Host; Immunosuppressive Agents; Itraconazole; Middle Aged; Panniculitis; Pemphigus

Topics: Adrenal Cortex Hormones; Amphotericin B; Cryptococcosis; Enzyme-Linked Immunosorbent Assay; Female; Follow-Up Studies; Graft Survival; Humans; Middle Aged; Pemphigus; Preoperative Care; Risk Assessment; Severity of Illness Index; Skin Transplantation; Skin Ulcer; Tissue and Organ Harvesting; Transplantation, Autologous; Treatment Outcome; Wound Healing

Topics: Amphotericin B; Anti-Inflammatory Agents; Antifungal Agents; Birefringence; Cellulitis; Cryptococcosis; Cryptococcus; Fluconazole; Humans; Male; Middle Aged; Pemphigus; Prednisone; Skin

With the setting up of a rural-medical post in the region of Pachitea-Pichis river, affluent of the Alto Ucayali, in the year 1973, the authors made the diagnosis of 120 cases of pigmentary Leishmaniasis (1,2 % of the total population). 55 % of this series corresponded to pure cutaneous forms and 65 were of the muco-cutaneous type, 21 of the latter being mutilating. Sixty per cent were young males working as wood labourers or farmers. The treatment with Repodral (Etilofen) was useful only in the initial froms. Brezilian Pemhigus foliaceous which is considered endemic in the same geographical area responded wery well to treatment with prednisolone.

Topics: Administration, Topical; Adolescent; Adult; Aged; Amphotericin B; Anti-Inflammatory Agents; Child; Child, Preschool; Dermatitis, Occupational; Humans; Infant; Leishmaniasis, Mucocutaneous; Male; Middle Aged; Pemphigus; Peru; Prednisolone; Skin Ulcer; Wood

Topics: Amphotericin B; Candidiasis, Oral; Female; Geotrichosis; Glucocorticoids; Humans; Middle Aged; Mitosporic Fungi; Mouth Mucosa; Mycoses; Pemphigus