amphotericin-b and Periodontitis

Papillon-Lefevre syndrome (PLS) is an autosomal recessive disease that is characterized by symmetric palmoplantar keratodermatitis and severe periodontal destruction. Mutations in the cathepsin C gene (CTSC) have recently been detected in PLS. Immune dysregulation, due to a mutation in CTSC, increases the risk of pyogenic infections in PLS patients. A child with PLS is presented here with liver abscesses and peritonitis caused by Rhizopus oryzae. His liver abscess and peritonitis were cured with amphotericin B without surgical care. This is the first case in the literature liver abscess due to Rhizopus oryzae in a child with PLS.

Topics: Adolescent; Amphotericin B; Humans; Liver Abscess, Pyogenic; Male; Mucormycosis; Papillon-Lefevre Disease; Periodontitis; Rhizopus; Treatment Outcome

The susceptibility of a total of 70 Candida albicans strains to five common antifungal agents was determined. Thirty-five of the strains were isolated from persistent cases of apical periodontitis and 35 from cases of marginal periodontitis. The susceptibility of the strains to amphotericin B, 5-fluorocytosine and three azoles: fluconazole, miconazole and clotrimazole, was tested. The antifungal agents and yeast inoculums were prepared according to the NCCLS (National Committee for Clinical Laboratory Standards) recommendations. The yeasts were incubated with ten different concentrations of antifungal agents at 35 degrees C for 48 h. Yeast growth was measured spectrophotometrically. All strains from both isolation sources were susceptible to low concentrations of amphotericin B and 5-fluorocytosine, whereas the susceptibility to the three azoles varied, and three of the strains showed azole cross-resistance. These findings are in agreement with recent reports of increased azole resistance in Candida species in general and suggest the possibility that the oral cavity may act as a reservoir of resistant yeast isolates in systemic infections.

Topics: Amphotericin B; Antifungal Agents; Candida albicans; Clotrimazole; Fluconazole; Flucytosine; Humans; Miconazole; Microbial Sensitivity Tests; Periapical Periodontitis; Periodontitis

Potencies of polyclonal B-cell activation in C3H/HeN mice of Actinobacillus actinomycetemcomitans, Fusobacterium nucleatum, and Porphyromonas gingivalis endotoxins were 0.36, 0.13 and 0.04, taking Salmonella abortusequi as 1.0. F. nucleatum and P. gingivalis endotoxins showed positive reactions in C3H/HeJ mice. Most activities in C3H/HeN other than that of F. nucleatum were suppressed by polymyxin B. In C3H/HeJ mice, similar inhibitions were only 60% for P. gingivalis and hardly observed with F. nucleatum. The resistances to polymyxin B could be due to protein in the endotoxins. A promoting effect of T cells added to B cells was observed only in the activity of F. nucleatum endotoxin in C3H/HeJ mice; there was no influence in other groups. Test endotoxins had nearly the same ability to produce colony stimulating factor as did references and could not produce the factor in tolerant mice. The clinical significance of tolerance is discussed. Regression lines of endotoxin doses and limulus activities of test endotoxins and Salmonella were parallel, either in specific or non-specific tests. The lines of two test groups were also parallel; values obtained by two tests were very close. These data indicate that the test endotoxins did not contain (1-3)-beta-D-glucan and elicited qualitatively similar limulus reactions to that of the reference, despite their different chemical natures. In conclusion, these test preparations had an endotoxicity similar to that of the reference and contribute to produce periodontitis through polyclonal B cell activation.

Topics: Aggregatibacter actinomycetemcomitans; Amphotericin B; Animals; B-Lymphocytes; Dose-Response Relationship, Immunologic; Endotoxins; Fusobacterium nucleatum; Gram-Negative Anaerobic Bacteria; Immune Tolerance; Limulus Test; Lymphocyte Activation; Male; Mice; Mice, Inbred C3H; Periodontitis; Porphyromonas gingivalis; Regression Analysis