amphotericin-b and Ulcer

Topics: Acquired Immunodeficiency Syndrome; Adult; AIDS-Related Opportunistic Infections; Amphotericin B; Antifungal Agents; Antigens, Fungal; Biopsy; Chronic Disease; Female; Histoplasma; Histoplasmosis; Humans; Lip Diseases; Mouth Mucosa; Staining and Labeling; Ulcer

The purpose of this study was to determine whether astigmatism or corneal scarring is mediating the reduced visual acuity among patients with fungal keratitis randomized to corneal cross-linking (CXL).. This was a prespecified exploratory outcome from an outcome-masked, 2 × 2 factorial design, randomized controlled clinical trial.. Consecutive patients presented with moderate vision loss from a smear-positive fungal ulcer at Aravind Eye Hospital, Madurai, India.. Study eyes were randomized to one of 4 treatment combinations using an adaptive randomization protocol. The treatment arms included (1) topical natamycin 5% alone, (2) topical natamycin 5% plus CXL, (3) topical amphotericin B 0.15% alone, and (4) topical amphotericin 0.15% plus CXL. Best spectacle-corrected visual acuity (BSCVA), contact lens over-refraction, and scar size and depth as measured by a masked study ophthalmologist using a standardized protocol were recorded at 3 months. Pentacam Scheimpflug imaging was also obtained at 3 months.. BSCVA and contact lens over-refraction, infiltrate and/or scar size and depth, total astigmatism of the front and back of the cornea, total lower-order and higher-order aberrations of the anterior and posterior cornea, and total densitometry of the anterior, central, and posterior stroma were recorded. We performed a mediation analysis looking at the proportion of the effect of CXL on BSCVA that was mediated through scar size, scar depth, astigmatism and density.. BSCVA at 3 months was available for 99 of 111 patients (89%) who had a mean of 0.82-LogMAR (SD 0.68). Three-month infiltrate and/or scar size ( P < 0.001), depth ( P < 0.001), and densitometry ( P = 0.001) were statistically significant predictors of 3-month BSCVA. Astigmatism seemed to mediate 23% of the effect of CXL on BSCVA, whereas scar size mediated 23%, scar depth 17%, and densitometry 7%.. Corneal scarring and astigmatism are mediators of worse visual acuity after cross-linking in fungal keratitis. Corneal densitometry may be a helpful cornea-specific variable for clinicians and researchers in determining the effect of corneal scarring on visual acuity in specific patients and as an objective study outcome.. NCT02570321.

Topics: Amphotericin B; Astigmatism; Cicatrix; Cornea; Corneal Injuries; Corneal Ulcer; Cross-Linking Reagents; Eye Infections, Fungal; Humans; India; Natamycin; Treatment Outcome; Ulcer; Visual Acuity

Topics: Amphotericin B; Antiprotozoal Agents; Humans; Leishmaniasis, Cutaneous; Meglumine; Meglumine Antimoniate; Organometallic Compounds; Ulcer

A series of curcumin bis-conjugates 3a-q, 5a-k and 6a-k were synthesized in good yields utilizing an optimized reaction condition. We explored the effect of different amino acids and protecting groups on biological activities of curcumin. The conjugates were screened for anti-inflammatory, analgesic and antimicrobial properties. Some of the conjugates showed promising biological observations with a potency comparable with the standard references. The variations in biological properties concerning different amino acids and protecting groups are interesting observations. Effects of the synthesized conjugates on splenocytes and the production of nitric oxide by lipopolysaccharide-stimulated peritoneal macrophages are correlated with the observed anti-inflammatory properties. We have also established the safety profile of the most active conjugates. Robust 2D-QSAR studies supported and validated biological data.

Topics: Amino Acids; Analgesics; Animals; Anti-Bacterial Agents; Anti-Inflammatory Agents, Non-Steroidal; Antifungal Agents; Candida albicans; Carrageenan; Cell Proliferation; Curcumin; Dose-Response Relationship, Drug; Edema; Mice; Microbial Sensitivity Tests; Molecular Structure; Pain; Pseudomonas aeruginosa; Quantitative Structure-Activity Relationship; Rats; Salmonella typhi; Spleen; Staphylococcus aureus; Streptococcus pyogenes; Ulcer

Sporotrichosis is an implantation mycosis highly prevalent in Brazil, associated with soil activities and contact with infected animals. It has numerous clinical manifestations and its disseminated cutaneous form is uncommon, found in approximately 4% of cases and usually related to immunosuppressive conditions. We report an alcoholic 56-year-old male patient with no other comorbidities, presenting with multiple cutaneous nodules and ulcers. The patient was diagnosed with disseminated cutaneous sporotrichosis based on the isolation and identification of Sporothrix spp. The patient was initially treated with amphotericin B with satisfactory results and then with itraconazole.

Topics: Alcoholism; Amphotericin B; Animals; Antifungal Agents; Brazil; Humans; Itraconazole; Male; Middle Aged; Sporothrix; Sporotrichosis; Treatment Outcome; Ulcer

We report the first case of invasive ophthalmologic infection by Acrophialophora sp. that was successfully treated using voriconazole (VRCZ). Acrophialophora spp., which has been reported to be an opportunistic pathogen, is a rare thermotolerant soil fungus, but its pathogenicity remains unclear. A 77-year-old man had neutropenia and prostate carcinoma and was receiving hemodialysis. His right eye had been infected for 2 days. His conjunctiva was congested, and it partially formed an abscess. Liposomal amphotericin B (L-AMB) was administered following systemic itraconazole. However, the treatment was changed from L-AMB to systemic VRCZ and VRCZ eye drops because his eye symptoms worsened. Subsequently, his symptoms stabilized and his vision was maintained. Acrophialophora sp. was identified by analyzing regions of internal transcribed spacer and domain 1 and 2 of the ribosomal RNA gene. He completed the 7-week systemic VRCZ course. The mean minimum inhibitory concentration of VRCZ for Acrophialophora spp. has been reported to be the lowest among various antifungal agents, and our results indicated the efficacy of VRCZ treatment for Acrophialophora sp. infection. Our results suggest that invasive Acrophialophora sp. infection may require long-term therapy. Further analysis of the clinical spectrum of Acrophialophora spp. infection and adequate treatment methods are required in the future.

Topics: Adolescent; Adult; Aged; Amphotericin B; Antifungal Agents; Ascomycota; Child; Child, Preschool; Cluster Analysis; Conjunctival Diseases; DNA, Fungal; DNA, Ribosomal Spacer; Eye Infections, Fungal; Female; Humans; Immunocompromised Host; Itraconazole; Male; Microbial Sensitivity Tests; Middle Aged; Phylogeny; RNA, Ribosomal; Sequence Analysis, DNA; Treatment Outcome; Ulcer; Uveitis; Voriconazole

Topics: Amphotericin B; Antifungal Agents; Germany; Histoplasmosis; Humans; Itraconazole; Male; Middle Aged; Tongue Diseases; Treatment Outcome; Ulcer

Topics: Adenocarcinoma; Aged; Amphotericin B; Antifungal Agents; Aspergillosis; Aspergillus fumigatus; Biopsy; Bronchitis; Bronchoscopy; Chemoradiotherapy; Humans; Immunocompromised Host; Lung Neoplasms; Male; Tomography, X-Ray Computed; Tracheitis; Ulcer

We present a case of a 59-year-old woman with Chagas disease who received a kidney transplant. At month 44 post-transplantation, the patient presented with diarrhea that had persisted for 2 months. Colonoscopy showed a colon ulcer and differential diagnoses included cytomegalovirus, bacteria, or parasite infection; drug-related diarrhea; Crohn's disease; celiac disease; and malignancy. The ulcer tissue was positive for Cryptococcus neoformans. Successful treatment consisted of amphotericin B for 8 days and oral fluconazole (800 mg daily) for 3 months. This case illustrates that a colonic ulcer, although rare, could be cryptococcosis.

Topics: Amphotericin B; Antifungal Agents; Colonic Diseases; Cryptococcosis; Cryptococcus neoformans; Diagnosis, Differential; Female; Fluconazole; Humans; Kidney Transplantation; Middle Aged; Ulcer

Topics: Adult; Amphotericin B; Antiprotozoal Agents; Arm; Biopsy; Diagnosis, Differential; Forearm; Humans; Leishmania; Leishmaniasis, Cutaneous; Male; Thoracic Wall; Treatment Outcome; Ulcer

Histoplasmosis is an infection caused by the dimorphic fungus Histoplasma capsulatum and primarily presents with pulmonary symptoms. Immunocompromised individuals are at high risk for contracting disseminated histoplasmosis, which can be fatal if left untreated.. We present a case involving a 50-year-old woman with acquired immunodeficiency syndrome with an ulcerated vulvar lesion concerning for carcinoma. Extensive workup revealed disseminated histoplasmosis without pulmonary manifestations. She was treated with an extended course of an antifungal agent. Her vulvar lesion resolved.. Vulvar histoplasmosis is a rare etiology of vulvar pathology but one that should be considered in immunocompromised patients.

Topics: AIDS-Related Opportunistic Infections; Amphotericin B; Antifungal Agents; Female; Histoplasma; Histoplasmosis; Humans; Middle Aged; Ulcer; Vulvar Diseases

Topics: Amphotericin B; Antifungal Agents; Coccidioides; Coccidioidomycosis; Diabetes Mellitus, Type 1; Diabetic Nephropathies; Fluconazole; Humans; Kidney Transplantation; Lip Diseases; Male; Middle Aged; Pancreas Transplantation; Ulcer

Topics: Aged; Amphotericin B; Antibodies, Monoclonal; Antirheumatic Agents; Arthritis, Rheumatoid; Colonic Diseases; Colonoscopy; Female; Follow-Up Studies; Fungemia; Histoplasmosis; Humans; Immunocompromised Host; Infliximab; Risk Assessment; Ulcer

To describe a case of a scleral ulceration caused by Cryptococcus albidus in a patient with acquired immune deficiency syndrome (AIDS).. Interventional case report. A 16-year-old girl with AIDS was admitted to the hospital with a 1-week history of cough, fever, and sudden onset of a painless scleral lesion on her left eye. Culture of the lesion revealed the fungus Crypotococcus albidus.. The patient was treated with topical amphotericin B and systemic itraconazole, and she recovered fully over 4 weeks without sequelae.. Cryptococcus albidus rarely causes disease in humans. It should be considered as a potential cause of ocular and systemic disease in patients with AIDS.

Topics: Adolescent; AIDS-Related Opportunistic Infections; Amphotericin B; Antifungal Agents; Cryptococcosis; Eye Infections, Fungal; Female; Humans; Itraconazole; Scleral Diseases; Ulcer

Topics: Amphotericin B; Antifungal Agents; Biopsy; Diagnosis, Differential; Fusarium; Humans; Leukemia, Myelogenous, Chronic, BCR-ABL Positive; Lung; Male; Middle Aged; Mycoses; Penile Diseases; Respiratory Tract Infections; Spain; Tomography, X-Ray Computed; Ulcer

Topics: Acute Disease; Adult; Amphotericin B; Antifungal Agents; Antineoplastic Combined Chemotherapy Protocols; Dermatomycoses; Fusarium; Humans; Leukemia, Myeloid; Male; Ulcer

Topics: Adult; Aerosols; Amphotericin B; Anastomosis, Surgical; Antifungal Agents; Aspergillosis; Bronchitis; Female; Follow-Up Studies; Humans; Itraconazole; Lung Transplantation; Male; Middle Aged; Surgical Wound Infection; Tracheitis; Ulcer

A 59-year-old Caucasian male patient with AIDS is described who presented with an oral lesion of cryptococcosis. The gingival ulceration was the only detectable lesion of cryptococcosis. Diagnosis was established by histopathologic findings from biopsy and detection of serum cryptococcal antigen. The patient was treated with amphotericin B and flucytosine. After four weeks of therapy cryptococcal antigen turned negative. The oral ulceration diminished in size, but an inflammatory tissue reaction persisted.

Topics: AIDS-Related Opportunistic Infections; Amphotericin B; Cryptococcosis; Dental Care for Chronically Ill; Drug Therapy, Combination; Fatal Outcome; Flucytosine; Gingival Diseases; Humans; Male; Middle Aged; Mouth Diseases; Ulcer

The fungus Fusarium moniliforme causes fusariosis, which can be invasive and fatal in immunocompromised patients. We report a case of oral Fusarium infection in a granulocytopenic patient with acute myelogenous leukemia who developed necrotic ulceration of the gingiva, extending to the alveolar bone, but was otherwise free of any active systemic lesions. Fusarium moniliforme was identified, by histopathology and culture, to be present in the lesion and was deduced to be the causative organism for this invasive oral infection.

Topics: Acute Kidney Injury; Aged; Agranulocytosis; Amphotericin B; Antineoplastic Combined Chemotherapy Protocols; Cytarabine; Epirubicin; Etoposide; Fatal Outcome; Fusarium; Gingival Diseases; Humans; Immunocompromised Host; Leukemia, Myeloid, Acute; Male; Maxillary Diseases; Mercaptopurine; Mycoses; Necrosis; Prednisolone; Ulcer; Vindesine

Topics: Aged; Amphotericin B; Chronic Disease; Diagnosis, Differential; Female; Histoplasmosis; Humans; Ketoconazole; Maxillary Diseases; Mouth Diseases; Mouth Neoplasms; Ulcer

Topics: Amphotericin B; Ethmoid Bone; Ethmoid Sinus; Female; Humans; Middle Aged; Mouth Diseases; Mucormycosis; Necrosis; Nose Diseases; Palate; Paranasal Sinus Diseases; Turbinates; Ulcer

Flucytosine-associated diarrhea has been previously described in 6%-10% of patients receiving the drug. A potentially fatal ulcerating enterocolitis has been reported in 4 patients. In none of these reports has radiologic or pathologic data been presented. This report describes a case of flucytosine-associated ulcerating enteritis in which the small bowel x-ray demonstrated severe luminal narrowing, ulceration, and marked separation of loops of bowel. Ileal biopsy revealed an erosive enteritis with mucosal inflammatory infiltrate and disruption of the surface epithelium. Discontinuation of the drug resulted in total resolution of the clinical and radiologic abnormalities.

Topics: Aged; Amphotericin B; Biopsy; Cryptococcosis; Cytosine; Diarrhea; Flucytosine; Humans; Ileitis; Ileum; Male; Radiography; Ulcer

Rhinocerebral mucormycosis is a fungal diseases that has a 50% mortality. Its occurrence has increased, possibly because of greater use of chemotherapeutic agents that mya compromise the immunologic defenses of the host or alter the normal flora. The earliest signs, ulceration and pain, may appear in the mouth. In the patient described in this report, the autopsy showed that mucormycosis had entered the brain cells.

Topics: Amphotericin B; Brain Diseases; Female; Humans; Middle Aged; Mouth Diseases; Mucormycosis; Necrosis; Nose Diseases; Prognosis; Ulcer

Rhinocerebral mucormycosis (phycomycetes), a human fungal disease with oral and perioral findings, has an extremely high morbidity and mortality. The disease is most frequently seen in patients with poorly controlled diabetes. The symptoms, findings, and treatment of rhinocerebral mucormycosis are discussed, and two case histories are presented.

Topics: Adult; Amphotericin B; Blepharoptosis; Cellulitis; Diagnosis, Differential; Eye Diseases; Female; Humans; Male; Maxillary Sinus; Middle Aged; Mucormycosis; Nose Diseases; Ophthalmoplegia; Orbit; Palatal Neoplasms; Palate; Paranasal Sinus Neoplasms; Paresthesia; Radiography; Sinus Thrombosis, Intracranial; Ulcer; Vision Disorders

Topics: Amphotericin B; Female; Histoplasmosis; Humans; Injections, Intramuscular; Middle Aged; Mouth Mucosa; Pharyngeal Diseases; Skin Diseases, Infectious; Ulcer

Topics: Adult; Amphotericin B; Blastomyces; Blastomycosis; Bone Diseases; Diagnosis, Differential; Female; Foot; Humans; Leg Ulcer; Lung Diseases, Fungal; Metatarsus; Osteomyelitis; Penicillins; Radiography; Ulcer

Topics: Addison Disease; Adrenal Glands; Amphotericin B; Autopsy; Histoplasma; Histoplasmosis; Humans; Hydrocortisone; Lung; Male; Middle Aged; Oral Manifestations; Sodium Chloride; Thrombophlebitis; Tongue Diseases; Ulcer; Vena Cava, Inferior

Topics: Amphotericin B; Basidiomycota; Biopsy; Female; Humans; Infant; Mouth Diseases; Mouth Mucosa; Mycoses; Palate; Spores, Fungal; Ulcer

Topics: Adult; Amphotericin B; Australia; Biopsy; Gingival Diseases; Histoplasma; Histoplasmosis; Humans; Liver; Male; Radiography; Soil Microbiology; Ulcer

Topics: Aged; Amphotericin B; Histoplasmosis; Humans; Male; Mouth Diseases; Oral Manifestations; Ulcer

Topics: Amphotericin B; Histoplasmosis; Humans; Male; Middle Aged; Tongue Diseases; Ulcer

Topics: Amphotericin B; Anti-Bacterial Agents; Atropine; Chloramphenicol; Cornea; Corneal Ulcer; Diabetes Mellitus; Eye Injuries; Fusarium; Glaucoma; Humans; Mycoses; Ointments; Ophthalmic Solutions; Ophthalmology; Penicillins; Streptomycin; Toxicology; Ulcer