nystatin-a1 and Diabetes-Mellitus--Type-2

To determine number, species of Candida and Candida resistance to antifungal therapy according to the metabolic control state and the associated salivary changes in patients with type 2 diabetes mellitus (DM2).. Samples of non-stimulated saliva were collected from 52 patients with DM2. Salivary pH was measured and cultured on Sabouraud glucose agar and the values of CFU/ml were calculated. The species were presumptively identified using CHROMagar Candida. Sixty six percent of the yeasts isolated were Candida albicans, followed by C. glabrata (20.7%). In patients with decompensated DM2, there was an inverse association between HbA1c value and salivary pH. At higher levels of salivary acidification, a greater diversity and quantity of yeasts of the genus Candida were observed. With nystatin, higher inhibition was observed at lower pH.. The antifungal therapies could be more effective if it consider, qualitative salivary characteristics as pH, that could determine the susceptibility of species of Candida to at least to nystatin, which is the most used antifungal for treatment to oral candidiasis in patients with DM2.

Topics: Adult; Antifungal Agents; Candida; Candida albicans; Candida glabrata; Candidiasis, Oral; Diabetes Mellitus, Type 2; Drug Resistance, Fungal; Female; Fluconazole; Humans; Microbial Sensitivity Tests; Nystatin

Oral hairy leukoplakia (OHL) presents as a white, plaque-like lesion typically occurring on the lateral border of the tongue. This condition is caused by the Epstein-Barr virus, a human herpesvirus that often establishes lifelong, asymptomatic latent infection. OHL, initially described in immunocompromised men infected with the human immunodeficiency virus (HIV), has also been described in other severely immunocompromised patients. Only rarely has OHL been reported in less profoundly immunocompromised patients primarily in the setting of corticosteroid therapy. Here we report on two additional cases of OHL attributable to immunosuppressive medications.

Topics: Aged; Anti-Infective Agents; Anti-Inflammatory Agents; Antifungal Agents; Arthritis, Rheumatoid; Clobetasol; Dapsone; Dermatologic Agents; Dexamethasone; Diabetes Mellitus, Type 2; Epstein-Barr Virus Infections; Female; Fluconazole; Humans; Immunocompromised Host; Leukoplakia, Hairy; Lichen Planus; Methotrexate; Nystatin; Prednisone; Zinc Oxide

An increase in the frequency of fungal infections is related with progress in mycology and decreased susceptibility of fungal strains to commonly used antifungal agents. Diabetes and pregnancy are two independent factors believed to be responsible for an increased risk of mycoses.. The aim of the study was to assess the susceptibility of fungal strains isolated from pregnant women with diabetes as well as healthy pregnant women to ten antifungal agents.. In the study 106 diabetic pregnant women and 102 healthy pregnant women were included. Susceptibility of the fungal strains was assessed in vitro by disk diffusion test.. Fungal strains were detected in 190 (30.4%) out of 624 samples obtained from vagina, rectum and oral cavity of 208 women. Fungi were found in 42.1% of pregnant women with diabetes and in 41.5% of health pregnant patients. Strains isolated from the diabetic women showed the highest susceptibility to pimaricin (34.4%), nystatin (31.3%) and tioconazole (31.3%) while those from healthy pregnant women were mostly susceptible to itraconazole (59.6%) and miconazole (53.2%). The comparison of the susceptibility of fungi to antifungal agents revealed that the strains isolated form healthy women were significantly more susceptible to clotrimazole (p=0.003), itraconazole (p<0.001) and miconazole (p=0.001). No difference was found in susceptibility to pimaricin (p=0.54), nystatin (p=0.75), amphotericine B (p=0.84), ketoconazole (p=0.123) and fluconazole (p=0.61) between those two groups of fungal strains.. Significant differences in susceptibility of fungi isolated from pregnant diabetic women to clotrimazole, itraconazole and miconazole suggest that diabetes has influence on resistance of fungal strains to some antifungal agents.

Topics: Adult; Antifungal Agents; Candida; Diabetes Complications; Diabetes Mellitus, Type 2; Dose-Response Relationship, Drug; Drug Resistance, Fungal; Female; Humans; Imidazoles; Itraconazole; Miconazole; Microbial Sensitivity Tests; Natamycin; Nystatin; Poland; Pregnancy; Pregnancy Complications, Infectious; Reference Values; Young Adult

Acarbose and nystatin are usually well-tolerated drugs because of their minimal intestinal absorption. We report herein two cases of acute generalized exanthematous pustulosis induced by these two molecules.. A 43 year-old man with a history of insulin-deficient diabetes was admitted to our department for a febrile generalized cutaneous pustular erythema, that had appeared 48 hours after acarbose (Glucor) introduction. Acarbose was discontinued and the eruption resolved in one week. A 29 year-old man developed a flexural erythema twenty four hours after nystatin (Mycostatin) treatment, progressing towards a febrile pustular erythroderma, with elevated neutrophilic and eosinophilic counts. The lesions regressed rapidly with topical steroid treatment. The patch tests performed a few months later with Mycostatin and nystatin were positive.. The clinical presentation of these two patients was typical of acute generalized exanthematous pustulosis, according to the EuroSCAR group criteria and acarbose and nystatin were the most likely factors that caused the disease according to the French unexpected or toxic drug reaction assessment. The minimal intestinal absorption of these two molecules explains their usual good tolerance. However, some cases of toxiderma have already been reported. There is the first described case of acute generalized exanthematous pustulosis with acarbose. Our two observations underline the possibility of severe toxiderma induced by low-absorbed and low-blood concentration molecules and focus on the need to take them in account in the toxiderma anamnesis.

Topics: Acarbose; Adult; Antifungal Agents; Candidiasis, Cutaneous; Diabetes Mellitus, Type 2; Diagnosis, Differential; Drug Eruptions; Genital Diseases, Male; Humans; Hypoglycemic Agents; Intestinal Absorption; Male; Nystatin; Patch Tests; Skin Diseases, Vesiculobullous