RESUMEN
INTRODUCTION: The aggressive and timely treatment of post-traumatic fungal infections is the most efficacious way to reduce morbidity and mortality. Compared to the military trauma population, studies reporting on fungal infections in civilian trauma are not well described. The purpose of this study was to describe characteristics of civilian trauma patients who developed fungal infections and to identify common risk factors and report any delays between injury and treatment. METHODS: This was a five-year (1/1/2013-3/1/2018) retrospective, descriptive study across six level 1 trauma centers. All consecutively admitted trauma patients (≥18 years) with laboratory-confirmed fungal wound infections were included. Patients with solely candida wound isolates were excluded. Patient demographics, clinical wound and infection characteristics, organisms cultured, treatment modalities, length of stay, in-hospital mortality, and any diagnostic or treatment delays were described. RESULTS: Of the 54,521 trauma patients screened for fungal infection, 12 were identified. All patients suffered major injuries after blunt trauma (abbreviated injury score 3-5) and sustained wound contamination, and in nine patients, the cause of injury was motor vehicle. Six had open wounds/fractures on admission. The geographical region with the highest rate of fungal infection was Texas (n = 7), followed by Kansas (N = 3), then Missouri (N = 2). First symptoms of infection (leukocytosis or fever (n = 10)) presented a median of 6.3 (4.1-9.8) days after injury. Wound management entailed a combination of debridements (n = 8), negative pressure wound therapy (n = 9), amputation (n = 6), and antifungal treatment (n = 10). All fungal isolates identified from the wound site were hyphomycetes. A median of 2.1 (1.8-4.0) days passed from diagnosis to first antifungal treatment, and 3 patients died. CONCLUSIONS: Our study shows the challenges surrounding diagnosis and treatment of fungal infections secondary to trauma. Non-specific fungal infection symptoms, such as leukocytosis and fever, typically presented a week after injury. Vigilance for investigating risk factors and infection symptoms may help clinicians with more timely management of trauma patients with a severe fungal infection.
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Antifúngicos/uso terapéutico , Desbridamiento , Hongos Mitospóricos/aislamiento & purificación , Micosis , Infección de Heridas , Heridas no Penetrantes/complicaciones , Adulto , Amputación Quirúrgica/métodos , Amputación Quirúrgica/estadística & datos numéricos , Desbridamiento/métodos , Desbridamiento/estadística & datos numéricos , Femenino , Mortalidad Hospitalaria , Humanos , Puntaje de Gravedad del Traumatismo , Tiempo de Internación/estadística & datos numéricos , Masculino , Micosis/diagnóstico , Micosis/epidemiología , Micosis/fisiopatología , Micosis/cirugía , Terapia de Presión Negativa para Heridas/métodos , Factores de Riesgo , Centros Traumatológicos/estadística & datos numéricos , Estados Unidos/epidemiología , Infección de Heridas/tratamiento farmacológico , Infección de Heridas/epidemiología , Infección de Heridas/microbiología , Infección de Heridas/cirugía , Heridas no Penetrantes/diagnóstico , Heridas no Penetrantes/epidemiologíaRESUMEN
In the Neotropics, almost every species of the stream-dwelling harlequin toads (genus Atelopus) have experienced catastrophic declines. The persistence of lowland species of Atelopus could be explained by the lower growth rate of Batrachochytrium dendrobatidis (Bd) at temperatures above 25 °C. We tested the complementary hypothesis that the toads' skin bacterial microbiota acts as a protective barrier against the pathogen, perhaps delaying or impeding the symptomatic phase of chytridiomycosis. We isolated 148 cultivable bacterial strains from three lowland Atelopus species and quantified the anti-Bd activity through antagonism assays. Twenty-six percent (38 strains representing 12 species) of the bacteria inhibited Bd growth and just two of them were shared among the toad species sampled in different localities. Interestingly, the strongest anti-Bd activity was measured in bacteria isolated from A. elegans, the only species that tested positive for the pathogen. The cutaneous bacterial microbiota is thus likely a fitness-enhancing trait that may (adaptation) or not (exaptation) have appeared because of natural selection mediated by chytridiomycosis. Our findings reveal bacterial strains for development of local probiotic treatments against chytridiomycosis and also shed light on the mechanisms behind the frog-bacteria-pathogen interaction.
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Fenómenos Fisiológicos Bacterianos , Bufonidae/microbiología , Quitridiomicetos/patogenicidad , Micosis/fisiopatología , Animales , Secuencia de Bases , Bufonidae/clasificación , Quitridiomicetos/crecimiento & desarrollo , Cartilla de ADN , Micosis/microbiología , Reacción en Cadena de la Polimerasa , Especificidad de la EspecieRESUMEN
BACKGROUND: Empiric antifungal treatment has become standard of care in children with cancer and prolonged fever and febrile neutropenia (FN), with the downside that it leads to significant over treatment. We characterized epidemiologic, clinical, and laboratory features of invasive fungal disease (IFD) in children with cancer and FN with the aim to identify risk factors for IFD that can aid in better selecting children who require antifungal treatment. METHODS: In a prospective, multicenter study, children admitted with FN at high-risk for sepsis, in 6 hospitals in Santiago, Chile were monitored from admission until the end of the FN episode. Monitoring included periodic evaluation of clinical findings, absolute neutrophil count, absolute monocyte count (AMC), serum C-reactive protein (CRP), bacterial cultures, imaging studies, and galactomannan antigen. A diagnosis of proven, probable, and possible IFD was made after episode resolution based on European Organization for Research and Treatment of Cancer classification. RESULTS: A total of 646 high-risk FN episodes were admitted during the study period, of which 604 were enrolled. IFD was diagnosed in 35 episodes (5.8%) of which 7 (1.2%) were proven, 10 (1.6%) probable, and 18 (3.0%) possible. Four variables obtained on day 4 were significantly more common in IFD cases, which were presence of fever, absolute neutrophil count < or =500/mm, AMC < or =100/mm, and CRP > or =90 mg/L. The combination of fever, AMC < or =100/mm, and CRP > or =90 at day 4 provided a RR for IFD of 5.4 (99% CI, 3.2-9.2) with a sensitivity of 75%, specificity of 87%, positive and negative predictive values of 13% and 99%, respectively. CONCLUSIONS: Fever persisting at day 4 of admission, together with AMC < or =100 and CRP > or =90 significantly increased the risk for IFD in children with cancer.
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Fiebre de Origen Desconocido/etiología , Micosis/diagnóstico , Micosis/epidemiología , Neoplasias/complicaciones , Neoplasias/terapia , Neutropenia/complicaciones , Adolescente , Bacterias/aislamiento & purificación , Proteína C-Reactiva/análisis , Niño , Preescolar , Chile , Femenino , Galactosa/análogos & derivados , Humanos , Huésped Inmunocomprometido , Lactante , Recuento de Leucocitos , Masculino , Mananos/sangre , Micosis/patología , Micosis/fisiopatología , Estudios Retrospectivos , Factores de RiesgoRESUMEN
The yeast Candida albicans belongs to the microflora of healthy individuals, although it can infect a variety of tissues ensuing changes in the host's immune status. To evaluate the effect of neuroendocrine input on the early immune response during the fungal infection, we use a 3-day paradigm of chronic varied stress in Wistar rats infected with C. albicans. We find that stress mediators contribute to the spread of the fungus and downregulate critical functions of phagocytic cells at the infection site. Phenotypic and functional alterations of effector cells account for the decreased resistance to candidiasis and condition the development of the adaptive response. Stressed hosts exhibit a higher fungal burden in kidneys and livers associated with hyphal forms. The hepatic inflammatory reaction is compromised with severe steatosis, increment of functional enzymes, marked lipid peroxidation and hepatocyte apoptosis. Moreover, infection-related sickness symptoms are significantly increased by exposure to stress with anorexia, weight loss, lack of leptin and depletion of glycogen depots. Food deprivation exacerbates the liver injury. Stress mediators perturb the complex immune and metabolic program that operates early during fungal spread and promotes severe tissue damage.
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Tolerancia Inmunológica/inmunología , Huésped Inmunocomprometido/inmunología , Micosis/inmunología , Sistemas Neurosecretores/inmunología , Inmunidad Adaptativa/inmunología , Animales , Caquexia/inmunología , Caquexia/metabolismo , Caquexia/fisiopatología , Modelos Animales de Enfermedad , Hepatitis/inmunología , Hepatitis/metabolismo , Hepatitis/fisiopatología , Humanos , Inmunidad Innata/inmunología , Inmunocompetencia/fisiología , Micosis/fisiopatología , Ratas , Estrés Psicológico/inmunologíaRESUMEN
Melanin pigments are substances produced by a broad variety of pathogenic microorganisms, including bacteria, fungi, and helminths. Microbes predominantly produce melanin pigment via tyrosinases, laccases, catecholases, and the polyketide synthase pathway. In fungi, melanin is deposited in the cell wall and cytoplasm, and melanin particles ("ghosts") can be isolated from these fungi that have the same size and shape of the original cells. Melanin has been reported in several human pathogenic dimorphic fungi including Paracoccidioides brasiliensis, Sporothrix schenckii, Histoplasma capsulatum, Blastomyces dermatitidis, and Coccidioides posadasii. Melanization appears to contribute to virulence by reducing the susceptibility of melanized fungi to host defense mechanisms and antifungal drugs.
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Melaninas/metabolismo , Hongos Mitospóricos/patogenicidad , Micosis/microbiología , Paracoccidioides/patogenicidad , Paracoccidioidomicosis/fisiopatología , Factores de Virulencia/metabolismo , Animales , Humanos , Hongos Mitospóricos/clasificación , Hongos Mitospóricos/crecimiento & desarrollo , Micosis/fisiopatología , Paracoccidioides/crecimiento & desarrollo , Paracoccidioides/metabolismo , Paracoccidioidomicosis/microbiología , VirulenciaRESUMEN
Herein, we describe a combination of clinical, microbiologic, and histopathologic findings significantly associated with osteomyelitis in chronic granulomatous disease. When present, these features should raise the suspicion of underlying chronic granulomatous disease. In patients with these findings, anti-infective prophylactic measures aiming to cover highly prevalent microorganisms, as well as aggressive therapeutic measures, should be strongly encouraged.
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Antibacterianos/uso terapéutico , Quimioprevención , Enfermedad Granulomatosa Crónica/complicaciones , Enfermedad Granulomatosa Crónica/microbiología , Osteomielitis/microbiología , Osteomielitis/patología , Aspergilosis/tratamiento farmacológico , Aspergilosis/microbiología , Aspergilosis/patología , Aspergilosis/fisiopatología , Aspergillus/aislamiento & purificación , Huesos/patología , Estudios de Casos y Controles , Niño , Preescolar , Enfermedad Granulomatosa Crónica/patología , Enfermedad Granulomatosa Crónica/fisiopatología , Humanos , Lactante , Micosis/tratamiento farmacológico , Micosis/microbiología , Micosis/patología , Micosis/fisiopatología , Osteomielitis/tratamiento farmacológico , Osteomielitis/fisiopatología , Penicillium/aislamiento & purificación , Infecciones por Serratia/tratamiento farmacológico , Infecciones por Serratia/microbiología , Infecciones por Serratia/patología , Infecciones por Serratia/fisiopatología , Serratia marcescens/aislamiento & purificaciónRESUMEN
Fusarium species cause a broad spectrum of infections in humans, including superficial, locally invasive, and disseminated infections. The clinical form of fusariosis depends largely on the immune status of the host and the portal of entry, with superficial and localized disease occurring mostly in immunocompetent patients and invasive and disseminated disease affecting immunocompromised patients. Risk factors for severe fusariosis include prolonged neutropenia and T-cell immunodeficiency, especially in hematopoietic stem cell transplant recipients with severe graft-versus-host disease. The most frequent presentation of disseminated fusariosis is a combination of characteristic cutaneous lesions and positive blood cultures, with or without lung or sinus involvement. The prognosis is poor and is determined largely by degree of immunosuppression and extent of infection, with virtually a 100% death rate among persistently neutropenic patients with disseminated disease. These infections may be clinically suspected on the basis of a constellation of clinical and laboratory findings, which should lead to prompt therapy. Treatment options include the lipid formulations of amphotericin B, voriconazole, and posaconazole. Prevention of fusarial infection among high-risk patients should be considered.
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Fusarium/patogenicidad , Huésped Inmunocomprometido , Micosis , Animales , Antifúngicos/farmacología , Antifúngicos/uso terapéutico , Fusarium/clasificación , Fusarium/efectos de los fármacos , Humanos , Ratones , Pruebas de Sensibilidad Microbiana , Micosis/tratamiento farmacológico , Micosis/epidemiología , Micosis/microbiología , Micosis/fisiopatologíaRESUMEN
Se describe un caso de histoplamosis diseminada alóctona en un paciente con SIDA, de nacionalidad colombiana, quien ingresó al país en Marzo del 2006. Consultó por cuadro clínico de 2 meses de evolución, con dolor abdominal intenso, vómitos, baja de peso, diaforesis, fiebre vespertina, adenopatías múltiples y candidosis oral. De los exámenes destacó radiografía de tórax con infiltrado intersticial, pancitopenia, ELISA para VIH positivo y cultivos microbiológicos negativos. El paciente evolucionó desfavorablemente a pesar del tratamiento antimicrobiano empírico de amplio espectro; se tomó biopsia de ganglio cervical cuyo informe reveló presencia de levaduras gemantes en focos de necrosis, por lo que se inició tratamiento con anfotericina B y se repitió la biopsia para cultivo micológico cuyo informe fue Histoplasma capsulatum. Posteriormente evolucionó favorablemente, afebril y con parcial mejoría del estado general, sin embargo, el día 17/11/06 cursa con agitación, desaturación y un día después fallece por causa indeterminada. Se comenta este inhabitual caso nacional con algunos aportes epidemiológicos, de diagnóstico y sistemáticos.
A case of disseminated allocthonous histoplasmosis in a Colombian AIDS patient who came to the countryin March 2006 is described. He consulted for a clinic syndrome which had started two months before and which was characterized by intense abdominal pain, vomits, weight loss, diaphoresis, evening fever, multiple adenopathies and oral candidosis. Among the exams he was submittedto it is noteworthy a thorax X-rays with interstitial infiltrate, pancitopenia, ELISA to detect positive VIH and negative microbiological cultures. The patient reacted unsatisfactorily in spite of the empirical, broad spectrum antimicrobian treatment; the cervical ganglion was byopsed revealing the presence of gemant yeasts in necrosis focuses after which a treatment with anfotericine B was started, byopsia was repeated to get a mycological culture resulting Histoplasma capsulatum. Later on he reacted satisfactorily, he had no fever and showed a partial improvementin his general state, however on 11/17/06 he undergoes agitation, desaturation and he dies the followingday due to an undetermined cause. This rarely frequent national case is commented together with the delivery of some epidemiological as well as diagnostic and systematic information.
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Humanos , Masculino , Adulto , Histoplasma , Histoplasma/patogenicidad , Micosis/clasificación , Micosis/complicaciones , Micosis/diagnóstico , Micosis/epidemiología , Síndrome de Inmunodeficiencia Adquirida/complicaciones , Chile , Micosis/etiología , Micosis/fisiopatología , Micosis/terapiaAsunto(s)
Animales , Ratones , Clofazimina/síntesis química , Clofazimina/uso terapéutico , Itraconazol/síntesis química , Itraconazol/uso terapéutico , Micosis/clasificación , Micosis/fisiopatología , Paracoccidioidomicosis/diagnóstico , Paracoccidioidomicosis/fisiopatología , Paracoccidioidomicosis/rehabilitación , Anticuerpos Antifúngicos/fisiología , Anticuerpos Antifúngicos/inmunología , Ratones Endogámicos BALB C/fisiología , Ratones Endogámicos BALB C/genéticaAsunto(s)
Virus/aislamiento & purificación , Virus/clasificación , Virus/patogenicidad , Herpes Simple/clasificación , Herpes Simple/diagnóstico , Herpes Simple/fisiopatología , Herpes Simple/epidemiología , Herpes Simple/patología , Herpes Simple/terapia , Herpes Simple/transmisión , Bacterias/aislamiento & purificación , Bacterias/clasificación , Bacterias/patogenicidad , Interacciones Huésped-Parásitos , Micosis/clasificación , Micosis/diagnóstico , Micosis/epidemiología , Micosis/fisiopatología , Micosis/patología , Micosis/terapia , Micosis/transmisión , Bacterias Gramnegativas/aislamiento & purificación , Bacterias Gramnegativas/fisiología , Bacterias Gramnegativas/patogenicidad , Bacterias Anaerobias , Esterilización , Antibacterianos/administración & dosificación , Antibacterianos/clasificación , Antibacterianos/uso terapéutico , Antibacterianos/toxicidad , Vacunas , Enfermedades de Transmisión Sexual/clasificación , Enfermedades de Transmisión Sexual/diagnóstico , Enfermedades de Transmisión Sexual/etiología , Enfermedades de Transmisión Sexual/patología , Enfermedades de Transmisión Sexual/terapia , Enfermedades de Transmisión Sexual/transmisión , Meningitis/clasificación , Meningitis/diagnóstico , Meningitis/epidemiología , Meningitis/patología , Meningitis/terapia , Gastroenteritis/clasificación , Gastroenteritis/diagnóstico , Gastroenteritis/epidemiología , Gastroenteritis/patología , Gastroenteritis/terapia , Infección Hospitalaria/clasificación , Infección Hospitalaria/diagnóstico , Infección Hospitalaria/fisiopatología , Infección Hospitalaria/patología , Infección Hospitalaria/epidemiología , Infección Hospitalaria/transmisiónRESUMEN
Fungal urinary tract infections are an increasing problem in hospitalized patients. Funguria may be a result of contamination of the urine specimen, colonization of hte urinary tract, or may be indicative of true invasive infection. In this study, we report the risk factors, clinical features, treatments and outcome in a group of 68 hospitalized patients (adults and children) with fungal isolates recovered from 103 urinary samples. Underlying medical conditions were present in most patients. In the pediatric group, urinary tract abnormalities (86%) and prematurity (19%)accounted for the majority of the cases. Diabetes mellitus (28%), nephrolithiasis, and benign prostatic hyperplasia were the most common diseases in adults. Indwelling urethral catheters were noted in 38% of the pediatric patients and in 43% of adults during hospitalization. Candida albicans strains were responsible for 97% and 75% of positive cultures in children and adults, respectively. Symptoms such as fever, dysuria, frequency and flank pain were generally absent in both groups. Fluconazole was the most frequent antifungal utilized (61%) in children and ketoconazole in the adult group (42%). Removing the urinary catheter was attempted in 6 pediatric patients (29%) and in only 8 adults (17%). One patient (4%) in the pediatric group died compared to 10 in the adult group (21%, p=0.04). Successful diagnosis and treatment of funguria depends on a clear understanding of the risk factors and awareness of fungal epidemiology.
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Antifúngicos/uso terapéutico , Hongos , Hongos/aislamiento & purificación , Hospitalización , Micosis , Infecciones Urinarias , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Candida albicans/aislamiento & purificación , Candidiasis/tratamiento farmacológico , Candidiasis/epidemiología , Candidiasis/microbiología , Candidiasis/fisiopatología , Niño , Preescolar , Medios de Cultivo , Femenino , Hongos/clasificación , Humanos , Lactante , Recién Nacido , Masculino , Persona de Mediana Edad , Micosis/tratamiento farmacológico , Micosis/epidemiología , Micosis/microbiología , Micosis/fisiopatología , Factores de Riesgo , Resultado del Tratamiento , Infecciones Urinarias/tratamiento farmacológico , Infecciones Urinarias/epidemiología , Infecciones Urinarias/microbiología , Infecciones Urinarias/fisiopatología , Orina/microbiologíaRESUMEN
The incidence of invasive fungal infection (IFI) has increased considerably over the past 20 years, and transplant recipients are at especially high risk for fungal infections owing to their overall immunosuppressed condition. Organ transplantation procedures were incorporated as a therapeutic option for many patients who lacked the normal functions of organs such as the heart, liver, kidney, lung, pancreas and small bowel. The prevalence of IFI in solid organ transplant (SOTR) patients ranges from 5 to 50% in kidney and liver transplants, respectively. In bone marrow transplant (BMT) patients, IFI are major causes of morbidity and mortality due to the protracted neutropenic period and graft-versus-host disease. Candida spp. and Aspergillus spp. account for >80% of fungal episodes in both SOTR and BMT. The development of new immunosuppressive agents, new prophylaxis strategies (as pre-emptive therapy) and the improvement in surgical techniques led to increase survival of transplant recipients. In this session, a clear and concise update of the recent advances in the laboratory diagnosis of candidiasis and aspergillosis in this kind of patients was presented. However, we still need to establish more rapid, sensitive and specific methods for IFI diagnosis. Representatives of the 'Subcomision de Infecciones en el Paciente Neutropenico y Transplantado (SIPNYT)' de la Sociedad Argentina de Infectologia (SADI), presented the results of an unusual multicenter study both retrospective and descriptive studies of IFI in SOTR and BMT patients in Argentina. In addition, a study of IFI in 1,861 SOTR patients from four centers and the analysis of IFI in 2,066 BMT patients from all 12 BMT centers from Argentina was presented. From these studies it can be concluded that 'all transplant recipients are not the same' and that they should be stratified according to their different risk degrees in order to determine the best prophylaxis and treatment strategies.
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Trasplante de Médula Ósea/efectos adversos , Micosis/diagnóstico , Trasplante de Órganos/efectos adversos , Hongos/clasificación , Humanos , Micosis/microbiología , Micosis/fisiopatologíaRESUMEN
Despite advances in diagnosis and treatment, the epidemiological status of the human immunodeficiency virus (HIV) infection is far from under control in most of the developing world. Sub-Saharan Africa, Southeast Asia and India show increased rates of new infections. In Latin America and the Caribbean there were 1.6 million estimated cases of HIV-infected patients at the end of 1997. Fungal diseases have been one of the most relevant diagnoses in relation to the acquired immunodeficiency syndrome (AIDS). Infections due to Candida species and Cryptococcus neoformans var. neoformans are common worldwide. Histoplasma capsulatum, Coccidioides immitis and Penicillium marneffei are important causes of disease in endemic areas. Infection due to Sporothrix schenckii, Blastomyces dermatitidis and Paracoccidioides brasiliensis are uncommon even where they are endemic. Phaeohyphomycetes, hyalohyphomycetes and zygomycetes are still rare as a cause of disease among AIDS patients. However, agents pertaining to these groups, such as Aspergillus spp., have an increasing incidence. Superficial mycoses due to dermatophytes have special features from epidemiological, clinical and therapeutic points of view.
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Infecciones Oportunistas Relacionadas con el SIDA/epidemiología , Infecciones Oportunistas Relacionadas con el SIDA/microbiología , Hongos , Micosis/epidemiología , Antifúngicos/uso terapéutico , Países en Desarrollo , Hongos/clasificación , Humanos , Micosis/tratamiento farmacológico , Micosis/microbiología , Micosis/fisiopatologíaRESUMEN
La sinusitis alérgica micótica es una enfermedad de la nariz y senos paranasales de reporte relativamente reciente. Desde los primeros estudios efectuados por Lamb y Katzenstein se ha generado una gran controversia en relación con su diagnóstico y manejo. Hace poco se sugirieron criterios diagnóstico y manejo. Hace poco se sugirieron criterios diagnósticos que para nuestro juicio tienen un alto grado de especificidad. La alergia a los elementos micóticos es esencial para el mismo. En la actualidad, el manejo quirúrgico consiste en crear una aireación adecuada de la nariz y los senos paranasales, seguida del uso de esteroides por vía oral e inhalados. La inmunoterapia es motivo de controversia y, mientras no existan estudios prospectivos que las avalen, deberá recurrirse a ella con cautela
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Humanos , Hipersensibilidad/complicaciones , Micosis/diagnóstico , Micosis/patología , Micosis/fisiopatología , Sinusitis/etiología , Sinusitis/terapiaRESUMEN
A Candidose oral é uma das infecçöes fúngicas mais freqüentes em pacientes HIV positivos e portadores da AIDS. Durante a infecçäo pelo HIV, o paciente apresenta inúmeros episódios de Candidose oral. Inicialmente, essa infecçäo apresenta-se localizada na mucosa oral, de forma assintomática e de pequena dimensäo, por fim torna-se invasiva, atingindo a mucosa do palato e regiäo orofaríngea e esofágica, e resiste freqüentemente aos antifúngicos usuais. Avaliou-se neste trabalho, a freqüência do aspecto clínico da Candidose oral, e concluíu-se que a forma pseudomembranosa é mais freqüente. Avaliou-se também, através de estudo microbiológico, o material removido da lesäo, para identificaçäo das espécies do fungo. Concluíu-se que a espécie mais freqüente é a C. albicans. Pediu-se exames complementares, para avaliar o perfil imunológico dos pacientes. Constatou-se que os pacientes apresentavam-se com o sistema imunológico deprimido pelo HIV. Avaliou-se ainda a eficácia do medicamento itraconazol. Constatou-se que foi de grande valia, na terapêutica das lesöes resistentes aos antifúngicos usuais
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Candida albicans/citología , Candida albicans/patogenicidad , Técnicas Microbiológicas , Mucosa Bucal/microbiología , Mucosa Bucal/fisiopatología , Síndrome de Inmunodeficiencia Adquirida/complicaciones , Síndrome de Inmunodeficiencia Adquirida/fisiopatología , Micosis/complicaciones , Micosis/diagnóstico , Micosis/fisiopatologíaRESUMEN
A case of Fusarium sp. infection of the brain in a 6-year-old child who underwent allogeneic BMT is reported. As far as the authors know, this is the first report of Fusarium sp. encephalitis in a BMT patient. Fusarium sp. infection is a rare but emerging fungal pathogen after BMT and, because of several similarities, it is often mistaken for other mold infections, such as Aspergillus sp. The importance of early identification of this fungus as a cause of disseminated fungal infection in BMT patients, and some new modalities of Fusarium sp disseminated infection treatment are discussed here.