Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0006849 (oral candidiasis)
 1,939 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The infectious complications of the acquired immunodeficiency syndrome (AIDS) are discussed, and the conventional and nonconventional therapies used for these infections are reviewed. The infections most commonly encountered in patients with AIDS are Pneumocystis carinii pneumonia (58%), Candida esophagitis (31%), toxoplasmosis (21%), cytomegalovirus infections (15%), and herpes-simplex virus infections (12%). Pneumocystis carinii pneumonia is the most common life-threatening process in these patients. Trimethoprim-sulfamethoxazole (TMP-SMZ) is considered the drug of choice for its treatment. Oral candidiasis often indicates the progression to AIDS in the high-risk populations of homosexual or bisexual men, intravenous drug abusers, and individuals with hemophilia. Nystatin suspension is commonly used to treat oral candidiasis, while Candida esophagitis demands systemic therapy with ketoconazole. Toxoplasmosis most commonly manifests itself in patients with AIDS as a cerebral mass lesion. The recommended therapy includes sulfadiazine and pyrimethamine. AIDS patients frequently experience protozoal invasion of the intestinal tract with Giardia lamblia, Isospora belli, and Cryptosporidium muris. Various drugs have been tried for these infections, including quinacrine hydrochloride, metronidazole, TMP-SMZ, and spiramycin. Cytomegalovirus (CMV) infections commonly involve the lungs, gastrointestinal tract, eyes, brain, and nervous system. Attempts to treat these disseminated CMV infections with antiviral agents, including acyclovir, have not been successful. However, acyclovir has been found beneficial in the treatment of herpes-simplex virus infections. Multiple infectious complications may occur in patients with AIDS as a result of the cellular-immune deficiency associated with this disease. Until more research is done with AIDS patients, therapy must be based on the data available from the treatment of these infections in immunosuppressed patients without AIDS.
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PMID:Treatment of infectious complications of acquired immunodeficiency syndrome. 299 29

We conducted a randomized, double-blind, placebo-controlled study to evaluate the efficacy of oral trimethoprim/sulfamethoxazole (TMP/SMX) in the prevention of bacterial infections in children with cancer. Sixty-three patients with acute leukemia were studied during the induction phase of chemotherapy; 28 patients with solid tumors who were starting intensive chemotherapy were also enrolled and treated for 2 months. There was no significant difference in the frequency of febrile episodes between the 43 children receiving trimethoprim/sulfamethoxazole and the 48 receiving placebo. However, when the group of 74 children who experienced granulocytopenia (absolute granulocyte count less than 500/microL) was analyzed separately, significant reductions in the frequencies of confirmed bacteremia (2.6% v 20.0%, P = .02) and febrile episodes (35.9% v 65.7%, P = .01) were observed in the trimethoprim/sulfamethoxazole group. Furthermore, life table analysis showed that children with leukemia receiving trimethoprim/sulfamethoxazole had significantly more days without fever and without bacteremia. No benefits from prophylaxis were recognized in the subgroup with solid tumors. Although the frequency of oral thrush was greater (P = .02) in the trimethoprim/sulfamethoxazole group (25.6%) than in the placebo group (6.3%), invasive fungal infection did not occur. Although the mean duration of granulocytopenia was greater among those receiving trimethoprim/sulfamethoxazole (13.7 v 9.0 days, P = .05), this did not appear to increase the overall risk for bacterial infection. These data suggest that trimethoprim/sulfamethoxazole reduces the frequency of bacteremia and febrile episodes in granulocytopenic children undergoing induction chemotherapy for acute leukemia.
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PMID:Oral trimethoprim/sulfamethoxazole for prevention of bacterial infection during the induction phase of cancer chemotherapy in children. 390 47

Urinary tract infection (UTI) during the four months after renal transplantation occurs in 30%-40% of recipients at the Massachusetts General Hospital and is often associated with gram-negative bacteremia, significant graft dysfunction, and relapse. Of these "early" UTIs, 90% affect the graft itself. In a randomized trial of prophylaxis of UTI with trimethoprim-sulfamethoxazole (TMP-SMZ), 52 consecutive allograft recipients received either no prophylaxis or one TMP-SMZ tablet (160 mg of TMP plus 800 mg of SMZ) daily for four months, beginning on removal of the Foley catheter (usually during the first four days after transplantation). Three of the first five patients given TMP-SMZ developed oral candidiasis; they and all subsequent recipients of TMP-SMZ were given oral mycostatin throughout prophylaxis. Two of 26 patients (8%) taking TMP-SMZ developed UTIs; 10 of 26 patients (38%) not taking the drug developed UTIs with evidence of graft infection (P less than 0.05). The two groups were comparable in age, sex, history of UTI before transplantation, type of donor, type of ureteral anastomosis, and antibiotic use for other types of infection. Only one complication, a skin eruption, was observed among patients taking TMP-SMZ and mycostatin. It is concluded that TMP-SMZ is well tolerated and effective prophylaxis in this setting.
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PMID:A controlled study of trimethoprim-sulfamethoxazole prophylaxis of urinary tract infection in renal transplant recipients. 705 Dec 49

In June 1993, in Taiwan, a woman admitted to a local hospital with cough, fever, chills, and difficult breathing who tested positive for HIV-1 infection was transferred to Taipei Veterans General Hospital. In January 1985, at a provincial hospital, then 46 years old, she underwent an anterior total hysterectomy and bilateral salpingo-oophorectomy during which she received two units of whole blood. One of the blood donors was an AIDS patient who had been treated at the same hospital in 1991 and who had died in 1993. In the interim between hospitalizations, she had two episodes of herpes zoster infection, including oral ulcers diagnosed as herpetic gingivostomatitis, and an episode of oral candidiasis. Physicians at the Taipei Veterans General Hospital diagnosed oral candidiasis, herpes simplex type 1 virus infection forming ulcers on her lips, and Pneumocystis carinii pneumonia in June 1993. Her CD4 count was 0 and her CD8 count was 20%. Treatment consisted of intravenous (IV) trimethoprim/sulfamethoxazole (TMP/SMX) and oral zidovudine, fluconazole, and acyclovir. She continued this medication after discharge in August 1993. She was readmitted to Taipei Veterans General Hospital in February 1994 for blurred vision. She was diagnosed with cytomegalovirus retinitis. Her CD4 count was up to 1% and her CD8 count was down to 8%. The candidiasis infection had extended from her oral cavity to the esophageal mucosa. She was put on IV ganciclovir, TMP/SMX, and fluconazole. She was discharged 3 weeks after admission. Her condition deteriorated thereafter, resulting in her death in August 1994. Up until this study, this HIV/AIDS case was listed with 79 other HIV/AIDS patients as unknown cause. During the 8 years between HIV exposure and her diagnosis of AIDS, she had unprotected sexual intercourse with her husband. Neither the husband nor any of her four children have AIDS. Screening for HIV-1 in Taiwan began in January 1988. The authors urgently recommend that anyone who received a blood transfusion between 1984 and 1987 in Taiwan and who currently suffers repeated episodes of opportunistic infections undergo an HIV-1 blood test.
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PMID:Transfusion-acquired AIDS in Taiwan. 864 96

A case of a 45-year-old HIV-infected male who developed a severe throat infection with serious complications is reported. Despite a low CD4 count, the patient suffered only one significant illness in ten years since his diagnosed HIV infection. Overly aggressive antibiotic therapy caused fungal and thrush infections, leading to dehydration and extreme weight loss. The patient was treated with rehydration therapy, antifungal agents, and TMP-SMX, after which other complications, including multiple infections and B-cell lymphoma, were diagnosed. He refused chemotherapy after one course of treatment and was sent home with hospice care.
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PMID:Severe sore throat in a patient with AIDS. 1136 58

In July 1993, the United States Public Health Service and the Infectious Disease Society of America gave a set of recommendations for early intervention and prevention of opportunistic infections in HIV-positive people. These guidelines follow CD4 counts. According to the guidelines, CD4 counts above 500 should be monitored every 4 to 6 months and screenings for tuberculosis, sexually transmitted diseases, and other diseases should also be done. At a CD4 count of 75, a prophylaxis of rifabutin against Mycobacterium avium complex (MAC) is advised. Oral ganciclovir has been effective in preventing or delaying cytomegalovirus in people with CD4 counts below 50. HIV-positive patients should be vaccinated for streptococcal pneumonia, hepatitis B, and influenza and avoid alcohol, drugs, and nicotine. AZT is still considered the first line therapy when symptoms appear or when CD4 counts fall. Combination antiretroviral therapies (AZT and ddI, AZT and ddC, and AZT and 3TC) are thought to be the best way to fight HIV. If symptoms include thrush, a prophylaxis against Pneumocystis carinii pneumonia should be started, such as TMP-SMX (Bactrim or Septra), dapsone, or aerosolized pentamidine.
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PMID:Early intervention and prevention options. 1136 17

Reports from the 1997 Fourth Conference on Retroviruses and Opportunistic Infections reveal encouraging responses to the latest antiretroviral regimens, including using protease inhibitors for treating opportunistic infections. Unfortunately, there appears to be less interest in the development and validation of newer agents and regimens for opportunistic infection treatment and prevention. Reports are presented addressing the following areas: the impact of opportunistic infections on survival in HIV-infected patients; the success of protease inhibitors and antiretroviral therapy on opportunistic infections; the relationship of viral load plus CD4+ levels and prophylactic therapy for opportunistic infections. A report indicating that patients with a history of previous febrile reactions to trimethoprim/sulfamethoxazole (TMP/SMX) may be at increased risk of recurrence of TMP/SMX hypersensitivity following initiation of protease inhibitor therapy, and studies suggesting that, in HIV-infected patients, cytomegalovirus reactivation occurs a median of six months prior to the development of clinically detectable manifestations of cytomegalovirus infection are included. Questions on the length of prophylactic therapy and the role of prophylaxis in anergic patients who are being treated for Mycobacterium disease; risk factors associated with recurrent oral candidiasis in patients who received continuous antifungal therapy for less than three months; the detection of human herpesvirus eight DNA sequences in the semen of HIV-infected men without Kaposi's sarcoma; and occurrences of cervical dysplasia and genital tract infections in HIV-infected women are also discussed.
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PMID:Opportunistic infections: stemming the tide. 1136 2

Trimethoprim-sulfamethoxazole (TMP-SMX) is a combination chemotherapeutic agent, a commonly used antibiotic. Adverse drug reactions occur in 6-8% of patients. Although, the most common adverse reactions include mild gastrointestinal distress and cutaneous events, also a wide range of hematological abnormalities have been ascribed to TMP-SMX. We report a 40-year-old male patient who developed an early onset neutropenia, thrombocytopenia, generalised rash and oral candidiasis after 5 days long TMP-SMX therapy. Although generalised rash may seen more and improves with discontinuation of the therapy; severe neutropenia, thrombocytopenia and oral candidiasis are seen very rare and rarely leads to fatality as it was in our case. Despite thrombocyte transfusions, whole blood transfusions, red cell concentrates and filgrastim therapy we lost our patient. We want to underline that although the TMP-SMX combination is usually well tolerated it can also lead to fatal complications.
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PMID:Trimethoprim-sulfamethoxazole induced rash and fatal hematologic disorders. 1599 41

To evaluate the palatability and cost as variables in the selection of antimicrobial suspensions to treat staphylococcal infections and oral thrush, 31 physicians and health care personnel randomly sampled 7 antistaphylococcal antibiotics and 2 antifungal agents, evaluating them in categories of appearance, smell, texture, taste, and aftertaste. Final scoring was then adjusted for cost. Overall taste (palatability) ranking of antistaphylococcal antibiotics, highest to lowest, was as follows: rifampin, cephalexin, EES, TMP/SMX, clindamycin with FLAVORx, linezolid, and clindamycin without FLAVORx. Fluconazole was superior to nystatin. Cost was considered a major factor if the medication was more than $60.00 for treatment of a hypothetical 2-year-old, 13-kg child.
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PMID:Adherence issues related to the selection of antistaphylococcal or antifungal antibiotic suspensions for children. 1670 37