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 277,896 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Fluconazole is a broad spectrum anti-fungal agent which combines good tolerance, efficacy and low toxicity, and offers useful advantages in the treatment of certain forms of mycosis. Three cases of renal fungal disease treated with surgery (nephrectomy in two cases and pyelolitectomy plus partial nephrectomy in the third one) and fluconazole or amphotericin B are presented. In all three cases there was at least one predisposing factor (diabetes, urolithiasis, urinary catheter, previous therapy with antibiotics, or AIDS), and the causing pathogens were Candida and Mucor. Administration of fluconazole 100 mg b.i.d. for 4 weeks in the two candida infected patients accomplished a complete cure of the disease. Incidence, etiopathology, presentation forms and diagnostic techniques of urinary mycosis are analyzed together with the current therapeutical options, making special reference to fluconazole.
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PMID:[Renal fungal infection: presentation forms and therapeutic advances]. 163 52

Between May 1, 1988 and January 1, 1990, 10 patients were treated for Candida peritonitis. Origins of the infections were lesions and perforations of the gastrointestinal tract. Risk factors promoting the disease were tumours, diabetes mellitus and extensive antibiotic therapy. The mean classification by the APACHE score 2 was 19.0. All patients underwent the programmed peritoneal lavage for diffuse peritonitis. Daily relaparotomy and lavage of all quadrants of the abdomen was performed. The diagnosis of Candida peritonitis had been established by microbiological investigation, increasing serologic titres, histologic demonstration of a deep mycosis and clinical picture. All patients were treated with 300 mg fluconazole daily. Five of the ten patients died from their severe primary diseases in spite of control of fungal peritonitis. Daily relaparotomies allowed to follow up the microbiologic and histologic course of the disease. Within 2 to 4 days after administration of fluconazole, hydrous swelling and reduction of fungal elements could be demonstrated histologically. On the 4th day after onset of antifungal therapy, fungal mycelia were markedly reduced and distendedly decayed. Fluconazole clearly leads to a destruction of deeply invading Candida elements within 4 days.
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PMID:Fluconazole monitoring in Candida peritonitis based on histological control. 209 40

Thirty patients with documented sporotrichosis were treated with 200-800 mg of fluconazole daily. Fourteen patients had lymphocutaneous infection; only five (36%) of these patients had any underlying illnesses. Sixteen patients had osteoarticular or visceral sporotrichosis; 12 (75%) of these patients had underlying diseases, mostly alcoholism, diabetes mellitus, and chronic obstructive pulmonary disease. Eleven of the 30 patients had relapsed after prior antifungal therapy. Most patients were treated with 400 mg of fluconazole; however, four received 200 mg of fluconazole daily for the entire course, and four received 800 mg of fluconazole daily for a portion of their therapy or for the entire course of therapy. Fluconazole therapy cured 10 (71%) of 14 patients with lymphocutaneous sporotrichosis. However, only five (31%) of 16 patients with osteoarticular or visceral sporotrichosis responded to therapy; the conditions of two of these five patients improved only, and there was no documented cure of their infections. With the exception of alopecia in five patients, toxic effects were minimal. Fluconazole is only modestly effective for treatment of sporotrichosis and should be considered second-line therapy for the occasional patient who is unable to take itraconazole.
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PMID:Treatment of lymphocutaneous and visceral sporotrichosis with fluconazole. 882 65

Diabetes mellitus is associated with a higher incidence of certain infections, including fungal infections like rhinocerebral zygomycosis (RCZ) and cutaneous candidosis. As the pathophysiology of increased susceptibility to infection of diabetic patients is very complex, a general therapeutic approach is not existing yet. Appropriate diabetes control remains as the best preventive measure. Nevertheless, effective drug therapy is very often required. Fluconazole has proven efficacy in prophylaxis, treatment and suppressive therapy of both systemic and superficial fungal infections, especially in candidosis and cryptococcosis. Therefore it is used routinely against fungal infections in diabetes (FID). Clinical efficacy of fluconazole against cutaneous candidosis, oropharyngeal candidosis (OPC) and vulvovaginal candidosis (VVC) has been confirmed in more than 100 studies, involving more than 10,000 patients (pts). The overall success rate is 90%, with a mean dosage of 100-200 mg/d. In severe cases, e.g. in OPC in late-stage AIDS pts or in recurrent VVC, higher dosages of up to 800 mg/d may be required. In the treatment of RCZ, therapeutic experience with fluconazole is limited. Four diabetic pts have been treated with dosages of 200-300 mg/d and all of them recovered. Nevertheless, treatment of RCZ should include surgical debridement combined with aggressive antifungal therapy. In conclusion, proven efficacy and the excellent safety profile justify the routine use of fluconazole in the treatment of FID.
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PMID:Therapeutic experience with fluconazole in the treatment of fungal infections in diabetic patients. 1086 13

Vaginal candidiasis is an infection caused by a fungus. Normally found in the vagina, it usually has no symptoms but can cause problems when it grows uncontrollably. The infection can be caused by antibiotics or chronic illnesses, such as diabetes or HIV. Symptoms include a white discharge, irritation, and itching which can cause small lesions. A physician can perform a pelvic exam to diagnose candidiasis. Anti-fungal cremes, including nystatin, clotrimazole, micona zole, or suppositories used for one to two weeks can treat candidiasis. Chronic cases may require oral anti-fungal medications. Oral Diflucan is being studied for the prevention of oral and vaginal candidiasis.
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PMID:[Vaginal candidiasis]. 1136 36

Candida vaginitis is one of the most frequent infection of the female genital tract with a high incidence. Approximately 75% of sexually active women suffer at least one episode of Candida vaginitis and 10% of them have recurrent episodes. Pregnancy, diabetes mellitus and antibiotic treatment are the most common predisposing factors, C. albicans is the etiologic agent most frequently found. The widespread reports of fluconazole resistance in Candida species and the selection of non Candida albicans prompted the study of species distribution of vulvovaginal candidiasis and their in vitro susceptibility against current antifungal agents. A total of 314 women with vaginal infection were studied. Yeasts were isolated from 104 patients with vulvovaginal candidiasis. The following species were identified: C. albicans 87.5%, C. glabrata 8.6% and 3.9% included C. krusei, C. famata, C. tropicalis and S. cerevisiae. The minimal inhibitory concentration (MIC) was determined for nystatin, isoconazole, fluconazole and ketoconazole, using a broth microdilution method based on NCCLS procedure. Although most of the isolates were C. albicans, the high percentage of C. glabrata recovered suggests the need to identify the yeasts isolated. Fluconazole resistant C. albicans were isolated in 13.46% of the cases. Thus, further studies are required to correlate the possible role of these strains in recurrent vulvovaginal candidiasis.
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PMID:[Vaginal candidiasis: etiology and sensitivity profile to antifungal agents in clinical use]. 1183 53

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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PMID:Hospital-associated funguria: analysis of risk factors, clinical presentation and outcome. 1198 May 93

A 47-year-old man with newly diagnosed acute myeloblastic leukemia and non-insulin-dependent diabetes mellitus developed Trichosporon asahii fungemia while receiving caspofungin as empirical antifungal therapy. The diagnosis was based on repeated isolation of T. asahii in culture of blood for three times. Despite treatment with amphotericin B and voriconazole, the patient died. The in vitro antifungal susceptibilities of the T. asahii isolates were only available after the patient died. In vitro antifungal susceptibility tests showed high caspofungin and amphotericin B minimal inhibitory concentrations (MICs) value for this Trichosporon strain (MICs, 16 microg/ml, and>32 microg/ml, respectively). Fluconazole, itraconazole, and voriconazole exhibited low MICs in vitro (MICs, 4 microg/ml, 0.5 microg/ml, and<or=0.015 microg/ml, respectively). Our experience strongly suggest that identification and antifungal susceptibility testing for T. asahii in neutropenic patients who may develop signs of infection in the presence of caspofungin as well as broadspectrum antibiotics treatment should not be overlooked.
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PMID:Breakthrough Trichosporon asahii fungemia in neutropenic patient with acute leukemia while receiving caspofungin. 1788 60

Fungal peritonitis is a relatively uncommon complication of peritoneal dialysis that contributes significantly to morbidity, drop out from the continuous ambulatory peritoneal dialysis (CAPD) program, and mortality. Candida sake infections were rarely published in literature. We present the first case of peritonitis due to C. sake. A 41-year-old man was admitted to our hospital with abdominal pain, nausea, vomiting, fever, weakness. Abdominal ultrasonography demonstrated a fistula tract, which has an opening at inferolateral of the umbilicus extending 5 cm from the skin into the abdominal cavity with a foreign body (11 x 10 mm length) inside the fistula. The foreign body was removed by surgery being apparently a part of a previously inserted peritoneal catheter. Postoperative specimens revealed polymorph leucocytes and yeast cells in Gram stain, and culture on Sabouraud dextrose agar (SDA) yielded a growth of a fungus, subsequently identified as C. sake with Api ID 32C. Fluconazole (200 mg/day) therapy was started. He recovered after two weeks of therapy. In conclusion, C. sake, a rare type of Candida species, should be considered as a probable peritoneal pathogen in patients with multiple episodes of bacterial peritonitis, previous broad-spectrum antibiotic therapy and diabetes mellitus.
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PMID:First case of continuous ambulatory peritoneal dialysis peritonitis due to Candida sake. 1862 71

We report a case of nail candidiasis with severe deformities. The patient was a 71-year-old woman who initially consulted our department on April 5, 2006. She had diabetes, chronic rheumatoid arthritis and multiple liver metastasis of unknown origin. She had taken prednisolone for treatment of chronic rheumatoid arthritis for a long period. The initial examination demonstrated deformation of 1/3 of the inner part of the nail plate in both the third and fourth fingers, with apparent hyperkeratosis under the deformed nail plates. KOH-prepared direct microscopy revealed the presence of numerous spores and pseudohyphae. Numerous fungal elements were detected by Grocott staining and PAS staining. Candida albicans was isolated and identified by cultivation on the ATG agar and PCR-RFLP. Fluconazole (100 mg/day) was administered from April 8, 2006. After 14 weeks of treatment her clinical findings had improved, however she died of multiple organ failure on July 25, 2006.
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PMID:[A case of nail candidiasis with severe deformities treated with oral fluconazole]. 1868 73


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