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 6,116 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A case of Candida albicans arthritis involving a knee and cuneiform bone is presented. As with other forms of candidiasis, multiple antibiotic treatment and hyperalimentation predisposed to the infection. Fourteen previously published cases are reviewed. The knee is the most common site of infection and there is a high frequency of associated osteomyelitis. Treatment with both amphotericin and 5-fluorocytosine seems to be effective. The case presented was treated successfully with a small dose of amphotericin followed by five and one-half months of 5-fluorocytosine.
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PMID:Arthritis and osteomyelitis due to Candida albicans: a case report. 33 87

Systemic candidiasis is frequently unrecognized before death of the patient because of lack of specific clinical signs, insensitive laboratory tests, and difficulties in culturing Candida albicans from the blood. Recent attention has been focused on the use of serologic testing and ocular signs to increase the rate of diagnosis of candidiasis. Because of the association between hyperalimentation fluids and disseminated candidiasis, a preliminary prospective study was carried out to determine more accurately the incidence in patients receiving hyperalimentation fluids of inapparent candida infection, candida endophthalmitis, or positive candida precipitins. Five of 23 patients developed small, white eye lesions consistent with candida endophthalmitis. Three of the five patients with eye lesions had blood cultures positive for C. albicans, and no patients without eye lesions had positive blood cultures. Candida precipitins were positive in three of the five patients with eye lesions. The results of this study suggest that unrecognized systemic candida infection may be more frequent in patients receiving hyperalimentation than previously suspected.
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PMID:Association of infection due to Candida albicans with intravenous hyperalimentation. 41 98

Postoperative candidiasis in the gastroenterological surgery has an increasing tendency with poor prognosis particularly in generalized cases. Candida is difficult to be specified as infectious agent only by culture findings, and has a problem on rapidity and sensitivity. Furthermore, also as for the time starting antifungal treatment, the start after the blood culture has given positive result is problematic. We analyzed the present state of candidiasis in our department and studied its background factors. Totaling of 4,424 samples from all of bacterial and fungal culture tests performed at our department for recent 9 years revealed detection of Candida with the incidence of 24%. The incidence was about 2.5 times increased in the former half of the period as compared with the later half of the period. The background factors were intravenous hyperalimentation, major operations (long operative time, insertion of many drains), splenectomy, pancreatectomy, intensive chemotherapy, radiation therapy, hyperthermia therapy, aging, continuous use of steroids, etc. Then, we determined concentrations of beta-D-glucan, a fungal component, and evaluated the results since it is being applied to early diagnosis of candidiasis. We performed early antifungal treatment before confirmation of positive culture finding in high risk group of candidiasis and obtained effective results.
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PMID:[Candidiasis in the field of gastroenterological surgery]. 194 5

With the increased number of immunocompromised patients there has been a concomitant increase in patient morbidity and mortality due to fungi. The etiologic microorganisms vary depending upon the type of immune dysfunction. Patients with malignancies and chemotherapy-induced neutropenia commonly are infected with Candida and Aspergillus. Other ubiquitous fungi such as Rhizopus, Fusarium, and Trichosporon are more frequently implicated as agents of disease in these patients. Patients with cell-mediated immune dysfunction such as acquired immune deficiency syndrome (AIDS) are susceptible to mucocutaneous candidiasis and pulmonary and disseminated cryptococcosis. Histoplasmosis and coccidioidomycosis have been particularly lethal infections in AIDS patients. Contributing factors such as broad-spectrum antibiotic use, intravenous catheterization, malnutrition, hyperalimentation, multiple surgical procedures and/or trauma, and steroids used either singly or in combination may also predispose patients to invasive fungal disease. Definitive diagnosis is often difficult to establish and usually requires invasive biopsy. Delay of culture results due to the time required to process specimens and to allow the fungus to grow also contributes to the poor results of therapy. Biopsy of skin lesions represents a useful technique for making a diagnosis. Recent advances in antifungal therapeutics promise to change the current approach to treatment for several of the mycoses. The availability of new oral azoles with spectra of activity that include aspergillosis and cryptococcosis, which currently require treatment with parenteral amphotericin B, may prove practical for prolonged oral therapy of otherwise lethal mycoses.
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PMID:Fungal infections in the immunocompromised host. 268 23

To determine the frequency of endogenous Candida endophthalmitis in patients with candidemia, we prospectively evaluated 32 inpatients with fungemia by weekly indirect ophthalmoscopic examinations. Chorioretinitis compatible with Candida infection was found in 9 (28%) patients. Patient age, sex, underlying diseases, or hospital-acquired factors, such as presence of central venous or Foley catheters, bacteremia, use of multiple antibiotics, hyperalimentation, or surgery, did not distinguish between groups. Groups were also similar in number of sites colonized with yeast and species of Candida recovered. Patients with endophthalmitis tended to have more blood cultures positive for Candida (mean, 4.3) than the patients without endophthalmitis (mean, 2.8), but this trend did not reach statistical significance. Based on these results, we recommend periodic ophthalmoscopic examinations in all patients with documented candidemia.
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PMID:Prospective study of Candida endophthalmitis in hospitalized patients with candidemia. 280 88

Although abdominal candidiasis in critically ill surgical patients is becoming increasingly common, optimal management has not been defined. We treated 16 patients with abdominal candidiasis over a 36 month period. Violation of the gastrointestinal tract mucosa was the most common precipitating event (13 patients). Predisposing factors included: CVP catheters, broad spectrum antibiotics, and parenteral hyperalimentation in all patients, H2-blockers/antacids in 14 patients, as well as malnutrition (7 patients), DM (3 patients), alcoholism (3 patients), and steroids/chemotherapy (3 patients). Candida was isolated from an abscess in seven patients, peritoneal fluid in six patients and both in three patients. In four patients abdominal candidiasis was preceded by positive cultures from blood or two peripheral sites which had not been treated. All patients were treated with amphotericin B (146-4000 mg) without any major adverse effects. Fungal infection was eradicated in ten patients; three patients succumbed to candidiasis. Patients treated within seven days required less Amphotericin B and appeared to have a better outcome than those having delayed treatment. The authors conclude that abdominal candidiasis is a potentially lethal infection in critically ill surgical patients that should be aggressively treated. Amphotericin B can be safely administered and concurrent antibiotics need not be stopped.
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PMID:Abdominal candidiasis in surgical patients. 291 8

Infections caused by the opportunistic yeast pathogen, Candida albicans, are becoming increasingly important. Superficial Candida infections, particularly those of the mouth and vagina, are very common; for example, candidal vaginitis plaques millions of women worldwide, often proving refractory to treatment. Systemic candidosis is much rarer, but it is an important hazard of modern medical procedures such as transplant surgery, i.v. hyperalimentation, and immunosuppressive therapy. One significant virulence factor of C. albicans is its ability to secrete extracellular acid proteinase. This attribute is shared by C. tropicalis and C. parapsilosis, but not by other less pathogenic Candida species. The enzymes produced by these yeasts are all carboxyl proteinases capable of degrading secretory IgA, the major immunoglobulin of mucous membranes. Some have keratino- or collagenolytic activity. Two secretory proteinases of C. albicans have been purified and characterized; their properties are reviewed. Possible applications of this work to the treatment and diagnosis of candidosis are discussed.
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PMID:Candida proteinases and candidosis. 306 60

Premature infants, (in whom prolonged hyperalimentation long term indwelling catheters are used), serve as the ideal hosts for overwhelming Candida sepsis. Two cases of disseminated Candidiasis were studied. Case 1 had sonographically enlarged and highly echogenic kidneys. Case 2 had diffusely enlarged echogenic kidneys with actual fungus balls in the collecting system. This infant also developed hydrocephalus with debris in the ventricular system and abnormal brain parenchymal echogenicity.
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PMID:Ultrasound in the diagnosis of systemic candidiasis (renal and cranial) in very low birth weight premature infants. 351 35

Two premature neonates with birth weight less than 1,200 g developed systemic candidiasis during treatment with multiple antibiotics and parenteral hyperalimentation. Clinical findings included signs of necrotizing enterocolitis in one patient and multiple fungal renal cortical abscesses in the other. The Candida antigen, mannan, was present in the sera of both patients at the time of clinical deterioration. Multiple blood cultures and urine and stool samples from both patients grew Candida albicans. Systemic antifungal therapy was given for a 6-week period and was associated with prolonged antigenemia despite negative findings on follow-up cultures. Antifungal therapy was stopped soon after antigen was no longer detected. Both patients recovered without evidence of further fungal infection. Candida antigen detection may be useful in the diagnosis and follow-up of premature infants with disseminated candidiasis.
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PMID:Candida antigen detection in two premature neonates with disseminated candidiasis. 643 83

To determine the incidence of hematogenous candida endophthalmitis in seriously ill patients given parenteral hyperalimentation fluids, 131 hyperalimented postoperative patients were prospectively evaluated. All patients were screened weekly for the development of chorioretinal lesions, blood cultures positive for Candida albicans, and signs and symptoms of candida infection. Thirteen (9.9%) of 131 patients developed chorioretinal lesions compatible with hematogenous candida endophthalmitis. Seven of the 13 patients with eye lesions had blood cultures positive for yeast, whereas only two of 118 without eye lesions had blood cultures positive for yeast (P less than 0.0005). Thus, the occurrence of eye lesions consistent with hematogenous candida endophthalmitis correlated with positive blood cultures for yeast and strongly suggested invasive candidiasis.
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PMID:Hematogenous candida endophthalmitis in patients receiving parenteral hyperalimentation fluids. 678 41


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