Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0021311 (Infection)
 38,178 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

For ten years, a 25-year-old immune-competent man experienced a progressive disseminated infection with the saprophytic soil fungus, Curvularia lunata, following presumptive cutaneous inoculation while playing football. Deep, soft tissue abscesses, pulmonary suppuration, paravertebral abscess, and cerebral abscess all followed leg ulcers from neglected abrasions. The patient's delay in obtaining treatment was partially responsible for the paravertebral-mediastinal-pleural-cutaneous fistula that resulted. The importance of prompt and aggressive surgical drainage procedures is clear. Infection was arrested only by surgery. The fungus was inhibited by miconazole nitrate and amphotericin B but it developed resistance to flucytosine. Miconazole appeared to cause resolution of the cerebral abscess. Amphotericin B (1 mg/kg/day) clearly was beneficial but only after effective drainage procedures were done. The patient refused to continue amphotericin B after 5.4 g had been given in two treatments. He became bedridden one year later from back pain that was caused by recurrent disease.
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PMID:Disseminated Curvularia lunata infection in a football player. 57 62

The diagnosis and successful control of systemic Aspergillus niger infection in 2 adult patients with acute leukemia is reported. During induction therapy, the first patient developed pulmonary infiltrates, skin lesions and abnormal liver function tests. Aspergillus niger was found on skin and liver biopsy. This patient was successfully treated with Amphotericin B and granulocyte transfusions and he remains in remission. The second patient developed a pneumonitis and adynamic ileus with positive sputum and stool cultures for Aspergillus niger. The infection only responded to Amphotericin B and granulocyte transfusions and the leukemia to cytoreductive chemotherapy. The patient later relapsed and died after a febrile illness. Fungi morpholocially consistent with Aspergillus were found in the liver at autopsy. Infection with A. niger is rare even in this patient population; however fungal infections have become an increasing problem. The need for a high index of suspicion, especially when an infection is unresponsive to antibacterial antibiotics, the various diagnostic tools, and the need for aggressive therapy are stressed. Amphotericin B is the chemotherapy of choice but may be insufficient in a severely neutropenic host where the simultaneous use of granulocyte transfusions might be lifesaving.
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PMID:Successful control of systemic Aspergillus niger infections in two patients with acute leukemia. 106 May 8

Infection of the small intestine of humans with the parasitic protozoan Giardia lamblia may have an asymptomatic course, or else, may produce acute or chronic diarrhea. In order to establish if the different clinical outcome of giardiasis in children could be due, at least partially, to strain differences, isolates from asymptomatic and symptomatic cases studied in Mexico City during 1986 and 1987 were cultured under axenic conditions. With modifications of available methods for the isolation of G. lamblia from cysts in stools, we obtained 19 axenic isolates: 5 from symptomatic patients and 14 from asymptomatic cyst carriers. The isolation procedure involved: (1) concentration and cleaning of cysts through centrifugation in sucrose gradients; (2) excystment induction in acid solution; (3) culture in modified TYI-S-33 medium, and (4) axenization of isolates using ceftriaxone and Amphotericin B. Results indicate that isolates from carriers and from symptomatic cases of giardiasis are equally amenable to isolation and axenization. The Giardia isolates obtained are being studied to analyze differences in isoenzyme pattern, antigenicity, and molecular markers.
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PMID:Isolation and axenization of Giardia lamblia isolates from symptomatic and asymptomatic patients in Mexico. 181 80

An immunosuppressed rabbit model of invasive aspergillosis was used to evaluate a novel micellar preparation of cholesterol sulfate complexed to amphotericin B. The acute LD50 of amphotericin B-deoxycholate was 5.1 mg/kg versus 20 mg/kg for the amphotericin/cholesterol-sulfate complexes. Amphotericin B-deoxycholate given iv at a dose of 1.5 mg/kg was more effective in sterilizing liver and kidney than the amphotericin/cholesterol-sulfate complexes given iv at 1.5-4.5 mg/kg, but infection persisted in the lungs of all rabbits treated with those doses. Infection persisted even when the rabbits were given a lethal dose of amphotericin B-deoxycholate (4.5 mg/kg), but a dose of 15 mg/kg of the amphotericin/cholesterol-sulfate complexes sterilized tissues and was associated with no acute lethality. Equivalent doses of the amphotericin/cholesterol-sulfate complexes were less effective than amphotericin B-deoxycholate, but a fourfold decrease in acute lethality improved the therapeutic index of amphotericin B. The amphotericin/cholesterol-sulfate complexes appear to be an improved means of amphotericin B delivery and may improve therapy for invasive aspergillosis.
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PMID:Treatment of experimental invasive aspergillosis with novel amphotericin B/cholesterol-sulfate complexes. 292 62

A case of imported Histoplasma duboisii osteitis in a visitor from Africa to Switzerland is described. The diagnosis was by histology confirmed by culture. Infection of other organs was ruled out. Amphotericin B therapy and its side effects are discussed.
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PMID:[Histoplasma duboisii osteitis as an imported disease]. 343 83

We have reported 7 new cases of Bipolaris infection and 2 of Exserohilum infection, which demonstrate the capability of these 2 genera to cause invasive as well as "allergic" disease. As noted previously, it is likely that all of the cases of "Helminthosporium" and Drechslera infections reported in the literature were caused by Bipolaris or Exserohilum. Infections due to these 2 genera are probably more common than previously recognized. They should be included in the differential diagnosis of central nervous system and disseminated fungal disease, sinusitis, keratitis, peritonitis associated with continuous ambulatory peritoneal dialysis, and allergic bronchopulmonary disease. These various entities have distinct histopathologic characteristics. With disseminated disease in the immunocompromised patient, the most frequent findings are acute inflammation with prominent vascular invasion, thrombosis, and infarction. In contrast, granulomatous inflammation and leukocytoclastic vasculitis are seen in meningoencephalitis caused by these fungi. The histologic features of allergic bronchopulmonary disease and sinusitis are similar. A chronic inflammatory infiltrate of lymphocytes, plasma cells and eosinophils within edematous granulation tissue is found in addition to squamous metaplasia and thickening of the basement membrane. Infections caused by Bipolaris/Exserohilum and Aspergillus show many clinical and pathologic similarities despite the lack of taxonomic relationship between these fungi. Both cause disseminated disease in immunocompromised patients that is characterized by tissue necrosis and vascular invasion. Both cause central nervous system disease, osteomyelitis, and sinusitis and are associated with allergic bronchopulmonary disease. Sinusitis, the most common form of disease caused by Bipolaris and Exserohilum, occurs in otherwise healthy patients with nasal polyposis and allergic rhinitis. Although pathologic evidence of bone invasion may not be found, there frequently is radiographic evidence of invasive disease. Most patients who are treated initially with surgical debridement and amphotericin B have apparently been cured. However, longer follow-up will be necessary in these patients. Amphotericin B appears to be the treatment of choice for invasive infections caused by Bipolaris/Exserohilum species. Ketoconazole and other imidazole derivatives may also be effective in certain of the disease entities caused by these black moulds; however, their role has yet to be defined.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:Phaeohyphomycosis caused by the fungal genera Bipolaris and Exserohilum. A report of 9 cases and review of the literature. 352 12

Infections caused by Candida albicans have been reported in many organ systems in intravenous drug users. Amphotericin B (Fungizone) has been shown to be effective in treatment. However, because of its numerous side effects and difficulty in maintaining intravenous access in this population, the agent is difficult to use. Ketoconazole (Nizoral), administered orally, is a more convenient and better tolerated agent and was efficacious in the case of candidal costochondritis described here. Further evaluation of ketoconazole is needed to better define its role in the treatment of disseminated candidiasis, particularly in cases associated with intravenous drug abuse.
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PMID:Candidal costochondritis responsive to ketoconazole in an iv drug abuser. 370 72

Laboratory vector competence of Culex (Melanoconion) cedecei was examined for Venezuelan equine encephalomyelitis (VEE) viruses. Colonized adult female mosquitoes originating from a southern Florida population were given bloodmeals from viremic hamsters circulating various titers of 3 hemagglutination inhibition (HI) subtypes of VEE viruses. Following extrinsic incubation of about 3 weeks, mosquitoes were allowed to refeed on uninfected hamsters for transmission trials. Cx. cedecei was highly efficient in becoming infected with and transmitting its sympatric, HI subtype II "Everglades" virus. With bloodmeal titers of 10(0.9) chick embryo cell culture (CEC) plaque forming units (PFU), the infection rate was 9% and transmission occurred following extrinsic incubation. Infection rates were greater than or equal to 80% with oral doses of greater than or equal to 10(1.8), and all infected mosquitoes were capable of transmission following incubation. Cx. cedecei was also highly sensitive to infection with allopatric HI subtype IE Middle American VEE virus isolates. Infection rates were greater than or equal to 50% with bloodmeal titers undetectable by CEC assay. Rates were 100% with oral doses of greater than or equal to 10(0.8) CECPFU. Transmission rates were 100% in all experiments. Similar results were obtained with HI subtype IAB "epizootic" VEE virus isolates from the 1969 Middle American outbreak. Infection rates were 100% with oral doses of greater than or equal to 10(1.2), and transmission rates were 100% after extrinsic incubation. Comparisons with laboratory vector competence of the Middle American enzootic VEE virus vector, Culex (Melanoconion) taeniopus, are discussed.
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PMID:Laboratory vector competence of Culex (Melanoconion) cedecei for sympatric and allopatric Venezuelan equine encephalomyelitis viruses. 370 26

Invasive pulmonary aspergillosis as a cause of mortality and morbidity in patients with haematological malignancies is becoming more common. Predisposing factors are powerful immunosuppressive chemotherapy, neutropenia and synergistic combinations of antibiotics of great potency and wide spectrum of activity. Clinical and radiological signs are heterogeneous, sometimes misleading and often absent. Treatment is often empirical on suspicion alone. Amphotericin B is the only effective drug but it has marked toxicity, mainly renal. Infection is usually fatal without adequate treatment. This paper describes eight cases of invasive pulmonary aspergillosis seen in one centre in two years, reviews the literature and assesses associated problems.
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PMID:Pulmonary aspergillosis in immunosuppressed patients with haematological malignancies. 374 52

We have reported the 22nd case in the literature of protothecosis, a rare disease of man and animals due to infection with non-chlorophyll-producing algae of the genus Prototheca. The skin is most often affected, but generalized, disseminated involvement has been reported. Infection is usually severe and may be fatal. Amphotericin B in combination with tetracycline is the treatment of choice.
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PMID:Protothecosis. 649 78


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