Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0023380 (lethargy)
 5,697 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Treatment of cryptococcal meningitis in patients with AIDS with amphotericin B plus flucytosine is associated with a failure rate of 20%-30%. In the absence of chronic suppressive therapy, 40%-60% of patients develop recurrent disease. Recent comparative studies have evaluated fluconazole, a new triazole antifungal agent. In primary therapy, fluconazole is associated with response rates of 35%-60%, which are equivalent to those seen with amphotericin B alone. However, a smaller study suggested that amphotericin B plus flucytosine was superior to fluconazole alone. Both studies identified risk factors associated with a poor outcome; these factors include lethargy or obtundation at presentation, a high titer of cryptococcal antigen titer in the cerebrospinal fluid, and a low leukocyte count in the cerebrospinal fluid. Fluconazole is highly effective in suppressing relapses of cryptococcal meningitis. Itraconazole has been investigated less extensively in the treatment of cryptococcosis but offers promise. Future studies need to address alternative approaches to the management of acute cryptococcal disease and primary prophylaxis for cryptococcal infection in patients with AIDS.
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PMID:Therapy for cryptococcal meningitis in patients with AIDS. 156 96

Microsporum canis sensitive to itraconazole and terbinafine was isolated from two cats presented with generalized dermatophytosis and dermatophyte mycetoma. Itraconazole therapy was withdrawn through lack of efficacy in one cat (a Persian) and unacceptable adverse effects in the other (a Maine Coon). Both cats achieved clinical and mycological cure after 12-14 weeks therapy with 26-31 mg kg(-1) terbinafine every 24 h per os (PO). Clinical signs in the Maine Coon resolved completely after 7 weeks treatment. Four weeks of therapy with additional weekly washes with a 2% chlorhexidine/2% miconazole shampoo following clipping produced a 98% reduction in the Persian cat's mycetoma, which was then surgically excised. Recurrent generalized dermatophytosis in the Persian cat has been managed with pulse therapy with 26 mg kg(-1) terbinafine every 24 h PO for 1 week in every month. No underlying conditions predisposing to dermatophytosis were found in either cat despite extensive investigation. Terbinafine administration was associated with mild to moderate lethargy in the Persian cat, but no other adverse effects or changes in blood parameters were seen. To the best of the authors' knowledge this is the first report of a dermatophyte mycetoma in a Maine Coon and of successful resolution of this condition in cats following terbinafine therapy.
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PMID:Successful resolution of dermatophyte mycetoma following terbinafine treatment in two cats. 1905 14

Histoplasmosis is the most commonly diagnosed major systemic mycosis in dogs and the second most commonly reported fungal infection in cats. The causative organism, Histoplasma capsulatum, is endemic in 31 of the 48 contiguous US states and has a worldwide distribution. Histoplasma organisms enter the body via inhalation or, possibly, ingestion. They are phagocytized by macrophages and can be disseminated via the bloodstream or lymphatic system to the reticuloendothelial and gastrointestinal (GI) systems and, sometimes, the bones, skin, eyes, or brain. Clinical signs are often nonspecific, including lethargy, weight loss, and inappetence, although respiratory or GI signs may help localize the infection. Definitive diagnosis requires identification of H. capsulatum on cytology or histopathology. However, antigen testing may be useful in animals in the future. Itraconazole is the treatment of choice. The prognosis is fair for animals with pulmonary histoplasmosis and guarded to poor for those with GI or disseminated disease.
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PMID:Histoplasmosis. 2187 Mar 49