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Query: UMLS:C0042963 (vomiting)
 31,883 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Esophageal candidosis was found endoscopically in 135 of 496 AIDS patients with upper gastrointestinal symptoms. Vomiting, dysphagia and retrosternal pain were the leading symptoms. Endoscopy showed different stages of esophagitis with Candida patches as early changes up to severe esophagitis with hemorrhage. 36 patients were treated with fluconazole orally or intravenously administered (100 mg per day). In 33 of 36 patients clinical, endoscopic and microbiological results were good with complete cure of the lesions after 7, 14 or 21 days of treatment. In 3 patients with wasting syndrome and severe opportunistic infections a resistance to the drug was discussed because of lack of sufficient therapy results. Maintenance therapy seems to be necessary to prevent relapses.
Mycoses 1990
PMID:[The therapy of Candida esophagitis in AIDS patients with fluconazole]. 210 62

This paper presents a case of successful treatment of candida meningitis with miconazole. A 55-year-old woman was admitted due to high fever, vomiting and urinary incontinence on November 11, 1986. Four months prior to this episode, she had been treated for a ruptured aneurysm with neck-clipping and V-P shunt for NPH. Candida albicans was cultured from her CSF. The shunt system was immediately removed and an Ommaya's reservoir was installed for external drainage and intrathecal administrations. Combination therapy (amphotericin B and flucytosine) was initiated. However, it was discontinued after ten days because of high fever and chills after intrathecal injection of amphotericin B. Treatment with miconazole intrathecally (10-90 mg/week, total 565 mg) and intravenously (200-1200 mg/day, total 70.4 g) was begun on November 23. Clinical and CSF findings were improved soon. No side effect of miconazole was observed. After V-P shunt revision, she was discharged without neurological deficit on March 12, 1987. Reports of mycosis in central nervous system are recently increasing, especially for candidosis. Cryptococcosis is noted frequently as an opportunistic infection of AIDS. The administration of amphotericin B and flucytosine has been the main therapy for mycotic meningitis. Unfortunately, however, Amphotericin B has many toxic effects, including renal dysfunction, and flucytosine can induce the emergent resistance. Miconazole has been used to successfully treat cryptococcosis, aspergillosis or coccidiosis, and was effective in our case of candida meningitis. Few side effects have been reported with its use. The intrathecal injection of miconazole is recommended for meningitis, because the drug is taken up minimally into CSF space after intravenous administration.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Successful treatment of Candida meningitis with miconazole]. 224 81

Cryptococcal meningitis is the most frequent fungal infection of the central nervous system, known readily to complicate with immuno-compromised patients. There are only a few cases of primary infection in healthy non-immuno-compromised patients. Amphotericin-B (AMPH-B) and 5-Fluorocytosine (5-FC) are effective agents against Cryptococcal meningitis, although, their toxicity and drug resistance are limiting factors. However, in recent years Miconazole has been widely used against fungal infections and it's effectiveness has been reported. This is a 68 y.o. male who was admitted to Toyohashi Municipal Hospital on March 15, 1987 because of headache, vomiting, diplopia and gait disturbance. Continuous lumbar drainage was performed since lumbar puncture revealed surprisingly high cerebrospinal fluid (CSF) pressure and presence of many Cryptococcus neoformans, i.v. AMPH-B and p.o. 5-FC was also administrated. A 7 day course of i.v. AMPH-B and p.o. 5-FC showed no improvement with side effects of macrohematuria and anorexia. Then Miconazole was administrated i.v. and intrathecal (i.t.). The clinical signs and CSF laboratory data improved after a 90 day course of Miconazole therapy and the patient was discharged on August 24. But the patient was readmitted from March 10 to April 30, 1988, because of a slight increase of C. neoformans in CSF (17/mm3) and improved by i.v. and i.t. Miconazole. The total Miconazole dosage was 90.6 g (i.t.: 505 mg) at the first admission and 36 g (i.t.: 50 mg) at the second admission, but no side effect was seen. The reduction of elevated CSF pressure with continuous CSF drainage was also important for the treatment of such cases with increased intracranial pressure.
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PMID:[A case of cryptococcal meningitis successfully treated with miconazole and CSF drainage]. 261 99

Ketoconazole suspension (20 mg per ml) was compared with nystatin (100,000 units per ml) in the treatment of oral candidosis in newborns and infants. In all patients Candida infection was proven by culture. Twenty patients were treated with ketoconazole and 15 patients with nystatin. Treatment was discontinued 2 days after clinical cure, or after 3 weeks. The investigator assessed the severity of the thrush and accompanying symptoms at the start of the study and at weekly controls. After one week all 20 patients on ketoconazole (100%) and 8 (53%) patients on nystatin were cured clinically. At the end of the treatment 12 patients on nystatin (80%) were cured. Clinical cure was confirmed by negative culture in 94% of the patients on ketoconazole and in 73% of the patients on nystatin. No side-effects were observed in the patients on ketoconazole. Only in the case of one patient on nystatin, was vomiting observed. This study shows that ketoconazole cures thrush faster and more effectively than nystatin.
Mycoses 1989 Jun
PMID:Comparison of ketoconazole suspension and nystatin in the treatment of newborns and infants with oral candidosis. 277 12

Between 1984 and 1987 14 patients with acute non-lymphocytic leukemia were treated with sequential high-dose cytosine arabinoside in combination with asparaginase. Twelve patients were suffering from refractory leukemia; in these patients complete remissions were achieved in 58%. The efficacy of this schedule was much better in patients with substantial leukemia cell reduction due to antecedent conventional therapy and no more than 25% blast cells in the bone marrow. In this subgroup complete remissions were achieved in 75% and 86% respectively, taking into account only the completed treatment courses. Beside the well-known side-effects such as alopecia, nausea, vomiting and hepatotoxicity, we observed an increase in severe infections. Three patients died of pulmonary mycosis.
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PMID:[Sequential high-dose cytarabine therapy in combination with asparaginase in acute myeloid leukemia]. 307 62

A case of cryptococcal meningitis in a patient with the acquired immunodeficiency syndrome (AIDS) is described, as well as the epidemiology, pathogenesis, clinical manifestations, diagnosis, and therapeutic management of the disease. In July 1987 a 38-year-old white man was admitted to the hospital because of confusion, disorientation, and headache. His medical history was notable for a positive human immunodeficiency virus test. Culture of the cerebrospinal fluid was positive for Cryptococcus neoformans. The patient was started on amphotericin B 16 mg/day (0.3 mg/kg/day) intravenously and flucytosine 2 g every six hours (150 mg/kg/day) orally. Despite premedication with diphenhydramine and acetaminophen, he experienced rigors that were treated with hydrocortisone and meperidine. Three weeks later he was discharged on flucytosine 2 g orally every six hours and amphotericin B 50 mg intravenously every other day. One week later the patient developed fever and chills; blood cultures were positive for methicillin-sensitive Staphylococcus aureus, and his peripheral leucocyte count was 1.8 X 10(3)/cu mm. Flucytosine was discontinued, and he was treated with intravenous nafcillin while remaining on amphotericin B. In October the patient complained of nausea, vomiting, weakness, and agitation. A CSF latex agglutination titer for cryptococcal antigen was 1:32. He was treated with amphotericin B 50 mg daily until symptoms resolved and then continued on amphotericin B 50 mg twice weekly. Cryptococcosis is the most common life-threatening fungal infection among AIDS patients. In contrast to immunocompetent hosts, this population invariably develops disseminated disease, with 85% having meningeal involvement. The most effective therapy for cryptococcal meningitis in patients with AIDS has not been established.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Management of cryptococcal meningitis in patients with AIDS. 341 73

The efficacy and safety of two antibiotic combination (clindamycin + gentamycin [C + G] versus metronidazole + gentamycin [M + G]) have been compared in 45 in-patients suffering from pelvic inflammatory disease in a clinical prospective randomized trial. The rates of clinical and bacteriological recovery reached respectively 85.7% and 71.4% for C + G group compared to 83.3% and 78.6% for M + G group (no significant differences). Side effects (vomiting, gastralgia and vaginal mycosis) developed in four occasions in each group. The most frequently isolated organisms were chlamydiae, E. coli and Neisseria gonorrheae (around 50% of overall isolated organisms). Due to the lack of significant differences between the two antibiotic combinations, the final choice will depend on potential risks generated by these products.
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PMID:[Prospective randomized study comparing the efficacy and tolerance of clindamycin-gentamycin versus metronidazole-gentamycin in acute utero-adnexal infections in hospitalized patients]. 355 61

Forty patients (22 males and 18 nonpregnant females) with tegumentary mycoses were treated with ketoconazole (R41,400). The group included 39 patients with dermatophytoses and one with tinea versicolor. Ketoconazole was administered in one dose per day taken with water 2 hr before or after breakfast for one month; patients weighing < 30 kg received 100 mg of ketoconazole per day, whereas those weighing > 30 kg received 200 mg per day. Twenty-one patients had complete clinical and mycologic cure, two responded clinically but the last culture was positive, eight had partial improvement, and three had no improvement at all. In six cases the treatment was stopped (in one because of gastric intolerance). The main adverse effect of ketoconazole was nausea; only one patient had vomiting. The results indicate that ketoconazole is a safe and effective drug for treatment of dermatomycosis.
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PMID:Treatment of dermatomycoses with ketoconazole. 625 34

The pharmacology, in vitro mycologic activity, toxicity, and efficacy of ketoconazole were studied in a Phase-II evaluation by the National Institutes of Health and National Institute of Allergy and Infectious Disease Mycoses Study Group. This report emphasizes the toxicity and clinical response data in 52 patients with the following systemic mycoses: blastomycosis in 16 patients; nonmeningeal coccidioidomycosis in 13; histoplasmosis in 8; nonmeningeal cryptococcosis in 7; sporotrichosis in 7; and both blastomycosis and nonmeningeal coccidioidomycosis in 1. Maximum daily doses of ketoconazole were 100 mg in 1 patient; 200 mg in 23; 400 mg in 12; and 600 mg in 16. In 52% of the patients, duration of therapy ranged from less than 1 to 6 months, whereas in 35%, duration ranged from 7 to 12 months, and in 13%, from 12 to 22 months. In 35 patients (67%), evidence of toxicity was not seen. Nausea, anorexia, or vomiting occurred in 21%. Cure or marked improvement was shown in 27 patients (52%), whereas failure of the primary course was seen in 14 (27%) and relapse after ketoconazole was discontinued in 11 (21%). Although this evaluation did not provide clear-cut clinical response data, our results indicate that ketoconazole, in the dosage regimens used, was more effective in patients with histoplasmosis and nonmeningeal cryptococcosis than in patients with blastomycosis and nonmeningeal coccidioidomycosis, and least effective in patients with sporotrichosis.
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PMID:Treatment of systemic mycoses with ketoconazole: emphasis on toxicity and clinical response in 52 patients. National Institute of Allergy and Infectious Diseases collaborative antifungal study. 629 61

Zygomycosis is an uncommon, but frequently fatal, fungal infection caused by members of the class Zygomycetes. The risk factors include diabetes mellitus, uremia, leukemia and use of deferoxamine as an iron-chelating agent; healthy persons also are occasionally infected. Those fungi, spread by their ubiquitous spores, most frequently involve the respiratory system. Rhinocerebral zygomycosis occurs predominantly in patients with uncontrolled diabetic ketoacidosis. Pulmonary zygomycosis most frequently is observed in granulocytopenic and corticosteroid-treated patients. Other clinical manifestations are gastrointestinal, cutaneous, disseminated and miscellaneous. This report concerns a previously robust farmer who suffered from left upper lung abscess caused by Rhizopus spp.-one member of the order Mucorales. Initially, it was intended to administer amphotericin B to a total dose of 2,000 mg; however, the patient could not tolerate such side effects as nausea, vomiting and refused further management when the cumulative dose was 948 mg. However, he did recover without further fever and cough. Chest X-ray, followed every three months, disclosed satisfactory improvement.
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PMID:Zygomycotic lung abscess: a case report. 755 21


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