RESUMO
Primary cutaneous Aspergillus flavus infections of the hand are exceedingly rare. Usually, these infections are present in severely immunocompromised patients suffering from lymphoreticular malignancies. The majority of cases result in invasive systemic infections and often culminate in death. We report a case of primary cutaneous A. flavus infection in the hand of a patient immunocompromised only by non-insulin-dependent diabetes, who ultimately was cured of this infection with oral itraconazole.
Assuntos
Antifúngicos/administração & dosagem , Aspergilose/tratamento farmacológico , Aspergillus flavus , Dermatoses da Mão/tratamento farmacológico , Itraconazol/administração & dosagem , Administração Oral , Humanos , Masculino , Pessoa de Meia-Idade , RecidivaRESUMO
Infections of deep soft tissues with the dimorphic fungus Sporothrix schenckii are uncommon in humans, and therapy has often required toxic drugs. We report our experience in treating 11 patients who had deep-seated sporotrichosis with ketoconazole, a well-tolerated, orally absorbed antifungal agent. Eight infections involved one or more joints, and three involved thoracic, cervical, and widespread cutaneous sites, respectively. For eight patients all evidence of infection resolved during therapy. Sustained remissions (6 months to 5 years) were noted for six patients after the discontinuation of all therapy and for an additional patient 4 years after the initiation of ketoconazole treatment. Durable responses were associated with prolonged treatment with 400-800 mg of ketoconazole daily. Our favorable experience suggests that oral therapy with ketoconazole may benefit other patients with systemic sporotrichosis.
Assuntos
Artrite Infecciosa/tratamento farmacológico , Dermatomicoses/tratamento farmacológico , Cetoconazol/uso terapêutico , Esporotricose/tratamento farmacológico , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos RetrospectivosAssuntos
Cerveja , Etanol/análise , Odorantes/análise , Idoso , Líquido Ascítico/microbiologia , Candida/isolamento & purificação , Candida albicans/isolamento & purificação , Diabetes Mellitus/microbiologia , Diabetes Mellitus/urina , Fezes/microbiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Bexiga UrináriaRESUMO
A 63-year-old woman presented with cellulitis of the upper anterior chest and neck that rapidly extended into an acute mediastinitis. Pleural effusions and meningitis subsequently developed. The infection was due to an ampicillin-susceptible strain of Hemophilus influenzae type B. The patient was treated with and responded to chloramphenicol therapy. No definite predisposing factor could be determined.