Comparison of the kidney fungal burden in experimental disseminated candidiasis by species of the Candida parapsilosis complex treated with fluconazole, amphotericin B and caspofungin in a temporarily neutropenic murine model.

BACKGROUND: The efficacy of fluconazole (FLU), amphotericin B (AMB) and caspofungin (CAS) was tested against three Candida orthopsilosis, three C. metapsilosis and two C. parapsilosis sensu stricto isolates in neutropenic mice. METHODS: Mice were immunosuppressed by 200 mg/kg cyclophosphamide. Five-day intraperitoneal treatment was started 24 h after infection. Kidney burden was analyzed using the Kruskal-Wallis test. RESULTS: FLU 10 and 20 mg/kg as well as AMB 1 mg/kg significantly decreased the fungal burden (p < 0.05) for all eight isolates of the three species. CAS 2 and 5 mg/kg were efficacious against all C. orthopsilosis and C. metapsilosis isolates (p < 0.05), but only 5 mg/kg CAS was effective against C. parapsilosis isolates (p < 0.05). CONCLUSIONS: The efficacy of FLU and AMB against the three species was comparable. Though the activity of CAS was higher against C. orthopsilosis and C. metapsilosis, the current treatment guidelines for C. parapsilosis sensu stricto seem to be applicable to other 'psilosis' species.

[An unusual cause of fever: chronic meningococcemia]. / Een ongewone oorzaak van koorts: chronische meningokokkemie.

In a 14-year old boy admitted because of fever of unknown origin chronic meningococcaemia was diagnosed. He had suffered for the last four months from periods of high fever accompanied by skin rash and arthralgia. Blood culture showed the presence of Neisseria meningitidis. Cerebrospinal fluid culture remained negative. Following the administration of high-dose intravenous benzylpenicillin a prompt resolution of all signs and symptoms was observed. No immunological abnormalities were found. Chronic meningococcaemia can be a--nowadays uncommon--cause of fever of unknown origin.