Combination therapy of disseminated Fusarium oxysporum infection with terbinafine and amphotericin B.

A case of disseminated infection with Fusarium oxysporum following chemotherapy of acute myelogenous leukemia is reported. Antifungal treatment was successful with a 13-day course of oral terbinafine 250 mg t.i.d. in combination with amphotericin B deoxycholate 1.0-1.5 mg/kg qd and subsequently intravenous liposomal amphotericin B 5 mg/kg qd. Preceding monotherapy with amphotericin B deoxycholate 1.0-1.5 mg/kg qd had not stopped the progression of infection. The combination therapy described here represents a novel approach to the treatment of Fusarium spp. in the immunocompromised host in whom Fusarium spp. are known to cause disseminated infection with high mortality.

The value of glucagon in routine barium investigations of the gastrointestinal tract.

Four hundred thirty-five consecutive barium studies of the gastrointestinal tract were examined to determine the efficacy and effectiveness of routinely giving intravenous (IV) glucagon in these studies. Administration of glucagon was randomized. Two staff radiologists evaluated the examinations to determine whether they were of diagnostic quality and rated them on a scale of 1 to 3. Patient response to the injection was monitored. Diagnostic quality of the examinations with and without IV glucagon did not differ significantly, and patient response to the injection was unfavorable. It is concluded that with the additional cost of glucagon, and the lack of demonstrable benefit, routine administration of glucagon is not warranted.