RESUMEN
We report 3 cases of post-traumatic cutaneous mucormycosis caused by Lichtheimia corymbifera, two of them occurring after a farm working accident. Management of post-traumatic mucormycoses consists of a wide excision of the infected tissue, combined with immediate antifungal therapy. Liposomal amphotericin B is the recommended first line treatment. Few studies have evaluated the efficacy of posaconazole. All 3 patients received a surgical debridement and liposomal amphotericin B, which was followed by posaconazole in 2 cases. The duration of the antifungal treatment is not yet well defined. All three patients received a treatment of five weeks with a favorable outcome.
Asunto(s)
Absidia/aislamiento & purificación , Dermatomicosis/microbiología , Mucormicosis/microbiología , Heridas y Lesiones/microbiología , Adolescente , Adulto , Antifúngicos/uso terapéutico , Desbridamiento , Dermatomicosis/tratamiento farmacológico , Dermatomicosis/cirugía , Humanos , Huésped Inmunocomprometido , Masculino , Persona de Mediana Edad , Mucormicosis/tratamiento farmacológico , Mucormicosis/cirugía , Heridas y Lesiones/tratamiento farmacológico , Heridas y Lesiones/cirugíaAsunto(s)
Diarrea/etiología , Gastritis/complicaciones , Infecciones por VIH/complicaciones , Infecciones por Helicobacter/complicaciones , Helicobacter pylori/aislamiento & purificación , Anciano , Amoxicilina/uso terapéutico , Fármacos Anti-VIH/uso terapéutico , Terapia Antirretroviral Altamente Activa , Pruebas Respiratorias , Enfermedad Crónica , Claritromicina/uso terapéutico , Diarrea/tratamiento farmacológico , Quimioterapia Combinada , Femenino , Gastritis/diagnóstico , Gastritis/tratamiento farmacológico , Gastritis/microbiología , Infecciones por VIH/tratamiento farmacológico , VIH-1 , Infecciones por Helicobacter/diagnóstico , Infecciones por Helicobacter/tratamiento farmacológico , Infecciones por Helicobacter/microbiología , Humanos , Masculino , Persona de Mediana Edad , Omeprazol/uso terapéuticoAsunto(s)
Alopecia Areata/diagnóstico , Alopecia Areata/etiología , Osteítis/diagnóstico , Osteítis/etiología , Cráneo , Sífilis/complicaciones , Sífilis/diagnóstico , Infecciones Oportunistas Relacionadas con el SIDA/complicaciones , Infecciones Oportunistas Relacionadas con el SIDA/diagnóstico , Adulto , Diagnóstico Diferencial , Infecciones por VIH/complicaciones , VIH-1 , Humanos , MasculinoRESUMEN
One hundred eighteen Candida clinical isolates from human immunodeficiency virus-infected patients were tested for their susceptibilities to fluconazole and itraconazole by Fungitest and the National Committee for Clinical Laboratory Standards MIC method. Fungitest results depended on both yeast species and antifungal agents. This test is able to detect sensitive strains (97% agreement with results of the MIC method in tests with fluconazole and 84% agreement in tests with itraconazole) but has a poor capacity to detect resistant strains (26% agreement in tests with fluconazole and 5% agreement in tests with itraconazole).
Asunto(s)
Infecciones Oportunistas Relacionadas con el SIDA/tratamiento farmacológico , Antifúngicos/farmacología , Candida/clasificación , Candidiasis/tratamiento farmacológico , Fluconazol/farmacología , Itraconazol/farmacología , Infecciones Oportunistas Relacionadas con el SIDA/diagnóstico , Infecciones Oportunistas Relacionadas con el SIDA/microbiología , Antifúngicos/uso terapéutico , Candida/efectos de los fármacos , Candida/aislamiento & purificación , Candida albicans/efectos de los fármacos , Candidiasis/complicaciones , Candidiasis/diagnóstico , Fluconazol/uso terapéutico , Humanos , Itraconazol/uso terapéutico , Pruebas de Sensibilidad Microbiana , Micología/métodos , Juego de Reactivos para Diagnóstico , Sensibilidad y EspecificidadAsunto(s)
Bursitis/inducido químicamente , Inhibidores de la Proteasa del VIH/efectos adversos , Articulación del Hombro/efectos de los fármacos , Adulto , Quimioterapia Combinada , Femenino , Infecciones por VIH/tratamiento farmacológico , Humanos , Indinavir/efectos adversos , Lamivudine/efectos adversos , Masculino , Persona de Mediana Edad , Estavudina/efectos adversosRESUMEN
Polymerase chain reaction (PCR) technology was used to detect Toxoplasma gondii DNA in 253 immunodeficient subjects, 179 of whom were infected with the human immunodeficiency virus (HIV). The incidence of toxoplasmosis was 12.3% (22/179) in the HIV-infected subjects and 2.7% (2/74) in the remainder. The sensitivity of the PCR during episodes of toxoplasmosis in HIV-infected subjects not on antiparasitic treatment was 86.6% on peripheral blood and 60% on cerebrospinal fluid (CSF), but was only 25% and 16.7%, respectively, in subjects receiving specific treatment or prophylaxis against Pneumocystis carinii. Among the HIV-seronegative population, six patients undergoing anticancer chemotherapy were PCR positive on bronchoalveolar lavage fluid but did not develop pulmonary toxoplasmosis, suggesting transient carriage.
Asunto(s)
Infecciones Oportunistas/diagnóstico , Infecciones Oportunistas/parasitología , Toxoplasma/aislamiento & purificación , Toxoplasmosis/diagnóstico , Animales , Antiparasitarios/uso terapéutico , ADN Protozoario/análisis , Infecciones por VIH/complicaciones , Humanos , Huésped Inmunocomprometido , Infecciones Oportunistas/tratamiento farmacológico , Reacción en Cadena de la Polimerasa , Sensibilidad y Especificidad , Toxoplasmosis/complicacionesRESUMEN
A review of 5,116 cases of animal bites (587 of which were studied prospectively) has shed some light on their epidemiological aspects and on the risk of infection they carry. It has also led to a more objective assessment of the real effect of the therapeutic and prophylactic measures usually applied in such cases. The most frequent wounds are those of the hands and face, the former rising an infectious problem, the latter a predominantly cosmetic problem. The overall risk of infection is 30 per cent, but it is increased, notably as regards pasteurellosis, in the case of cat bite. Precise and simple rules concerning the prevention of this risk cannot easily be given, but it seems that the systematic antibiotic treatment initially prescribed has not clearly proved effective. Similarly, early sutures do not significantly increase the risk of infection.
Asunto(s)
Infecciones Bacterianas/etiología , Mordeduras y Picaduras/epidemiología , Adolescente , Adulto , Animales , Animales Domésticos , Animales Salvajes , Mordeduras y Picaduras/complicaciones , Niño , Femenino , Humanos , Masculino , Estudios Prospectivos , Factores de RiesgoRESUMEN
The authors report 4 cases of cerebral abscesses (C.A.) complicating Rendu Osler disease (hereditary haemorrhagic telangiectasia: H.H.T.). These cases and 43 others comparable found in literature enable to assess C.A. complicates H.H.T. by the way of pulmonary arteriovenous fistulas (P.A.V.F.). C.A. appears during known H.H.T. in only a quarter of cases; in all other cases C.A. reveals the disease. When the etiological search for metastatic C.A. fails to find any classical cause: O.R.L., stomatologic, cardiac, it seems important to suspect H.H.T., and research P.A.V.F. by chest X ray and pulmonary angiography. Preventive treatment consists in excluding pulmonary fistulas without waiting neurological complications of known H.H.T.