RESUMEN
AIM: To represent the advances of Russia and Uzbekistan in studying the problem of paecilomycosis. The goal of the investigation was to develop the diagnosis and treatment of pulmonary paecilomycosis (PP). SUBJECTS AND METHODS: Two hundred and twenty-five people, including 200 patients with bronchopulmonary infection with fungi of the Paecilomyces genus and 25 clinically healthy individuals (a control group), were examined. Clinico-anamnestic, laboratory diagnostic, mycological, and immunological studies were conducted; a lymphocyte antigen-binding test was used for differential diagnosis. Paecilomyces infection was diagnosed by microscopically examining the morphology of the fungi in the pathological material (blood, sputum) and by isolating the cultured fungi in the media (Sabouraud's and Czapek's ones). The severe complication of PP - atypical paecilomycosis-associated myocarditis (APAM) - was studied in 112 patients with helminthiasis-complicated paecilomycosis. These patients underwent using the conventional echocardiography. RESULTS: Bronchopulmonary paecilomycosis resulting from primary and secondary infection with fungi of the Paecilomyces genus was clinically manifested as chronic obstructive bronchitis (11.5%), recurrent pneumonia (13.5%), exogenous allergic alveolitis (37%), and asthma (26%) complicated by helminthiasis (12%). Iodine deficiency promotes the prevalence of paecilomycosis and echinococcosis favors Paecilomycosis infection; moreover, the helminth capsule itself serves as a nutrient medium for the development of the mycelial form of the fungus. APAM is a severe complication of PP. Almost 50% of the patients with PP presented with carditis. The patients with APAM occasionally experienced fear and the most severe intermittent pain. The latter first occurred in the chest.and irradiated to the axilla, left hand, and its fingertips, paralyzing the arm. In some patients, the pain manifested itself in both arms with abdominal irradiation, by being accompanied by faints. Current analgesics (meloxicam, tizanidine, nimesulide, morphine, promedole) in combination with fluconazole provided a temporary positive effect. CONCLUSION: Further investigations that must also include neurologists and anesthetists are required to work out effective pain relief regimens for APAM in patients with PP.
Asunto(s)
Enfermedades Pulmonares Fúngicas/diagnóstico , Enfermedades Pulmonares Fúngicas/tratamiento farmacológico , Paecilomyces/aislamiento & purificación , Adulto , Analgésicos/administración & dosificación , Analgésicos/uso terapéutico , Antifúngicos/administración & dosificación , Antifúngicos/uso terapéutico , Diagnóstico Diferencial , Quimioterapia Combinada , Femenino , Ventrículos Cardíacos/fisiopatología , Humanos , Yodo/deficiencia , Enfermedades Pulmonares Fúngicas/diagnóstico por imagen , Enfermedades Pulmonares Fúngicas/microbiología , Masculino , Persona de Mediana Edad , Contracción Miocárdica/fisiología , Miocarditis/etiología , Miocarditis/microbiología , Miocarditis/fisiopatología , Paecilomyces/efectos de los fármacos , Dolor/tratamiento farmacológico , Dolor/etiología , Radiografía , Federación de Rusia , Esputo/microbiología , Pruebas de Función de la Tiroides , Glándula Tiroides/metabolismo , Glándula Tiroides/fisiopatología , Hormonas Tiroideas/sangre , Uzbekistán , Función Ventricular IzquierdaRESUMEN
Experiments were carried out on animal species. The experiments used 30-day chicks, 80 rats, and 70 rabbits. Three hundred and twenty-nine patients with echinococcus complicated by paecilomycosis were meticulously examined. The fungi of the genus Paecilomyces undergo two transformation directions: the saprotrophic mycelial form of the fungus Paecilomyces variotii transforms to the tissue parasitic one as a globular form of spherules that transforms to the mycelial form in larval Echinococcus infection because the cyst capsule is a favorable environment for growth of fungal mycelia. The growth and aggressiveness of larval Echinococcus in the human lung are associated with the fact that fungal mycelial fibrous tunic contains Paecilomyces that have been first used to isolate active hyaluronidase that lyses host cells. Pulmonary echinococcosis complicated by the tissue form of paecilomycosis can be complicated by the mycelial form of the fungus of the genus Paecilomyces, by afflicting the nails and skin of patients, which requires particular treatment after surgery for hydatid disease. The chicks that had been brooded in an incubator and grown under special conditions to rule out fungal infection were first contaminated with the fungal mycelium labeled with methionine, sodium sulfate, sodium phosphate, or iodine. Each chick received 0.5 g of the labeled fungal mycelium. Regardless of the contamination mode, all the chicks from 3 groups were infected with Paecilomyces; the spherules exhibited labeled isotopes. Thus, it has been first conclusively proven that the diagnosis of paecilomycosis based on the blood detection of fungal globular spherules is valid and easy-to-use in any health care facility.
Asunto(s)
Equinococosis Pulmonar/metabolismo , Equinococosis Pulmonar/microbiología , Echinococcus , Micelio/metabolismo , Micosis/metabolismo , Paecilomyces/metabolismo , Animales , Pollos , Perros , Equinococosis Pulmonar/diagnóstico , Echinococcus/metabolismo , Echinococcus/microbiología , Cobayas , Humanos , Micosis/diagnóstico , Micosis/parasitología , Conejos , Ratas , Ratas WistarRESUMEN
Changes of selenium, chromium, antimony, silver, cobalt, rubidium, zinc, iron and bromine concentration in whole blood of Wistar rats were examined in early period after gamma irradiation by 3, 7.5 and 10 Gy. Level of these trace elements was measured by instrumental neutron activation and X-ray fluorescence analysis. Diagnostic and prognostic significance of some trace elements were established.