Results of alcohol and albendazole injections in hepatic hydatidosis: experimental study.

BACKGROUND: Percutaneous drainage with alcohol injection for hydatid cysts has been commonly used in the last two decades. Albendazole is the drug of choice in the medical treatment of hydatidosis, and has also been used as an intraoperative scolicidal solution. The side-effects of its local application are not well known and have not been investigated. The purpose of the present study was to investigate the effects of the intracystic injections of alcohol and albendazole solutions on the hydatid cysts and hepatobiliary system of rabbits. METHODS: There were three groups of eight rabbits: a control group, an alcohol group and an albendazole group. In all groups hepatic hydatidosis was obtained. The control group received no therapeutic procedure. Cyst liquid was aspirated, and alcohol or albendazole solutions were injected in the other two study groups. alanine aminotransferase (ALT), aspartate aminotransferase (AST) and gamma-glutamyl transferase (GGT) levels, echinococcus indirect hemagglutination (IHA) tests, and the size and volume of the residual cysts were investigated. Liver was histopathologically evaluated. RESULTS: The ALT, AST, GGT, and alkaline phosphatase (ALP) levels were significantly higher in the alcohol group, whereas echinococcus IHA level was highest in the control group than in the study groups. Albendazole had similar effects but of a lesser degree (P < 0.01). After therapy, the cyst volume was greater in the control than in the albendazole group (P < 0.01). In histopathological evaluation hepatocellular necrosis, portal inflammation and fibrosis were most severe in the alcohol group (P < 0.01). CONCLUSIONS: Alcohol and albendazole solutions are effective as scolicidal solutions. Higher scolicidal effect and lesser side-effects on hepatobiliary system are the advantages of albendazole solution.

Disseminated Trichosporon asahii infection in a preterm.

Trichosporon asahii (T. asahii) is an uncommon cause of yeast infection in preterms. We present a 27-week gestational age female with clinical evidence of sepsis, such as patchy infiltrations on chest roentgenogram, and yeast growing in urine and blood cultures. Conventional amphotericin B was empirically added in a dose of 0.5 mg/kg, q8h to standard protocol of the neonatal intensive care unit. Dose of the drug was induced to 1 mg/kg because the patient had not improved when the organism was identified as T. asahii on the pretreatment urine and blood cultures. Both cultures were clear on the 10th day of amphotericin B therapy and treatment was ceased on the 21st day. The patient was healthy when discharged. Trichosporon infections in neonates have been almost uniformly fatal. Most strains of T. asahii may be confused with Candida spp. on initial culture examinations. Therefore, delays in appropriate treatment may occur.