[New opportunities for complex treatment of oropharyngeal candidiasis in HIV-infected patients in the later stages of the disease].

Treatment of recurrent oropharyngeal candidiasis (OPC) in HIV-infected patients is a serious clinical problem due to the emergence of resistant Candida strains, the risk of invasive disease, and high economic costs, which warrants the need for new treatment regimens. AIM: To improve the treatment regimen of OPC in the later stages of HIV infection by combining the complex herbal medicinal product Tonsilgon® N with fluconazole and evaluate the effectiveness of this combination. MATERIALS AND METHODS: A comparative randomized clinical study included 65 patients divided into observation and comparison groups, receiving fluconazole plus Tonsilgon® H and fluconazole monotherapy, respectively, for 7 days. On days 1 and 8, the severity of OPC clinical signs was assessed using a visual analog scale. The secretory immunoglobulin A in saliva was measured as a criterion for changing the level of local mucosal protection of the oral cavity and pharynx. CONCLUSION: This treatment regimen for oropharyngeal candidiasis in patients with HIV infection in the later stages of the disease (IVB-IVC) with fluconazole and Tonsilgon® N is effective, which is confirmed by a significantly more pronounced regression of clinical signs (pM-U<0.01), as well as an increase in the level of secretory immunoglobulin A in the oral fluid (from 0.62±0.33 g/L to 0.81±0.18 g/L; p<0.05).

[Morphological characteristics of Palatine tonsils candidiasis in the late stages of HIV-infection]. / Morfologicheskaya kharakteristika kandidoznogo porazheniya nebnykh mindalin na pozdnikh stadiyakh VICh-infektsii.

Candida lesion of Palatine tonsils was studied in 32 HIV-infected patients in the late stages of the disease using histological and cytological methods. There were used conventional methods during pathomorphological studies of palatine tonsils tissue fragments obtained by biopsy, and smears from the surface of the organ. It was found that micromycetes Candida spp. were located in association with various bacteria (mainly Streptococcus spp.), as well as Cryptococcus spp., with the formation of the biofilms, both on the surface of the Palatine tonsils and in the depth of their parenchyma. We revealed the minimal response cellular protective reaction to the deep introduction of the pathogen. Mycosis proceeded against the background of pronounced follicular lymphoid depletion of the tissue of the Palatine tonsils. The examined patients represent a risk group for invasion of Candida micromycetes into the vascular channel and their dissemination with the development of generalized candidiasis.

[The clinical and microbiological characteristics of oropharyngeal candidiasis in the HIV-infected patients at the late stages of the disease]. / Kliniko-mikrobiologicheskaia kharakteristika orofaringeal'nogo kandidoza u VICh-infitsirovannykh patsientov na pozdnikh stadiiakh zabolevaniia.

Oropharyngeal candidiasis in 512 HIV-infected patients at the late stages of the disease was studied with special reference to the clinical and microbiological characteristics of this condition. The diagnosis was established based on the results of the clinical and microbiological examination of the patients including investigation of the tissue samples taken from the oral cavity and the throat with the use of the device specially developed for this purpose. It was shown that the disease existed in various clinical forms the most common of which were monocomponent pathology represented by pseudomembranous candidiasis in 37.5±2.14% of the patients, the two-component mixed form (pseudomembranous candidiasis with concomitant angular chelitis) diagnosed in 27.5±1.97% cases, and the ternary form (the combination of pseudomembranous candidiasis, acute atrophic process, and angular chelitis) documented in 11.9±1.43% patients. The main clinical features of the disease included the combination of its various forms, multiple localization of the pathological process, and its polymorphous manifestations. Changes in the clinical course of oropharyngeal candidiasis associated with the progression of HIV from the 4A to the 4B stage were detected for the first time. They were shown to be accompanied by variations in the species composition and concentration of fungal flora in the crypts of the palatine tonsils and its sensitivity to fluconazole therapy.

[Characterization of contamination of hematology hospital environmental objects with micromycetes].

The paper presents of laboratory studies of the environmental objects in the hematology unit of a multidisciplinary hospital for micromycetes. Its air was found to be highly contaminated with mold fungi (85.4 ± 5.5%). The structure of micromycetes showed a preponderance of the fungi Aspergillus (47%), Rhizopus (36%), Penicillium, and other species (17%). The air contamination rate was 15.6 ± 3.3 CFU/m3 and did not exceed the recommended thresholds. Yeast fungi were prevalent in washouts. The contamination rate of ward louvers was 12 and 4 times higher than that of bedside tables and door handles, respectively. The degree of micromycetes contamination of environmental objects in the hematology unit did not depend on the destination of rooms and the length of stay of hematology patients in them.