Oesophagitis caused by Candida kefyr.

The unusual case of an oesophagitis caused by Candida kefyr in a patient with squamous cell carcinoma of the oropharynx is reported. The further implementation of C. kefyr in the production of milk products is discussed.

Geotrichosis of oral mucosa.

A livid, sharply defined enanthema of the oral mucosa with ulcerations on the soft palate in a patient presenting with de novo acute myeloid leukaemia with prolonged, therapy-induced granulocytopenia (< 0.5 nl-1 for 113 days!) was diagnosed as geotrichosis. Geotrichum capitatum was identified both in vivo and in vitro. Pneumonic infiltrates in the upper lobes of both lungs were treated with amphotericin B infusions. Healing of the aforementioned enanthema was only achieved after addition of 5-fluorocytosine to therapy. Susceptibility determinations with several Geotrichum capitatum isolates led to the conclusion that amphotericin B was unsuitable as a therapeutic agent in this case. 5-Fluorocytosine and itraconazole exhibited superior antifungal and antimycotic activity.

Exophiala mesophila spec. nov.

In this paper a new fungus species, Exophiala mesophila Listemann et Freiesleben, is described. The species was isolated from silicone seals in the shower room of a hospital ward.

[HIV-associated mycoses]. / HIV-assoziierte Mykosen.

Candidosis, cryptococcosis, and histoplasmosis often occur as HIV-associated mycoses. However, aspergillosis can be observed quite recently. The morphology of the pathogen of HIV-associated mycoses in vivo and in vitro is demonstrated and discussed.

Invasive Trichosporon beigelii infection in immunosuppressed rats.

Fulminant systemic mycoses were seen as complications in rats undergoing drug trials for the treatment of Pneumocystis carinii pneumonia. Rats were immunosuppressed with corticosteroids and by feeding with a low-protein diet. Homogenized pulmonary tissue from a rat with pneumocystosis was inoculated transtracheally. Secondary invasive mycosis was found in 56 of 59 rats examined. Trichosporon beigelii was identified as the causative agent in the majority of cases. After examining possible sources of infection, a Pneumocystis inoculum contaminated with fungi was found to be the obvious source. T. beigelii infections are becoming increasingly significant in immunocompromised human patients. The need for suitable and reproducible animal models is therefore also increasing. Observations described in this paper may help in the further development of such models.

[Antifungal activity of sulfonated shale oils]. / Antimyzetische Aktivität von sulfonierten Schieferölen.

Bituminous shale, developed from marine sediments during the Jura era, is the raw substance for the production of shale oil. The shale oil undergoes heating, distillation, fractionated refining and sulfonation (according to a patented method) resulting in water-soluble sulfonated shale oils (Ichthyol) for medical purposes. The antifungal effect of sulfonated shale oils have been described earlier. In this study an in vitro method is applied which is based upon the CO2 detection as a measure for the sensitivity of fungi to sulfonated shale oils. In addition to the minimal inhibitory concentration values (MIC values), sub-inhibitory concentrations are also determined. The actual efficacy of these antifungal agents is demonstrated via dose-effect curves. Our results show that the fractions of sulfonated shale oils refined at 150 to 210 degrees C (Ichthyol, dark) are fungicidal in concentrations between 0.2 and 16.8% for yeasts, dermatophytes and other hyphomycetes. The fractions of sulfonated shale oils refined at 85 to 150 degrees C (Ichthyol, light), on the other hand, showed a clearly higher antifungal activity (concentrations between 0.1 and 5.9%) for all fungi tested. An extended exposition (24 to 168 h) of Candida albicans to these fractions resulted in a further increase of fungicidal activity. Due to the complex nature of sulfonated shale oils the chemically defined antifungal substance(s) have not yet been identified.

Oral candidosis in HIV-infected patients. Prognostic value and correlation with immunological parameters.

In a prospective study, 29 patients were observed over a period of 42 weeks for signs of oral candidosis (OC), immunological parameters and other typical AIDS-related events. Before the study started, no OC was observed in any of the patients. During the observation period, OC was diagnosed in 12 of the 29 patients (41%). 5 of these 12 patients (42%) developed full-blown AIDS during the 42 weeks. In contrast, a progression to AIDS was observed in only 1 of the 17 patients (5.9%) without OC. The laboratory findings for patients with and without OC showed statistically significant differences for neopterin (23.6 against 14.4 nmol l-1), CD4 counts (417 against 763/mm3) and CD4/CD8 ratios (0.45 against 0.85). Based on these results, it seems justifiable to consider prophylactic measures such as pentamidine inhalation and/or treatment with zidovudine in HIV-infected patients with immunodeficiency and occurrence of OC.