RESUMO
Fungal infection of the genitourinary system is a relatively uncommon presentation. Cryptococcuria has rarely been recognized in clinical practice. Patients with positive urine culture for Cryptococcus neoformans from 1992 to 2003 were retrospectively reviewed. Sixteen patients were identified. Nine (56%) patients were male, with a mean age of 44 +/- 21 (range, 16-88) years. Fifteen (94%) patients had underlying conditions such as HIV infection, diabetes mellitus, hypertension, and/or systemic lupus erythematosus. Thirteen (81%) patients had cryptococcuria as a manifestation of disseminated cryptococcosis, and the rest had only isolated cryptococcuria. Urinary analysis revealed proteinuria (75%), pyuria (31%), and budding yeast (13%). Nine (56%) patients received antifungal therapy. Other patients were misdiagnosed or died before treatment. The mortality rate was 64%. In conclusion, cryptococcuria is not extremely rare and can present as a manifestation of disseminated cryptococcosis or isolated urinary tract infection.
Assuntos
Criptococose/diagnóstico , Infecções Urinárias/microbiologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Antifúngicos/uso terapêutico , Criptococose/tratamento farmacológico , Criptococose/urina , Cryptococcus neoformans/isolamento & purificação , Feminino , Infecções por HIV/complicações , Humanos , Masculino , Pessoa de Meia-Idade , Infecções Oportunistas/microbiologia , Estudos Retrospectivos , Infecções Urinárias/complicaçõesRESUMO
A rapid, inexpensive, and reliable antimycobacterial susceptibility assay is needed to effectively deal with the increasing prevalence of resistant strains of M. tuberculosis in Thailand. The microtiter plate Alamar blue assay (MABA) appears to be promising but requires additional data regarding correlation with clinical outcome. The correlation between the susceptibility by MABA and clinical outcomes was studied. There were 123 specimens obtained from extra-pulmonary sites of 108 patients at Ramathibodi Hospital in 1999. The authors found that susceptibility of M. tuberculosis isolates by the MABA correlated with the clinical outcome; patients with isolates sensitive to isoniazid, rifampicin, and ethambutol had a better clinical outcome than patients with isolates resistant to at least one of these drugs (p=0.004). Studies to determine this correlation in pulmonary tuberculosis are still needed.
Assuntos
Antituberculosos/uso terapêutico , Bioensaio/métodos , Corantes , Mycobacterium tuberculosis/efeitos dos fármacos , Avaliação de Resultados em Cuidados de Saúde , Oxazinas , Tuberculose/tratamento farmacológico , Xantenos , Resistência a Medicamentos , Humanos , Mycobacterium tuberculosis/isolamento & purificaçãoRESUMO
The in vitro activities of cloxyquin (5-chloroquinolin-8-ol) against 9 standard strains and 150 clinical isolates of Mycobacterium tuberculosis were studied. The MICs ranged from 0.062 to 0.25 microg/ml. The MIC(50) and MIC(90) were 0.125 and 0.25 microg/ml, respectively. These indicate that cloxyquin exhibited good antituberculosis activity, even for multidrug-resistant isolates.