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https://www.readbyqxmd.com/read/28108867/administration-of-voriconazole-in-disseminated-talaromyces-penicillium-marneffei-infection-a-retrospective-study
#1
Yanyin Ouyang, Shuangqi Cai, Hao Liang, Cunwei Cao
Talaromyces (Penicillium) marneffei infection is a fatal disseminated mycosis caused by the dimorphic fungus Talaromyces marneffei; the therapeutic strategies for this infectious disease are limited. The aim of this retrospective study was to evaluate the efficacy and safety of voriconazole for treating patients with disseminated T. marneffei infection with or without HIV infection in a clinical setting. Patients who intravenously received voriconazole (6 mg/kg q12 h for the first 24 h followed by 4 mg/kg q12 h) as the initial antifungal treatment were enrolled...
January 20, 2017: Mycopathologia
https://www.readbyqxmd.com/read/28108679/therapeutic-drug-monitoring-and-use-of-an-adjusted-body-weight-strategy-for-high-dose-voriconazole-therapy
#2
Patrick G Richards, Kimberlyn M Dang, Carol A Kauffman, Kay Lyn Stalker, David Sudekum, Lisa Kerr, Michelle Brinker-Bodley, Beena Cheriyan, Nina West, Curtis D Collins, Shikha Polega, Anurag N Malani
OBJECTIVES: A high-dose 12 mg/kg/day (6 mg/kg twice daily) voriconazole regimen was recommended by the CDC to treat patients injected with contaminated methylprednisolone acetate that caused a multi-state fungal outbreak in 2012-13. Therapeutic drug monitoring results of this unique regimen are unknown, as is the most appropriate dosing weight for obese patients. We evaluated voriconazole trough measurements for this dosing scheme, as well as the use of adjusted body weight dosing for obese patients...
January 20, 2017: Journal of Antimicrobial Chemotherapy
https://www.readbyqxmd.com/read/28104503/invasive-candida-krusei-infection-and-candida-vasculitis-of-a-leg-ulcer-in-an-immunocompetent-patient-a-case-report
#3
Jud Philipp, Valentin Thomas, Regauer Sigrid, Gary Thomas, Hackl Gerald, Rief Peter, Brodmann Marianne, Hafner Franz
A 71year old female Caucasian farmer without any known immunosuppression presented with a painful ulcer of her right lower leg after a trauma caused by a wood billet. There was no response to empirical antibacterial treatment. An ulcer biopsy showed an invasive Candida infection of the soft tissue and leucocytoclastic vasculitis. Voriconazole treatment was followed by wound healing. Invasive Candida infection and localized Candida vasculitis represent a rare cause of persisting leg ulcers. The similar clinical picture of chronic venous leg ulcers might blur the true cause and refractory cases should therefore promptly be processed by histopathological diagnostics...
January 16, 2017: International Journal of Infectious Diseases: IJID
https://www.readbyqxmd.com/read/28104135/renal-allograft-aspergillus-infection-presenting-with-obstructive-uropathy-a-case-report
#4
L Sadagah, M Alharbi, M Alshomrani, A Almalki
BACKGROUND: Isolated renal allograft aspergillosis is rare and usually presents with fever and decreased glomerular filtration rate. Presentation with obstructive uropathy caused by aspergillus fungal balls is much less common. We report a young male patient who presented with obstructive uropathy secondary to isolated renal allograft aspergillus infection 6 weeks after transplant. He was treated with nephrectomy and antifungal medications. CASE PRESENTATION: A 29-year-old Saudi male patient had a recent living non-related kidney transplantation in Pakistan...
January 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/28101934/detection-of-neonatal-unit-clusters-of-candida-parapsilosis-fungaemia-by-microsatellite-genotyping-results-from-laboratory-based-sentinel-surveillance-south-africa-2009-2010
#5
Rindidzani E Magobo, Serisha D Naicker, Jeannette Wadula, Maphoshane Nchabeleng, Yacoob Coovadia, Anwar Hoosen, Shawn R Lockhart, Nelesh P Govender
Neonatal candidaemia is a common, deadly and costly hospital-associated disease. To determine the genetic diversity of Candida parapsilosis causing fungaemia in South African neonatal intensive care units (NICUs). From February 2009 through to August 2010, cases of candidaemia were reported through laboratory-based surveillance. C. parapsilosis isolates from neonatal cases were submitted for identification by internal transcribed spacer (ITS) region sequencing, antifungal susceptibility testing and microsatellite genotyping...
January 19, 2017: Mycoses
https://www.readbyqxmd.com/read/28099778/pseudozyma-and-other-non-candida-opportunistic-yeast-bloodstream-infections-in-a-large-stem-cell-transplant-center
#6
Anupam Pande, Lemuel R Non, Rizwan Romee, Carlos A Q Santos
INTRODUCTION: Non-Candida opportunistic yeasts are emerging causes of bloodstream infection (BSI) in immunocompromised hosts. However, their clinical presentation, management, and outcomes in stem cell transplant (SCT) recipients are not well described. CASE REPORT AND REVIEW: We report the first case to our knowledge of Pseudozyma BSI in a SCT recipient. He had evidence of cutaneous involvement, which has not been previously described in the literature. He became infected while neutropenic and receiving empiric micafungin, which is notable because Pseudozyma is reported to be resistant to echinocandins...
January 18, 2017: Transplant Infectious Disease: An Official Journal of the Transplantation Society
https://www.readbyqxmd.com/read/28096163/large-scale-evaluation-of-in-vitro-amphotericin-b-triazole-and-echinocandin-activity-against-coccidioides-species-from-united-states-institutions
#7
George R Thompson, Bridget M Barker, Nathan P Wiederhold
Large-scale testing of Coccidioides isolates has not previously been performed, nor has the frequency of clinical isolates with elevated amphotericin B or triazole MICs been evaluated. Coccidioides isolates (n=581) underwent antifungal susceptibility testing. Elevated MIC values were observed for: fluconazole (MIC ≥16 μg/ml, 37.3% of isolates; ≥32 μg/ml, 7.9%), itraconazole (1.0% ≥2 μg/ml), posaconazole (1.0% ≥1 μg/ml), and voriconazole (1.2% ≥2 μg/ml). However mould-active triazoles exhibited low MICs for the majority of isolates tested...
January 17, 2017: Antimicrobial Agents and Chemotherapy
https://www.readbyqxmd.com/read/28087293/first-itraconazole-resistant-aspergillus-fumigatus-clinical-isolate-harbouring-a-g54e-substitution-in-cyp51ap-in-south-america
#8
Florencia Leonardelli, Laura Theill, María Elena Nardin, Daiana Macedo, Catiana Dudiuk, Emilce Mendez, Soledad Gamarra, Guillermo Garcia-Effron
BACKGROUND: A 27-year-old male rural worker was admitted with a fungal keratitis due to an injury involving plant detritus. MATERIALS AND METHODS: Specimens were collected for microscopy examination and culture. The isolate was identified by morphological and molecular criteria. Susceptibility testing was performed using CLSI methods. CYP51A gene was PCR amplified and sequenced. RESULTS: An Aspergillus fumigatus strain resistant to itraconazole (MIC>8μg/ml) was isolated...
January 10, 2017: Revista Iberoamericana de Micología
https://www.readbyqxmd.com/read/28080986/clinical-implications-of-globally-emerging-azole-resistance-in-aspergillus-fumigatus
#9
REVIEW
Jacques F Meis, Anuradha Chowdhary, Johanna L Rhodes, Matthew C Fisher, Paul E Verweij
Aspergillus fungi are the cause of an array of diseases affecting humans, animals and plants. The triazole antifungal agents itraconazole, voriconazole, isavuconazole and posaconazole are treatment options against diseases caused by Aspergillus However, resistance to azoles has recently emerged as a new therapeutic challenge in six continents. Although de novo azole resistance occurs occasionally in patients during azole therapy, the main burden is the aquisition of resistance through the environment. In this setting, the evolution of resistance is attributed to the widespread use of azole-based fungicides...
December 5, 2016: Philosophical Transactions of the Royal Society of London. Series B, Biological Sciences
https://www.readbyqxmd.com/read/28080217/synergistic-effects-of-tetrandrine-with-posaconazole-against-aspergillus-fumigatus
#10
Shui-Xiu Li, Yan-Jun Song, Ling Jiang, Ya-Jing Zhao, Hui Guo, Dong-Mei Li, Kun-Ju Zhu, Hong Zhang
In our earlier in vitro and in vivo studies, synergistic effects were observed when itraconazole or voriconazole were combined with tetrandrine (TET) against Aspergillus fumigatus, and the synergistic mechanism was related to inhibition of the drug efflux pump. Posaconazole (PCZ) is a broad-spectrum triazole antifungal agent used for the treatment of diverse fungal infections, including aspergillosis and candidiasis. Herein, the antifungal effects of TET are further investigated in vitro and in vivo alone or combined with PCZ against 20 clinical isolates of A...
January 12, 2017: Microbial Drug Resistance: MDR: Mechanisms, Epidemiology, and Disease
https://www.readbyqxmd.com/read/28079262/pediatric-obesity-pharmacokinetic-alterations-and-effects-on-antimicrobial-dosing
#11
Stephanie Natale, John Bradley, William Huy Nguyen, Tri Tran, Pamela Ny, Kirsten La, Eva Vivian, Jennifer Le
BACKGROUND: Limited data exist for appropriate drug dosing in obese children. This comprehensive review summarizes pharmacokinetic alterations that occur with age and obesity, and these effects on antimicrobial dosing. A thorough comparison of different measures of body weight and specific antimicrobial agents, including cefazolin, cefepime, ceftazidime, daptomycin, doripenem, gentamicin, linezolid, meropenem, piperacill-tazobactam, tobramycin, vancomycin, and voriconazole, are presented...
January 12, 2017: Pharmacotherapy
https://www.readbyqxmd.com/read/28070116/aspergillus-terreus-brain-abscess-complicated-by-tension-pneumocephalus-in-a-patient-with-angiosarcoma
#12
Thejal Srikumar, Smitha Pabbathi, Jorge Fernandez, Sowmya Nanjappa
BACKGROUND Aspergillus terreus is an evolving opportunistic pathogen, and patients with A. terreus often have poor outcomes due to its intrinsic resistance to several systemic antifungal agents. Here we present a unique case of intracranial abscesses of A. terreus in a patient with recurrent angiosarcoma, complicated by development of tension pneumocephalus. CASE REPORT A 67-year old gentleman with history of scalp angiosarcoma with wide excision two years prior presented to the hospital for left arm clumsiness, altered mental status, and low-grade fever...
January 10, 2017: American Journal of Case Reports
https://www.readbyqxmd.com/read/28070050/-clinical-comparative-analysis-for-pulmonary-histoplasmosis-and-progressive-disseminated-histoplasmosis
#13
Yan Zhang, Xiaoli Su, Yuanyuan Li, Ruoxi He, Chengping Hu, Pinhua Pan
To compare clinical features, diagnosis and therapeutic effect between pulmonary histoplasmosis and progressive disseminated histoplasmosis.
 Methods: A retrospective analysis for 12 cases of hospitalized patients with histoplasmosis, who was admitted in Xiangya Hospital, Central South University during the time from February 2009 to October 2015, was carried out. Four cases of pulmonary histoplasmosis and 8 cases of progressive disseminated histoplasmosis were included. The differences of clinical features, imaging tests, means for diagnosis and prognosis were analyzed between the two types of histoplasmosis...
December 28, 2016: Zhong Nan da Xue Xue Bao. Yi Xue Ban, Journal of Central South University. Medical Sciences
https://www.readbyqxmd.com/read/28069658/scy-078-is-fungicidal-in-time-kill-studies-against-candida-species
#14
Bernard Scorneaux, David Angulo, Katyna Borroto-Esoda, Mahmoud Ghannoum, Michael Peel, Stephen Wring
SCY-078 is an orally bioavailable ß-1,3-glucan synthesis inhibitor (GSI) and the first-in-class of structurally novel triterpine antifungals in clinical development for treating candidemia and invasive candidiasis. In vitro susceptibility by broth micro-dilution, antifungal carry-over, and time-kill dynamics were determined for 3 reference (ATCC) strains (C. albicans 90028, C. parapsilosis 90018, and C. tropicalis 750), a Quality Control (QC) strain (C krusei 6258), and 4 other strains (C. albicans MYA-2732, 64124, 76485 and C...
January 9, 2017: Antimicrobial Agents and Chemotherapy
https://www.readbyqxmd.com/read/28057172/substrate-specificity-of-human-cytochrome-p450-cyp-2c-subfamily-and-effect-of-azole-antifungal-agents-on-cyp2c8
#15
Toshiro Niwa, Yurie Imagawa
PURPOSE: The metabolic activities of aminopyrine N-demethylation and tolbutamide methylhydroxylation by the human hepatic cytochrome P450 (P450 or CYP) 2C subfamily were compared and the effects of azole antifungal agent on the drug-metabolizing activity of CYP2C8 were investigated. METHODS: Aminopyrine N-demethylation and tolbutamide methylhydroxylation by CYP2C8, CYP2C9, and CYP2C19 were determined by the previous reported methods. The effects of five azole antifungal agents, fluconazole, itraconazole, ketoconazole, miconazole, and voriconazole, on the aminopyrine N-demethylation activity by CYP2C8 were investigated...
October 2016: Journal of Pharmacy & Pharmaceutical Sciences: a Publication of the Canadian Society for Pharmaceutical Sciences
https://www.readbyqxmd.com/read/28054219/intracranial-aspergillosis-in-an-immunocompetent-young-woman
#16
Prasan Kumar Panda, Sunil Kumar Mavidi, Naveet Wig, Ajay Garg, Aasma Nalwa, M C Sharma
Intracranial aspergillosis (ICA) is very rare in the immunocompetent individuals, usually misdiagnosed as a tumor or an abscess. A high index of clinical suspicion is required in patients who present with focal neurological deficits, headache, or seizures. We report the case of a 25-year-old immunocompetent female, who presented with a 15-month history of headache, seizures, left-sided proptosis and ophthalmoplegia, and right hemiparesis. Recovery from the symptoms and decrease in the lesion size seen on the radiological assessment were achieved through two decompressive craniotomies followed by prolonged combined systemic antifungal therapies...
January 4, 2017: Mycopathologia
https://www.readbyqxmd.com/read/28053850/disseminated-coccidioidomycosis-presenting-with-intramedullary-spinal-cord-abscesses-management-challenges
#17
Kristina L Bajema, Mark F Dalesandro, David N Fredricks, Meena Ramchandani
Coccidioides species are endemic to the southwestern United States and typically cause a mild or asymptomatic primary infection. In some instances, infection can disseminate and involve the central nervous system with meningitis being the most common manifestation. Non-osseous spinal cord involvement is exceedingly rare. We report a case of disseminated coccidioidomycosis in an otherwise healthy 20 year old man with diffuse leptomeningeal enhancement, cerebrospinal fluid findings suggestive of meningitis, and intramedullary spinal cord abscesses...
March 2017: Medical Mycology Case Reports
https://www.readbyqxmd.com/read/28053848/rapid-development-of-a-mycotic-aneurysm-of-the-intracranial-artery-secondary-to-scedosporium-apiospermum-sinusitis
#18
Yoshihiko Ogawa, Masatoshi Sato, Masato Tashiro, Masayuki Miyazaki, Kiyoshi Nagata, Nobuyuki Takahashi, Kei Kasahara, Koichi Izumikawa, Hisakazu Yano, Keiichi Mikasa
An 85-year-old man complained of a 2-month history of pain on the left side of his face. Brain computed tomography (CT) and magnetic resonance imaging/magnetic resonance angiography did not clearly show any intracranial abnormality and only showed fluid effusion in his left sphenoid sinus. Filamentous fungi were detected from the left sphenoid sinus specimen. The isolate was Scedosporium apiospermum. He was empirically treated with voriconazole, to which the isolate was susceptible. His consciousness decreased rapidly...
December 2016: Medical Mycology Case Reports
https://www.readbyqxmd.com/read/28053212/multilocus-phylogeny-and-antifungal-susceptibility-of-aspergillus-section-circumdati-from-clinical-samples-and-description-of-a-pseudosclerotiorum-sp-nov
#19
J P Z Siqueira, D A Sutton, J Gené, D García, N Wiederhold, S W Peterson, J Guarro
A multilocus phylogenetic study was carried out to assess species identity of a set of 34 clinical isolates from Aspergillus section Circumdati from the USA, and to determine their in vitro antifungal susceptibility against eight antifungal drugs. The genetic markers used were ITS, BenA, CaM and RPB2, and the drugs tested were amphotericin B, itraconazole, posaconazole, voriconazole, anidulafungin, caspofungin, micafungin, and terbinafine. The most common species sampled was A. westerdijkiae (29.4%), followed by a novel species, which was described here as A...
January 4, 2017: Journal of Clinical Microbiology
https://www.readbyqxmd.com/read/28052853/activity-of-a-long-acting-echinocandin-cd101-and-seven-comparator-antifungal-agents-tested-against-a-global-collection-of-contemporary-invasive-fungal-isolates-in-the-sentry-2014-antifungal-surveillance-program
#20
Michael A Pfaller, Shawn A Messer, Paul R Rhomberg, Mariana Castanheira
The activity of CD101 and comparators was evaluated against 606 invasive fungal isolates collected worldwide during 2014 using the CLSI method. All C. albicans (n=251), C. tropicalis (n=51), C. krusei (n=16), and C. dubliniensis (n=11) were inhibited by ≤0.12 μg/ml of CD101 and were susceptible or wild type to other echinocandins. Five C. glabrata (n=100) displayed CD101 MIC values of 1-4 μg/ml, elevated caspofungin (2->8 μg/ml), anidulafungin (2-4 μg/ml), and micafungin (2-4 μg/ml) MICs, and carried mutations on fks1/fks2 C...
January 4, 2017: Antimicrobial Agents and Chemotherapy
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