DOCSLIB.ORG

Allergic Bronchopulmonary Aspergillosis and Candida Albicans Colonization of the Respiratory Tract in Corticosteroid· Dependent Asthma

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
Allergic Bronchopulmonary Aspergillosis and Candida Albicans Colonization of the Respiratory Tract in Corticosteroid· Dependent Asthma Asian Pacific Journal of Allergy and Immunology (1990) 8: 123·126 Allergic Bronchopulmonary Aspergillosis and Candida albicans Colonization of the Respiratory Tract in Corticosteroid· Dependent Asthma S. Ramachandran, Ashok Shah, Kaushal Pant, Rajesh Bhagat, and O.P. Jaggl "Corticosteroids are funda­ SUMMARY Fungal studies were conducted on 35 patients with corticosteroid· mental to the treatment of asthma", I dependent asthma (CSDA) and 20 asthmatics who had never received prednisolone. but prolonged use can alter pulmonary Candida albicans was repeatedly cultured from the sputa of 12 patients with CSDA. host defence mechanisms which Isolation was more frequent In those patients who were receiving more than 10 mg results in the airway providing a hos­ prednisolone for more than six months. Nearly half of these patients demonstrated pitable environment for the growth a positive Immediate cutaneous reaction and precipitating antibodies against C.albicans. of opportunistic fungi.:U This can Although no pathological significance, beside colonization, could be attributed to this finding, It was felt that It would be prudent to restrict the dally dose of prednl. also lead to systemic mycosis. 4,5 solone to less than 10 mg, when administered for more than six moths. Two patients Recent studies 6,7 have reported the with allergic bronchopulmonary aspergillosis (ABPA). were Identified, one from each occurance of allergic bronchopul­ group. The possibility of ABPA. however, remained open In two other patients with monary aspergillosis (ABPA) among CSDA. It is probable that some patients with CSDA may be suffering fro~ ABPA patients with corticosteroid - depen­ but characteristic features of the disease are masked by costlcosterold tnerapy, dent asthma (CSDA) and have also making It difficult to diagnose. highlighted the difficulty in diagnosis of ABPA in this group of asthmatics, as therapy with corticosteroids masks mum doses of 7.5 mg daily or 15 mg KOH directly on a slide and observed many of the characteristic features on alternate days. Clinical assessment microscopically for fungal elements. of the disease. This study on 35 pa­ of all patients was done along with All specimens were also streaked on tients of CSDA was prompted by routine investigations of blood and Sabouraud's dextrose agar (Emmon's the paucity of such information from urine, chest radiograph and spiro­ modification) containing chloram­ the subcontinent. metery. All studies were conducted phenicol (0.5 mg/mt) as well as chlo­ with patients maintained on doses ramphenicol and cycloheximide (0.5 of prednisolone required for control mg/ml). MATERIALS AND METHODS of their symptoms. Twenty asthmatics One set of these innoculated The study comprised 35 patients who had never received corticosteroids tubes was incubated at 25° C and the with CSDA attending the Clinical functioned as controls and underwent other was incubated at 37° C for 4 Research Centre of the vallabhai an identical work up as the study weeks. The identity of Candida albi­ Patel Chest Institute. Corticosteroid­ population. dependent asthma was defined as Mycological investigations in­ patients requiring prednisolone for cluded examination of sputum samples From the Department of Clinical Research, the control of their symptoms for a of patients from both, the study and Vallabhai Patel Chest Institute, University of Delhi, P.O. BOX 2101 Delhi·110007, India. I minimum period of 3 months or control groups. A loopfull of each more prior to presentation at mini- specimen was digested in 10 percent Correspondence: Dr. Ashok Shah 124 RAMACHANDRAN, ET AL. cans was confirmed by Germ tube test pitating antibodies to A.jumigatus, and in I patient amongst the controls. and chlamydospore production. Iden­ A.flavus, A.niger and C.albicans were Bronchography demonstrated central tification of Aspergillus jumigatus, detected, by the gel double immuno­ bronchiectasis in one patient in the A. jlavus and A. niger was based on diffusion technique of Ouchterlony. 9 study group. their microscopic and macroscopic A total of 164 sputum samples, characteristics as seen on Sabouraud's RESULTS 104 from the study group and 60 from agar at 25° C and 37° C. There were 16 males and 19 the control group were studied for Skin tests were performed intra­ females in the study group with an pathogenic fungi. C.albicans was cutaneously on the forearm with anti­ age range of 11-16 years. The control isolated from 30 sputum samples from gens of Aspergillus jumigatus, A. group consisted of 12 females and 8 12 patients of the study group as niger, A.flavus and Candida albicans males. No significant occupational compared to a single patient from the il) dilutions of 1:500, obtained from history could be elicited in either control group. As many as 11 of Council of Scientific and Industrial group. Peripheral eosinophilia (> these 12 patients receiving predni­ Research-Centre of Biochemicals, 500/mm3) was observed in 17 patients solone had repeated heavy growth Delhi. All sites were examined after in the study group as compared to (arbitrarily taken as more than 10 20 minutes for immediate reaction 13 in the control group. Chest radio­ colonies per culture) of the fungus, and periodically over 4-8 hours for graphs showed transient pulmonary which was directly linked to the dose type-III reaction and graded. 8 Preci­ infiltrates in 3 patients with CSDA and duration of corticosteroid therapy Table 1. Frequency of isolation of growth of Candida albicans in sputum of patients with corticosteroid-dependent asthma. Duration of therapy Dose of prednisolone Less than 6 months More than 6 months (mg per day) Positive Sputum Patient Positive Sputum Patient specimens number specimens number Less than 10 a/a a/a 5/28 2/8 11-20 8/11 2/5 15/50 6/17 21-30 0/3 0/1 3/6 1/2 More than 30 0/3 0/1 3/3 1/1 Total 8/17 217 26/87 10/28 Table 2. Salient characteristics of patients with allergic bronchopulmonary aspergiliosts (ABPA) and probable ABPA. Cutaneous hypersensitivity Sputum culture Serum Peripheral Chest Group Age/Sex against A. fumigatus Bronchogram for A. fumigatus precip itins eosinophilia X-ray Type-I Type-III 1, Study 45, F + + + + TPI CB 25, F* + + + TPI NO 37, M* + + + TPI NO 2. Control 26, M + + + + + TPI NO Probable ABPA TPI Transient pulmonary infiltrates CB = Central bronchiectasis NO ~ Not done I FUNGAL STUDIES IN CORTICOSTEROID-DEPENDENT ASTHMA 125 II (Table I). Aspergillus species were However, apart from colonization, ACKNOWLEDGEMENTS t isolated from sputum of 11 patients no significance could be established, I We are thankful to Professor ~ in the study group and 4 in the control especially in view of the fact that H.S. Randhawa for helping with the group. many normal individuals have cutane­ mycological investigations. Of the 35 patients with CSDA, ous reactivity to Calbicans. 12 In­ ! 6 had cutaneous reactivity to candidin creased Calbicans colonization of i ! and 11 to aspergillin. One patient the respiratory tract must, neverthe­ References less, be viewed with concern, especially i exhibited both type I and III reaction I. Woolcock AJ. Use of corticosteroids in ! against A.jumigatus. Only 1 patient in light of the fact that corticosteroids treatment of patients with asthma. J I had an immediate cutaneous reaction alone or in combination with anti­ Allergy Clin Immunol 1989; 84 : 975-8. [ against Calbicans III the control biotics, supress neutrophilic responses 2. Chiu n, Wells I, Novey HS. Incidence group while 5 patients reacted posi­ to Candida which is crucial to the of fungal precipitins in patients treated I tively to aspergillin, one of whom defence against this organism. 13.14 with beclomethasone dipropionate t also demonstrated a type III reaction Furthermore, the possible role of aerosol. Ann Allergy 1981; 46: 137-9. t to A.jumigatus. Calbicans as an allergen in chronic 3. Kwong FK, Sue MA, Klaustermeyer WB. asthma must also be considered. 15 Serum precipitins against C Corticosteroid complications in respira­ Increased colonization assumes im­ tory disease. Ann Allergy 1987; 58 : 326-30. albicans, were demonstrated in 8 pa­ portance in context of the fact that tients with CSDA and in none of the 4. Anderson CJ, Craig S, Bardana EJ. Calbicans is not an airborne allergen, control group. Of the 12 patients in Allergic bronchopulmonary aspergillosis the only source of exposure being and bilateral fungal balls terminating in whom Calbicans was cultured in the saprophytic growth in the body. 16 disseminated aspergillosis. J Allergy Clin sputum, 7 had serum precipitins In view of our finding, it may there­ Immunol 1980; 65 : 140-4. against Calbicans. Serum precipi­ fore be prudent to restrict the dose 5. Dehan AL, Ketai L. Invasive aspergillosis. tins against A .jumigatus were detected of prednisolone to less than 10 mg Chest 1988; 94 : 1117-8. in 1 patient each from both groups. daily, when given for more than six 6. Clayton DE, Busse WW. Development On the basis of clinical and radio­ months. of allergic bronchopulmonary aspergil­ logical profile and supported by posi­ Two of our patients, one from losis during treatment of severe asthma tive mycological, immunological and each group, had ABPA. Two other with systemic corticosteroids. J Allergy serological data, a diagnosis of ABPA patients from the study group had Clin Immunol 1981; 67 : 243-6. was established in 2 patients, 1 from transient pulmonary infiltrates, peri­ 7. Basich JE, Graves TS, Baz MN, Scanlon each group (Table 11). Two other pheral eosinophilia and an immediate G, Hoffmann RG Patterson R, Fink IN. patients in the study group had tran­ cutaneous reaction to aspergillin. Allergic bronchopulmonary aspergillosis sient pulmonary infiltrates, with peri­ Serum precipitins to Aspergillus were in corticosteroid-dependent asthmatics. J Allergy C1in Immunol 1981; 68 : 98-102. pheral eosinophilia, A.jumigatus in not detected in these two patients nor sputum and a type I cutaneous hyper­ did they consent to bronchography.
Load more

Recommended publications
  • Candida Auris
    microorganisms Review Candida auris: Epidemiology, Diagnosis, Pathogenesis, Antifungal Susceptibility, and Infection Control Measures to Combat the Spread of Infections in Healthcare Facilities Suhail Ahmad * and Wadha Alfouzan Department of Microbiology, Faculty of Medicine, Kuwait University, P.O. Box 24923, Safat 13110, Kuwait; [email protected] * Correspondence: [email protected]; Tel.: +965-2463-6503 Abstract: Candida auris, a recently recognized, often multidrug-resistant yeast, has become a sig- nificant fungal pathogen due to its ability to cause invasive infections and outbreaks in healthcare facilities which have been difficult to control and treat. The extraordinary abilities of C. auris to easily contaminate the environment around colonized patients and persist for long periods have recently re- sulted in major outbreaks in many countries. C. auris resists elimination by robust cleaning and other decontamination procedures, likely due to the formation of ‘dry’ biofilms. Susceptible hospitalized patients, particularly those with multiple comorbidities in intensive care settings, acquire C. auris rather easily from close contact with C. auris-infected patients, their environment, or the equipment used on colonized patients, often with fatal consequences. This review highlights the lessons learned from recent studies on the epidemiology, diagnosis, pathogenesis, susceptibility, and molecular basis of resistance to antifungal drugs and infection control measures to combat the spread of C. auris Citation: Ahmad, S.; Alfouzan, W. Candida auris: Epidemiology, infections in healthcare facilities. Particular emphasis is given to interventions aiming to prevent new Diagnosis, Pathogenesis, Antifungal infections in healthcare facilities, including the screening of susceptible patients for colonization; the Susceptibility, and Infection Control cleaning and decontamination of the environment, equipment, and colonized patients; and successful Measures to Combat the Spread of approaches to identify and treat infected patients, particularly during outbreaks.
    [Show full text]
  • Candida Species Identification by NAA
    Candida Species Identification by NAA Background Vulvovaginal candidiasis (VVC) occurs as a result of displacement of the normal vaginal flora by species of the fungal genus Candida, predominantly Candida albicans. The usual presentation is irritation, itching, burning with urination, and thick, whitish discharge.1 VVC accounts for about 17% to 39% of vaginitis1, and most women will be diagnosed with VVC at least once during their childbearing years.2 In simplistic terms, VVC can be classified into uncomplicated or complicated presentations. Uncomplicated VVC is characterized by infrequent symptomatic episodes, mild to moderate symptoms, or C albicans infection occurring in nonpregnant and immunocompetent women.1 Complicated VVC, in contrast, is typified by severe symptoms, frequent recurrence, infection with Candida species other than C albicans, and/or occurrence during pregnancy or in women with immunosuppression or other medical conditions.1 Diagnosis and Treatment of VVC Traditional diagnosis of VVC is accomplished by either: (i) direct microscopic visualization of yeast-like cells with or without pseudohyphae; or (ii) isolation of Candida species by culture from a vaginal sample.1 Direct microscopy sensitivity is about 50%1 and does not provide a species identification, while cultures can have long turnaround times. Today, nucleic acid amplification-based (NAA) tests (eg, PCR) for Candida species can provide high-quality diagnostic information with quicker turnaround times and can also enable investigation of common potential etiologies
    [Show full text]
  • Fungi in Bronchiectasis: a Concise Review
    International Journal of Molecular Sciences Review Fungi in Bronchiectasis: A Concise Review Luis Máiz 1, Rosa Nieto 1 ID , Rafael Cantón 2 ID , Elia Gómez G. de la Pedrosa 2 and Miguel Ángel Martinez-García 3,* ID 1 Servicio de Neumología, Unidad de Bronquiectasias y Fibrosis Quística, Hospital Universitario Ramón y Cajal, 28034 Madrid, Spain; [email protected] (L.M.); [email protected] (R.N.) 2 Servicio de Microbiología, Hospital Universitario Ramón y Cajal and Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), 28034 Madrid, Spain; [email protected] (R.C.); [email protected] (E.G.G.d.l.P.) 3 Servicio de Neumología, Hospital Universitario y Politécnico la Fe, 46016 Valencia, Spain * Correspondence: [email protected]; Tel.: +34-60-986-5934 Received: 3 December 2017; Accepted: 31 December 2017; Published: 4 January 2018 Abstract: Although the spectrum of fungal pathology has been studied extensively in immunosuppressed patients, little is known about the epidemiology, risk factors, and management of fungal infections in chronic pulmonary diseases like bronchiectasis. In bronchiectasis patients, deteriorated mucociliary clearance—generally due to prior colonization by bacterial pathogens—and thick mucosity propitiate, the persistence of fungal spores in the respiratory tract. The most prevalent fungi in these patients are Candida albicans and Aspergillus fumigatus; these are almost always isolated with bacterial pathogens like Haemophillus influenzae and Pseudomonas aeruginosa, making very difficult to define their clinical significance. Analysis of the mycobiome enables us to detect a greater diversity of microorganisms than with conventional cultures. The results have shown a reduced fungal diversity in most chronic respiratory diseases, and that this finding correlates with poorer lung function.
    [Show full text]
  • Managing Athlete's Foot
    South African Family Practice 2018; 60(5):37-41 S Afr Fam Pract Open Access article distributed under the terms of the ISSN 2078-6190 EISSN 2078-6204 Creative Commons License [CC BY-NC-ND 4.0] © 2018 The Author(s) http://creativecommons.org/licenses/by-nc-nd/4.0 REVIEW Managing athlete’s foot Nkatoko Freddy Makola,1 Nicholus Malesela Magongwa,1 Boikgantsho Matsaung,1 Gustav Schellack,2 Natalie Schellack3 1 Academic interns, School of Pharmacy, Sefako Makgatho Health Sciences University 2 Clinical research professional, pharmaceutical industry 3 Professor, School of Pharmacy, Sefako Makgatho Health Sciences University *Corresponding author, email: [email protected] Abstract This article is aimed at providing a succinct overview of the condition tinea pedis, commonly referred to as athlete’s foot. Tinea pedis is a very common fungal infection that affects a significantly large number of people globally. The presentation of tinea pedis can vary based on the different clinical forms of the condition. The symptoms of tinea pedis may range from asymptomatic, to mild- to-severe forms of pain, itchiness, difficulty walking and other debilitating symptoms. There is a range of precautionary measures available to prevent infection, and both oral and topical drugs can be used for treating tinea pedis. This article briefly highlights what athlete’s foot is, the different causes and how they present, the prevalence of the condition, the variety of diagnostic methods available, and the pharmacological and non-pharmacological management of the
    [Show full text]
  • Red-Brown Patches in the Groin
    DERMATOPATHOLOGY DIAGNOSIS Red-Brown Patches in the Groin Dong Chen, MD, PhD; Tammie C. Ferringer, MD Eligible for 1 MOC SA Credit From the ABD This Dermatopathology Diagnosis article in our print edition is eligible for 1 self-assessment credit for Maintenance of Certification from the American Board of Dermatology (ABD). After completing this activity, diplomates can visit the ABD website (http://www.abderm.org) to self-report the credits under the activity title “Cutis Dermatopathology Diagnosis.” You may report the credit after each activity is completed or after accumu- lating multiple credits. A 66-year-old man presented with reddish arciform patchescopy in the inguinal area. THE BEST DIAGNOSIS IS: a. candidiasis b. noterythrasma c. pitted keratolysis d. tinea cruris Doe. tinea versicolor H&E, original magnification ×600. PLEASE TURN TO PAGE 419 FOR THE DIAGNOSIS CUTIS Dr. Chen is from the Department of Pathology and Anatomical Sciences, University of Missouri, Columbia. Dr. Ferringer is from the Departments of Dermatology and Laboratory Medicine, Geisinger Medical Center, Danville, Pennsylvania. The authors report no conflict of interest. Correspondence: Dong Chen, MD, PhD, Department of Pathology and Anatomical Sciences, University of Missouri, One Hospital Dr, MA204, DC018.00, Columbia, MO 65212 ([email protected]). 416 I CUTIS® WWW.MDEDGE.COM/CUTIS Copyright Cutis 2018. No part of this publication may be reproduced, stored, or transmitted without the prior written permission of the Publisher. DERMATOPATHOLOGY DIAGNOSIS DISCUSSION THE DIAGNOSIS: Erythrasma rythrasma usually involves intertriginous areas surface (Figure 1) compared to dermatophyte hyphae that (eg, axillae, groin, inframammary area). Patients tend to be parallel to the surface.2 E present with well-demarcated, minimally scaly, red- Pitted keratolysis is a superficial bacterial infection brown patches.
    [Show full text]
  • Tinea Capitis 2014 L.C
    BJD GUIDELINES British Journal of Dermatology British Association of Dermatologists’ guidelines for the management of tinea capitis 2014 L.C. Fuller,1 R.C. Barton,2 M.F. Mohd Mustapa,3 L.E. Proudfoot,4 S.P. Punjabi5 and E.M. Higgins6 1Department of Dermatology, Chelsea & Westminster Hospital, Fulham Road, London SW10 9NH, U.K. 2Department of Microbiology, Leeds General Infirmary, Leeds LS1 3EX, U.K. 3British Association of Dermatologists, Willan House, 4 Fitzroy Square, London W1T 5HQ, U.K. 4St John’s Institute of Dermatology, Guy’s and St Thomas’ NHS Foundation Trust, St Thomas’ Hospital, Westminster Bridge Road, London SE1 7EH, U.K. 5Department of Dermatology, Hammersmith Hospital, 150 Du Cane Road, London W12 0HS, U.K. 6Department of Dermatology, King’s College Hospital, Denmark Hill, London SE5 9RS, U.K. 1.0 Purpose and scope Correspondence Claire Fuller. The overall objective of this guideline is to provide up-to- E-mail: [email protected] date, evidence-based recommendations for the management of tinea capitis. This document aims to update and expand Accepted for publication on the previous guidelines by (i) offering an appraisal of 8 June 2014 all relevant literature since January 1999, focusing on any key developments; (ii) addressing important, practical clini- Funding sources cal questions relating to the primary guideline objective, i.e. None. accurate diagnosis and identification of cases; suitable treat- ment to minimize duration of disease, discomfort and scar- Conflicts of interest ring; and limiting spread among other members of the L.C.F. has received sponsorship to attend conferences from Almirall, Janssen and LEO Pharma (nonspecific); has acted as a consultant for Alliance Pharma (nonspe- community; (iii) providing guideline recommendations and, cific); and has legal representation for L’Oreal U.K.
    [Show full text]
  • Detection of Histoplasma DNA from Tissue Blocks by a Specific
    Journal of Fungi Article Detection of Histoplasma DNA from Tissue Blocks by a Specific and a Broad-Range Real-Time PCR: Tools to Elucidate the Epidemiology of Histoplasmosis Dunja Wilmes 1,*, Ilka McCormick-Smith 1, Charlotte Lempp 2 , Ursula Mayer 2 , Arik Bernard Schulze 3 , Dirk Theegarten 4, Sylvia Hartmann 5 and Volker Rickerts 1 1 Reference Laboratory for Cryptococcosis and Uncommon Invasive Fungal Infections, Division for Mycotic and Parasitic Agents and Mycobacteria, Robert Koch Institute, 13353 Berlin, Germany; [email protected] (I.M.-S.); [email protected] (V.R.) 2 Vet Med Labor GmbH, Division of IDEXX Laboratories, 71636 Ludwigsburg, Germany; [email protected] (C.L.); [email protected] (U.M.) 3 Department of Medicine A, Hematology, Oncology and Pulmonary Medicine, University Hospital Muenster, 48149 Muenster, Germany; [email protected] 4 Institute of Pathology, University Hospital Essen, University Duisburg-Essen, 45147 Essen, Germany; [email protected] 5 Senckenberg Institute for Pathology, Johann Wolfgang Goethe University Frankfurt, 60323 Frankfurt am Main, Germany; [email protected] * Correspondence: [email protected]; Tel.: +49-30-187-542-862 Received: 10 November 2020; Accepted: 25 November 2020; Published: 27 November 2020 Abstract: Lack of sensitive diagnostic tests impairs the understanding of the epidemiology of histoplasmosis, a disease whose burden is estimated to be largely underrated. Broad-range PCRs have been applied to identify fungal agents from pathology blocks, but sensitivity is variable. In this study, we compared the results of a specific Histoplasma qPCR (H. qPCR) with the results of a broad-range qPCR (28S qPCR) on formalin-fixed, paraffin-embedded (FFPE) tissue specimens from patients with proven fungal infections (n = 67), histologically suggestive of histoplasmosis (n = 36) and other mycoses (n = 31).
    [Show full text]
  • Therapies for Common Cutaneous Fungal Infections
    MedicineToday 2014; 15(6): 35-47 PEER REVIEWED FEATURE 2 CPD POINTS Therapies for common cutaneous fungal infections KENG-EE THAI MB BS(Hons), BMedSci(Hons), FACD Key points A practical approach to the diagnosis and treatment of common fungal • Fungal infection should infections of the skin and hair is provided. Topical antifungal therapies always be in the differential are effective and usually used as first-line therapy, with oral antifungals diagnosis of any scaly rash. being saved for recalcitrant infections. Treatment should be for several • Topical antifungal agents are typically adequate treatment weeks at least. for simple tinea. • Oral antifungal therapy may inea and yeast infections are among the dermatophytoses (tinea) and yeast infections be required for extensive most common diagnoses found in general and their differential diagnoses and treatments disease, fungal folliculitis and practice and dermatology. Although are then discussed (Table). tinea involving the face, hair- antifungal therapies are effective in these bearing areas, palms and T infections, an accurate diagnosis is required to ANTIFUNGAL THERAPIES soles. avoid misuse of these or other topical agents. Topical antifungal preparations are the most • Tinea should be suspected if Furthermore, subsequent active prevention is commonly prescribed agents for dermatomy- there is unilateral hand just as important as the initial treatment of the coses, with systemic agents being used for dermatitis and rash on both fungal infection. complex, widespread tinea or when topical agents feet – ‘one hand and two feet’ This article provides a practical approach fail for tinea or yeast infections. The pharmacol- involvement. to antifungal therapy for common fungal infec- ogy of the systemic agents is discussed first here.
    [Show full text]
  • Chronic Mucocutaneous Candidiasis Associated with Paracoccidioidomycosis in a Patient with Mannose Receptor Deficiency: First Case Reported in the Literature
    Revista da Sociedade Brasileira de Medicina Tropical Journal of the Brazilian Society of Tropical Medicine Vol.:54:(e0008-2021): 2021 https://doi.org/10.1590/0037-8682-0008-2021 Case Report Chronic mucocutaneous candidiasis associated with paracoccidioidomycosis in a patient with mannose receptor deficiency: First case reported in the literature Dewton de Moraes Vasconcelos[1], Dalton Luís Bertolini[1] and Maurício Domingues Ferreira[1] [1]. Universidade de São Paulo, Faculdade de Medicina, Hospital das Clinicas, Departamento de Dermatologia, Ambulatório das Manifestações Cutâneas das Imunodeficiências Primárias, São Paulo, SP, Brasil. Abstract We describe the first report of a patient with chronic mucocutaneous candidiasis associated with disseminated and recurrent paracoccidioidomycosis. The investigation demonstrated that the patient had a mannose receptor deficiency, which would explain the patient’s susceptibility to chronic infection by Candida spp. and systemic infection by paracoccidioidomycosis. Mannose receptors are responsible for an important link between macrophages and fungal cells during phagocytosis. Deficiency of this receptor could explain the susceptibility to both fungal species, suggesting the impediment of the phagocytosis of these fungi in our patient. Keywords: Chronic mucocutaneous candidiasis. Paracoccidioidomycosis. Mannose receptor deficiency. INTRODUCTION “chronic mucocutaneous candidiasis and mannose receptor deficiency,” “chronic mucocutaneous candidiasis and paracoccidioidomycosis,” Chronic mucocutaneous
    [Show full text]
  • Identification of Culture-Negative Fungi in Blood and Respiratory Samples
    IDENTIFICATION OF CULTURE-NEGATIVE FUNGI IN BLOOD AND RESPIRATORY SAMPLES Farida P. Sidiq A Dissertation Submitted to the Graduate College of Bowling Green State University in partial fulfillment of the requirements for the degree of DOCTOR OF PHILOSOPHY May 2014 Committee: Scott O. Rogers, Advisor W. Robert Midden Graduate Faculty Representative George Bullerjahn Raymond Larsen Vipaporn Phuntumart © 2014 Farida P. Sidiq All Rights Reserved iii ABSTRACT Scott O. Rogers, Advisor Fungi were identified as early as the 1800’s as potential human pathogens, and have since been shown as being capable of causing disease in both immunocompetent and immunocompromised people. Clinical diagnosis of fungal infections has largely relied upon traditional microbiological culture techniques and examination of positive cultures and histopathological specimens utilizing microscopy. The first has been shown to be highly insensitive and prone to result in frequent false negatives. This is complicated by atypical phenotypes and organisms that are morphologically indistinguishable in tissues. Delays in diagnosis of fungal infections and inaccurate identification of infectious organisms contribute to increased morbidity and mortality in immunocompromised patients who exhibit increased vulnerability to opportunistic infection by normally nonpathogenic fungi. In this study we have retrospectively examined one-hundred culture negative whole blood samples and one-hundred culture negative respiratory samples obtained from the clinical microbiology lab at the University of Michigan Hospital in Ann Arbor, MI. Samples were obtained from randomized, heterogeneous patient populations collected between 2005 and 2006. Specimens were tested utilizing cetyltrimethylammonium bromide (CTAB) DNA extraction and polymerase chain reaction amplification of internal transcribed spacer (ITS) regions of ribosomal DNA utilizing panfungal ITS primers.
    [Show full text]
  • Vaginal Yeast Infection a Vaginal Yeast Infection Is an Infection of the Vagina, Most Commonly Due to the Fungus Candida Albicans
    5285 Anthony Wayne Drive, Detroit, MI 48202 (P) 313-577-5041 | (F) 313-577-9581 health.wayne.edu Vaginal Yeast Infection A vaginal yeast infection is an infection of the vagina, most commonly due to the fungus Candida albicans. Causes, incidence, and risk factors Most women have a vaginal yeast infection at some time. Candida albicans is a common type of fungus. It is often found in small amounts in the vagina, mouth, digestive tracts, and on the skin. Usually it does not cause disease or symptoms. Candida and the many other germs that normally live in the vagina keep each other in balance. However, sometimes the number of Candida albicans increases, leading to a yeast infection. A yeast infection can happen if you are: • Taking antibiotics used to treat other types of infections. Antibiotics change the normal balance between germs in the vagina by decreasing the number of protective bacteria. • Pregnant • Obese • Have diabetes A yeast infection is not a sexually transmitted illness. However, some men will develop symptoms such as itching and a rash on the penis after having sexual contact with an infected partner. Having many vaginal yeast infections may be a sign of other health problems. Other vaginal infections and discharges can be mistaken for vaginal yeast infection. Symptoms • Pain with intercourse • Painful urination • Redness and swelling of the vulva • Vaginal and labial itching, burning • Abnormal Vaginal Discharge • Ranges from a slightly watery, white discharge to a thick, white, chunky discharge (like cottage cheese) Signs and Tests A pelvic examination will be done. It may show swelling and redness of the skin of the vulva, in the vagina, and on the cervix.
    [Show full text]
  • Yeast Infection Division of Disease Control What Do I Need to Know?
    Division of Disease Control What Do I Need To Know? Yeast Infection (Thrush, Diaper Rash, Vaginitis) What is a yeast infection? Yeast infections are caused by a fungus called Candida albicans. These infections can present in a variety of forms. Yeast infections in women can infect the vagina, called vaginitis. Thrush causes mouth infections in young infants and can also be a presenting sign of HIV infection in adults. Candida also may be the cause of many types of diaper rash in young children. Who is at risk for a yeast infection? Anyone can get a yeast infection. What are the symptoms of a yeast infection? Candidia diaper rash: The diaper area is red. The redness is worse in the creases. Redness is often bordered by red pimples. Rash may have a shiny appearance. Sores or cracking or oozing is present in severe cases. Thrush White patches appear on the inside of cheeks and gums and tongue. Thrush usually causes no other signs or symptoms. Vaginitis Vaginal irritation, intense itchiness and vaginal discharge. How soon do symptoms appear? Incubation period is unknown. How is a yeast infection spread? The fungus is present in the intestinal tract and mucous membranes of healthy people. A warm environment allows for growth and spread. Page 1 of 2 Last Updated: 01/2016 Person-to-person transmission may occur from a woman to her infant when the mother has a yeast infection in her vagina and in breastfeeding mothers whose babies with thrush infect the mothers’ nipples. When and for how long is a person able to spread the disease? A person can spread disease as long as the infection is present.
    [Show full text]