Posts filed under ‘Antimicoticos’

EDITOR’S CHOICE – Congenital Cutaneous Candidiasis: Prompt Systemic Treatment Is Associated With Improved Outcomes in Neonates

Clin Inf Dis May 15, 2017 V.64 N.10

David A. Kaufman; Sarah A. Coggins; Santina A. Zanelli; Jörn-Hendrik Weitkamp

Congenital cutaneous candidiasis is an invasive infection that presents as a diffuse manifold rash in preterm and term infants. Prompt systemic antifungal treatment at the time of skin presentation for ≥14 days prevents dissemination and Candida-related mortality.



May 6, 2017 at 3:52 pm

Biofilm-Forming Capability of Highly Virulent, Multidrug-Resistant Candida auris

Emerging Infectious Diseases February 2017 V.23 N.2


Leighann Sherry, Gordon Ramage, Ryan Kean, Andrew Borman, Elizabeth M. Johnson, Malcolm D. Richardson, and Riina Rautemaa-RichardsonComments to Author

University of Glasgow, Glasgow, Scotland, UK (L. Sherry, G. Ramage, R. Kean); Public Health England, Bristol, UK (A. Borman, E.M. Johnson); The University of Manchester, Manchester, UK (M.D. Richardson, R. Rautemaa-Richardson); University Hospital of South Manchester, Manchester (M.D. Richardson, R. Rautemaa-Richardson)

The emerging multidrug-resistant yeast pathogen Candida auris has attracted considerable attention as a source of healthcare–associated infections.

We report that this highly virulent yeast has the capacity to form antifungal resistant biofilms sensitive to the disinfectant chlorhexidine in vitro.


April 10, 2017 at 3:30 pm

Estimating the burden of invasive and serious fungal disease in the United Kingdom

Journal of Infection January 2017 V.74 N.1

Matthew Pegorie a, David W. Denning b,c,d, *, William Welfare a,d

a Public Health England North West Health Protection Team (Greater Manchester), UK

bNational Aspergillosis Centre, University Hospital of South Manchester, Manchester, UK

c The University of Manchester, Manchester, UK

d Manchester Academic Health Sciences Centre, University of Manchester, UK

Background: The burden of fungal disease in the UK is unknown. Only limited data are systematically collected. We have estimated the annual burden of invasive and serious fungal disease.

Methods: We used several estimation approaches. We searched and assessed published estimates of incidence, prevalence or burden of specific conditions in various high risk groups. Studies with adequate internal and external validity allowed extrapolation to estimate current UK burden. For conditions without adequate published estimates, we sought expert advice.

Results: The UK population in 2011 was 63,182,000 with 18% aged under 15 and 16% over 65. The following annual burden estimates were calculated: invasive candidiasis 5142; Candida peritonitis complicating chronic ambulatory peritoneal dialysis 88; Pneumocystis pneumonia 207e587 cases, invasive aspergillosis (IA), excluding critical care patients 2901e2912, and IA in critical care patients 387e1345 patients, <100 cryptococcal meningitis cases. We estimated 178,000 (50,000e250,000) allergic bronchopulmonary aspergillosis cases in people with asthma, and 873 adults and 278 children with cystic fibrosis. Chronic pulmonary aspergillosis is estimated to affect 3600 patients, based on burden estimates post tuberculosis and in sarcoidosis.

Conclusions: Uncertainty is intrinsic to most burden estimates due to diagnostic limitations, lack of national surveillance systems, few published studies and methodological limitations. The largest uncertainty surrounds IA in critical care patients. Further research is needed to produce a more robust estimate of total burden


March 25, 2017 at 5:40 pm

Maxillary Sinusitis Caused by Actinomucor elegans



Departamento Micologıa, INEI, ANLIS Dr. Carlos G. Malbran, Buenos Aires,1 and Hospital San Juan de Dios2 and Fundacion Jose Marıa Mainetti, Centro Oncologico,3 La Plata, Argentina

We report the first case of maxillary sinusitis caused by Actinomucor elegans in an 11-year-old patient. Histopathological and mycological examinations of surgical maxillary sinuses samples showed coenocytic hyphae characteristic of mucoraceous fungi. The fungi recovered had stolons and rhizoids, nonapophyseal and globose sporangia, and whorled branched sporangiophores and was identified as A. elegans. After surgical cleaning and chemotherapy with amphotericin B administered intravenously and by irrigation, the patient became asymptomatic and the mycological study results were negative.


February 22, 2017 at 8:46 am

Fatal Actinomucor elegans var. kuwaitiensis Infection following Combat Trauma


Charla C. Tully,1 Anna M. Romanelli,2 Deanna A. Sutton,3,4 Brian L. Wickes,2,4 and Duane R. Hospenthal4,5*

Department of Medicine, Wilford Hall Medical Center, Lackland Air Force Base, Lackland,1 Department of Microbiology and Immunology2 and Fungus Testing Laboratory, Department of Pathology,3 University of Texas Health Science Center at San Antonio, San Antonio, San Antonio Center for Medical Mycology, San Antonio,4 and Infectious Disease Service, Department of Medicine, Brooke Army Medical Center, Fort Sam Houston, Houston,5 Texas

A previously healthy 30-year-old male was injured by an improvised explosive device in Iraq, sustaining extensive wounds to his right side. He was evacuated to a military hospital in Iraq and taken immediately to the operating room for complex pelvic fracture debridement and fixation, right lower extremity disarticulation, right through-the-elbow amputation, and an exploratory laparotomy. He was stabilized and evacuated to a military medical center in Germany. After further evaluation and stabilization, including washing out of his right flank, hip, and forearm and washing out of his abdomen without evidence of bowel injury, a wound vacuum-assisted closure device was placed over his open abdomen, and he was transferred to Brooke Army Medical Center (BAMC) for further care …


February 22, 2017 at 8:45 am

Flow Cytometry To Assess Cerebrospinal Fluid Fungal Burden in Cryptococcal Meningitis

Journal of Clinical Microbiology March 2016 V.54 N.3 P.802-804


James E. Scriven, Lisa M. Graham, Charlotte Schutz, Thomas J. Scriba, Robert J. Wilkinson, David R. Boulware, Graeme Meintjes, David G. Lalloo, and Britta C. Urban

aLiverpool School of Tropical Medicine, Liverpool, Merseyside, United Kingdom

bWellcome Trust Liverpool Glasgow Centre for Global Health Research, Liverpool, United Kingdom

cClinical Infectious Diseases Research Initiative, Institute of Infectious Disease and Molecular Medicine, University of Cape Town, Cape Town, South Africa

dDepartment of Medicine, University of Cape Town and Groote Schuur Hospital, Cape Town, South Africa

eSouth African TB Vaccine Initiative, Institute of Infectious Disease and Molecular Medicine and Department of Paediatrics and Child Health, University of Cape Town, Cape Town, South Africa

fDepartment of Medicine, Imperial College, London, United Kingdom

gFrancis Crick Institute, Mill Hill Laboratory, London, United Kingdom

hDepartment of Medicine, University of Minnesota, Minnesota, USA

James E. Scriven,

Fungal burden in the cerebrospinal fluid is an important determinant of mortality in cryptococcal meningitis, but its use in aiding clinical decision making is hampered by the time involved to perform quantitative cultures. Here, we demonstrate the potential of flow cytometry as a novel and rapid technique to address this issue.


February 21, 2017 at 3:24 pm

Posterior Reversible Encephalopathy Syndrome and Fatal Cryptococcal Meningitis After Immunosuppression in a Patient With Elderly Onset Inflammatory Bowel Disease.

ACG Case Rep J. 2016 Aug 3;3(4):e98. eCollection 2016.

Vasant DH1, Limdi JK1, Borg-Bartolo SP1, Bonington A2, George R3.

Author information

1Department of Gastroenterology, Pennine Acute Hospitals NHS Trust, United Kingdom; Manchester Academic Health Sciences Centre, The University of Manchester, Manchester, United Kingdom.

2Department of Infectious Diseases, Pennine Acute Hospitals NHS Trust, United Kingdom; Manchester Academic Health Sciences Centre, The University of Manchester, Manchester, United Kingdom.

3Department of Gastroenterology, Pennine Acute Hospitals NHS Trust, United Kingdom.


Advanced age and associated comorbidities are-recognized predictors of life-threatening adverse outcomes, such as opportunistic infection following immunosuppressive therapy.

We describe the case of an elderly patient with stricturing colonic Crohn’s disease and significant clinical comorbidities, initially controlled with corticosteroid induction followed by infliximab, whose course was complicated by fatal disseminated cryptococcal infection and posterior reversible encephalopathy syndrome.

Our patient’s case highlights rare, but serious, complications of immunosuppression.

In applying modern treatment paradigms to the elderly, the clinician must consider the potential for more pronounced adverse effects in this potentially vulnerable group, maximizing benefit and minimizing harm.


February 10, 2017 at 8:54 am

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