MedWorm: Fungal Infections

T cell depletion utilizing CD34+ stem cell selection and CD3+ addback from unrelated adult donors in paediatric allogeneic stem cell transplantation recipients

British Journal of Haematology — Wed, 08 Feb 2012 05:00:00 +0100

SummaryCD34‐selected haploidentical and unrelated donor allogeneic stem cell transplantation (AlloSCT) in paediatric recipients is associated with sustained engraftment and low risk of acute graft‐versus‐host disease (aGVHD), but limited by delayed immune reconstitution and increased risk of viral and fungal infection. The optimal dose of donor T cells to prevent graft failure and minimize risk of early opportunistic infection and post‐transplant lymphoproliferative disorder (PTLD), while avoiding severe aGVHD, remains unknown. We prospectively studied CD34‐selected 8–10/10 human leucocyte antigen (HLA)‐matched unrelated donor (MUD) peripheral blood stem cell transplantation (PBSCT) in a cohort of 19 paediatric AlloSCT recipients with malignant (n = 13) or non‐malignant (...

MedWorm Sponsor Message: Find the best January Sales in the UK.

Woman gets artificial jawbone transplant

NHS News Feed — Tue, 07 Feb 2012 18:00:00 +0100

An 83-year-old woman has been implanted with the world’s first “3D printer-created jaw”. Using cutting-edge laser manufacturing techniques, doctors and metal experts were able to build up layers of titanium to form a custom metal jawbone to exactly fit her face. The metal jawbone was then inserted into her lower jaw, replacing a large section of bone that was destroyed by a chronic infection. The technique of 3D printing has been used to build prototype products for some time, but in recent years scientists have begun experimenting with the medical possibilities offered by the process. In this case, a specialist metalwork company called Layerwise was able to translate 3D bone scans into a custom jaw. The company had previously used the process to make bone-shaped prostheses and denta...

Cutaneous Lesions Caused by Scytalidium hyalinum Resembling Dermatophycosis

Clinical Microbiology Newsletter — Tue, 07 Feb 2012 02:10:40 +0100

We describe a case of cutaneous infection caused by Scytalidium hyalinum in a 32-year-old patient who was born and raised in Sierra Leone but resided in Spain for the last 10 years. He sought medical attention in our dermatology department for the evaluation of skin lesions that were initially thought to be a contact dermatitis caused by exposure to a chemical irritant. (Source: Clinical Microbiology Newsletter)

Tissue Distribution of Anidulafungin in Neonatal Rats

Birth Defects Research Part B: Developmental and Reproductive Toxicology — Mon, 06 Feb 2012 05:00:00 +0100

In conclusion, anidulafungin distributes to bone, brain, and heart tissues of neonatal rats; such results are supportive of further investigation of efficacy against infections involving bone, brain, and heart tissues. (Source: Birth Defects Research Part B: Developmental and Reproductive Toxicology)

Trichophyton tonsurans induced recurrent onychomadesis in a very young infant

Pediatric Dermatology — Fri, 03 Feb 2012 05:00:00 +0100

We present here a case of Trichophyton tonsurans–induced onychomycosis and resultant onychomadesis in a 9‐month‐old boy with onset of lesions at 2 weeks of life. (Source: Pediatric Dermatology)

Minnesota Partnership Researchers Close in on Drug to Fight Fungal Infections

News from Mayo Clinic — Wed, 01 Feb 2012 12:46:47 +0100

Researchers from the University of Minnesota in Minneapolis and Mayo Clinic in Rochester, Minn., are another step closer to developing a drug to combat fungal infections - one of the major problems confronting patients with compromised immune systems. (Source: News from Mayo Clinic)

MedWorm Sponsor Message: Please support the Doctors In Chains campaign for the medics tortured and sentenced for up to 15 years in Bahrain. #FreeDoctors

Mendelian traits causing susceptibility to mucocutaneous fungal infections in human subjects

Journal of Allergy and Clinical Immunology — Wed, 01 Feb 2012 05:00:00 +0100

Mucocutaneous candidiasis and dermatophyte infections occur either in isolation or alongside other symptoms in patients with various primary immunodeficiency diseases with diverse genetic defects, which result in impaired IL-17 immunity, IL-22 immunity, or both. In patients with chronic mucocutaneous candidiasis, disease-associated polymorphisms in DECTIN1 act on the level of fungal recognition, whereas mutations in caspase recruitment domain–containing protein 9 (CARD9) disturb the subsequent spleen tyrosine kinase 2–CARD9/BCL10/MALT1–driven signaling cascade, impairing nuclear factor κB–mediated maturation of antigen-presenting cells and priming of naive T cells to differentiate into the TH17 cell lineage. TH17-priming cytokines signal through the transcription factor signal tr...

Triple fungal infection in a patient with liver cirrhosis.

Annales de Biologie Clinique — Wed, 01 Feb 2012 05:00:00 +0100

We report a case of triple fungal infection including an invasive pulmonary aspergillosis by Aspergillus fumigatus, a candidemia by Candida albicans and a Pneumocystis pneumonia. The overall clinical picture of this patient was liver cirrhosis with medical history of immunosuppressive treatment for Crohn disease and a non-hodgkin lymphoma. There was no antifungal prophylaxis for this patient. Under treatment, the issue was unfavourable with multivisceral failure. PMID: 22294141 [PubMed - as supplied by publisher] (Source: Annales de Biologie Clinique)

MedWorm Sponsor Message: Find the best January Sales in the UK.

Evaluation of the safety and efficacy of liposomal amphotericin B (L-AMB) in children

Journal of Infection and Chemotherapy — Mon, 30 Jan 2012 06:32:06 +0100

Abstract A multicenter, uncontrolled clinical study has been conducted to evaluate the safety, efficacy, and pharmacokinetics of liposomal amphotericin B (L-AMB) in children. In this article, the safety and efficacy of L-AMB are discussed. Subjects were diagnosed with invasive fungal infection (definitely diagnosed cases), possible fungal infection (clinically diagnosed cases), and febrile neutropenia with suspected fungal infection (febrile neutropenia cases). Of the 39 subjects treated with L-AMB, 18 received a definite (11) or clinical (7) diagnosis of invasive fungal infection. In these subjects, excluding one unevaluable subject, L-AMB was effective in nine out of 17 subjects (52.9%). Of 12 febrile neutropenia cases, improvement in clinical symptoms, etc., was observe...

The deceased organ donor with an “open abdomen”: proceed with caution

Transplant Infectious Disease — Sun, 29 Jan 2012 05:00:00 +0100

AbstractIn solid organ transplantation, the disparity between donor supply and patients awaiting transplant continues to increase. The organ shortage has led to relaxation of historic contraindications to organ donation. A large percentage of deceased organ donors have been subjected to traumatic injuries, which can often result in intervention that leads to abdominal packing and intensive care unit resuscitation. The donor with this “open abdomen” (OA) presents a situation in which the risk of organ utilization is difficult to quantify. There exists a concern for the potential of a higher risk for both bacterial and fungal infections, including multidrug‐resistant (MDR) pathogens because of the prevalence of antibiotic use and critical illness in this population. No recommendations ...

Infectious complications in kidney-transplant recipients desensitized with rituximab and intravenous immunoglobulin

Nephrology Now — Sat, 28 Jan 2012 08:23:37 +0100

Patients who are desensitized prior to renal transplant require more intensive immunosuppression compared to average-risk patients. In this single-centre, non-randomized study, the use of rituximab was not associated with an increased risk of bacterial, viral or fungal infections. : Incidence and Predictive Factors for Infectious Disease after Rituximab Therapy in Kidney-Transplant Patients Troponin I is a Predictor of Acute Cardiac Events in the Immediate Postoperative Renal Transplant Period Similar Outcomes for Canadian Renal Transplant Recipients Followed Up in Transplant Centers and Satellite Clinics (Source: Nephrology Now)

Raynaud's Phenomenon of the Nipple.

Obstetrics and Gynecology — Thu, 26 Jan 2012 20:33:18 +0100

CONCLUSION: : Increased awareness in the obstetric field will lead to appropriate diagnoses, earlier treatment and relief, and more successful breastfeeding experiences. PMID: 22270434 [PubMed - in process] (Source: Obstetrics and Gynecology)

Evaluation of Coccidioides Antigen Detection in Dogs with Coccidioidomycosis.

Clinical and Vaccine Immunology — Wed, 25 Jan 2012 05:00:00 +0100

Authors: Kirsch EJ, Greene RT, Prahl A, Rubin SI, Sykes JE, Durkin MM, Wheat LJ Abstract Antigen detection has been reported to be a promising method for rapid diagnosis of coccidioidomycosis in humans. Coccidioides antigen detection has not been previously reported in dogs with coccidioidomycosis, and was evaluated in 60 cases diagnosed based on detection of anti-Coccidioides antibodies at titers of 1:16 or more in serum. Controls included dogs with presumed histoplasmosis or blastomycosis, other fungal infections, non-fungal diseases, and healthy dogs. Urine and serum specimens were tested using an enzyme immunoassay for Coccidioides spp. galactomannan antigen. Antibody testing was performed at commercial veterinary reference laboratories. Antigen was detected in urine or serum o...

MedWorm Sponsor Message: Please support the Doctors In Chains campaign for the medics tortured and sentenced for up to 15 years in Bahrain. #FreeDoctors

---

Revista Iberoamericana de Micologia — Wed, 25 Jan 2012 05:00:00 +0100

CONCLUSION: In this study, C. albicans was the most frequently detected species in candidiasis and risk exposures increased the susceptibility of hospitalized patients to acquiring a nosocomial infection by Candida spp. PMID: 22285886 [PubMed - as supplied by publisher] (Source: Revista Iberoamericana de Micologia)

The role of cytokines and pathogen recognition molecules in fungal keratitis - Insights from human disease and animal models.

Cytokine — Tue, 24 Jan 2012 05:00:00 +0100

Authors: Leal SM, Pearlman E Abstract Fungal infections of the cornea are an important cause of blindness and visual impairment worldwide, with contact lens wear being the main risk factor in the USA and other industrialized countries, and traumatic injury being the main risk factor in developing countries. In this review, we highlight recent advances in the understanding of the host response to Aspergillus and Fusarium species in infected human corneal tissue and in mouse models of fungal keratitis. PMID: 22280957 [PubMed - as supplied by publisher] (Source: Cytokine)

Endemic Fungal Infections Among Older PersonsEndemic Fungal Infections Among Older Persons

Medscape Today Headlines — Tue, 24 Jan 2012 04:00:00 +0100

Which geographical areas of the United States have increased incidence of fungal infections among older adults? Emerging Infectious Diseases (Source: Medscape Today Headlines)

Concomitant Gene Mutations of MBL and CYBB in Chronic Granulomatous Disease: Implications for Host Defense.

Inflammation and Allergy Drug Targets — Fri, 20 Jan 2012 05:00:00 +0100

We present the case of a 2-year old male patient hospitalized with recurrent pneumonia, a non-healing skin ulcer, necrotizing lung granulomas, and epididymo-orchitis. Defective neutrophil chemiluminescence was detected by dihydrorhodamine (DHR) testing. Further evaluation demonstrated characteristic molecular mutations of CYBB consistent with CGD. Immune evaluation demonstrated polyclonal hyperglobulinemia, but a greatly reduced mannose binding lectin (MBL) level. Six biallelic polymorphisms in MBL gene and its promoter were analyzed using Light CyclerTM Real-time PCR assay. The LXPA/LYPB haplotype of MBL was detected in our patient; the latter is the defective haplotype associated with low MBL levels. Due to the implications for innate immunity and the protection against bacterial, viral,...

Spectrum of fungal infection in a neurology tertiary care center in India

Neurological Sciences — Thu, 19 Jan 2012 06:56:24 +0100

This study reports clinical, MRI and outcome of patients with central nervous system (CNS) fungal infections. 39 patients with CNS fungal infections treated in neurology service during the last 3 years were included and a detailed medical history and clinical examination were undertaken. Cranial MRI including paranasal sinuses were carried out and the location and nature of abnormalities were noted. Fungal infection was confirmed by CSF examination or histopathology. Death during hospital stay was noted. The median age was 37 (8–72) years and 8 were females. The clinical features included altered sensorium in 31, focal motor deficits in 13, visual loss in 12, seizures in 10, diplopia in 7, and papilledema in 9 patients. 28 patients had the following predisposing condition...

MedWorm Sponsor Message: Find the best January Sales in the UK.

Better Treatments For Systemic Fungal Infections May Result From Discovery Of Powerful Drug's Surprising, Simple Method

Health News from Medical News Today — Wed, 18 Jan 2012 08:00:00 +0100

With one simple experiment, University of Illinois chemists have debunked a widely held misconception about an often-prescribed drug. Led by chemistry professor and Howard Hughes Medical Institute early career scientist Martin Burke, the researchers demonstrated that the top drug for treating systemic fungal infections works by simply binding to a lipid molecule essential to yeast's physiology, a finding that could change the direction of drug development endeavors and could lead to better treatment not only for microbial infections but also for diseases caused by ion channel deficiencies... (Source: Health News from Medical News Today)

Skin diseases in Greek and immigrant children in Athens

International Journal of Dermatology — Tue, 17 Jan 2012 17:43:15 +0100

Conclusions Children diagnosed with skin diseases 24–30 years earlier were younger; exhibited lower prevalences of dermatitis/eczema (P = 0.01), viral infections (P < 0.001) and nevi (P < 0.001); higher prevalences of bacterial and fungal infections (P < 0.001) and insect bites (P < 0.01); and similar rates of scabies (P = 0.17). This study documents the high prevalence of atopic dermatitis in the region, the increasing incidence of viral infections and nevi, and the continuing problem of scabies, especially in immigrants. (Source: International Journal of Dermatology)

Powerful drug's surprising, simple method could lead to better treatments

EurekAlert! - Medicine and Health — Mon, 16 Jan 2012 05:00:00 +0100

(University of Illinois at Urbana-Champaign) With one simple experiment, University of Illinois chemists have debunked a widely held misconception about an often-prescribed drug. The researchers demonstrated that amphotericin, the top drug for treating systemic fungal infections, works by simply binding to a lipid molecule essential to yeast's physiology, a finding that could change the direction of drug development endeavors and could lead to better treatment not only for microbial infections but also for diseases caused by ion channel deficiencies. (Source: EurekAlert! - Medicine and Health)

Targeted treatment of invasive fungal infections accelerates healing of foot wounds in patients with Type 2 diabetes

Diabetic Medicine — Mon, 16 Jan 2012 05:00:00 +0100

Conclusions: Fluconazole plus standard care was superior to standard care alone in accelerating wound reduction among patients with diabetes with deep‐seated fungal infections in diabetic foot wounds. Those in the treatment group who did heal, healed more quickly (P = 0.022), but overall healing was not different.© 2012 The Authors. Diabetic Medicine © 2012 Diabetes UK (Source: Diabetic Medicine)

The diagnostic yield of CT‐guided percutaneous lung biopsy in solid organ transplant recipients

Clinical Transplantation — Mon, 16 Jan 2012 05:00:00 +0100

Conclusion: CT‐guided PLB is a safe modality that provides a moderate yield for diagnosing pulmonary nodules of malignant or fungal etiology in SOT recipients. (Source: Clinical Transplantation)

MedWorm Sponsor Message: Please support the Doctors In Chains campaign for the medics tortured and sentenced for up to 15 years in Bahrain. #FreeDoctors

The V-ATPase as a Target for Antifungal Drugs.

Current Protein and Peptide Science — Mon, 16 Jan 2012 05:00:00 +0100

Authors: Zhang Y, Rao R Abstract The ubiquitous and essential V-ATPase is a worthy chemotherapeutic target in the escalating battle against invasive fungal infections. Pathogenic fungi require optimum V-ATPase function for secretion of virulence factors, induction of stress response pathways, hyphal morphology and homeostasis of pH and other cations in order to successfully survive within and colonize the host. This review discusses why impairment of V-ATPase activity confers multidrug sensitivity and loss of virulence. Recent evidence points to the V-ATPase as a novel downstream target of the azole class of antifungals that inhibit the biogenesis of ergosterol. Depletion of ergosterol from vacuolar membranes led to progressive alkalization of yeast vacuoles, loss of V-ATPase activ...

Resistance to HSV-1 infection in the epithelium resides with the novel innate sensor, IFI-16.

Herpes — Wed, 11 Jan 2012 05:00:00 +0100

We report that TLR signaling is expendable in herpes simplex virus (HSV)-1 containment as depicted by plaque assays of knockout mice (MyD88(-/-), Trif(-/-) and MyD88(-/-) Trif(-/-) double knockout) resembling wild-type controls. To identify the key sentinel in viral recognition of the cornea, in vivo knockdown of the DNA sensor IFI-16/p204 in the corneal epithelium was performed and resulted in a loss of IFN-regulatory factor-3 (IRF-3) nuclear translocation, interferon-α production, and viral containment. The sensor seems to have a similar function in other HSV clinically relevant sites such as the vaginal mucosa in which a loss of p204/IFI-16 results in significantly more HSV-2 shedding. Thus, we have identified an IRF-3-dependent, IRF-7- and TLR-independent innate sensor responsible for...

Investigation and threshold of optimum blood concentration of voriconazole: a descriptive statistical meta-analysis

Journal of Infection and Chemotherapy — Tue, 10 Jan 2012 06:42:05 +0100

Abstract Voriconazole (VRCZ) reportedly possesses a broad spectrum of antifungal activity against Aspergillus spp. and Candida spp., and the blood concentration of VRCZ is correlated with both the efficacy and the adverse effects of this drug. Monitoring of the blood concentration target level of VRCZ has not yet been widely adopted in the medical field, and no evidence concerning this target level has been reported. Accordingly, we used a meta-analysis to investigate the optimal blood concentration of VRCZ. Using data from 12 reports, we found that the success rate for fungal infection treatment increased significantly at VRCZ levels greater than 1.0 μg/ml when a graded cutoff value within the range of 1.0–3.0 μg/ml was used as the VRCZ trough blood concentra...

Cost-effectiveness of posaconazole versus fluconazole for prevention of invasive fungal infections in U.S. patients with graft-versus-host disease.

American Journal of Health-System Pharmacy : AJHP — Fri, 06 Jan 2012 20:26:05 +0100

Conclusion Posaconazole is in the range of currently accepted criteria for cost- effectiveness relative to fluconazole for the prevention of IFIs among patients with GVHD. PMID: 22215361 [PubMed - in process] (Source: American Journal of Health-System Pharmacy : AJHP)

Surgical treatment of spondylodiscitis. An update

International Orthopaedics — Wed, 04 Jan 2012 06:48:05 +0100

Abstract Concept Spondylodiscitis refers to an infection affecting the intervertebral disk, the vertebral body or the posterior arch of the vertebra being aetiologically, pyogenic, granulomatous (tuberculosis, brucellosis, or fungal infection) or parasitic. Diagnosis Spondylodiscitis diagnosis is based on clinical symptoms, a combination of erythrocyte sedimentation rate with C-reactive protein (CRP) tests and, less useful, leukocytosis. Blood culture is also a very cost-effective method of identifying organisms. Plain radiographs are useful, however changes may take several months to appear. Radionuclide tests are currently less used; nevertheless, fluorine-18 fluorodeoxyglucose positron emission tomography (FDG-PET) shows encouraging results particular...

MedWorm Sponsor Message: Find the best January Sales in the UK.

AmBisome 50 mg Powder for solution for infusion (amphotericin (50,000 units) encapsulated in liposomes)- Revised SPC

NeLM - SPC Changes — Tue, 03 Jan 2012 05:00:00 +0100

Source: eMC (electronic Medicines Compendium) Area: Other Library Updates > SPC Changes There have been significant updates to several sections of the SPC, including the following: Change to section 4.1 - Therapeutic indications Extension of the indication to first-line treatment of severe systemic or deep mycoses Change to section 4.2 - Posology and method of administration Paediatric Patients: Both systemic fungal infections in children and presumed fungal infections in children with febrile neutropenia have been successfully treated with AmBisome, without reports of unusual adverse events. AmBisome has been studied in paediatric patients aged one month to 18 years old. Doses used in these clinical studies were the same as those used in ad...

ProFASTA: A pipeline web server for fungal protein scanning with integration of cell surface prediction software.

Fungal Genetics and Biology — Tue, 03 Jan 2012 05:00:00 +0100

Authors: de Groot PW, Brandt BW Abstract Surface proteins, such as those located in the cell wall of fungi, play an important role in the interaction with the surrounding environment. For instance, they mediate primary host-pathogen interactions and are crucial to the establishment of biofilms and fungal infections. Surface localization of proteins is determined by specific sequence features and can be predicted by combining different freely available web servers. However, user-friendly tools that allow rapid analysis of large datasets (whole proteomes or larger) in subsequent analyses were not yet available. Here, we present the web tool ProFASTA, which integrates multiple tools for rapid scanning of protein sequence properties in large datasets and returns sequences in FASTA form...

Keratoprosthesis Surveillance Cultures

Ophthalmology — Sun, 01 Jan 2012 05:00:00 +0100

We read with great interest and appreciation the paper “Long-term vision outcomes and complications with the Boston type 1 keratoprosthesis” by Greiner et al. They conclude that keratoprosthesis implantation is a viable option for salvaging vision. However, a significant number of patients lost vision over the postoperative course. Endophthalmitis was documented in 5 eyes (12.5%) in their series, including 3 gram-negative and 1 fungal infection. The spectrum of infectious organisms differs from previous studies that found that gram-positive infections were most typical after keratoprosthesis surgery. Greiner et al comment that vancomycin prophylaxis might alter the ocular surface flora and encourage the selection of gram-negative and fungal infections. These infections occurred in pati...

Author reply

Ophthalmology — Sun, 01 Jan 2012 05:00:00 +0100

We concur with observations made by Yu et al regarding the unique characteristics of the keratoprosthesis-related endophthalmitis cases we reported recently. Although the rate of endophthalmitis in our series (12.5%) was similar to other published reports, the spectrum of the causative organisms represents the most striking departure from other series, with Gram-negative bacteria (3 eyes) and fungus (1 eye) isolated. The addition of vancomycin to the postoperative antibiotic regimen has improved protection against bacterial endophthalmitis. However, a slight increase in fungal infections without a change in the rate of fungal colonization over 1 year of surveillance has been documented by the same study group, and in the current era of vancomycin use, cases of endophthalmitis have been rep...

Diabetes and Your Skin

About Diabetes — Sat, 31 Dec 2011 05:00:00 +0100

It is not well-known, but diabetes can express itself through your skin. Do you have itchy lower legs? Do you have dry skin? Is the skin on your legs thin, cool, and with very little hair? Do you have frequent bacterial or fungal infections? You may not realize it, but high blood sugar levels might be causing these problems. Diabetes can effect every system in your body. Here is a list of some skin problems that diabetes may be affecting.Diabetes and Your Skin originally appeared on About.com Diabetes on Saturday, December 31st, 2011 at 05:06:15.Permalink | Comment | Email this (Source: About Diabetes)

MedWorm Sponsor Message: Please support the Doctors In Chains campaign for the medics tortured and sentenced for up to 15 years in Bahrain. #FreeDoctors

Bovine Lactoferrin Prevents Invasive Fungal Infections in Very Low Birth Weight Infants: A Randomized Controlled Trial

PEDIATRICS — Fri, 30 Dec 2011 05:00:00 +0100

Lactoferrin is a glycoprotein with anti-infective activities being part of the innate defensive network. Bovine and human lactoferrin share high homology. Bovine lactoferrin can prevent late-onset sepsis in preterm very low birth weight neonates. In preterm very low birth weight infants, bovine lactoferrin is able to prevent not only late-onset sepsis but also systemic fungal infections. This protection is achieved independently from their colonization status. (Read the full article) (Source: PEDIATRICS)

Fungal disease of the nose and paranasal sinuses

Journal of Allergy and Clinical Immunology — Fri, 30 Dec 2011 05:00:00 +0100

Fungal infections of the nose and paranasal sinuses represent a spectrum of diseases ranging from colonization to invasive rhinosinusitis. Clinical manifestations are largely dependent on the immune status of the host, and given the ubiquitous nature of these organisms, exposure is unavoidable. Noninvasive disease includes asymptomatic fungal colonization, fungus balls, and allergic fungal rhinosinusitis. Invasive disease includes indolent chronic rhinosinusitis, granulomatous fungal sinusitis, and acute fulminant fungal rhinosinusitis. A differentiation of these somewhat overlapping syndromes and the disparate treatment regimens required for effective management are the focus of this review. (Source: Journal of Allergy and Clinical Immunology)

Crayfish invasion of England's waterways tracked by radio

Guardian Unlimited Science — Fri, 30 Dec 2011 00:01:06 +0100

North American predators move upstream at 500m a month, spreading disease to native species, Environment Agency findsMembers of an aggressive species of crayfish which have been invading England's waterways are being tracked with radio transmitters in an attempt to better understand them.The Environment Agency said virile crayfish (Orconectes virilis), which are non-native, prey on native wildlife and spread crayfish plague, a disease deadly to native white clawed crayfish. The north American predators have recently been seen in waterways in east London after first being found on the river Lea near Enfield in 2004.They have since colonised more than 10 miles of the river and linked waterways, spreading into Hertfordshire.The agency has fitted small radio transmitters on the backs of the un...

Accuracy of β‐D‐glucan for the diagnosis of Pneumocystis jirovecii pneumonia: a meta‐analysis

Clinical Microbiology and Infection — Thu, 29 Dec 2011 22:15:27 +0100

Conclusion: Serum BDG shows excellent sensitivity and very good specificity in the diagnosis of PCP. Still, in clinical practice the test results should be interpreted in the context of the underlying clinical characteristics of the individual patient. (Source: Clinical Microbiology and Infection)

MedWorm Sponsor Message: Find the best January Sales in the UK.

Treatment of primary aspergilloma of the central nervous system in a diabetic immunocompetent patient with surgical resection and voriconazole: a case report and review of the literature.

Turkish Neurosurgery — Thu, 29 Dec 2011 18:00:03 +0100

We describe a case of central nervous system aspergilloma without any evidence of systemic or paranasal foci in a diabetic but otherwise immunocompetent 71-year-old female treated successfully with surgical resection and medical therapy with voriconazole. Magnetic resonance imaging (MRI) after 6 months of voriconazole showed improvement and no evidence of residual or recurrent disease. Given its good CNS penetration, voriconazole along with surgical resection appears to be promising in treatment of these infections. Our case also demonstrates the importance of surgical intervention in the diagnosis and management of these atypical cases. PMID: 22194129 [PubMed - in process] (Source: Turkish Neurosurgery)

Neck abscess: an unusual presentation of actinomycosis

Journal of Pakistan Medical Students — Thu, 29 Dec 2011 05:00:00 +0100

CONCLUSION Cervicofacial AM is an uncommon disease. However, it can mimic various other common conditions. A high index of suspicion, proper investigations and long term treatment are needed for complete eradication. Therefore, AM should be suspected in any soft tissue swelling not responding to conventional treatment REFRENCES Miller M, Haddad AJ. Cervicofacial actinomycosis. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 1998; 85:496-508. Bennhoff DF. Actinomycosis: diagnostic and therapeutic considerations and a review of 32 cases. Laryngoscope. 1984; 94:1198-217. Honda H, Bankowski MJ, Kajioka EH, Chokrungvaranon N, Kim W, Gallacher ST. Thoracic vertebral actinomycosis: Actinomyces israelii and Fusobacterium nucleatum. J Clin Microbiol. 2008; 46:2009-2014. Lancella A, Abba...

Fungus Found in Sinks Can Cause Serious Infections

MedlinePlus Health News — Wed, 28 Dec 2011 21:00:00 +0100

Fusarium was the cause of an outbreak of hard-to-treat cornea infections in contact lens wearers Source: HealthDay Related MedlinePlus Page: Fungal Infections (Source: MedlinePlus Health News)

New families of carboxyl peptidases: serine-carboxyl peptidases and glutamic peptidases

Journal of Biochemistry — Mon, 26 Dec 2011 05:00:00 +0100

Peptidases or proteinases are now classified into seven families based on the nature of the catalytic residues [MEROPS—the peptidase database (http://merops.sanger.ac.uk/)]. They are aspartic- (first described in 1993), cysteine- (1993), serine- (1993) metallo- (1993), threonine- (1997), glutamic- (2004) and asparagine-peptidase (2010). By using an S-PI (pepstatin Ac) as a probe, a new subfamily of serine peptidase, serine-carboxyl peptidase (sedolisin) was discovered in 2001. In addition, the sixth family of peptidase, glutamic peptidase (eqolisin) was also discovered in 2004. The former peptidase is widely distributed in nature from archea to mammals, including humans. One of these enzymes is related to a human fatal hereditable disease, Batten disease. In contrast, the distributio...

Susceptibility of different populations of ticks to entomopathogenic fungi.

Experimental Parasitology — Mon, 26 Dec 2011 05:00:00 +0100

This study aimed to evaluate the in vitro effect of the entomopathogenic fungi Metarhizium anisopliae sensu lato (s.l.) and Beauveria bassiana sensu lato (s.l.) on two distinct populations of Rhipicephalus microplus, from two different experimental farms. Bioassays were performed with engorged females, eggs and larvae. Fungal infection was evaluated based on biological parameters of treated engorged females, percentage of hatch from treated eggs, and percentage of mortality and mean lethal time (LT90) of treated larvae. When the treatments were compared between the two populations, there were significant differences in the following parameters: pre-oviposition period, hatching period and egg production index. Moreover, the results showed that B. bassiana s.l., isolate Bb 986, was more viru...

MedWorm Sponsor Message: Please support the Doctors In Chains campaign for the medics tortured and sentenced for up to 15 years in Bahrain. #FreeDoctors

Epidemiology and outcome of infections in human immunodeficiency virus/hepatitis c virus–coinfected liver transplant recipients: A FIPSE/GESIDA Prospective Cohort Study

Liver Transplantation — Fri, 23 Dec 2011 13:27:25 +0100

In conclusion, the rates of severe and opportunistic infections are high in HIV/HCV‐coinfected liver recipients and especially in those with a history of AIDS, a high MELD score, or non–tacrolimus‐based immunosuppression. Liver Transpl 18:70–82, 2012. © 2011 AASLD. (Source: Liver Transplantation)

The NLRP3/ASC/Caspase‐1 axis regulates IL‐1β processing in neutrophils

European Journal of Immunology — Fri, 23 Dec 2011 05:00:00 +0100

AbstractNeutrophils play a pivotal role in the defense against bacterial, viral and fungal infections and are important mediators in the acute inflammatory response. At the same time, neutrophils are also involved in sterile inflammatory responses that are triggered by endogenous ligands. A series of immediate effector functions and the expression of proinflammatory genes enable neutrophils to initiate the immune response against the injurious agent. Among these, interleukin‐1β (IL‐1β) plays a key role in the orchestration of the inflammatory response. Induction of IL‐1β expression leads to production of cytosolic pro‐IL‐1β, which requires further processing by a proteolytic cleavage event. Caspase‐1 was initially identified as the main IL‐1β converting enzyme and the up...

Hot? Or not? The economics of red-hot chili peppers | @GrrlScientist

Guardian Unlimited Science — Thu, 22 Dec 2011 18:03:35 +0100

Chilies that produce the hottest fruits grow best when they are given lots of waterOne of my passions as an evolutionary biologist is understanding the balance between different forms of particular traits expressed within a population, traits such as eye colour. I recently told you about a paper that looked at one such evolutionary trade-off in birds, but birds aren't the only living things where we can see this phenomenon. I was delighted to run across an elegant hot-off-the-presses study in chili peppers by a group from my alma mater, the University of Washington. Even though chili fruits are popular amongst humans for being hot, they didn't evolve this character to keep foodies and so-called "chili-heads" happy. Previous research indicates that chilis, Capsicum spp., evolved their chara...

Hot? Or not? The economics of red-hot chili peppers | GrrlScientist

Guardian Unlimited Science — Thu, 22 Dec 2011 18:03:00 +0100

Chilies that produce the hottest fruits grow best when they are given lots of waterOne of my passions as an evolutionary biologist is understanding the balance between different forms of particular traits expressed within a population, especially either-or traits such as eye colour. I recently told you about a paper that looked at one such evolutionary trade-off in birds, but birds aren't the only living things where we can see this phenomenon. I was delighted to run across an elegant hot-off-the-presses study in chili peppers by a group from my alma mater, the University of Washington. Even though chili fruits are popular amongst humans for being hot, they didn't evolve this character to keep foodies and so-called "chili-heads" happy. Previous research indicates that chilis, Capsicum spp....

Bovine lactoferrin prevents invasive fungal infections in VLBW newborns

Modern Medicine — Thu, 22 Dec 2011 05:00:00 +0100

NEW YORK (Reuters Health) - Very low birthweight (VLBW) newborns are less vulnerable to invasive fungal infections if they receive bovine lactoferrin prophylactically, an Italian group reports. (Source: Modern Medicine)

MedWorm Sponsor Message: Find the best January Sales in the UK.

Echinocandin Use in the Neonatal Intensive Care Unit (January).

The Annals of Pharmacotherapy — Tue, 20 Dec 2011 05:00:00 +0100

CONCLUSIONS:Although studies suggest that the echinocandins may have a favorable safety profile, the lack of pharmacokinetic data and standardized study designs limit current recommendations of use of echinocandins as first-line agents in neonates in the treatment of fungal infections. However, if an echinocandin is to be used in this population, the data presented in this review suggest the use of micafungin over the other echinocandins, and higher doses of micafungin (10-15 mg/kg/day) should be used when central nervous system involvement is suspected. PMID: 22190252 [PubMed - as supplied by publisher] (Source: The Annals of Pharmacotherapy)

PLC{gamma}2 in Dectin-2-induced NF-{kappa}B MAPK Activation [Signal Transduction]

Journal of Biological Chemistry — Fri, 16 Dec 2011 05:00:00 +0100

C-type lectin receptors (CLRs) such as Dectin-2 function as pattern recognition receptors to sense fungal infection. However, the signaling pathways induced by these receptors remain largely unknown. Previous studies suggest that the CLR-induced signaling pathway may utilize similar signaling components as the B cell receptor-induced signaling pathway. Phospholipase Cγ2 (PLCγ2) is a key component in B cell receptor signaling, but its role in other signaling pathways has not been fully characterized. Here, we show that PLCγ2 functions downstream of Dectin-2 in response to the stimulation by the hyphal form of Candida albicans, an opportunistic pathogenic fungus. Using PLCγ2- and PLCγ1-deficient macrophages, we found that the lack of PLCγ2, but not PLCγ1, impairs cytokine production i...

Detection of Candida albicans by Mass Spectrometric Fingerprinting.

Current Microbiology — Fri, 16 Dec 2011 05:00:00 +0100

In this study, the profile of low-molecular weight volatile compounds in the headspace of C. albicans-urine suspensions of four different fungal cell concentrations compared to nutrient media and urine without C. albicans was determined using proton-transfer reaction mass spectrometry (PTR-MS). At fungal counts of ≥1.5 × 10(5) colony forming units (CFU)/ml signals at 45, 47 and 73 atomic mass units (amu) highly significantly increased. At fungal counts of <1.5 × 10(5) CFU/ml signals at 47 and 73 amu also increased, but only at 45 amu a statistically significant increase was seen. Time course alterations of signal intensities dependent on different cell concentrations and after addition of Sabouraud nutrient solution were analysed. Recommendations for measurement conditions ar...

Identify Clinically Relevant Fungi Confidently and Accurately

American Society for Microbiology — Thu, 15 Dec 2011 18:55:00 +0100

WASHINGTON, DC – December 13, 2011 – A new edition of the definitive practical resource for laboratory identification of fungal infections is now available. The fully revised Medically Important Fungi: A Guide to Identification, 5th Edition, published by ASM Press, offers step-by-step guidance and textual descriptions that allow both novice and experienced lab technologists to accurately distinguish between fungi that display similar characteristics. Read more... (Source: American Society for Microbiology)

Identify clinically relevant fungi confidently and accurately

EurekAlert! - Medicine and Health — Thu, 15 Dec 2011 05:00:00 +0100

(American Society for Microbiology) A new edition of the definitive practical resource for laboratory identification of fungal infections is now available. The fully revised "Medically Important Fungi: A Guide to Identification, 5th Edition," published by ASM Press, offers step-by-step guidance and textual descriptions that allow both novice and experienced lab technologists to accurately distinguish between fungi that display similar characteristics. (Source: EurekAlert! - Medicine and Health)

MedWorm Sponsor Message: Please support the Doctors In Chains campaign for the medics tortured and sentenced for up to 15 years in Bahrain. #FreeDoctors

The β-Glucan Receptor Dectin-1 Activates the Integrin Mac-1 in Neutrophils via Vav Protein Signaling to Promote Candida albicans Clearance.

Cell Host and Microbe — Thu, 15 Dec 2011 05:00:00 +0100

Authors: Li X, Utomo A, Cullere X, Choi MM, Milner DA, Venkatesh D, Yun SH, Mayadas TN Abstract Resistance to fungal infections is attributed to engagement of host pattern-recognition receptors, notably the β-glucan receptor Dectin-1 and the integrin Mac-1, which induce phagocytosis and antifungal immunity. However, the mechanisms by which these receptors coordinate fungal clearance are unknown. We show that upon ligand binding, Dectin-1 activates Mac-1 to also recognize fungal components, and this stepwise process is critical for neutrophil cytotoxic responses. Both Mac-1 activation and Dectin-1- and Mac-1-induced neutrophil effector functions require Vav1 and Vav3, exchange factors for RhoGTPases. Mac-1- or Vav1,3-deficient mice have increased susceptibility to systemic candidia...

Successful management of cryptococcosis of the bilateral adrenal glands and liver by unilateral adrenalectomy with antifungal agents: a case report

BMC Infectious Diseases — Wed, 14 Dec 2011 05:00:00 +0100

Conclusions: This is the first report describing adrenal cryptococcosis with adrenal insufficiency and liver invasion without central nervous system involvement. Adrenal cryptococcosis should be considered in the differential diagnosis for patients with bilateral adrenal masses with primary adrenal deficiency. Unilateral adrenalectomy was quite effective in controlling the cryptococcosis in this case. Even in patients with bilateral adrenal cryptococcosis, unilateral adrenalectomy should be an option for treatment of disseminated cryptococcosis. (Source: BMC Infectious Diseases)

Emotional and behavioural difficulties in chronic granulomatous disease

Archives of Disease in Childhood — Tue, 13 Dec 2011 05:00:00 +0100

Chronic granulomatous disease (CGD) is a rare primary immunodeficiency, characterised by life-threatening bacterial and fungal infections and inflammatory complications.1 Cognitive difficulties are also described.2 Chronic ill health and cognitive difficulties potentially expose patients to psychological difficulties. We analysed data in a national cohort of patients with CGD to understand how these difficulties might manifest. Physicians enrolled patients in the national CGD registry between 2000 and 2001.1 Clinical data were gathered from medical records. Parents of children aged 5–15 years and children aged 11 years and above completed the Strengths and Difficulties Questionnaire (SDQ). Mean SDQ scores for the five domains were compared with the UK population norms.3 Scores were a...

Causes of pulmonary granulomas: a retrospective study of 500 cases from seven countries

Journal of Clinical Pathology — Tue, 13 Dec 2011 05:00:00 +0100

Conclusions Across several geographical settings, sarcoidosis and infections are the most common causes of pulmonary granulomas diagnosed in pathological specimens. Fungi are more commonly identified than mycobacteria in the USA, whereas the reverse is true in other countries. A definite aetiology cannot be demonstrated in more than a third of all cases of pulmonary granulomas, even after histological examination. These findings highlight the need to submit material for histology as well as cultures in all cases in which granulomatous disease enters the differential diagnosis. (Source: Journal of Clinical Pathology)

Antifungal Prophylaxis in Lung Transplantation

Seminars in Respiratory and Critical Care Medicine — Tue, 13 Dec 2011 05:00:00 +0100

Semin Respir Crit Care Med 2011; 32: 717-726DOI: 10.1055/s-0031-1295719ABSTRACTFungal infections are among the most serious complications of lung transplantation. The 1-year cumulative incidence of invasive fungal infections in lung transplant recipients is 6 to 10%, which is higher than most other solid organ transplant recipients. Aspergillus spp. are the most common etiologic agents, but Candida spp., non-Aspergillus mycelial fungi, Cryptococcus, Pneumocystis, and endemic mycoses can cause active infections in this population. Clinical manifestations of fungal infection in lung transplant recipients are protean, and include invasive pulmonary disease, airway and anastomotic infections, posttransplant empyemas, and disseminated infections. Most centers employ either universal or targeted...

MedWorm Sponsor Message: Find the best January Sales in the UK.

Pulmonary Cryptococcosis

Seminars in Respiratory and Critical Care Medicine — Tue, 13 Dec 2011 05:00:00 +0100

Semin Respir Crit Care Med 2011; 32: 727-734DOI: 10.1055/s-0031-1295720ABSTRACTCryptococcosis is an invasive fungal infection (IFI), caused predominantly by Cryptococcus neoformans or Cryptococcus gattii, that affects both immunocompromised (IC) and non-IC patients. Although the most serious disease manifestation is meningoencephalitis, cryptococcal pneumonia is underdiagnosed and may disseminate to the central nervous system (CNS) and other sites depending upon host defenses and administration of appropriate antifungal therapy. The clinical presentation of pulmonary cryptococcosis varies along a spectrum from asymptomatic infection to severe pneumonia and respiratory failure, and the radiological presentation can be characterized by an array of findings, including nodules, consolidation, ...

Pulmonary Paracoccidioidomycosis

Seminars in Respiratory and Critical Care Medicine — Tue, 13 Dec 2011 05:00:00 +0100

Semin Respir Crit Care Med 2011; 32: 764-774DOI: 10.1055/s-0031-1295724ABSTRACTParacoccidioidomycosis is a subacute or chronic systemic mycosis caused by Paracoccidioides brasiliensis, a soil saprophyte and thermally dimorphic fungus. The disease occurs mainly in rural workers in Latin America and is the most frequent endemic systemic mycosis in many countries of South America, where almost 10 million people are believed to be infected. Paracoccidioidomycosis should be regarded as a disease of travelers outside the endemic area. The primary pulmonary infection is subclinical in most cases, and individuals may remain infected throughout life without ever developing clinical signs. A small proportion of patients present with clinical disease. The lungs are frequently involved, and the pulmon...

Pulmonary Fungal Infections

Seminars in Respiratory and Critical Care Medicine — Tue, 13 Dec 2011 05:00:00 +0100

Semin Respir Crit Care Med 2011; 32: 661-662DOI: 10.1055/s-0031-1295713© Thieme Medical PublishersArticle in Thieme eJournals:Table of contents | Full text (Source: Seminars in Respiratory and Critical Care Medicine)

Empirical antibiotics for suspected early neonatal sepsis

Archives of Disease in Childhood - Fetal and Neonatal Edition — Tue, 13 Dec 2011 05:00:00 +0100

In responding to the article by Muller-Pebody and colleagues,1 Michael Hall and colleagues2 report that they use empiric cefotaxime monotherapy for suspected neonatal sepsis, contrary to the UK national guidelines, because they are concerned about aminoglycoside toxicity. They also state wrongly that the authors do not distinguish early- from late-onset sepsis.The concerns about aminoglycoside toxicity in neonates are largely theoretical, because there is virtually no evidence of normal aminoglycoside dosing causing significant hearing impairment in neonates.3 The recommendation against cefotaxime monotherapy is based on three factors: selection of resistant organisms, particularly extended-spectrum β-lactamase (ESBL) producing organisms, selection of organisms that are intrinsically ...

Triazole Antifungal Agents in Invasive Fungal Infections: A Comparative Review

Drugs — Sat, 10 Dec 2011 07:06:09 +0100

(Source: Drugs)

MedWorm Sponsor Message: Please support the Doctors In Chains campaign for the medics tortured and sentenced for up to 15 years in Bahrain. #FreeDoctors

MSF Statement in Response to Gilead Donation of AmBisome for Visceral Leishmaniasis

MSF News — Thu, 08 Dec 2011 10:15:00 +0100

December 8, 2011--“This agreement is significant in that it helps address immediate treatment needs in some countries for one of the world’s most neglected diseases. But it can not be seen as a global solution as it only covers a small proportion of patients worldwide. We have doubts about whether this is a sustainable solution: more needs to be done to ensure treatment is affordable and available worldwide in the long-term, and that means encouraging competition from similar products to bring down the price of treatment.” —Dr. Koert RITMEIJER, health advisor, Doctors Without Borders/Médecins Sans Frontières (MSF) Context The US pharmaceutical company Gilead Sciences has announced that it has signed an agreement with the World Hea...

Early implementation of antifungal therapy in the management of febrile neutropenia is associated with favourable outcome during induction chemotherapy for acute leukaemias

Internal Medicine Journal — Thu, 08 Dec 2011 05:00:00 +0100

ABSTRACTMortality related to induction chemotherapy during the treatment of acute leukaemias (AL) has been estimated at 5‐20%, and this increases with age. Fungal infection remains one of the major causes of morbidity and mortality and is considered an obstacle to the successful management of acute leukaemias.We retrospectively analysed all patients treated for acute leukaemias at a single institution between July 2006 and January 2009, to assess the impact of early antifungal therapy on outcome during induction chemotherapy. There were 44 episodes of induction chemotherapy, with a median age of patients of 61 years (range 18‐81), including 29 patients with acute myeloid leukaemia, 9 with acute lymphoblastic leukaemia, and 6 with relapsed AL. The median age was 61 years (range 18‐81)...

Arabidopsis lysin-motif proteins LYM1 LYM3 CERK1 mediate bacterial peptidoglycan sensing and immunity to bacterial infection [Plant Biology]

Proceedings of the National Academy of Sciences — Tue, 06 Dec 2011 05:00:00 +0100

Recognition of microbial patterns by host pattern recognition receptors is a key step in immune activation in multicellular eukaryotes. Peptidoglycans (PGNs) are major components of bacterial cell walls that possess immunity-stimulating activities in metazoans and plants. Here we show that PGN sensing and immunity to bacterial infection in Arabidopsis thaliana requires three lysin-motif (LysM) domain proteins. LYM1 and LYM3 are plasma membrane proteins that physically interact with PGNs and mediate Arabidopsis sensitivity to structurally different PGNs from Gram-negative and Gram-positive bacteria. lym1 and lym3 mutants lack PGN-induced changes in transcriptome activity patterns, but respond to fungus-derived chitin, a pattern structurally related to PGNs, in a wild-type manner. Notably, l...

The decline of typhoid and the rise of non-typhoid salmonellae and fungal infections in a changing HIV landscape: bloodstream infection trends over 15 years in southern Vietnam

Transactions of the Royal Society of Tropical Medicine and Hygiene — Mon, 05 Dec 2011 22:39:33 +0100

Summary: The etiological spectrum of bloodstream infections is variable between industrialized and developing countries and even within a defined location over time. We investigated trends in bloodstream infections at an infectious disease hospital in Ho Chi Minh City, Vietnam, from 1994–2008. Amongst 66111 blood cultures performed, a clinically relevant pathogen was isolated in 7645 episodes (positivity rate; 116/1000 cultures). Salmonella Typhi was the predominant pathogen until 2002; however, a considerable annual decline in the proportion of S. Typhi was observed (OR 0.6993, 95% CI [0.6885, 0.7103], p (Source: Transactions of the Royal Society of Tropical Medicine and Hygiene)

Mistaken Identity: New Report Highlights The Global Impact Of Medical Misdiagnosis

Health News from Medical News Today — Mon, 05 Dec 2011 08:00:00 +0100

Researchers have discovered that over a million people worldwide diagnosed with TB go on to develop an incurable but manageable fungal infection which is usually left untreated because it is mistaken for a recurrence of the disease. In a new report published in the Bulletin of the World Health Organization, the researchers from University of Manchester and University of Toronto say because the X-ray features and symptoms are so similar doctors often misdiagnose and prescribe the wrong treatment which can lead to tens of thousands of unnecessary deaths... (Source: Health News from Medical News Today)

MedWorm Sponsor Message: Find the best January Sales in the UK.

Fungal Sinus Infection Case with Omnilock Implant: Can This Be Related to a Dental Implant?

Dental Implants Discussed by Experts — Mon, 05 Dec 2011 01:54:29 +0100

The ENT specialist suspects that the fungal infection may be related to her dental implant and he wants me to remove the fixed partial denture so he can have greater visual access to the area. (Source: Dental Implants Discussed by Experts)

Diatomaceous earth and oil enhance effectiveness of Metarhizium anisopliae against Triatoma infestans.

Acta Tropica — Sun, 04 Dec 2011 05:00:00 +0100

Authors: Luz C, Rodrigues J, Rocha LF Abstract Entomopathogenic fungi, especially Metarhizium anisopliae, have potential for integrated control of peridomestic triatomine bugs. However, the high susceptibility of these vectors to fungal infection at elevated ambient humidities decreases in the comparatively dry conditions that often prevail in their microhabitats. A formulation adapted to this target pest that induces high and quick mortality can help to overcome these drawbacks. In the present study diatomaceous earth, which is used against pests of stored grains or as an additive to mycoinsecticides, delayed but did not reduce in vitro germination of M. anisopliae s.l. IP 46 conidia after >24h agitation without affecting viability, and did not hamper the survival of Triatoma i...

Mistaken identity: New report highlights the global impact of medical misdiagnosis

EurekAlert! - Medicine and Health — Thu, 01 Dec 2011 05:00:00 +0100

(University of Toronto) Researchers have discovered that over a million people worldwide diagnosed with TB go on to develop an incurable but manageable fungal infection which is usually left untreated because it is mistaken for a recurrence of the disease. (Source: EurekAlert! - Medicine and Health)

Fungal infections in immunocompromised patients

Mycoses — Thu, 01 Dec 2011 05:00:00 +0100

(Source: Mycoses)

Invasive candidiasis following liver transplantation and surgical complications

Mycoses — Thu, 01 Dec 2011 05:00:00 +0100

SummaryThe following case report describes a patient with acute liver failure who presented in multiple organ failure and required emergency liver transplantation. A complicated postoperative course lead to sepsis which did not respond to conventional anti bacterial therapy. Despite antifungal prophylaxis with an azole invasive candidiasis was diagnosed and the patient was successfully treated with anidulafungin. The difficulties in diagnosis and treatment of invasive fungal infections in this population are highlighted. (Source: Mycoses)

MedWorm Sponsor Message: Please support the Doctors In Chains campaign for the medics tortured and sentenced for up to 15 years in Bahrain. #FreeDoctors

Invasive pulmonary aspergillosis in a patient with seminomatous testicular cancer

Mycoses — Thu, 01 Dec 2011 05:00:00 +0100

SummaryIn the past years there has been an increasing incidence of invasive fungal infections, particularly in immunocompromised patients. These infections continue to pose a diagnostic and therapeutic challenge. Considering these facts, the authors report a clinical case of invasive pulmonary aspergillosis which illustrates the improved outcomes associated with the extended‐spectrum triazole, voriconazole, used in first‐line therapy. (Source: Mycoses)

SREBP Coordinates Iron and Ergosterol Homeostasis to Mediate Triazole Drug and Hypoxia Responses in the Human Fungal Pathogen Aspergillus fumigatus

PLoS Genetics — Thu, 01 Dec 2011 05:00:00 +0100

by Michael Blatzer, Bridget M. Barker, Sven D. Willger, Nicola Beckmann, Sara J. Blosser, Elizabeth J. Cornish, Aurelien Mazurie, Nora Grahl, Hubertus Haas, Robert A. Cramer Sterol regulatory element binding proteins (SREBPs) are a class of basic helix-loop-helix transcription factors that regulate diverse cellular responses in eukaryotes. Adding to the recognized importance of SREBPs in human health, SREBPs in the human fungal pathogens Cryptococcus neoformans and Aspergillus fumigatus are required for fungal virulence and susceptibility to triazole antifungal drugs. To date, the exact mechanism(s) behind the role of SREBP in these observed phenotypes is not clear. Here, we report that A. fumigatus SREBP, SrbA, mediates regulation of iron acquisition in response to hypoxia and low ir...

Frequent and widespread vascular abnormalities in human STAT3 deficiency

Artery Research — Thu, 01 Dec 2011 05:00:00 +0100

Background: STAT3 deficiency is responsible for autosomal dominant hyper-IgE syndrome characterized by recurrent bacterial and fungal infections, connective tissue abnormalities, hyper-IgE and Th17 lymphopenia. Although vascular abnormalities have been reported in some patients, the prevalence, characteristics and etiology of these features have yet to be described. (Source: Artery Research)

Aspergillus otomycosis

Advances in Small Animal Medicine and Surgery — Thu, 01 Dec 2011 05:00:00 +0100

Canine external otitis is a common multifactorial inflammatory disorder. Primary causes of otitis are said to include atopy, food allergy, contract hypersensitivity to topical ear medications, otic tumors of foreign bodies, otic parasites, keratinization of glandular disorders, immune-mediated disease, and fungal infections with dermatophytes or Sporothrix schenkii. Secondary infections with bacteria or Malassezia pachydermatis commonly complicate treatment. (Source: Advances in Small Animal Medicine and Surgery)

Preparation and Evaluation of Dermal Delivery System of Griseofulvin Containing Vitamin E-TPGS as Penetration Enhancer.

AAPS PharmSciTech — Thu, 01 Dec 2011 05:00:00 +0100

Authors: Aggarwal N, Goindi S, Mehta SD Abstract Griseofulvin, an antifungal agent, is a BCS class II drug slowly, erratically, and incompletely absorbed from the gastrointestinal tract in humans. The clinical failure of the conventional oral therapy of griseofulvin is most likely attributed to its poor solubility and appreciable inter- and intra-subject variation in bioavailability from different commercial products. Moreover, the conventional oral therapy is associated with numerous adverse effects and interactions with other drugs. The purpose of the study was to formulate a topical application of griseofulvin which would deliver the drug locally in a therapeutically effective concentration. Griseofulvin was solubilized in ethanol, D: -α-tocopheryl polyethylene glycol 1000 succ...

MedWorm Sponsor Message: Find the best January Sales in the UK.

Fungal Infection in Heart-Lung Transplant Recipients Receiving Single-agent Prophylaxis with Itraconazole.

Thu, 01 Dec 2011 05:00:00 +0100

Conclusions: Single-agent use with itraconazole in heart or lung transplant recipients did not affect the rate of fungal infection as compared with previous reports. The incidence of fungal infection increased significantly within 3 months after escalation of immunosuppressant for treatment of acute rejection. PMID: 22142048 [PubMed - in process] (Source: Experimental and Clinical Transplantation : official journal of the Middle East Society for Organ Transplantation)

Invasive fungal infections in renal transplant recipients.

Thu, 01 Dec 2011 05:00:00 +0100

Authors: Badiee P, Alborzi A Abstract Invasive fungal infections are a significant and often lethal problem in transplant patients. Infections caused by geographically limited endemic fungi are infrequent, and Aspergillus species, Mucorales species, Candida species, and Cryptococcus neoformans are the opportunistic fungi responsible for most such infections. The symptoms of systemic fungal infections are nonspecific, particularly in their early stages. The high rates of mortality and graft loss owing to fungal infections render early diagnosis and treatment imperative in immunosuppressed patients. Current methods for the diagnosis of systemic fungal infections include imaging procedures, endoscopic methods and biopsies, microscopic and culture techniques, antibody and antigen-based...

A real‐time PCR for the detection and characterisation of Aspergillus species

Mycoses — Thu, 01 Dec 2011 05:00:00 +0100

SummaryAn early diagnosis of an invasive fungal infection is essential for the initiation of a specific antifungal therapy and to avoid unnecessary discontinuation of a baseline therapy for haematological or oncological diseases. A real‐time PCR assay for the detection and strain identification of Aspergillus species from culture strains was evaluated. DNA preparation was evaluated in contaminated culture media, urine and serum. A LightCycler PCR to differentiate various Aspergillus species was established. A real‐time PCR assay for the detection of Aspergillus species was improved and was able to detect and differentiate medically important Aspergillus spp. The sensitivity of the test was <10 plasmid equivalents/assay. The real‐time PCR assay is a useful tool for the rapid identi...

Recommendations for the treatment of invasive fungal infection caused by filamentous fungi in the hematological patient.

Revista Espanola de Quimioterapia — Thu, 01 Dec 2011 05:00:00 +0100

Authors: Barberán J, Mensa J, Vallejo JC, Jarque I, García JC, Cabrera JR, Baltasar P, Batlle M, Besalduch J, Calvo JM, Capote FJ, Carreras E, Díaz J, Díaz ML, Escalante F, Fernández P, Garzón S, Grande C, Hernández D, López A, López J, Martín E, Olave M, Pérez J, Ramírez G, Rojas R, Román A, Rovira M, Rubio D, Sánchez P, Sánchez A, Sanz MA, de la Serna J, Válcarcel D, Vázquez L, Aguado JM, Azanza JR, Cantón R, Cisterna R, Fortún J, García J, Gómez J, Gómez E, Montejo JM, Pemán FJ, Ruiz I, Salavert M, de la Torre J Abstract Antifungal treatment in the hematological patient has reached a high complexity with the advent of new antifungals and diagnostic tests, which have resulted in different therapeutic strategies. The use of the most appropriate treatment in ...

Chrysosporium sp. Infection in Eastern Massasauga Rattlesnakes.

Emerging Infectious Diseases — Thu, 01 Dec 2011 05:00:00 +0100

Authors: Allender MC, Dreslik M, Wylie S, Phillips C, Wylie DB, Maddox C, Delaney MA, Kinsel MJ Abstract TO THE EDITOR: During 2008, the ninth year of a long-term biologic monitoring program, 3 eastern massasauga rattlesnakes (Sistrurus catenatus catenatus) with severe facial swelling and disfiguration died within 3 weeks after discovery near Carlyle, Illinois, USA. In spring 2010, a similar syndrome was diagnosed in a fourth massasauga; this snake continues to be treated with thermal and nutritional support and antifungal therapy. A keratinophilic fungal infection caused by Chrysosporium sp. was diagnosed after physical examination, histopathologic analysis, and PCR in all 4 snakes. The prevalence of clinical signs consistent with Chrysosporium sp. infection during 2000-2007 was 0...

MedWorm Sponsor Message: Please support the Doctors In Chains campaign for the medics tortured and sentenced for up to 15 years in Bahrain. #FreeDoctors

Risk factors for invasive fungal disease in critically ill, adult patients: a systematic review

Critical Care — Tue, 29 Nov 2011 05:00:00 +0100

Conclusion: This review has shown a number of risk factors to be significantly associated with the development of IFD in critically ill adults. Methodological limitations were identified in the design and conduct of studies in this area, and caution should be used in their interpretation. (Source: Critical Care)

Modulating immune system against fungal infections – where are we?

Clinical Microbiology and Infection — Tue, 29 Nov 2011 05:00:00 +0100

(Source: Clinical Microbiology and Infection)

Cytokines and the regulation of fungus-specific CD4 T cell differentiation.

Cytokine — Tue, 29 Nov 2011 05:00:00 +0100

Authors: Espinosa V, Rivera A Abstract CD4 T cells play important and non-redundant roles in protection against infection with diverse fungi. Distinct CD4 T cell subsets can mediate protection against fungal disease where Th1 and Th17 CD4 T cell subsets have been found to promote fungal clearance and protective immunity against diverse fungal pathogens. The differentiation of naïve CD4 T cells into Th1 or Th17 cells is crucially controlled by their interaction with dendritic cells and instructed by cytokines. IL-12 and IFN-γ promote Th1 differentiation while TGF-β, IL-6, IL-1, IL-21 and IL-23 promote Th17 differentiation and maintenance. The production of these cytokines by DCs is in turn regulated by innate receptors triggered in response to fungal infection. In this review we ...

A prospective survey of febrile events in hematological malignancies

Annals of Hematology — Mon, 28 Nov 2011 16:58:16 +0100

Abstract The Hema e-Chart prospectively collected data on febrile events (FEs) in hematological malignancy patients (HMs). The aim of the study was to assess the number, causes and outcome of HM-related FEs. Data were collected in a computerized registry that systematically approached the study and the evolution of FEs developing in a cohort of adult HMs who were admitted to 19 hematology departments in Italy from March 2007 to December 2008. A total of 869 FEs in 3,197 patients with newly diagnosed HMs were recorded. Fever of unidentified origin (FUO) was observed in 386 cases (44.4%). The other causes of FE were identified as noninfectious in 48 cases (5.5%) and infectious in 435 cases (50.1%). Bacteria were the most common cause of infectious FEs (301 cases), followed b...

Rare fungal infection often misdiagnosed

CTV Health — Mon, 28 Nov 2011 03:24:36 +0100

Doctors are warning about a rare, serious but treatable infection called blastomycosis that is being too often missed by doctors and hospitals alike, resulting in tragic consequences. (Source: CTV Health)

MedWorm Sponsor Message: Find the best January Sales in the UK.

Outcomes of Pneumocystis jiroveci pneumonia infections in pediatric heart transplant recipients

Pediatric Transplantation — Sat, 26 Nov 2011 13:45:28 +0100

This study utilizes data from the PHTS to establish the prevalence and outcome of PJP in pediatric heart transplant recipients. We conducted a retrospective cohort study using data from the PHTS, including data from 24 institutions between January 1, 1993, and December 31, 2004. Infections that occur in PHTS subjects are recorded in a standardized data collection form. The prevalence and outcomes of PJP in pediatric heart transplant recipients were determined. There were a total of 18 patients (1%) with PJP out of the 1854 pediatric heart transplant recipients in the PHTS database. A majority of PJP occurred two months to two yr post‐transplant, and patients with PJP had a significantly decreased mortality compared with other fungal infections. PJP is an infrequent complication experienc...

Candidaemia in a paediatric tertiary care hospital-species distribution and antifungal susceptibilities-a 6 year retrospective analysis: Category: Lesson in Microbiology & Infection Control

Journal of Infection — Fri, 25 Nov 2011 11:05:46 +0100

Candidaemia is associated with significant morbidity and mortality. Identification of Candida to species level is useful in predicting antifungal susceptibility patterns. In addition, antifungal MIC determination for individual isolates from blood cultures provides further therapeutic guidance. Continued local surveillance should detect any significant change in the prevalence of candidaemia, species distribution and antifungal susceptibilities. At this institution annual reviews of invasive fungal infection are performed. The following larger scale survey reviewed episodes over a 6 year period to provide comparative annual data and to provide a long-term epidemiological assessment of this infection. Laboratory records were examined for all cases of candidaemia from the beginning of 2004 t...

The Kidneys that Cost an Arm and a Leg: Unusual localised fungal infections in two renal transplant patients: Category: Clinical lesson

Journal of Infection — Fri, 25 Nov 2011 11:05:46 +0100

The number of solid organ transplants in the UK has increased significantly over the last decade. In 2008-2009 over 1,500 renal transplants were performed. Long term immunosuppression can lead to infection from opportunistic and unusual fungal infections which may be difficult to treat. (Source: Journal of Infection)

A novel application of statistical process control charts - monitoring air quality in a paediatric haematology/oncology unit: Category: Lesson in Microbiology & Infection Control

Journal of Infection — Fri, 25 Nov 2011 11:05:46 +0100

This study sought to determine whether the same principles of process management were useful in environmental air monitoring of high risk healthcare units. Results of air sampling at several sites within the paediatric haematology/oncology/BMT unit (in addition to external sites within the hospital grounds) collected over a 2 year period were used to produce SPC charts. (Source: Journal of Infection)

Use of steroids in the management of liver abscesses in Chronic Granulomatous Disease: Category: Clinical lesson

Journal of Infection — Fri, 25 Nov 2011 11:05:46 +0100

Chronic Granulomatous Disease (CGD) is a rare genetically heterogeneous primary immunodeficiency affecting intracellular killing by phagocytes, leading to recurrent and persistent bacterial and fungal infections with formation of granulomata. A range of defects in the NADPH oxidative enzyme complex have been identified. (Source: Journal of Infection)

MedWorm Sponsor Message: Please support the Doctors In Chains campaign for the medics tortured and sentenced for up to 15 years in Bahrain. #FreeDoctors

The effect of antifungal treatments on laboratory diagnostic assays for invasive fungal infections: Category: Scientific free paper

Journal of Infection — Fri, 25 Nov 2011 11:05:46 +0100

Invasive aspergillosis (IA) remains a major concern in the management of patients undergoing haematopoietic stem cell transplantation. Due to the acknowledged risk of IA a number of strategies have been developed for the use of antifungal agents ranging from prophylaxis, via pre-emptive therapy to empiric therapy, however diagnosis of IA remains problematic with clinical symptoms that are often non-specific and some radiological findings, such as the presence of a halo sign or cavitating nodules in the lungs may being strongly suggestive of aspergillosis also associated with other infections. Diagnostic tests such as Galactomannan (GM) enzyme immunoassay and qPCR have been widely employed, but it is not clear how the different antifungal treatment strategies influence these tests. (Source:...

Standardization of fungal polymerase chain reaction for the early diagnosis of invasive fungal infection

Indian Journal of Medical Microbiology — Thu, 24 Nov 2011 05:00:00 +0100

Conclusion: The assay was found to be effective for the rapid detection of Candida and Aspergillus in clinical specimens. (Source: Indian Journal of Medical Microbiology)

Bloodstream infection in heart transplant recipients: 12-year experience at a university hospital in Taiwan [Original articles]

European Journal of Cardio-Thoracic Surgery — Wed, 23 Nov 2011 05:00:00 +0100

Conclusions: There was a high incidence of BSI after heart transplantation in Taiwan, especially infections caused by Enterobacter species and A. baumannii. Mortality was high in patients with infection caused by Pseudomonas, Candida, and Cryptococcus and in patients with severe sepsis. (Source: European Journal of Cardio-Thoracic Surgery)

Blastomyces dermatitidis antigen detection by quantitative enzyme immunoassay.

Clinical and Vaccine Immunology — Wed, 23 Nov 2011 05:00:00 +0100

Conclusion: Quantification eliminated the need for concurrent testing of current and prior specimens for assessment of changes in antigen concentration. Pretreatment increased the sensitivity for detection of antigenemia. Differentiation of histoplasmosis and blastomycosis is not possible by antigen detection. PMID: 22116687 [PubMed - as supplied by publisher] (Source: Clinical and Vaccine Immunology)

Interesting effect of Malassezia spp. infection on dermatoses of other origins

International Journal of Dermatology — Tue, 22 Nov 2011 05:52:49 +0100

Conclusions Recent research has elucidated the immunomodulatory properties of Malassezia spp. in vitro. Our cases serve as possible in vivo models illustrating such properties. Further studies based on these reports could lead to the isolation of molecules from Malassezia, which may have potential use in anti‐inflammatory drug formulations. (Source: International Journal of Dermatology)

MedWorm Sponsor Message: Find the best January Sales in the UK.

Developmental regulation of Th17‐cell capacity in human neonates

European Journal of Immunology — Mon, 21 Nov 2011 05:00:00 +0100

AbstractHuman neonates are at significantly greater risk of serious infection than immunocompetent adults. In particular, very low birth weight infants in the neonatal intensive care nursery are at high risk of developing life‐threatening bacterial and fungal infections. Recent studies have identified Th17 cells as critical mediators of immunity to bacterial and fungal infections at epithelial barriers. Little is known, however, about the ontogeny of Th17‐cell responses in humans. The frequency of serious bacterial infections in preterm infants and the importance of Th17 cells in providing protection against such infections in animal studies prompted us to study Th17‐cell development in human neonates. Naïve CD4+ T cells from extremely preterm infants, term infants, and adults were ...

Differential psoriasis diagnosis required to exclude tinea corporis co-infection

MedWire News - Psoriasis — Sat, 19 Nov 2011 05:53:09 +0100

Findings from a case report show that tinea corporis fungal infections can co-occur with generalized psoriasis vulgaris, showing a similar clinical appearance. (Source: MedWire News - Psoriasis)

Epidemiology and potential preventative measures for viral infections in children with malignancy and those undergoing hematopoietic cell transplantation

Pediatric Blood and Cancer — Fri, 18 Nov 2011 05:00:00 +0100

AbstractIn pediatric patients with malignancy and those receiving hematopoietic stem cell transplants, bacterial and fungal infections have been the focus of fever and neutropenia episodes for decades. However, improved diagnostic capabilities have revealed viral pathogens as a significant cause of morbidity and mortality. Because of limited effective antiviral therapies, prevention of viral infections is paramount. Pre‐exposure and post‐exposure prophylaxis and antiviral suppressive therapeutic approaches are reviewed. Additionally, infection control practices specific to this patient population are discussed. A comprehensive approach utilizing each of these can be effective at reducing the negative impact of viral infections. Pediatr Blood Cancer © 2011 Wiley Periodicals, Inc. (Sour...

Antifungal prophylaxis in pediatric hematology/oncology: New choices & new data

Pediatric Blood and Cancer — Fri, 18 Nov 2011 05:00:00 +0100

AbstractA severe complication of the treatment of pediatric cancers is the development of an invasive fungal infection (IFI). The data to support antifungal prophylaxis in pediatric oncology patients derive primarily from adult patients, and thus the optimal agent to utilize is not clear. Fluconazole has been a standard option, but agents with antimold activity are now available, each with limitations. Pediatric dosing for voriconazole and posaconazole is uncertain and multiple drug interactions exist. The echinocandins are well‐tolerated, but only available in intravenous form. Ultimately, studies demonstrating biologic risk factors for the development of IFI may lead to personalized prophylactic strategies. Pediatr Blood Cancer © 2011 Wiley Periodicals, Inc. (Source: Pediatric Blood a...

Differential psoriasis diagnosis required to exclude tinea corporis co-infection

MedWire News - Dermatology — Fri, 18 Nov 2011 00:00:00 +0100

Findings from a case report show that tinea corporis fungal infections can co-occur with generalized psoriasis vulgaris, showing a similar clinical appearance. (Source: MedWire News - Dermatology)

MedWorm Sponsor Message: Please support the Doctors In Chains campaign for the medics tortured and sentenced for up to 15 years in Bahrain. #FreeDoctors

Antifungal susceptibility profiles of Candida isolates from a prospective survey of invasive fungal infections in Italian intensive care units.

Journal of Medical Microbiology — Thu, 17 Nov 2011 05:00:00 +0100

Authors: Tortorano AM, Prigitano A, Dho G, Grancini A, Passera M Abstract The antifungal susceptibility pattern of 302 Candida isolates collected during an Italian survey on invasive fungal infections in the intensive care setting was investigated. The results were correlated with some epidemiological data and compared to the antifungal profiles obtained in a previous survey. No resistance to echinocandins was detected. The overall resistance to fluconazole was 12.6%, to posaconazole 6%, and to voriconazole 7.1%. C. tropicalis and C. parapsilosis accounted for more than half of all fluconazole resistance. The decreased susceptibility to fluconazole is not uncommon (12.3%) and appears to be increasing, particularly among C. parapsilosis isolates from 2% in '90s to 25.8% in the prese...

Molecular assay to detect nosocomial fungal infections in intensive care units.

European Journal of Internal Medicine — Wed, 16 Nov 2011 17:59:39 +0100

CONCLUSIONS: Considering the incidence of fungal infections and their high mortality rate, early detection, prompt diagnosis and treatment are critical. Molecular assays can serve as a diagnostic tool to manage patients admitted to the intensive care unit. Antifungal susceptibility testing in different geographical regions can support the choice of prophylaxis and treatment for these patients. PMID: 22075290 [PubMed - in process] (Source: European Journal of Internal Medicine)

Fungal physiology: Ustilago takes control

Nature Reviews Microbiology — Wed, 16 Nov 2011 05:00:00 +0100

Nature Reviews Microbiology 9, 832 (2011). doi:10.1038/nrmicro2705 Author: Sheilagh Molloy Ustilago maydis Cmu1 is a virulence factor that can move through plant cells, redirecting plant metabolic pathways to favour fungal infection. (Source: Nature Reviews Microbiology)

The challenge of fungal keratitis

British Journal of Ophthalmology — Wed, 16 Nov 2011 05:00:00 +0100

Worldwide corneal infections are a major cause of unilateral blindness.1 In some parts of the world, fungal infections are commoner than bacterial infections.2 3 The challenge lies not only in the diagnosis but also in appropriate therapy, once diagnosis is established. It becomes more difficult when laboratory tests are inconclusive or do not support the clinical diagnosis and the challenge is greater when the infection is mixed with bacterial or acanthamoeba co-infections.4 One major reason is the restricted availability of commercially available anti-fungal agents for use in the eye. Although the need is great, it is predominantly in the poorer countries of the world where affordability may not recompense the investment required in developing and licensing a drug. Treatment of fungal ke...

Multiple emergences of genetically diverse amphibian-infecting chytrids include a globalized hypervirulent recombinant lineage [Ecology]

Proceedings of the National Academy of Sciences — Tue, 15 Nov 2011 05:00:00 +0100

Batrachochytrium dendrobatidis (Bd) is a globally ubiquitous fungal infection that has emerged to become a primary driver of amphibian biodiversity loss. Despite widespread effort to understand the emergence of this panzootic, the origins of the infection, its patterns of global spread, and principle mode of evolution remain largely unknown. Using comparative population genomics, we discovered three deeply diverged lineages of Bd associated with amphibians. Two of these lineages were found in multiple continents and are associated with known introductions by the amphibian trade. We found that isolates belonging to one clade, the global panzootic lineage (BdGPL) have emerged across at least five continents during the 20th century and are associated with the onset of epizootics in North Amer...

MedWorm Sponsor Message: Find the best January Sales in the UK.

(1-3)-Beta-D-Glucan Assay: Lab and Clinical Application(1-3)-Beta-D-Glucan Assay: Lab and Clinical Application

Medscape Today Headlines — Tue, 15 Nov 2011 04:00:00 +0100

Invasive fungal infections are associated with significantly high morbidity and mortality. This review highlights a new assay that can be used to aid in the diagnosis of these serious infections. Laboratory Medicine (Source: Medscape Today Headlines)

Musculoskeletal Fungal Infections

Seminars in Musculoskeletal Radiology — Fri, 11 Nov 2011 05:00:00 +0100

Semin Musculoskelet Radiol 2011; 15: 506-510DOI: 10.1055/s-0031-1293496ABSTRACTFungal infections of the musculoskeletal system are uncommon. They are often found in immunosuppressed or patients with the acquired immunodeficiency syndrome or in patients with a history of travel to an endemic region. Infections often present with multifocal chronic osteomyelitis or chronic mono- or polyarthritis resembling osteoarticular tuberculosis. A clinical clue to the correct diagnosis is the presence of overlying skin sinuses. Radiologists can suggest the correct diagnosis with a good clinical history, although a biopsy and/or fungal culture is usually necessary before beginning treatment.[...]© Thieme Medical PublishersArticle in Thieme eJournals:Table of contents | Abstract | Full text ...

Musculoskeletal Coccidioidomycosis

Seminars in Musculoskeletal Radiology — Fri, 11 Nov 2011 05:00:00 +0100

Semin Musculoskelet Radiol 2011; 15: 511-526DOI: 10.1055/s-0031-1293497ABSTRACTCoccidioidomycosis (valley fever) is a systemic fungal infection caused by soil fungi, Coccidioides species, and is associated with significant morbidity and mortality. This infection is endemic in northern Mexico, the southwestern United States, and parts of Central and South America. The risk factors include ethnicity (especially African and Pacific Island ancestry), male gender, and immunosuppression. The primary infection occurs in lungs, but fewer than 40% of patients are symptomatic. Fewer than 1% of infections result in disseminated disease, which may involve any organ. Skeletal infection occurs in 10 to 50% of these patients and is frequently multicentric with axial skeleton involvement. The diagnosis ca...

Variable clinical presentations of histoplasmosis: a report of six cases.

Tropical Doctor — Fri, 11 Nov 2011 05:00:00 +0100

Authors: Singh S, Kalra R, Chhabra S, Agarwal R, Garg S, Mathur SK Abstract Histoplasma is a dimorphic fungus that primarily involves the lungs and the environmental reservoir is soil. It has emerged as an important opportunistic fungal infection in immunocompromised patients. Six cases of histoplasmosis with variable clinical presentations diagnosed either on cytology or histopathology are discussed - three were HIV-positive. The possibility of histoplasmosis should always be borne in mind, especially in immunocompromised patients, as it can have variable clinical presentations. PMID: 22080483 [PubMed - as supplied by publisher] (Source: Tropical Doctor)

Invasive fungal infections following liver transplantation - risk factors, incidence and outcome

The Aspergillus Website - articles — Thu, 10 Nov 2011 16:19:03 +0100

Pacholczyk M, Lagiewska B, Lisik W, Wasiak D, Chmura A (Source: The Aspergillus Website - articles)

MedWorm Sponsor Message: Please support the Doctors In Chains campaign for the medics tortured and sentenced for up to 15 years in Bahrain. #FreeDoctors

Is elevation of the serum β-d-glucan level a paradoxical sign for Trichosporon fungemia in patients with hematologic disorders?

International Journal of Infectious Diseases — Wed, 09 Nov 2011 05:00:00 +0100

Summary: The detection of serum 1,3-β-d-glucan (BDG) has been reported to be useful for the diagnosis and therapeutic monitoring of various invasive fungal infections. Although Trichosporon fungemia is increasingly recognized as a fatal mycosis in immunocompromised patients, the utility of this assay for Trichosporon fungemia is still unknown. In our experience (28 cases), the level of BDG rose in about half of the patients with hematologic disorders who developed Trichosporon fungemia. Among them, early death from this infection was more frequently seen in BDG-negative patients than in BDG-positive patients. In addition, overall survival was also significantly worse in BDG-negative patients than in BDG-positive patients. There were no significant differences between these two patient gro...

Mycoviruses: future therapeutic agents of invasive fungal infections in humans?

The Aspergillus Website - articles — Tue, 08 Nov 2011 20:19:21 +0100

van de Sande WW, Lo-Ten-Foe JR, van Belkum A, Netea MG, Kullberg BJ, Vonk AG (Source: The Aspergillus Website - articles)

Micafungin Use in ChildrenMicafungin Use in Children

Medscape Today Headlines — Mon, 07 Nov 2011 11:20:19 +0100

How safe and effective is Micafungin in treating pediatric fungal infections? Expert Review of Anti-Infective Therapy (Source: Medscape Today Headlines)

An enhancing brainstem lesion in a patient with a history of worldwide travel

Neurology — Mon, 07 Nov 2011 05:00:00 +0100

(Source: Neurology)

Population Pharmacokinetics of Voriconazole in Adults.

Antimicrobial Agents and Chemotherapy — Mon, 07 Nov 2011 05:00:00 +0100

Authors: Hope WW Abstract Voriconazole is a first-line agent for the treatment of invasive fungal infections. The pharmacology of voriconazole is characterized by extensive inter-individual variability and nonlinear pharmacokinetics. The population pharmacokinetics of voriconazole in 64 adults are described. The patient population consisted of 21 healthy volunteers who received a range of i.v. and oral voriconazole regimens, and 43 patients with proven or probable invasive aspergillosis, who received the currently licensed dosage. Voriconazole concentrations were measured using HPLC. The pharmacokinetic data were modeled using a nonparametric methodology and with a nonlinear pharmacokinetic structural model. The extent and consequences of pharmacokinetic variability were explored u...

MedWorm Sponsor Message: Find the best January Sales in the UK.

Universal antifungal therapy is not needed in persistent febrile neutropenia: a tailored diagnostic and therapeutic approach.

Haematologica — Fri, 04 Nov 2011 04:00:00 +0100

Conclusions. Based on the high negative predictive value of this diagnostic and therapeutic approach, in persistent febrile neutropenic patients with hematological malignancies or hematopoietic stem cell transplant recipients, it is useful for identifying patients who are not likely to develop invasive fungal infection, therefore do not require antifungal therapy, and with a effectiveness similar to that reported in controlled trials which indicate empirical antifungal therapy universally. PMID: 22058202 [PubMed - as supplied by publisher] (Source: Haematologica)

Role of caspofungin in restoring the impaired phagocyte-dependent innate immunity towards Candida albicans in chronic haemodialysis patients

International Journal of Antimicrobial Agents — Fri, 04 Nov 2011 04:00:00 +0100

Abstract: Phagocyte-dependent cellular immunity in chronic kidney disease patients undergoing haemodialysis treatment is frequently impaired owing to the uraemic state, resulting in an intrinsic susceptibility to developing invasive fungal infections with high mortality rates. Since synergism between phagocytic cells and antifungal drugs may be crucial for successful therapy, the aim of this study was to evaluate the effects exerted by caspofungin (CAS) on the functional activities of polymorphonuclear cells (PMNs) in haemodialysed patients (HDs) towards Candida albicans compared with those of PMNs from healthy subjects (HSs). PMNs were separated from venous blood samples of 66 HDs and 30 HSs (as controls), and measurement of phagocytic and intracellular fungicidal activities of HD-PMNs an...

Fungal infections in children with malignant disease

The Aspergillus Website - articles — Thu, 03 Nov 2011 20:49:07 +0100

Michel G (Source: The Aspergillus Website - articles)

Fungal infections and congenital immune deficiencies

The Aspergillus Website - articles — Thu, 03 Nov 2011 20:43:55 +0100

Bustamante J, Mahlaoui N, Casanova JL, Blanche S (Source: The Aspergillus Website - articles)

Antifungal susceptibility patterns of yeasts and filamentous fungi isolated from nail infection

Journal of the European Academy of Dermatology and Venereology — Thu, 03 Nov 2011 04:00:00 +0100

Conclusion C. parapsilosis was the most common fungal species isolated from patients with onychomycosis. The different response obtained by in vitro susceptibility testing to drugs shows the importance of these methods to assist clinicians in choosing the best therapeutic option. (Source: Journal of the European Academy of Dermatology and Venereology)

MedWorm Sponsor Message: Please support the Doctors In Chains campaign for the medics tortured and sentenced for up to 15 years in Bahrain. #FreeDoctors

Subcutaneous dematiaceous fungal infection.

Dermatol Online J — Wed, 02 Nov 2011 03:40:04 +0100

Authors: Patel U, Chu J, Patel R, Meehan S Abstract Subcutaneous dematiaceous fungal infections, which include chromoblastomycosis and phaeohyphomycosis, are a heterogeneous group of clinical entities that are caused by dematiaceous or pigmented fungi found in soil. These infections have a wide spectrum of clinical presentations that depend largely on the specific causative organism and on the integrity of the host's immune response. Treatment is challenging and involves a highly individualized plan that often combines both surgical and long-term medical treatment. PMID: 22031645 [PubMed - in process] (Source: Dermatol Online J)

Does ampicillin‐sulbactam cause false positivity of (1,3)‐beta‐D‐glucan assay? A prospective evaluation of 15 patients without invasive fungal infections*

Mycoses — Tue, 01 Nov 2011 04:00:00 +0100

SummaryThe purpose of this study was to investigate the interaction between intravenous ampicillin‐sulbactam treatment and (1,3)‐beta‐D‐glucan (BDG) assay. Fifteen patients with a median age of 60 (16–81) without known risk factors for invasive fungal infections who received a daily dose of 3 × 2 g ampicillin‐sulbactam monotherapy from different batches were included in the study. Thirteen patients had soft tissue infections. The 5 of 13 patients who went under surgery had surgical dressings. Serum samples were obtained both before and after antibiotic infusion on the first, third, seventh and tenth days of an ampicillin‐sulbactam treatment course. BDG was assayed using the Fungitell kit (Associates of Cape Cod, East Falmouth, MA, USA) according to manufacturers’ spe...

Imported Acquired Immunodeficiency Syndrome-Related Histoplasmosis in Metropolitan France: A Comparison of Pre-Highly Active Anti-Retroviral Therapy and Highly Active Anti-Retroviral Therapy Eras.

The American Journal of Tropical Medicine and Hygiene — Tue, 01 Nov 2011 04:00:00 +0100

Authors: Peigne V, Dromer F, Elie C, Lidove O, Lortholary O Abstract Abstract. Histoplasma capsulatum var. capsulatum infection is rare outside disease-endemic areas. Clinical presentation and outcome of acquired immunodeficiency syndrome-related histoplasmosis are unknown in non-endemic areas with wide access to highly active anti-retroviral therapy (HAART). Retrospective analysis of cases recorded at the French National Reference Center for Mycoses and Antifungals during two decades: pre-HAART (1985-1994) and HAART (1997-2006). Clinical features and outcome of all adults with proven acquired immunodeficiency syndrome-related histoplasmosis were compared between the two periods. One hundred four patients were included (40 during the pre-HAART era and 64 during the HAART era). Diag...

Periostitis secondary to prolonged voriconazole therapy in a lung transplant recipient.

Orthopedics — Tue, 01 Nov 2011 04:00:00 +0100

This article reports a case of perostitis deformans in a lung transplantation patient taking the fluoride-containing medication voriconazole, a relatively new and potent anti-fungal. The patient had a normal range of motion in all joints and a normal gait. On radiographs at presentation, multifocal areas of periostitis were visualized involving the left-hand first, second, and third proximal phalanx shafts. Similar periostitis was present on the left-hand third, fourth, and fifth middle phalanx shafts. Plain radiographs of the right hand also demonstrated multifocal periostitis of the third and fourth proximal and middle phalanges. Aggressive periostitis at the level of the right fourth proximal and middle phalanges was also present. Given her long-term treatment with voriconazole and a pr...

Developmental regulation of Th17 capacity in human neonates

European Journal of Immunology — Tue, 01 Nov 2011 04:00:00 +0100

AbstractHuman neonates are at significantly greater risk of serious infection than immunocompetent adults. In particular, very low birth weight infants in the neonatal intensive care nursery are at high risk of developing life‐threatening bacterial and fungal infections. Recent studies have identified Th17 cells as critical mediators of immunity to bacterial and fungal infections at epithelial barriers. Little is known, however, about the ontogeny of Th17 cells responses in humans. The frequency of serious bacterial infections in preterm infants and the importance of Th17 cells in providing protection against such infections in animal studies prompted us to study Th17 cell development in human neonates. Naïve CD4+ T cells from extremely preterm infants, term infants, and adults were ass...

MedWorm Sponsor Message: Find the best January Sales in the UK.

Treatment with fungicides influences phytochemical quality of blackcurrant juice

Annals of Applied Biology — Tue, 01 Nov 2011 04:00:00 +0100

The impact of fungicide treatment on fungal infection and blackcurrant juice quality was examined in a series of field experiments over the course of 2 years. Fungicide treatment reduced the incidence of foliar disease and resulted in changes in the concentration of sugars, organic acids, polyphenols and anthocyanins in blackcurrant juice. Treatment with Signum® (containing pyraclostrobin, a strobilurin, and boscalid, a succinate dehydrogenase inhibitor) enhanced glucose, fructose and total sugar content in one treatment year but not in another. Treatment with Signum or Filan® (containing boscalid only) caused a reduction in the key organic acid citrate. Treatment with Signum or Platoon® (containing pyraclostrobin only) enhanced total polyphenol and anthocyanin content of juices. The da...

[Fungal infections in the intensive care unit].

Anasthesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie : AINS — Tue, 01 Nov 2011 04:00:00 +0100

Authors: Kerwat K, Rolfes C, Wulf H Abstract Invasive infections through to sepsis caused by fungi in intensive care units have increased markedly in the past few years. In the mean time almost every tenth case of sepsis in the intensive care unit is the result of an invasive fungal infection. Not only hemato-oncological or organ-transplanted patients are affected but increasingly also those patients who have been under intensive care for a considerable time and who exhibit particular risk factors. The lethality among the afflicted patients is high. The diagnosis of fungal infections is still difficult; unambiguous, highly sensitive and specific test procedures are still lacking. The decision for therapy must often be made empirically and as early as possible. In the past few years...

Segmental lesions in pityriasis rosea: a rare presentation.

Skinmed — Tue, 01 Nov 2011 04:00:00 +0100

Authors: Zawar V, Godse K Abstract A 34-year-old nonpregnant woman noted a mildly pruritic skin lesion on her right breast for 1 week following an episode of coryza, malaise, and low-grade fever of 3 days' duration. The latter symptoms subsided without any treatment. Ketoconazole cream prescribed by her family physician did not resolve the breast eruption after 1 week, so was stopped. A week later, multiple skin lesions erupted suddenly on her right chest wall starting near the herald patch in midaxillary line and spread distally until the midback. She then consulted the authors. She denied a history of abrasion or trauma to the affected areas. Travel, contact, sexual, and drug histories were unremarkable. She categorically denied past or family history of eczema, psoriasis, contac...

The influence of the fungal pathogen Mycocentrospora acerina on the proteome and polyacetylenes and 6-methoxymellein in organic and conventionally cultivated carrots (Daucus carota) during post harvest storage.

Journal of Proteomics — Sat, 29 Oct 2011 04:00:00 +0100

Authors: Louarn S, Nawrocki A, Edelenbos M, Jensen DF, Jensen ON, Collinge DB, Jensen B Abstract Many carrots are discarded during post harvest cold storage due to development of fungal infections, caused by, e.g., Mycocentrospora acerina (liquorice rot). We compared the susceptibility of carrots grown under conventional and organic agricultural practices. In one year, organically cultivated carrots showed 3× to 7× more symptoms than conventionally cultivated, when studying naturally occurring disease at 4 and 6months, respectively. On the other hand, we have developed a bioassay for infection studies of M. acerina on carrots and observed that organic roots were more susceptible after one month of storage than conventional ones, but no differences were apparent after four or six ...

It's Official: Fungus Causes Bat-Killing White-Nose Syndrome

Scientific American - Official RSS Feed — Wed, 26 Oct 2011 22:01:00 +0100

A fungus known as Geomyces destructans is indeed responsible for the dusting of white across bat noses and wings that has wiped out entire populations of the flying mammals, new research shows. By purposefully infecting healthy bats with the fungus--and confirming that seemingly healthy "control" bats from the same population did not get sick from a prior but hidden fungal infection--microbiologist David Blehert of the U.S. Geological Survey and his colleagues showed in a paper published online October 26 in Nature that G. destructans is in fact responsible for the disease known as white-nose syndrome (WNS), which has devastated bat populations across the northeastern U.S., killing an estimated one million of the animals. ( Scientific American is part of Nature Publishing Group....

MedWorm Sponsor Message: Please support the Doctors In Chains campaign for the medics tortured and sentenced for up to 15 years in Bahrain. #FreeDoctors

Invasive fungal infections in lung transplant recipients not receiving routine systemic antifungal prophylaxis: 12-year experience at a university lung transplant center

The Aspergillus Website - articles — Wed, 26 Oct 2011 15:54:07 +0100

Pinney MF, Rosenberg AF, Hampp C, Schain D, Akindipe O, Baz M (Source: The Aspergillus Website - articles)

Severe Fungal Infections After Injuries in TornadoSevere Fungal Infections After Injuries in Tornado

Medscape Today Headlines — Wed, 26 Oct 2011 13:29:42 +0100

Two teenagers sustained multiple open wounds in a tornado in May. The wounds became infected with an unusual fungus, leading to necrosis, multiple debridements, and prolonged hospital stays. Medscape Medical News (Source: Medscape Today Headlines)

Experimental infection of bats with Geomyces destructans causes white-nose syndrome

Nature AOP — Wed, 26 Oct 2011 04:00:00 +0100

Authors: Jeffrey M. Lorch, Carol U. Meteyer, Melissa J. Behr, Justin G. Boyles, Paul M. Cryan, Alan C. Hicks, Anne E. Ballmann, Jeremy T. H. Coleman, David N. Redell, DeeAnn M. Reeder & David S. Blehert White-nose syndrome (WNS) has caused recent catastrophic declines among multiple species of bats in eastern North America. The disease’s name derives from a visually apparent white growth of the newly discovered fungus Geomyces destructans on the skin (including the muzzle) of hibernating bats. Colonization of skin by this fungus is associated with characteristic cutaneous lesions that are the only consistent pathological finding related to WNS. However, the role of G. destructans in WNS remains controversial because evidence to implicate the fungus as the primary cause of this di...

Oligopeptide transport and regulation of extracellular proteolysis are required for growth of Aspergillus fumigatus on complex substrates but not for virulence

Molecular Microbiology — Mon, 24 Oct 2011 04:00:00 +0100

SummaryMoulds are characterized by their saprophytic lifestyle that is based on osmotrophy. Among them, Aspergillus fumigatus has emerged as the leading cause of fungal infections in the presence of an underlying immunodeficiency. To assess the role of its nutritional versatility for virulence, transcriptional profiling studies in the presence of varying sources of nitrogen were carried out and revealed an extensive reprogramming of the fungal transcriptome when shifting to a proteinaceous growth substrate. Transcripts encoding metabolic activities were predominantly upregulated, as were proteinases and transport activities. To probe whether fundamental aspects of its osmotrophic lifestyle, that is, extracellular proteolysis and uptake of oligopeptides, are required for A. fumigatus path...

MedWorm Sponsor Message: Find the best January Sales in the UK.

Early diagnosis of candidemia in intensive care unit patients with sepsis: a prospective comparison of (1->3)-beta-D-glucan assay, Candida score, and colonization index

Critical Care — Sat, 22 Oct 2011 04:00:00 +0100

Conclusions: A single-point BG assay based on a blood sample drawn at the sepsis onset, alone or in combination with Candida score, may guide the decision to start antifungal therapy early in patients at risk for Candida infection. (Source: Critical Care)

Flash pulmonary oedema during anidulafungin administration

Journal of Clinical Pharmacy and Therapeutics — Thu, 20 Oct 2011 04:00:00 +0100

Conclusion: This is the first report of pulmonary oedema attributable to an echinocandin antifungal agent. While such infusion‐related adverse events including pulmonary oedema appear uncommon, it is important for clinicians to be aware of this possibility and maintain the drug’s infusion rate to <1·1 mg/min and monitor for signs and symptoms of pulmonary oedema. (Source: Journal of Clinical Pharmacy and Therapeutics)

Correlation of the chemical composition of essential oils from Origanum vulgare subsp. virens with the in vitro activity against clinical yeast and filamentous fungi.

Journal of Medical Microbiology — Thu, 20 Oct 2011 04:00:00 +0100

Authors: Vale-Silva LA, Silva MJ, Oliveira D, Goncalves MJ, Cavaleiro C, Salgueiro L, Pinto E Abstract Origanum vulgare subsp. virens (Hoffmanns. & Link) Bonnier & Layens and its essential oil are widely used in the treatment of respiratory and cutaneous infections in traditional medicine. In order to establish a basis for its traditional employment, the antimicrobial activity of the essential oil of O. vulgare subsp. virens was evaluated against human fungal pathogens. Different oil samples were studied in order to elucidate the intraspecific chemical variability and its impact on the biological activity. Flowering aerial parts of three samples of O. vulgare subsp. virens were collected in different geographical locations and essential oils were isolated from air-dried pla...

Diagnostics of fungal infections in the Nordic countries: we still need to improve!

The Aspergillus Website - articles — Wed, 19 Oct 2011 19:01:35 +0100

Arendrup MC, Chryssanthou E, Gaustad P, Koskela M, Sandven P, Fernandez V (Source: The Aspergillus Website - articles)

Fish pedicure risk "very low"

NHS News Feed — Tue, 18 Oct 2011 17:45:00 +0100

“Trendy fish pedicures could spread HIV and hepatitis C,” The Sun has today reported. Its front-page story said that officials have raised an “alert” over the treatment, popular in beauty spas, where tiny fish are used to nibble away areas of hard foot skin. While The Sun has been carping on about warnings and alerts, the newspaper seems to have overestimated the scale of the risk, which health experts have described as being “extremely low”. Rather than being an alert, the news is based on a report by the Health Protection Agency that has set out good practice for so-called ‘fish spas’ that offer the service. While the report did acknowledge that the risk of infections could not be completely ruled out, it is important to view this in context and not be reeled in by fishy ...

MedWorm Sponsor Message: Please support the Doctors In Chains campaign for the medics tortured and sentenced for up to 15 years in Bahrain. #FreeDoctors

Bacterial and fungal microflora in surgically removed lung cancer samples

Journal of Cardiothoracic Surgery — Fri, 14 Oct 2011 04:00:00 +0100

Conclusions: A diversity of pathogens could be identified in surgically extracted tissue samples of patients with lung cancer, with mycoplasma strains being present in all samples. These results point to an etiologic role for chronic infection in lung carcinogenesis. Confirmation of these observations and additional studies are needed to further characterize the etiologic role of inflammation in lung carcinogenesis. (Source: Journal of Cardiothoracic Surgery)

Long-Term Voriconazole and Skin Cancer: Is There Cause for Concern?

Current Infectious Disease Reports — Thu, 13 Oct 2011 15:48:45 +0100

Abstract Skin toxicity due to voriconazole is well recognized. Recently, several series have reported skin cancer, particularly cutaneous squamous cell carcinoma (C-SCC), following photosensitivity reactions among patients receiving long-term voriconazole (>12 months). Almost all patients were immunosuppressed, including stem cell and solid organ transplant recipients. A case-control study of lung transplant recipients identified long-term voriconazole (median cumulative dose: 76 grams) and residence in areas of strong sun exposure as independent risk factors for C-SCC. The mechanism(s) by which voriconazole may predispose to skin cancer is not clear. Moreover, the relative contribution of voriconazole and other factors such as immunosuppression, ultraviolet e...

The incidence and risk factors of invasive fungal infection after haploidentical hematopoietic stem cell transplantation without in vitro T‐cell depletion

Clinical Microbiology and Infection — Thu, 13 Oct 2011 04:00:00 +0100

In conclusion, IFI is an important complication following haploidentical HSCT without in vitro T‐cell depletion. (Source: Clinical Microbiology and Infection)

The incidence and risk factors of invasive fungal infection after haploidentical haematopoietic stem cell transplantation without in vitro T‐cell depletion

Clinical Microbiology and Infection — Thu, 13 Oct 2011 04:00:00 +0100

In conclusion, IFI is an important complication following haploidentical HSCT without in vitro T‐cell depletion. (Source: Clinical Microbiology and Infection)