Tags: Flucytosine

Pathogenic Amebas

ENTAMOEBA HISTOLYTICA & ENTAMOEBA DISPAR Essentials of Diagnosis Patient living in or having traveled to endemic area increases risk. Frequent loose stools with blood and mucus. Demonstration of cyst or trophozoite on stool wet mount or in biopsy specimen. Serology positive within 7-10 days of infection, may remain positive for years after infection resolved. Monoclonal antibodies and polymerase chain reaction emerging; may help differentiate E histolytica and E dispar. General Considerations Epidemiology There are numerous distinct species of ameba within the genus Entamoeba, and the majority of these do not cause disease in humans. E histolytica is a pathogenic species that is capable of causing disease, such as colitis or liver […]

Fusarium, Penicillium, Paracoccidioides, & Agents of Chromomycosis

FUSARIUM INFECTION Essentials of Diagnosis Worldwide geographic distribution. Mold, septate hyphae 3-8 um in diameter. A rare infection in severely immunocompromised patients. Blood cultures often but not always positive. No serologic tests available. Cutaneous involvement is common feature. General Considerations Epidemiology Fusarium spp. is an emerging fungal pathogen. Although long recognized as a cause of local infection involving nails, traumatized skin, or the cornea (eg, in contact lens wearers), deep or disseminated infection was not described until the mid 1970s. Despite its worldwide distribution and its frequent recovery from soil and vegetative material, infection is quite rare. Only ~ 100 cases involving invasive disease in immunosuppressed patients have been described in […]


Essentials of Diagnosis Patients are usually immunocompetent. Found worldwide but usually in tropical or subtropical areas. Mold in culture; forms sclerotic body or muriform cell in tissue. Infection results from direct inoculation from contaminated soil or vegetative substances. Chronic indolent cutaneous verrucous lesions, most often on the feet. General Considerations Chromomycosis, also known as chromoblastomycosis, is a chronic subcutaneous infection caused by several different fungi. Although rarely seen in the United States, it is common worldwide. Epidemiology Chromomycosis occurs worldwide but is most frequently encountered in tropical and subtropical regions. The most common occurrence is in barefoot individuals, particularly among agricultural workers. The organisms causing chromomycosis are found commonly in soil, […]

Cryptococcus Neoformans

Essentials of Diagnosis Routine laboratory tests often normal. One-third of patients are afebrile. Definitive diagnosis made by fungal culture maintained at 37°C for 6 weeks. Cryptococcal antigen 95% sensitive in CNS infection in centrifuged CSF. India ink examination positive in only 50% of meningoencephalitis cases. CSF lymphocytes often low in CNS infection, especially in AIDS patients. Cryptococcal antigen most sensitive detection method in serum. Chest radiograph variable — multiple areas of infiltration in lower lobes most common in pulmonary disease. Molecular detection by PCR might soon become laboratory standard. General Considerations Epidemiology and Ecology Cryptococcus neoformans exists as two distinct varieties known as variety neoformans and variety gattii (Table 1). Cryptococcus […]

Fluconazole (Diflucan) Order No Prescription 50/100/150/200mg

Fluconazole: Drug-Drug Interactions Alfentanil In a randomized, double-blind, placebo-controlled, crossover study in nine subjects, fluconazole 400 mg reduced the clearance of alfentanil 20 micrograms/kg by 55% and increased alfentanil-induced subjective effects. Amitriptyline An interaction of fluconazole with amitriptyline has been reported. A 12-year-old boy with prostatic rhabdomyosarcoma had episodes of syncope periodically over 7 months while taking fluconazole for chemotherapy-induced mucositis. He had taken fluconazole in the past without problems but had also taken a stable dose of amitriptyline for neuropathic pain. On withdrawal of amitriptyline he had no further episodes. The effect was confirmed by readministration. Concurrent administration of fluconazole probably causes increased exposure to amitriptyline. Three reports of adults […]


Description of Medical Condition Candida albicans and related species cause a variety of infections. Cutaneous candidiasis syndromes include erosio interdigitalis blastomycetica, folliculitis, balanitis, intertrigo paronychia, onychomycosis, diaper rash, perianal candidiasis, and the syndromes of chronic mucocutaneous candidiasis. Mucous membrane infections include oral candidiasis (thrush), esophagitis, and vaginitis. The most serious manifestation of candidiasis is hematogenously disseminated invasive candidiasis (sometimes referred to as acute systemic candidiasis). System(s) affected: Skin/Exocrine, Gastrointestinal, Reproductive, Pulmonary, Renal/Urologic Genetics: N/A Incidence/Prevalence in USA: Approximately 50/100,000. Hematogenously disseminated candidiasis affects at least 120,000 patients annually in the USA. Predominant age: All ages are susceptible to hematogenously disseminated candidiasis. Premature neonates are at particularly high risk. Predominant sex: Male […]


Bacterial Meningitis Bacterial meningitis remains one of the most feared and dangerous infectious diseases that a physician can encounter. This form of meningitis constitutes a true infectious disease emergency. It is important that the physician quickly make the appropriate diagnosis and initiate antibiotic therapy. Minutes can make the difference between life and death in bacterial meningitis. The rapid progression of disease leaves no time to look through textbooks to decide on appropriate management. To assure the best outcome, every clinician needs a basic understanding of bacterial meningitis and its management. Epidemiology and Causes With the advent of the Haemophilus influenza В vaccine, the incidence of bacterial meningitis in children declined dramatically […]

Antifungal Agents

Fungi are eukaryotes, and they share many of the structural and metabolic characteristics of human cells. As a result, designing agents that affect fungi without harming human cells has proved difficult. One major difference between the two cell types is the primary sterol building block used to form the plasma membrane. The fungal plasma membrane consists of ergosterols; the major sterol component of the human plasma membrane is cholesterol. This difference has been exploited in the development of two classes of drugs. The polyenes act by binding to ergosterol and disrupting the fungal membrane. These agents are fungicidal. The azoles inhibit ergosterol synthesis, and lowered ergosterol levels results in fungal membrane […]


Definition Table Centers for Disease Control and Prevention 1993 Revised Classification System for HIV Infection in Adults and AIDS Surveillance Case Definition and Table Centers for Disease Control and Prevention 1994 Revised Classification System for HIV Infection in Children Younger than 13 Years present the revised classification systems for adult and child HIV infection. Pathogenesis Transmission of HIV Infection with HIV occurs through three primary modes: sexual, parenteral, and perinatal. Sexual intercourse, primarily receptive anal and vaginal intercourse, is the most common vehicle for transmission. The probability of HIV transmission from receptive anorectal intercourse is 0.1% to 3% per sexual contact and 0.1% to 0.2% per sexual contact for receptive vaginal […]

Specific fungal infections

Histoplasmosis Histoplasmosis is caused by inhalation of dust-borne microconidia of the dimorphic fungus Histoplasma capsulatum. In the United States, most disease is localized along the Ohio and Mississippi river valleys. Clinical Presentation In the vast majority of patients, low-inoculum exposure to H. capsulatum results in mild or asymptomatic pulmonary histoplasmosis. The course of disease is generally benign, and symptoms usually abate within a few weeks of onset. Patients exposed to a higher inoculum during a primary infection or reinfection may experience an acute, self-limited illness with flulike pulmonary symptoms, including fever, chills, headache, myalgia, and nonproductive cough. Chronic pulmonary histoplasmosis generally presents as an opportunistic infection imposed on a preexisting structural […]