China
Africa
Explore chapters and articles related to this topic
Heterocyclic Drugs from Plants
Published in Rohit Dutt, Anil K. Sharma, Raj K. Keservani, Vandana Garg, Promising Drug Molecules of Natural Origin, 2020
Debasish Bandyopadhyay, Valeria Garcia, Felipe Gonzalez
Fluconazole (Figure 8.13) is an antibiotic, frequently used in treating fungal and yeast infections (Fluconazole, 2018). This drug belongs to the triazole class of antifungal agents which works by inhibiting/reducing the fungal growth that causes infection in the human body. Substantial clinical studies demonstrated fluconazole’s effectiveness, its favorable pharmacokinetics, and safety profile; all these have a large contribution to its widespread uses (Cha et al., 2004). This drug works well in fungal meningitis and as a preventive medicine for infections due to chemotherapy, radiation therapy, or bone marrow transplant (Fluconazole, 2018). It also demonstrated activity up to a certain extent for the treatment of fungal infections in HIV positive patients. Fluconazole is taken orally but it some cases intravenous administration is preferred (Zervos et al., 1993).
Meningitis
Published in Firza Alexander Gronthoud, Practical Clinical Microbiology and Infectious Diseases, 2020
The most common causes of fungal meningitis are Cryptococcus neoformans and Cryptococcus gattii, most often seen in immunocompromised patients, especially patients living with HIV with a CD4 count of less than <100 cells/μL. In countries with a high prevalence of HIV such as South Africa, cryptococcal meningitis is the most common cause of community-acquired meningitis. Cerebral toxoplasmosis and progressive multifocal leukoencephalopathy caused by JC virus are other causes of meningitis in immunocompromised individuals. Tuberculous meningitis most often occurs in children under 4 years of age who have had contact with persons with infectious tuberculosis.
Headache associated with central nervous system infection
Published in Stephen D. Silberstein, Richard B. Upton, Peter J. Goadsby, Headache in Clinical Practice, 2018
Stephen D. Silberstein, Richard B. Upton, Peter J. Goadsby
Other conditions that can resemble aseptic meningitis include fungal meningitis, parameningeal infections, non-infectious conditions (malignant meningitis, sarcoidosis or chemical meningitis from spinal anesthesia, myelography, or intrathecal medications), and bacterial agents that are difficult to culture (such as those causing syphilis (Treponema palladium), tuberculosis (Mycobacterium tuberculosis), and Lyme disease (Borrelia burgdorferi)).34,37,42 EBV may have a very long chronic course, and it has been suggested that many cases of new daily persistent headache are triggered by an episode of Epstein-Barr infection. An interesting diagnosis of exclusion related to nonbacterial intracranial infections is the clinical syndrome of a migrainous headache, with prolonged aura, neck stiffness, fever, and a lymphocytosis in the CSF.43 The nature of this syndrome remains to be more clearly elucidated. The subacute aseptic meningitis syndrome may be because of a fungal infection, most frequently Cryptococcus neoformans. Fungal meningitis and its possible concomitant brain parenchymal involvement constitute a major diagnostic challenge, since the yield of traditional diagnostic methods, such as culture, may not be positive.
Mechanical filtration of the cerebrospinal fluid: procedures, systems, and applications
Published in Expert Review of Medical Devices, 2023
Fungal meningitis (FM) and fungal encephalitis (FE) are infections of the CNS caused by fungi, more frequent in immunocompromised patients, such as those with HIV or in organ – transplant recipients. Antifungal therapies are available for most fungi behind FM. The severity of the infection and outcome are very heterogeneous depending on the fungi and patient’s status, but the rate of permanent sequelae and mortality rates are high. Moreover, the parameters colony-forming unit (CFU) and management of ICP in the first 14 days of therapy (the induction phase) are the key drivers of patient outcomes [18]. Current gold standard therapies for FM and FE usually achieve a 5-log reduction of CFUs during the 14-day induction phase, with mortality of one-fifth of cases at 90 days. A boost to CSF CFU reduction early in the induction phase via CSF filtration may assist antifungals in clearing the fungus from the system and alleviate high ICP by preventing fungus from obstructing the arachnoid granulations. For instance, a rabbit model was used to investigate CSF filtration therapy in the context of cryptococcal meningitis. This study showed a 5-log reduction in yeast concentration and a 1-log reduction in its polysaccharide antigen over 24 h [19].
Study of cerebrospinal fluid levels of lactate, lactate dehydrogenase and adenosine deaminase in the diagnosis and outcome of acute meningitis
Published in Neurological Research, 2022
Lovelina Singh, Mahendra Javali, Anish Mehta, R. Pradeep, R. Srinivasa, P. T. Acharya
Meningitis is a notifiable disease, but its exact rate of incidence is not known. An estimated global figure has revealed that there were approximately 420,000 deaths associated with meningitis from 1990 to 2010 [1]. Bacteria and enteroviruses remain the major causes of meningitis [2]. Acute meningitis refers to cases with a duration of symptoms of less than one week. Early initiation of antibiotic therapy plays a crucial role in the improvement of the outcome of acute meningitis [3]. Pyogenic (bacterial) meningitis, tuberculous meningitis (TBM), and viral meningitis are commonly encountered. Fungal meningitis can result in chronic meningitis and is relatively uncommon. Cryptococcal meningitis is a form of fungal meningitis that is commonly encountered by immunosuppressed patients (acquired immunodeficiency syndrome) [3,4].
Transdermal delivery of bioidentical estrogen in menopausal hormone therapy: a clinical review
Published in Expert Opinion on Drug Delivery, 2020
The lack of oversight of compounding pharmacies by the FDA raises concerns about batch to batch variability in potency, efficacy and safety of compounded products. In 2012, a compounding center was linked to 750 cases of fungal meningitis resulting from intrathecally administered contaminated steroids. Custom compounded topical estrogens should be recommended only if a patient cannot tolerate an FDA approved preparation [50]. A number of medical societies including the North American Menopause society (NAMS), the Endocrine Society and the American College of Obstetricians and Gynecologists (ACOG) support the use of FDA approved products over custom compounded products.