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Diagnosis and Treatment of Fungal Keratitis
Published in Mahendra Rai, Marcelo Luís Occhiutto, Mycotic Keratitis, 2019
Systemic medication. In addition to local drug use, oral administration of triazoles like itraconazole, once a day, 0.2 g each time, for 2 to 3 weeks, could achieve good effects on filamentous fungal infection. For severe FK, which is accompanied by hypopyon or suspected for endophthalmitis, intravenous infusion of fluconazole or voriconazole can be given once per day, 0.2 g each time, for 1 to 2 weeks, and the first dose should be doubled (Shi and Wang 2013). It should be noted that clinical and laboratory follow-up of patients taking oral or intravenous antifungal medication is needed, especially because of high hepatotoxicity (Kyriakidis et al. 2017).
Thoracic cases
Published in Lt Col Edward Sellon, David C Howlett, Nick Taylor, Radiology for Medical Finals, 2017
Hannah Adams, Sarah Hancox, Cristina Ruscanu, David C Howlett
Treatment is usually considered when the patient is symptomatic: haemoptysis is the most common symptom. Antifungal medication is first-line treatment, using various routes (IV, inhalation, and CT-g uided percutaneous administration).
Candida Vulvovaginitis
Published in William J. Ledger, Steven S. Witkin, Vulvovaginal Infections, 2017
William J. Ledger, Steven S. Witkin
Thus, in women harboring C. albicans in their vagina as a commensal microorganism, any mechanism that increases vaginal PGE2 levels would promote Candida proliferation and germination and increase susceptibility to a symptomatic infection. One mechanism that increases vaginal PGE2 concentrations is a vaginal allergic response. An allergic reaction can be elicited in the vagina of sensitized women by Candida, other microbial products, intrinsic semen components or allergens ingested by the male sexual partner and present in his semen, components of vaginal medications or contraceptive products, or environmental allergens.22 The local release of histamine stimulates high levels of PGE2 production by macrophages and results in the local inhibition of cell-mediated immunity. It can easily be seen, therefore, that an underlying vaginal hypersensitivity reaction may be an underlying cause of VVC. In these cases, treatment with an antifungal medication will bring only temporary relief of symptoms, but if the underlying allergic response is not addressed, the woman will remain highly susceptible to recurrences.
Clinical Investigation of the Safety and Efficacy of Low-temperature Plasma as an Adjuvant Treatment for Mild to Moderate Fungal Keratitis: A Pilot Study
Published in Ocular Immunology and Inflammation, 2023
Jingyi Cheng, Anji Wei, Jiaxu Hong, Jianjiang Xu
The present study showed that those with more hypopyon were more likely to fail (P = .009). This might be related to the limitation of the effective depth of the LTP surgical system at nearly 50 μm. Therefore, in deeper-violation cases, especially with more hypopyon, the effect of LTP treatment was limited and more likely to fail; the presence of hypopyon has also been shown to increase the likelihood of surgical intervention.31 It was interesting to find that 2 patients showed an instant decrease in hypopyon after the LTP treatment as shown; however, one case ended in perforation (Figure 3) and the other in complete healing. This is, more or less, explained by the possible mechanism of LTP treatment mentioned above. At first, the penetration of the topical antifungal medication increased, but the therapeutic effect was still not sufficient to eradicate the fungi. Therefore, further research is needed regarding the dose and time of treatment so that it is safe enough for eliminating microbes.
The rise of mucormycosis in Covid-19 patients in India
Published in Expert Review of Anti-infective Therapy, 2022
The health-care system in India has been unable to cope with the onslaught of wave 2 Covid-19 pandemic. At its peak in early May 2021, over 400,000 cases of Covid-19 were being reported on a daily basis [1], and India found itself unprepared with acute shortage of drugs, vaccines, ventilators, and oxygen [2]. Although Covid cases are currently getting under control, India is now facing a public health emergency of mucormycosis, commonly labeled as ‘black fungus,’ a rare but potentially fatal fungal infection. Mucormycosis is caused by the mucormycetes, a group of molds, with Rhizopus and Mucor as the most common species [3]. As announced by Mr Harsh Vardhan, the former Health Minister of India, there are over 40,000 cases of mucormycosis reported as of 28 June 2021 [4]. Mucormycosis has been declared an epidemic in several Indian states and has been classified as a notifiable disease. Early diagnosis and prompt initiation of treatment is crucial as the condition can progress rapidly with fatal outcome. The treatment for this condition is based on a combination of antifungal medication and aggressive surgical debridement of necrotic tissue if necessary. The recommended anti-fungal drug is Liposomal Amphotericin B on a dose of 5 mg/kg/day. However, acute shortage of Amphotericin B on the one hand and its prohibitive cost to patients and their families on the other is a major challenge.
Development of purified cashew gum mucoadhesive buccal tablets containing nystatin for treatment of oral candidiasis
Published in Drug Development and Industrial Pharmacy, 2021
Ana Paula de Sá Pinto Abrahão Magalhães, Helena Keiko Toma, Flávia Almada do Carmo, Claudia Regina Elias Mansur
Topical antifungals are first choice drugs for the treatment of oral candidiasis. Locally administered antifungals offer the advantage of reducing systemic exposure, which results in fewer adverse drug reactions or interactions. In the case of the mouth, the cleaning action and dilutive effect of saliva often tends to reduce the availability of antifungals, by decreasing their concentration below what is necessary for the therapeutic effect. Therefore, the administration of the antifungal medication is required four to six times a day, making the patient adherence a challenge for the necessary 7–14 days of treatment. In addition, this pathology can progress to chronic disease recurrence and also to systemic conditions when it is not treated correctly [5–7]. Therefore, the development of a formulation that increases the contact of drug in the oral cavity can lead to an increase in its availability and therapeutic action, improving patient compliance, decreasing the recurrence of infection and microbial resistance, and consequently chronic and systemic cases.