Infecciones por Fusarium

AbstractFusarium species are primarily plant pathogens that occasionally cause human disease. Several members of this genus of molds have caused widespread destruction of food crops. Fusarium species are found primarily in soli and on decaying vegetable matter, but also occur in water. Localized infections, such as keratitis, sinusitis, and skin and nail infections, occur in immunocompetent persons. However, invasive sinusitis and pulmonary infection, as well as widespread dissemination, are the rule in markedly immunosuppressed patients, especially those who are profoundly neutropenic. The acute onset of painful skin lesions and the growth of a mold in blood cultures are clues to disseminated fusariosis in immunosuppressed patients. The organism grows readily in the laboratory, but identification to the species level is difficult. Biopsy of infected tissues shows acutely branching septate hyphae that are often indistinguishable from those of Aspergillus species. Localized lesions respond reasonably well to antifungal agents and surgical excision. Invasive pulmonary and disseminated infection respond poorly to antifungal therapy, in part because of the resistance of most species to many antifungal agents, but more importantly, to the absence of an effective host response. Most patients who have disseminated or invasive pulmonary infection are treated with a combination of voriconazole and a lipid formulation of amphotericin B, with the hope that at least one drug may have activity against the organism, and perhaps better killing can be achieved using two drugs. Unfortunately, patients who have disseminated fusariosis and who remain neutropenic rarely survive the infection, regardless of the therapy used

Deep Fungal Infections in the Elderly

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/111183/1/j.1532-5415.1988.tb04028.x.pd

Colorimetric method for susceptibility testing of voriconazole and other triazoles against Candida species

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/72523/1/j.1439-0507.1999.00511.x.pd

Protein Malnutrition and the Febrile Response in the Fischer Rat

We assessed the effect of protein deprivation on the ability of peritoneal macrophages from Fischer rats to produce interieukin‐1 (IL‐1) after in vitro stimulation. Pyrogenic activity of supernatants was measured by an in vivo febrile response assay. Control rats were given a 23% casein diet and protein‐malnourished rats were given an 8% casein diet for 4 weeks. IL‐1‐containing supernatants prepared from peritoneal macrophages were injected into assay rats, whose temperatures were measured for 6 hours (δT6). Rats injected with IL‐1‐containing supernatants derived from peritoneal macrophage cultures of protein‐deprived rats had significantly less fever (δT6 = 0.20 ± 0.09°) than rats injected with IL‐1 containing supernatants derived from peritoneal macrophage cultures of control rats (δT6 = 0.56 ± 0.09°), P < .01. Protein malnutrition leads to diminished pyrogenicity of macrophage culture supernatants and may be at least partly responsible for the decreased febrile response seen in the malnourished animals.Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/142038/1/jlb0036.pd

Cell-mediated immunity in ferrets delayed dermal hypersensitivity, lymphocyte transformation, and macrophage migration inhibitory factor production

Cell-mediated immune reactions -- delayed dermal hypersensitivity, lymphocyte transformation, and macrophage migration inhibitory factor production -- were investigated in the ferret. Ferrets immunized with streptokinase in complete Freund's adjuvant had skin test responses characterized by induration with little erythema; skin test biopsies showed mononuclear cell infiltration. In vitro transformation of peripheral blood or splenic lymphocytes was elicited by phytohemagglutinin, concanavalin A, pokeweed mitogen, and streptokinase; macrophage migration inhibitory factor was produced by spleen cells from immunized ferrets. These studies confirm the usefulness of certain tests of cell-mediated immunity in ferrets.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/24515/1/0000793.pd

Endogenous pyrogen/interleukin-1 production in aged rats

The effect of aging on the ability of macrophages to produce endogenous pyrogen/interleukin-1 (EP/IL-1) was tested in 13 young adult (2-3 mo) and 13 aged (24-26 mo) Fischer rats using a febrile response assay. Peritoneal macrophages from aged rats produced EP/IL-1 as well as young adult rats. Decreased production of EP/IL-1 does not appear to explain the diminished febrile response seen in the elderly.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/26340/1/0000427.pd

Susceptibility of Yeast-Like Fungi to a New Antifungal Agent, LY 121019

LY 121019, a new antifungal antibiotic agent, was tested for activity against 200 clinical isolates of Candida and other yeast-like fungi. LY 121019 had its greatest inhibitory effect on C. albicans , and C. tropicalis. C. glabrata and most other Candida species were not as sensitive. Cryptococcus and other yeast-like fungi, with the exception of a few strains, were not susceptible to LY 121019. Zusammenfassung :  LY 121019, ein neues Antimyzetikum, wurde auf seine AktivitÄt gegen 200 klinische Isolate von Candida und anderen, hefeÄhnlichen Pilzen untersucht. LY 121019 hat seine grÖßte Hemmwirkung gegen C. albicans und C. tropicalis. C. glabrata und die meisten anderen Candida -Arten waren nicht so empfindlich. Cryptococcus und andere, hefeÄhnliche Pilze waren, mit Ausnahme weniger StÄmme, nicht fÜr LY 121019 empfindlich.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/73892/1/j.1439-0507.1988.tb04426.x.pd

Fever of Unknown Origin in the Elderly: Lymphoma Presenting as Vertebral Compression Fractures

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/111209/1/j.1532-5415.1994.tb06080.x.pd

Opportunistic Infections in Patients with Temporal Arteritis Treated with Corticosteroids

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/111238/1/j.1532-5415.1997.tb00949.x.pd

Introduction of a Waterless Alcohol-based Hand Rub in a Long-term Care Facility

OBJECTIVE: To examine the impact of introduction of an alcohol-based hand rub on hand hygiene knowledge and compliance and hand colonization of healthcare workers (HCWs) in a long-term-care facility (LTCF). METHODS: Two floors of an LTCF participated. Ward A used the hand rub as an adjunct to soap and water; ward B was the control. HCWs\u27 hands were cultured using the bag-broth technique for Staphylococcus aureus, gram-negative bacilli (GNB), Candida, and vancomycin-resistant enterococci (VRE). HCWs completed a questionnaire at baseline and after an educational intervention and introduction of rub. RESULTS: Hand hygiene practices, knowledge, and opinions did not change after the educational or rub intervention. Ward A HCWs thought that the rub was faster (P = .002) and less drying (P = .04) than soap. Hand hygiene frequency did not differ at baseline between the two floors, but increased on ward A by the end of the study (P = .04). HCWs were colonized frequently with GNB (66%), Candida (41%), S. aureus (20%), and VRE (9%). Although colonization did not change from baseline on either ward, the rub was more effective in clearing GNB P =.03) and S. aureus (P = .003). Nosocomial infection rates did not change. CONCLUSION: The alcohol-based hand rub was a faster, more convenient, less drying method of hand hygiene for HCWs in an LTCF, and it improved compliance. Although microbial colonization did not change, the rub was more efficacious in removing pathogens already present on the hands of HCWs