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fluconazole AND prednisolone

Hiroaki Nishioka, Hiroshi Takegawa, Hiroki Kamei
Infections occur more frequently in patients receiving biologics. However, cryptococcal infection is uncommon in patients receiving tocilizumab, an interleukin-6 inhibitor, in contrast to patients receiving tumor necrosis factor-α inhibitors. In this report, we describe a case of disseminated cryptococcosis in a 55-year-old man who was receiving tocilizumab every 2 weeks along with daily prednisolone and cyclosporine for Castleman's disease. He initially developed cellulitis on both upper limbs, and his condition worsened despite antibacterial therapy...
February 2018: Journal of Infection and Chemotherapy: Official Journal of the Japan Society of Chemotherapy
Jens Kristian Pedersen, Magnus Christian Lydolph, Finn Somnier, Peter Junker
A 69-year-old female was admitted due to progressive loss of muscle strength following addition of fluconazole to long-term simvastatin treatment. Rhabdomyolysis was suspected and both drugs were discontinued. Forced diuresis was initiated together with a short course of prednisolone. After 21 weeks the patient had regained normal muscle strength and endurance. The favourable course and the absence of antibodies against 3-hydroxy-3-methylglutaryl-coenzyme A reductase suggest that the condition was due to interaction between the two drugs, which are both metabolized via the CYP3A4 pathway...
September 26, 2016: Ugeskrift for Laeger
Herry Mapesi, Adrià Ramírez, Marcel Tanner, Christoph Hatz, Emilio Letang
BACKGROUND: Immune reconstitution inflammatory syndrome associated with dermatophytoses (tinea-IRIS) may cause considerable morbidity. Yet, it has been scarcely reported and is rarely considered in the differential diagnosis of HIV associated cutaneous lesions in Africa. If identified, it responds well to antifungals combined with steroids. We present two cases of suspected tinea-immune reconstitution inflammatory syndrome from a large HIV clinic in rural Tanzania. CASES PRESENTATION: A first case was a 33 years-old female newly diagnosed HIV patient with CD4 count of 4 cells/μL (0 %), normal complete blood count, liver and renal function tests was started on co-formulated tenofovir/emtricitabine/efavirenz and prophylactic cotrimoxazole...
September 20, 2016: BMC Infectious Diseases
Le Wang, Chong Wang, Huan Mei, Yongnian Shen, Guixia Lv, Rong Zeng, Ping Zhan, Dongmei Li, Weida Liu
Mouse model is an appropriate tool for pathogenic determination and study of host defenses during the fungal infection. Here, we established a mouse model of candidiasis with concurrent oral and vaginal mucosal infection. Two C. albicans strains sourced from clinical candidemia (SC5314) and mucosal infection (ATCC62342) were tested in ICR mice. The different combinational panels covering estrogen and immunosuppressive agents, cortisone, prednisolone and cyclophosphamide were used for concurrent oral and vaginal candidiasis establishment...
February 2016: Mycopathologia
Maartje S Gordijn, Niki Rensen, Reinoud J B J Gemke, Elvira C van Dalen, Joost Rotteveel, Gertjan J L Kaspers
BACKGROUND: Glucocorticoids play a major role in the treatment of acute lymphoblastic leukaemia (ALL). However, supraphysiological doses can suppress the hypothalamic-pituitary-adrenal (HPA) axis. HPA axis suppression resulting in reduced cortisol response may cause an impaired stress response and an inadequate host defence against infections, which remains a cause of morbidity and death. Suppression commonly occurs in the first days after cessation of glucocorticoid therapy, but the exact duration is unclear...
August 17, 2015: Cochrane Database of Systematic Reviews
Yo Ueda, Kei Yamamoto, Koji Watanabe, Hiroyuki Yamashita, Norio Ohmagari, Akio Mimori
We herein report on a 69-year-old male who developed lung nocardiosis and brain abscessation. In April 2011, he was diagnosed as having systemic lupus erythematosus complicated by peripheral neuropathy. Immunosuppressive therapy with high-dose prednisolone was begun. In November 2011, he developed cryptococcal pneumonia and meningitis, which was treated with liposomal amphotericin and flucytosine for 4 weeks and was maintained with fluconazole. In April 2012, consolidation and peripheral atelectasis in the right middle lobe appeared...
May 2014: Kansenshōgaku Zasshi. the Journal of the Japanese Association for Infectious Diseases
Takaharu Ikeda, Chikako Kaminaka, Yuki Yamamoto, Fukumi Furukawa
We report the case of a 68-year-old woman with autoimmune hepatitis (AIH) who had leg ulcers induced by disseminated cryptococcosis. She had received prednisolone for her AIH at 20 mg/day for maintenance. On the initial visit, she complained of a painful ulcer that had round, shallow pockets with erythema and erythematous subcutaneous indurations on the right thigh. Several metacarpophalangeal joints and wrist joints were swollen, with tenderness and stiffness in the morning for over 3 h. Her serum rheumatoid factor was high...
January 2014: Case Reports in Dermatology
Kazeem A Oshikoya, Ibrahim A Oreagba, Saheed Lawal, Olufunsho Awodele, Olayinka O Ogunleye, Idowu O Senbanjo, Sunday O Olayemi, Veronica C Ezeaka, Edamisan O Temiye, Titilope A Adeyemo, Oluranti Opanuga, Olufunmilayo A Lesi, Sulaimon A Akanmu
BACKGROUND: Multi-therapy is common in HIV-infected children, and the risk for clinically significant drug interactions (CSDIs) is high. We investigated the prevalence of CSDIs between antiretroviral (ARV) and co-prescribed drugs for children attending a large HIV clinic in Lagos, Nigeria. METHODS: The case files of pediatric patients receiving treatment at the HIV clinic of the Lagos University Teaching Hospital (LUTH), Idi-Araba, between January 2005 and December 2010 were reviewed...
2014: HIV/AIDS: Research and Palliative Care
Alexandra Goe, Julie Swenson, Gary West, Jason Evans
An 8-yr-old male buff-cheeked gibbon (Nomascus gabriellae) acutely developed abnormal behavior, decreased appetite, and dull mentation. Mild generalized muscle wasting and weight loss were the only other abnormalities noted on examination. Routine immunodiffusion serology for Coccidioides spp. were IgG and IgM positive. Magnetic resonance imaging of the brain was suggestive of an infectious meningoencephalitis with secondary obstructive hydrocephalus. A ventriculoperitoneal shunt was placed in standard fashion to reduce the imminent risk of mortality from increased intracranial pressure...
September 2013: Journal of Zoo and Wildlife Medicine: Official Publication of the American Association of Zoo Veterinarians
Yoshiyuki Kuwae, Yumi Ogawa, Takashi Yoshiike, Reiko Ikeda, Takashi Sugita
 In April 2012 an 88-year-old woman, who was receiving oral prednisolone (15 mg/day) for the treatment of chronic inflammatory demyelinating polyneuropathy, was admitted to our hospital with suspected pneumonia. The patient was diagnosed with pulmonary cryptococcosis based on the findings from chest radiography and computed of tomographic imaging and observation of a high cryptococcal antigen titer. The general condition of the patient, including her fever, improved after initiation of an intravenous infusion of fluconazole (200 mg/day)...
2013: Medical Mycology Journal
Kentaro Ninomiya, Naho Maruyama, Shigeharu Inoue, Hiroko Ishibashi, Toshio Takizawa, Haruyuki Oshima, Shigeru Abe
The therapeutic efficacy of tea tree oil (TTO), Melaleuca alternifolia, and its main component, terpinen-4-ol, were evaluated in a murine oral candidiasis model. Prednisolone -pretreated mice were orally infected with a fluconazole-susceptible (TIMM 2640) or a resistant (TIMM 3163) strain of Candida albicans to induce oral candidiasis. TTO or terpinen-4-ol was administrated with a cotton swab 3 h and 24 h after candida infection. These treatments clearly showed a decrease in the symptom score of tongues and in the viable candida cell number in the oral cavity at 2 d after azole-susceptible C...
2012: Biological & Pharmaceutical Bulletin
Maartje S Gordijn, Reinoud Jbj Gemke, Elvira C van Dalen, Joost Rotteveel, Gertjan Jl Kaspers
BACKGROUND: Glucocorticoids play a major role in the treatment of acute lymphoblastic leukaemia (ALL). However, supraphysiological doses may cause suppression of the hypothalamic-pituitary-adrenal (HPA) axis. HPA axis suppression resulting in reduced cortisol response may cause an impaired stress response and an inadequate host defence against infections, which remains a cause of morbidity and death. The exact occurrence and duration of HPA axis suppression after glucocorticoid therapy for childhood ALL are unclear...
2012: Cochrane Database of Systematic Reviews
Luís Figueira, Dolores Pinheiro, Raul Moreira, Eugénia Pinto, Joana Simões, Elisa Camisa, Luís Torrão, Jorge Palmares, Fernando Falcão-Reis
PURPOSE: Beauveria bassiana is a ubiquitous fungus available as an insecticide. In humans, it has limited virulence; to our knowledge, only 3 cases of invasive disease and 10 cases of keratitis have been documented. METHODS AND RESULTS: We report the first case of B bassiana keratitis in a patient with aphakic bullous keratopathy. The fungal keratitis proved to be highly resistant to topical clotrimazole. Molecular identification was based on DNA sequence analysis...
September 2012: European Journal of Ophthalmology
Meral Karaman, Müge Kiray, Vahide Bayrakal, H Alper Bağrıyanık, Osman Yılmaz, I Hakkı Bahar
Oral candidiasis which is the most common type of Candida infections affecting humans, is most frequently caused by C.albicans. Immune response of the host, as well as a variety of virulence factors of the causative agent, play important roles in the development of Candida infections. The colonization rate of Candida in the oral cavity of healthy individuals, is between 25-30%, however, this rate is reported to be increased in immunosuppressive subjects. In our study, we established an oral candidiasis model with C...
April 2011: Mikrobiyoloji Bülteni
Yuji Hirai, Yusuke Ainoda, Takayo Shoji, Takahiro Fujita, Kentaro Yoshinaga, Masayuki Shiseki, Naoki Mori, Masanao Teramura, Kyoichi Totsuka, Toshiko Motoji
Rituximab-related late-onset neutropenia (R-LON) is an adverse event associated with rituximab. A 65-year-old woman presented with diffuse large B-cell lymphoma of the kidney without bone marrow involvement. She was treated with 4 cycles of CHOP chemotherapy consisting of doxorubicin, cyclophosphamide, vincristine, and prednisolone at 4-week intervals. Rituximab was also administrated of the second, third, fourth CHOP cycles. She developed a high fever of 38°C, nausea, and severe neutropenia following the four cycles of R-CHOP chemotherapy...
September 2011: Mycopathologia
Aiko Masunaga, Kozo Morimoto, Tunehiro Ando, Soichiro Ikushima, Tamiko Takemura, Masaru Oritsu
We report 3 cases of allergic bronchopulmonary mycosis (ABPM) due to Schizophyllum commune. The first patient, an 82-year-old woman, presented with atelectasis of the left upper lobe with mucoid impaction due to Schizophyllum commune. The second patient, a 53-year-old woman, presented with atelectasis of the right middle lobe with mucoid impaction due to Schizophyllum commune. The last patient, a 49-year-old woman, underwent a left lingular lobectomy with a diagnosis of lung abscess, but the diagnosis was retrospectively changed to ABPM in a later review of the findings of the surgical specimens...
December 2010: Nihon Kokyūki Gakkai Zasshi, the Journal of the Japanese Respiratory Society
Masami Matsumura, Rika Kawamura, Ryo Inoue, Kazunori Yamada, Mitsuhiro Kawano, Masakazu Yamagishi
Cryptococcal meningitis is a recognized complication of systemic lupus erythematosus (SLE), with high mortality rates, particularly in those treated with immunosuppressive agents. We describe a patient diagnosed simultaneously with cryptococcal meningoencephalitis and SLE and reviewed four similar cases reported in the literature. In our case, profound low CD4 lymphocyte count and low complement levels were observed. The patient was treated with prednisolone, fluconazole, and 5-flucytosine and evinced good clinical improvement...
June 2011: Modern Rheumatology
Elizabeth Dodds-Ashley
Azole antifungal agents are frequently used in hematopoietic stem cell and solid organ transplant recipients for prevention or treatment of invasive fungal infections. However, because of metabolism by or substrate activity for various isoenzymes of the cytochrome P450 system and/or P-glycoprotein, azole antifungals have the potential to interact with many of the drugs commonly used in these patient populations. Thus, to identify drug interactions that may result between azole antifungals and other drugs, we conducted a literature search of the MEDLINE database (1966-December 2009) for English-language articles on drug interaction studies involving the azole antifungal agents fluconazole, itraconazole, voriconazole, and posaconazole...
August 2010: Pharmacotherapy
Zui-Sheng Hung, Yu-Hsien Lai, Yung-Hsiang Hsu, Chih-Hsien Wang, Te-Chao Fang, Bang-Gee Hsu
Disseminated cryptococcosis infection occurs mainly in the immunocompromised host. There are only a few reports describing disseminated cryptococcosis in immunocompetent patients. Here, we describe the case of a 46-year-old healthy man who presented with primary adrenal insufficiency with hyponatremia, hyperkalemia and skin pigmentation. Contrast-enhanced adrenal computed tomography (CT) revealed bilaterally enlarged adrenal glands without enhancement. CT-guided percutaneous adrenal gland biopsy showed caseous-like necrosis and embedded cryptococcosis...
2010: Internal Medicine
Kyle Tofflemire, Caroline Betbeze
OBJECTIVE: To describe clinical and diagnostic features of ocular coccidioidomycosis in cats and the response to fluconazole and anti-inflammatory therapy. ANIMALS STUDIED: Three cats with naturally acquired coccidioidomycosis. PROCEDURE: Cats were treated with topical or systemic corticosteroids and systemic fluconazole, an antifungal of unproven efficacy against feline ocular coccidioidomycosis. RESULTS: Two cats presented for periocular swellings, either subpalpebral or periorbital, with systemic signs including weight loss, unkempt hair coat, and lethargy...
May 2010: Veterinary Ophthalmology
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