Chemotherapy of Fungal Diseases

Chemotherapy of Fungal Diseases
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There are three forms of coccidioidomycosis: acute, chronic, or disseminated. Acute is almost always mild, with few or no symptoms, and goes away without treatment.

Bibliographic Information

The incubation period -- the time between breathing in the spores and becoming sick -is 7 to 21 days. Chronic can develop 20 or more years after initial infection. Infections lung abscesses can form and rupture, releasing pus emphysema between the lungs and ribs pleural space. Disseminated coccidioidomycosis is a widespread form of the disease.

Infection spreads to other parts of the body, including the skin, brain, bones, and heart.

Chemotherapy of infectious diseases

Meningitis occurs in up to half of all people with disseminated coccidioidomycosis. Travelling to an area where the fungus is commonly seen raises the risk for this infection. Most people with this infection never have symptoms. Others may have cold- or flu-like symptoms or symptoms of pneumonia. If symptoms occur, they typically start 5 to 21 days after being exposed to the fungus. They include change in mental status, chest pain can vary from mild to severe cough, possibly producing blood, fever, headache, joint pain, loss of appetite, muscle aches, neck stiffness, etc. Histoplasmosis Histoplasmosis is an infection due to the Histoplasma capsulatum fungus.

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The infection enters the body through the lungs. Histoplasma fungus grows as a mold in the soil, and infection results from breathing in airborne particles. Soil contaminated with bird or bat droppings may have a higher concentration of histoplasma.

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There may be a short period of active infection, or it can become chronic and spread throughout the body. Histoplasmosis may have no symptoms. Most people who do develop symptoms will have a flu-like syndrome and lung pulmonary complaints related to pneumonia or other lung involvement.

Invasive Fungal Infections: Overcoming Management Challenges

Those with chronic lung disease such as emphysema and bronchiectasis are at higher risk of a more severe infection. People with histoplasmosis may develop inflammation irritation and swelling in response to the initial infection. This can affect the skin, bones or joints, or the lining of the heart pericardium. These symptoms are not due to fungal infection of those body parts, but to the inflammation.

Antifungal chemotherapy.

In a small number of patients, histoplasmosis may become widespread disseminated , and involve the blood, meninges outer covering of the brain , adrenal glands, and other organs. Symptoms depend on the type of infection.

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Fungal diseases have been with us from antiquity; interest in the chemo To plan and pro duce a book on the topic of antifungal chemotherapy has come as a . Antifungal chemotherapy has improved over the past several decades, first with the Disseminated Fungal Infections Reported with TNF Inhibitor Therapy.

Acute symptomatic pulmonary histoplasmosis: fever, chills, cough, chest pain, etc. Systemic mycoses due to opportunistic pathogens are infections of patients with immune deficiencies who would otherwise not be infected. Examples of opportunistic mycoses include Candidiasis, Cryptococcosis and Aspergillosis. Candidiasis Candidiasis or thrush is a fungal infection of any of the Candida species all yeasts , of which Candida albicans is the most common.

Also commonly referred to as a yeast. Candidiasis encompasses infections that range from superficial, such as oral thrush and vaginitis, to systemic and potentially life-threatening diseases. Candida infections of the latter category are also referred to as candidemia. Superficial infections of skin and mucosal membranes by Candida causing local inflammation and discomfort are common in many human populations.

Background

Candidiasis is usually a very localized infection of the skin or mucosal membranes, including the oral cavity thrush , the pharynx or oesophagus, the gastrointestinal tract, the urinary bladder, or the genitalia vagina, penis. Candidiasis is a very common cause of or vaginitis.

Candida infections can affect the oesophagus with the potential of becoming systemic, causing a much more serious condition, a fungemia called candidemia. In children it is normally seen around the mouth as white patches.

Introduction

Thus, the full clinical impact of this now ubiquitously employed modality on invasive fungal infections is unclear. Aspergillus terreus during hospital renovation. Table 5 Treatment of rare fungal infections in hemato-oncological patients. Scedosporium infection in immunocompromised patients: successful use of liposomal amphotericin B and itraconazole. Indwelling central venous catheters are tubes placed in a vein in the neck, groin or chest that remain in place for some time. Drink cool fluids every hour to prevent dehydration. Comparison of caspofungin and amphotericin B for invasive candidiasis.

Symptoms of Candidiasis may vary depending on the area affected. Symptoms of infection of the male genitalia include red patchy sores near the head of the penis or on the foreskin, severe itching, or a burning sensation. Candidiasis of the penis can also have a white discharge, although uncommon.

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Cryptococcosis Cryptococcosis, or cryptococcal disease, is a potentially fatal fungal disease. It is caused by one of two species; Cryptococcus neoformans and Cryptococcus gattii. Cryptococcosis is believed to be acquired by inhalation of the infectious propagule from the environment. The infection is due to the basidiospore created through sexual or asexual reproduction. Cryptococcosis is a defining opportunistic infection for AIDS. In humans, C.

Symptoms include fever, fatigue, chest pain, dry cough, swelling of abdomen, headache, blurred vision and confusion. Pulmonary Aspergillosis The spectrum of pulmonary disease ranges from noninvasive disease, such as with colonization of the organism or the presence of a fungus ball aspergilloma , or an allergic response responsible for the syndrome of allergic bronchopulmonary aspergillosis ABPA , to semi-invasive or invasive infections such as chronic necrotizing pneumonia and invasive pulmonary aspergillosis. Aspergillus species enter the host most commonly through the lungs by the inhalation of conidia.

The conidia resting in alveoli begin to enlarge and germinate. Hyphal transformation with vascular Invasion and dissemination of infection are potential sequela. Various types of Aspergillus species are: A. Niger, A. Although infection with Aspergillus has been reported involving virtually all organ sites, the upper airways, lungs, and surrounding structures are those most frequently involved.

A careful history should be taken in those at risk for IPA given their frequent inability to mount an immunologic response and thus lack of a febrile response. The symptoms of haemoptysis and pleuritic chest pain serve as a reminder to the angioinvasive nature of aspergillosis. Rhinocerebral mucormycosis Rhinocerebral mucormycosis is an opportunistic but fulminant fungal infection, Caused by Rhizopus species, order Mucorales. The fungus directly invades blood vessels.

It propagates by Arterial thrombosis causing ischemic necrosis of the surrounding tissue. The disease begins in the nasal cavity and then spreads to adjacent areas like parnasal sinuses, orbit and brain to produce life threatening, Orbito- cerebral manifestations. The Rhinoorbitocerebral mucormycosis is known to exist in two forms, the wellknown acute form and the less well-recognized chronic form. Acute Rhinocerebral mucormycosis is an opportunistic but fulminant fungal infection.

Chronic or indolent variety of Mucormycosis is a slowly progressive disease characterized by granulomatous chronic infection that extends beyond the sinus walls. Polyenes benzofuran Azoles ketokonazole lotrimazole miconazole fluconazole oriconazole traconazole osaconazole antimetabolites echinocandins. An antifungal agent is a drug that selectively eliminates fungal pathogens from a host with minimal toxicity to the host. These are the drugs that are used to treat mycoses.

Different classes of drugs are included in this that target various sites in the fungal cell such as the plasma membrane, sterol biosynthesis, DNA biosynthesis, and glucan biosynthesis. Fungi make -glucan, so drugs that target -glucan biosynthesis have low sideeffects. Until two to three decades ago, only a few drugs were available for the treatment of fungal infections.