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Direct Microscopy (direct + microscopy)
Selected AbstractsEfficacy and safety of a new single-dose terbinafine 1% formulation in patients with tinea pedis (athlete's foot): a randomized, double-blind, placebo-controlled studyJOURNAL OF THE EUROPEAN ACADEMY OF DERMATOLOGY & VENEREOLOGY, Issue 10 2006JP Ortonne Abstract Background, Tinea pedis is a common dermatophyte infection with frequent recurrences. Terbinafine (presently used as a 1-week topical treatment of tinea pedis) is now available in a novel topical solution (film-forming solution , FFS), developed to allow single application. Objectives, To demonstrate the efficacy and safety of terbinafine 1% FFS in a randomized, double-blind, placebo-controlled, phase III trial, and to determine relapse or re-infection rate of tinea pedis at 12 weeks. Patients/methods, Fifty-four centres (27 in France; 27 in Germany) enrolled 273 evaluable patients (2 : 1 randomization). Patients applied terbinafine 1% FFS or placebo only once between, under and over the toes, soles and sides of both feet. Efficacy assessments included direct microscopy, mycological culture, and clinical signs and symptoms at baseline, and at weeks 1, 6 and 12 after the single drug application. Results, Effective treatment (negative mycology plus absent/minimal symptoms) at week 6 in the terbinafine 1% FFS group was 63%; vehicle was 17% (P 0.0001). Mycological cure was 72% in the terbinafine group and 21% in the placebo (P 0.0001) at week 6. Clinical signs/symptoms decreased significantly in the active group compared to the placebo. The self-assessment of itching and burning sensation by the patient showed a clear reduction in symptoms starting 15 min after treatment application (this could be attributed to the cooling effect of the FFS). Recurrence (positive culture at 3 months) occurred in 12.5% of the effectively treated patients at week 6 in the terbinafine group. FFS was well tolerated. Conclusion, Terbinafine 1% FFS, single dose application is an effective, safe and convenient treatment for tinea pedis. The relapse/re-infection rate 3 months after the end of single-dose therapy is similar to that previously demonstrated in a study using terbinafine 1% cream for 7 days. [source] Efficacy of Ronidazole for Treatment of Feline Tritrichomonas foetus InfectionJOURNAL OF VETERINARY INTERNAL MEDICINE, Issue 3 2006Jody L. Gookin Objectives: To determine the efficacy of ronidazole (RDZ), tinidazole (TDZ), and metronidazole (MDZ) against Tritrichomonas foetus in vitro and of RDZ for treatment of feline naturally occurring or experimentally induced T foetus infection. Animals: A cat naturally infected with T foetus infection and diarrhea. Ten specific-pathogen-free (SPF) kittens. Procedure: RDZ, TDZ, and MDZ were tested for activity against 3 different feline isolates of T foetus in vitro. RDZ then was administered to a naturally infected cat at 10 mg/kg PO q24h for 10 days. SPF kittens were infected orogastrically with feline T foetus and treated with either placebo or RDZ (10 mg/kg PO q12h for 14 days). Cats with relapsing infection or those receiving placebo were treated subsequently with RDZ (either 30 or 50 mg/kg PO q12h for 14 days). Feces were examined for T foetus by direct microscopy, culture, and polymerase chain reaction (PCR) testing weekly. Results: Both RDZ and TDZ killed T foetus at concentrations >0.1 ,g/mL in vitro. In the naturally infected cat, RDZ abolished diarrhea and T foetus infection for 85 days after treatment, at which time infection and diarrhea relapsed. Retreatment with RDZ eradicated diarrhea and T foetus infection for over 407 days. In experimentally induced infection, RDZ at 10 mg/kg caused initial improvement, but infection relapsed in all 5 cats 2 to 20 weeks after treatment. At 30 or 50 mg/kg, 10/10 cats were negative for T foetus infection for follow-up durations of 21 to 30 weeks after treatment. Conclusions and Clinical Relevance: Oral administration of RDZ at 30 to 50 mg/kg q12h for 14 days resolved diarrhea and eradicated infection (on the basis of polymerase chain reaction [PCR] testing) in 1 naturally infected cat and 10 experimentally inoculated cats receiving a different isolate of T foetus. [source] Nuclear factor-,B inhibition improves myocardial contractility in rats with cirrhotic cardiomyopathyLIVER INTERNATIONAL, Issue 5 2008Hongqun Liu Abstract Background/Aims: Cytokines such as tumour necrosis factor (TNF-,) contribute to the pathogenesis of cirrhotic cardiomyopathy. Nuclear factor-,B (NF-,B) is crucial for cytokine regulation, and induces cardiac dysfunction in several heart disease models. We aimed to elucidate possible NF-,B involvement in cirrhotic cardiomyopathy. Methods: Rats were bile duct ligated (BDL) to produce cirrhosis; controls received sham operation. Animals were studied 4 weeks later. Two NF-,B inhibitors were used: pyrrolidine dithiocarbamate (PDTC) and Bay 11-7082. Four groups were studied in most protocols: sham control, sham+PDTC, BDL and BDL+PDTC. Additional contractility studies were performed with Bay 11-7082. Myocardial NF-,B and TNF-, expression was measured by Western blot and ELISA. The contractility of isolated cardiomyocytes was observed under direct microscopy. Results: Nuclear factor-,B and TNF-, levels were increased in cirrhotic hearts compared with controls. PDTC significantly reduced NF-,B activity and TNF-, expression in cirrhotic hearts; controls were unaffected. Cirrhotic cardiomyocytes showed decreased systolic and diatolic velocity compared with sham controls. Both PDTC and Bay 11-7082 restored contractile function in cirrhotic cardiomyocytes, but did not affect controls. Conclusions: Inhibition of the increased NF-,B activity in cirrhotic hearts was associated with improvement of attenuated cardiomyocyte contractility. NF-,B, via effects on cytokine expression, may contribute to the pathogenesis of cirrhotic cardiomyopathy. [source] Pneumocystis jiroveci thyroiditis: report of 15 cases in the literatureMYCOSES, Issue 6 2007Alexandre P. Zavascki Summary The authors review the epidemiology, clinical manifestations, diagnosis and treatment of Pneumocystis jiroveci thyroiditis of 15 cases reported in the medical literature. Patients with acquired immunodeficiency disease syndrome were particularly at risk. P. jiroveci thyroiditis was diagnosed at autopsy as a part of disseminated infection in a substantial number of patients without clinical manifestations and laboratory evidence of thyroid dysfunction. Local signs and symptoms of infection were indistinguishable from other infectious thyroiditis and included neck enlargement with or without cervical pain, sometimes associated with dysphagia and dysphonia, and clinical and laboratory features of hypothyroidism. Antemortem diagnosis of fungal thyroiditis was made by direct microscopy and culture of a fine-needle aspirate in most cases. As most patients with P. jiroveci thyroiditis had disseminated Pneumocystis infection with a delay in diagnosis and treatment, the overall mortality was high. Pneumocystis jiroveci thyroiditis is rare but should be suspected in HIV-infected patients with CD4 count lower than 200 cells ,,1 on prophylatic inhalatory pentamidine who present with neck enlargement with or without pain, and clinical and laboratory evidence of hypothyroidism. [source] Zygomycosis , a case report and overview of the disease in IndiaMYCOSES, Issue 4 2007Amit Diwakar Summary A case of zygomycosis caused by Rhizopus oryzae in a diabetic patient previously misdiagnosed as invasive pulmonary aspergillosis and an overview of the disease in India are presented. The case was diagnosed by direct microscopy, histopathologic examination and culture. Following surgical resection of pulmonary cavity under cover of amphotericin B administration, the patient recovered completely. Of 461 cases reported to-date, approximately 70% had been diagnosed at the Postgraduate Institute of Medical Education and Research, Chandigarh, in north India. This may be attributed to better awareness, expertise and infrastructural facilities for mycological diagnosis than to any particular regional preponderance of the disease. Rhino-orbito-cerebral manifestations were the most common feature of zygomycosis (269 cases), followed by cutaneous disease (66 cases), which is in conformity with the pattern prevalent worldwide. The etiologic agents encountered were Rhizopus oryzae, Apophysomyces elegans, Saksenaea vasiformis, Cunninghamella bertholletiae, Absidia corymbifera, Basidiobolus ranarum and Conidiobolus coronatus. In contrast to cases from the developed world where transplant recipients and patients with haematological malignancies seem to be most vulnerable to zygomycosis, the most common risk factor in India was uncontrolled diabetes mellitus. Amphotericin B was the mainstay of various treatment modalities employed. The relevance of a strong clinical suspicion and early diagnosis of zygomycosis for favourable prognosis can hardly be over-emphasised. [source] Yeast associated with human infections in south-eastern NigeriaMYCOSES, Issue 6 2006L. N. Abia-Bassey Summary A total of 1921 specimens from nine clinical sources were examined by direct microscopy and culture to recover yeast associated with human infection. Identification of yeast was based on their carbon assimilation patterns, using API 20C AUX and ID 32 C (bioMérieux, France) commercial kits. A total of 178 specimens (9.3%) were positive for yeast. Most of the yeast isolates were recovered from urine samples and genital swabs. Prevalence was significantly higher in women (14.7%) than in men (1.4%) (P < 0.05). The age group 21,30 years recorded the highest prevalence of yeast infection (65.2%) followed by age group 11,20 years (16.9%) and >40 years (9.0%). When genital samples were considered, prevalence was significantly higher in the age group 21,30 years than that in older ones (P < 0.05). Isolates recovered included seven species of Candida and Trichosporon inkin. C. albicans accounted for the highest number of isolates (128) followed by C. tropicalis (23) and C. parapsilosis (9). Two isolates each of C. famata and C. norvegensis were recorded and are reported for the first time in Nigeria. The two isolates of T. inkin were recovered from perianal lesions and are also reported for the first time from Nigeria. C. albicans, C. glabrata, C. parapsilosis and C. krusei were found to be the most common yeast species that act as agents of human disease in south-eastern Nigeria. [source] Two Hundred Ninety-Six Cases of Onychomycosis in Children and Teenagers: A 10-Year Laboratory SurveyPEDIATRIC DERMATOLOGY, Issue 5 2003N. Lateur M.D. Looking at our laboratory figures over a 10-year period provided us with some useful information. Nail keratin samples were taken by dermatologists from 21,557 patients with nail conditions, mainly in the Brussels region. The specimens were examined by direct microscopy and/or histology, and cultured on Sabouraud medium agar. Only patients less than 17 years of age were considered as children. Clinical information was gathered about age, sex, and the location of the infected nail. Nine hundred sixty-three of the samples were from children, and 296 of those children had proven onychomycosis. More than three-fourths of the cases were found in children more than 6 years old, and boys were more frequently affected than girls. Toenails were the predominant location of infection. Trichophyton rubrum was the main pathogen, followed by Candida spp. and Trichophyton interdigitale. One case was caused by Scopulariopsis spp. As in adults, onychomycosis is probably the main nail disease in children. After the age of 6 years, the presentation is very similar to that in adults: toenails are mostly involved, and T. rubrum, the main pathogen, is responsible for distal and lateral subungual onychomycosis. [source] Molecular detection of dermatophytes and nondermatophytes in onychomycosis by nested polymerase chain reaction based on 28S ribosomal RNA gene sequencesBRITISH JOURNAL OF DERMATOLOGY, Issue 5 2009M. Ebihara Summary Background, Onychomycosis is often caused by dermatophytes, but the role of nondermatophytes is underestimated due to the difficulty of identifying them by conventional direct microscopy and culture. Objectives, This study aims to detect nondermatophytes, as well as dermatophytes, in the nail samples of patients with onychomycosis using a polymerase chain reaction (PCR)-based culture-independent method. Materials and methods, The nested PCR assay targeting the sequence of the 28S ribosomal RNA gene was used to amplify fungal DNAs from 50 microscopy-positive nail specimens. Newly designed primer sets for dermatophyte universal, Trichophyton rubrum, T. mentagrophytes, Aspergillus spp., Scopulariopsis brevicaulis, Fusarium solani, F. oxysporum, F. verticillioides, Candida albicans and C. tropicalis were used after confirmation of their specificity. Results, Forty-seven cases (94%) were positive for fungal DNA, among which dermatophytes were detected in 39 cases (83·0%): T. rubrum in 35 cases (74·5%) and T. mentagrophytes in eight cases (17·0%). Surprisingly, nondermatophytes were detected in 18 cases (38·3%), both dermatophytes and nondermatophytes in 10 cases (21·3%) and nondermatophytes alone in eight cases (17·0%). Aspergillus spp. alone was observed in five cases (10·6%). Conclusions, This study indicates that most of the affected nail plates of patients with onychomycosis were positive for specific fungal DNAs, and suggests that nondermatophytes detected at high rates may be involved in the pathogenesis of onychomycosis. [source] A useful tip for direct microscopyBRITISH JOURNAL OF DERMATOLOGY, Issue 2 2007S. Ogden No abstract is available for this article. [source] | ||||||||||