1/22. Therapeutic experience with fluconazole in the treatment of fungal infections in diabetic patients.diabetes mellitus is associated with a higher incidence of certain infections, including fungal infections like rhinocerebral zygomycosis (RCZ) and cutaneous candidosis. As the pathophysiology of increased susceptibility to infection of diabetic patients is very complex, a general therapeutic approach is not existing yet. Appropriate diabetes control remains as the best preventive measure. Nevertheless, effective drug therapy is very often required. fluconazole has proven efficacy in prophylaxis, treatment and suppressive therapy of both systemic and superficial fungal infections, especially in candidosis and cryptococcosis. Therefore it is used routinely against fungal infections in diabetes (FID). Clinical efficacy of fluconazole against cutaneous candidosis, oropharyngeal candidosis (OPC) and vulvovaginal candidosis (VVC) has been confirmed in more than 100 studies, involving more than 10,000 patients (pts). The overall success rate is 90%, with a mean dosage of 100-200 mg/d. In severe cases, e.g. in OPC in late-stage AIDS pts or in recurrent VVC, higher dosages of up to 800 mg/d may be required. In the treatment of RCZ, therapeutic experience with fluconazole is limited. Four diabetic pts have been treated with dosages of 200-300 mg/d and all of them recovered. Nevertheless, treatment of RCZ should include surgical debridement combined with aggressive antifungal therapy. In conclusion, proven efficacy and the excellent safety profile justify the routine use of fluconazole in the treatment of FID.- - - - - - - - - - ranking = 1keywords = vulvovaginal (Clic here for more details about this article) |
2/22. Combined topical flucytosine and amphotericin b for refractory vaginal candida glabrata infections.patients with vaginitis due to highly azole resistant candida glabrata can be particularly difficult to treat. We describe three cases of longstanding vaginal candidiasis due to C glabrata. These had failed to respond to local and systemic antifungals. flucytosine (1 g) and amphotericin b (100 mg) formulated in lubricating jelly base in a total 8 g delivered dose, was used per vagina once daily for 14 days with significant improvement, both clinically and microbiologically.- - - - - - - - - - ranking = 0.020002402949466keywords = vaginitis, candidiasis (Clic here for more details about this article) |
3/22. Antifungal activity against Candida species of the selective serotonin-reuptake inhibitor, sertraline.Three patients with premenstrual dysphoric disorder (PMDD) and recurrent vulvovaginal candidiasis (VVC) underwent sertraline therapy (Tresleen, a selective serotonin-reuptake inhibitor; Pfizer) for PMDD. During sertraline intervention, patients had no recurrent episodes of acute VVC. Antifungal activity was observed for sertraline against various isolates of Candida species.- - - - - - - - - - ranking = 1.0050804209231keywords = vulvovaginal, candidiasis (Clic here for more details about this article) |
4/22. Candida lusitaniae as an unusual cause of recurrent vaginitis and its successful treatment with intravaginal boric acid.Increasing use of short-course antifungal therapies in patients with recurrent vulvovaginitis may enable the emergence of less-common, more resistant yeast strains as vaginal pathogens. We report the case of a patient with chronically symptomatic and repeatedly treated vaginal candidiasis whose infection was attributable to Candida lusitaniae, a previously unreported cause of candidal vaginitis.- - - - - - - - - - ranking = 0.09461231308112keywords = vaginitis, candidiasis (Clic here for more details about this article) |
5/22. Two cases of systemic candida glabrata infection following in vitro fertilization and embryo transfer.Presented here are two cases of systemic candida glabrata infection diagnosed in two expectant mothers and their fetuses at 34 and 22 weeks' gestation. The underlying risk factors in case 1 were in vitro fertilization and embryo transfer, recurrent yeast vaginitis and two intravenous injections of betamethasone. The risk factors in case 2 were in vitro fertilization and embryo transfer, recurrent yeast vaginitis, antibiotics for treatment of a urinary tract infection due to morganella morganii and amniocentesis. In both cases, vaginal fluid yielded growth of a yeast that was not identified. candida glabrata was isolated from samples obtained from the mothers and their babies. Since candida glabrata lacks hyphae, membranitis and infection of the fetuses were demonstrated only on slides stained with Gomori Grocott and periodic acid-Schiff. Both cases suggest that for such pregnancies the follow-up of vaginal fluid should include the identification of any yeasts grown on selective Candida medium. In case of premature rupture of membranes, systematic sampling of mothers and their infants or fetuses should be associated with microscopic study of placentas, membranes and stillborn fetuses with Gomori Grocott and periodic acid-Schiff staining techniques.- - - - - - - - - - ranking = 0.029843964052661keywords = vaginitis (Clic here for more details about this article) |
6/22. Socio-cultural factors affecting the spread of HIV/AIDS in africa: a case study.There is a disproportionate share of AIDS cases over the years in africa. This has occurred in racial and ethnic minority populations, a finding likely related to social, economic and cultural factors. Certain socio-cultural and religious practices such as polygamy and giving a daughter away in marriage without considering the social life of the man are likely contributory factors to the higher prevalence of HIV/AIDS in women in this part of the world. This is illustrated with a case of Mr. M. S. who married two wives within four months interval, having lived a promiscuous life before marriage. One of the wives was a virgin at the time of marriage. Neither of wives had any symptoms suggestive of STD or HIV before marriage, however, the three of them tested positive to hiv-1 following a visit to the special treatment clinic. He had genital herpes and his two wives also had vulvovaginal candidiasis, genital herpes and condyloma accuminata (genital warts). The husband would not want his HIV status declared to the wives. There is therefore a need to enact law on pre-marriage HIV screening for intending couples. Couple Pre-and post-test counseling must be encouraged and promoted. In addition, women should be empowered to negotiate safer sex.- - - - - - - - - - ranking = 1.0050804209231keywords = vulvovaginal, candidiasis (Clic here for more details about this article) |
7/22. Vulvovaginal candidiasis refractory to treatment with fluconazole.We present the case of an infertile patient, whose first attempt at IVF had to be postponed for 18 months due to a vulvovaginal yeast infection refractory to treatment. The main causative organism was a candida glabrata strain resistant to all the imidazolic agents tested. The organism and the host's humoral status were studied in depth, looking for possible causes of the refractoriness to treatment.- - - - - - - - - - ranking = 1.0203216836925keywords = vulvovaginal, candidiasis (Clic here for more details about this article) |
8/22. Intra-uterine Candida infection: a report of four infected fetusses from two mothers.Although candida albicans is a frequent inhabitant of the female genital tract, chorioamnionitis is rarely caused by this fungal organism. In this report we present two cases with manifest Candida chorioamnionitis. The first case is a twin pregnancy with premature delivery and survival of both twins. The second case is a pregnancy with intra-uterine contraceptive device in situ ending in a midtrimester abortion, followed by the next pregnancy also ending in an abortion in the second trimester. Possible triggers responsible for the increased invasiveness of otherwise benign Candida vaginitis are discussed. Foreign intra-uterine bodies such as contraceptive devices and cerclage sutures necessitate repetitive search for Candida species infection, and prompt adequate antifungal treatment in cases of documented infection. Both cases of the present report add further substantial evidence to the hypothesis of amniotic infection by ascending transcervical infection. The frequent concomitant cervical infections with other infectious agents as well as antibiotherapy influencing the normal Lactobacillary defence mechanisms are both likely to increase the risk. Systemic debilitating diseases that promote invasiveness are briefly discussed.- - - - - - - - - - ranking = 0.014921982026331keywords = vaginitis (Clic here for more details about this article) |
9/22. Congenital cutaneous candidiasis: report of four cases and review of the literature.Congenital cutaneous candidiasis (CCC) is a rare disease acquired by an ascending route, liable to affect the offspring of pregnant women suffering from vulvovaginitis. The cutaneous lesions are present at birth or within the first hours of life. Some infants may present with respiratory distress or clinical signs of sepsis during the first 2 days of life. We report four new cases of CCC, three of which presented transient respiratory distress and clinical signs of sepsis with hepatosplenomegaly. The evolution was favourable in all three cases with topical and oral therapy. We emphasize the self-limited character of this disease, although preterm infants may be at risk of systemic spread. Only one infant presented paronychia as a late complication.- - - - - - - - - - ranking = 0.040324086642009keywords = vaginitis, candidiasis (Clic here for more details about this article) |
10/22. Torulopsis glabrata vaginitis: clinical aspects and susceptibility to antifungal agents.Torulopsis glabrata is second only to candida albicans in frequency of isolation from the vagina in both asymptomatic women and patients with yeast vaginitis. We retrospectively studied 33 patients from whom vaginal isolates of T glabrata were obtained. Torulopsis glabrata caused symptomatic vaginitis in 42% of the patients but was unassociated with symptoms in 30%; in 27% of patients, its importance was uncertain because of concomitant pathology. Antifungal susceptibility testing was performed on 39 T glabrata strains isolated from 39 patients. The minimal inhibitory concentrations (MICs) of the majority of T glabrata isolates fell within the sensitive range of the antimycotic drugs tested; however, no correlation was found between in vitro antifungal MICs and the response to azole drug therapy. Clinical success was achieved in 67% of the patients although mycologic cure occurred in only 33%. A small number of patients developed recurrent and often chronic Torulopsis vaginitis unresponsive to conventional therapy. Limited experience suggests that vaginal boric acid therapy may be of value in these recalcitrant cases.- - - - - - - - - - ranking = 0.10445387418431keywords = vaginitis (Clic here for more details about this article) |
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