Fungal infections systemic

Fungal infection, systemic Treatment regimen Dose (mg/kg/day)... 

Absolute hypersensitivity to the drug or any other component of the product. Active or suspected ocular or periocular infection (herpes simplex keratitis, vaccinia, varicella, mycobacterial disease or fungal infection), systemic fungal infections, advanced glaucoma or concurrent administration of live vaccines in patients receiving immunosuppressive doses. 

Pneumogstis carini pneumonia (PCP), the most common of the opportunistic infections, occurs in more than 80% of AIDS patients (13). Toxoplasmosis, a proto2oan infection of the central nervous system, is activated in AIDS patients when the 004 count drops and severe impairment of ceU-mediated immunity occurs. Typically, patients have a mass lesion(s) in the brain. These mass lesions usually respond well to therapy and can disappear completely. Fungal infections, such as CTyptococcalmeningitis, are extremely common in AIDS patients, and Histop/asma capsulatum appears when ceU-mediated immunity has been destroyed by the HIV vims, leading to widespread infection of the lungs, Hver, spleen, lymph nodes, and bone marrow. AIDS patients are particularly susceptible to bacteremia caused by nontyphoidal strains of Salmonella. Bacteremia may be cleared by using antibiotic therapy. 

There are hundreds of topical steroid preparations that are available for the treatment of skin diseases. In addition to their aforementioned antiinflammatory effects, topical steroids also exert their effects by vasoconstriction of the capillaries in the superficial dermis and by reduction of cellular mitosis and cell proliferation especially in the basal cell layer of the skin. In addition to the aforementioned systemic side effects, topical steroids can have adverse local effects. Chronic treatment with topical corticosteroids may increase the risk of bacterial and fungal infections. A combination steroid and antibacterial agent can be used to combat this problem. Additional local side effects that can be caused by extended use of topical steroids are epidermal atrophy, acne, glaucoma and cataracts (thus the weakest concentrations should be used in and around the eyes), pigmentation problems, hypertrichosis, allergic contact dermatitis, perioral dermatitis, and granuloma gluteale infantum (251). 

Fluconazole (4) (s the first member of a new generation of orally acti ve antifungal agents, highly effective in the treatment of dermal and vaginal infections [6, 7] S-Fluorocyrtosine (5) is also used to treat serious systemic fungal infections [5]... 

Amphotericin B, is a polyene antibiotic, used in the therapy of systemic fungal infections. Its mode of action exploits differences in membrane composition between the pathogen and the human host. Ergosterol, the predominant sterol of fungi, plants, and some protozoan parasites, interacts with Amphotericin B, resulting in an increased ion permeability of the membrane. Humans contain cholesterol, which has a low affinity for amphotericin B. 

Distinguish between superficial and systemic fungal infections... 

Fungal infections range from superficial skin infections to fife-threatening systemic infections. Systemic fungal infections are serious infections that occur when fungi gain entrance into the interior of the body. 

Amphotericin B is the most effective drug available for die treatment of most systemic fungal infections. Administration often results in serious reactions,... 

Mr. Carr is receiving amphotericin B for a systemic fungal infection. Which of the following would most likely indicate to tiie nurse that Mr. Carr is experiencing an adverse reaction to amphotericin B ... 

Fludrocortisone is contraindicated in patients with hypersensitivity to fludrocortisone and those with systemic fungal infections. Fludrocortisone is used cautiously in patients with Addison s disease infection, and during pregnancy (Pregnancy Category C) and lactation. Fludrocortisone decreases the effects of the barbiturates, hydantoins, and rifampin. There is a decrease in serum levels of the salicylates when those agents are administered with fludrocortisone... 

Metraux, J.P. Boiler, Th. (1986). Local and systemic induction of chitinase in cucumber plants in response to viral, bacterial and fungal infections. Physiological and Molecular Plant Pathology, 28, 161-9. 

P. (1985). Liposomal amphotericin B for the treatment of systemic fungal infections in patients with cancer A preliminary study, J. Infect. Pis., 151, 704-710. 

Lopez-Berestein, G. (1989). Treatment of systemic fungal infections with liposomal-amphotericin B, in Liposomes in the Therapy of Infectious Diseases and Cancer (G. Lopez-Berestein and I. J. Fidler, eds.), Alan R. Liss, New York, pp. 317-327. 

Fungal infections are normally less virulent in nature than are bacterial or viral ones but may, nevertheless, pose a problem in individuals with a depressed immune system, e.g. AIDS sufferers. 

Immunocompetent patients generally do not require reassessment after treatment. Patients with neutropenia exhibit an increased risk of dissemination of infection, and therefore should be monitored for signs of systemic fungal infection. Due to an increased risk of recurrence, HIV-positive patients should routinely be evaluated for recurrence at each visit. 

A 60-year-old male with AIDS develops a systemic fungal infection that is treated with fluconazole. What is the mechanism of action of fluconazole ... 

North American blastomycosis is a systemic fungal infection caused by Blastomyces dermatitidis. 

Several opiate receptors have been identified on cells of the nervous systems of animals and humans, with mu (p), kappa (k), and gamma (y) subtypes being predominant. These classical opiate receptors are G- protein coupled 7-transmembrane molecules.27 Opiates predominantly affect immune responses directly by ligation of p, k, and y opiate receptors, as well as non-classical opiate-like receptors, on immune cells and indirectly by binding to receptors on CNS cells. Studies conducted in vitro with opiate-treated immune cells demonstrated receptor-mediated reduced phagocytosis, chemotaxis and cytokine and chemokine production. These effects are linked to modulation of host resistance to bacterial, protozoan, viral and fungal infections using animal models, cell lines and primary cells. 

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