Mycotic agents

Table 11.3 Required biosafety levels for research with mycotic agents...

Mycotic infections caused by dematiaceous fungi include chromoblastomycosis, mycetoma, phaeohyphomycosis, and sporotrichosis. In this chapter, only chromoblastomycosis, phaeohyphomycosis, and sporotrichosis will be considered. Sporotrichosis is treated here because the etiologic agent is dematiaceous in culture, even though the yeast form in tissue is hyaline. 

Uses. As broad-spectrum antimicrobial cold sterilant/disinfectant for hospital equipment as tanning agent for leather as tissue fixative as cross-linking agent for proteins as preservative in cosmetics as therapeutic agent for warts, hyperhidrosis, and dermal mycotic infections in X ray processing solutions and film emulsion as a disinfectant in the beauty industry... 

Pharmacotherapy of fungal disease has been revolutionized by the introduction of the relatively nontoxic oral azole drugs and the echinocandins. Combination therapy is being reconsidered, and new formulations of old agents are becoming available. Unfortunately, the appearance of azole-resistant organisms, as well as the rise in the number of patients at risk for mycotic infections, has created new challenges... 

Agarwal PK, Roy P, Das A, et al. Efficacy of topical and systemic itraconazole as a broad-spectrum antifungal agent in mycotic corneal ulcer. A preliminary smdy. Indian J Ophthalmol 2001 49(3) 173-176. 

In addition to topical antimycotic therapy, systemic NSAIDs and topical atropine sulfate are used to the control pain and ameliorate the effects of anterior segment injury associated with the iridocyclitis that inevitably accompanies ker-atomycosis. Topical proteinase inhibitor therapy is of significant clinical benefit in controlling stromal breakdown and, since potentially pathogenic bacteria contaminate most mycotic lesions, concurrent broad-spectrum, topical antibacterial agents should be used. 

A general approach to treatment of superficial mycotic infections includes keeping the infected area dry and clean and limiting exposure to the infected reservoir. Topical agents generally are considered to be first-line therapy for infections of the skin. Oral therapy is preferred when the infection is extensive or severe or when treating tinea capitis or onychomycosis." " Table 118-8 lists spe-... 

Strictly speaking, the biologic agents that cause occupational dermatoses are comprised of infections and infestations. It is not always easy to define the time when a natural hazard becomes an occupational hazard (Wilkinson 1987). Among infections, it is traditional to consider viral, microbial and mycotic infections. 

Its topical use lies mainly in the treatment of psoriasis, as a keratolytic agent to descale plaques (1-20% ointment). Salicylism is the term used to describe the toxicological state that occurs following percutaneous absorption of salicylic acid (Von Weis and Lever 1964). Intoxication depends largely on the total body area over which the salicylic acid is applied (Brubacher and Hoffman 1996). Formerly, salicylic acid also had a reputation as an anti-mycotic (3% in Whitfield ointment). Contact allergy was reported (Goh and Ng 1986). 

Infected (mycotic) aneurysms can be identified by its lobulated contour, soft tissue infiltration, and periaortic abscesses or trapped air (Rakita et al. 2007). Primary aorto-enteric fistulas as a complication of an AAA are rare and can be identified by extraluminal periaortic trapped air or by the extravasation of the contrast agent into the gastrointestinal tract. 

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