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[Severe mycosis-factors with fungus and host]
S Maesaki1, E Sasaki, H Kakeya
1The Second Department of Internal Medicine, Nagasaki University School of Medicine, 1-7-1 Sakamoto machi Nagasaki, 852-8501.
Abstract:
The deep-seated mycosis occurred in immunocompromized patients. Normally, the deep-seated mycosis became sever infection because of the defects of host defense or the adverse effects of antifungal agents. The major factors of the reason on the severity of the deep-seated mycosis depends on the pathogenesity and the drug resistance for antifungal agents in infected fungi. The clinical factors related with hosts defenses are important to the other reason on the severity. We investigated that the multiple drug resistant (MDR) mechanism may be one of the major roles plays in the azole resistant Candida albicans strains isolated form the patients with oropharyngeal candidiasis infected HIV. We analyzed which clinical factors are related with the prognosis of the patients with pulmonary cryptococcosis and aspergilloma. The titer of cryptococcal capsular antigen was earlier improve in the patient without underline disease than in the patients with underline diseases diagnosed pulmonary cryptococcosis. CRP was higher in the death cases in the patients with pulmonary aspergilloma, compared with alive cases.
Insights
Deep-seated mycosis is severe in immunocompromised patients. Multiple drug resistance mechanisms in Candida albicans and clinical factors like C-reactive protein influence prognosis in fungal infections.
Area of Science:
- Medical Mycology
- Infectious Diseases
- Clinical Microbiology
Context:
- Deep-seated mycosis poses significant threats to immunocompromised individuals.
- Severity is often exacerbated by host defense defects or antifungal drug resistance.
- Understanding these factors is crucial for effective patient management.
Purpose:
- To investigate the role of multiple drug resistance (MDR) mechanisms in azole-resistant Candida albicans strains from HIV-infected patients with oropharyngeal candidiasis.
- To analyze clinical factors associated with the prognosis of patients suffering from pulmonary cryptococcosis and aspergilloma.
Summary:
- Multiple drug resistance (MDR) mechanisms are implicated in azole-resistant Candida albicans.
- In pulmonary cryptococcosis, patients without underlying diseases showed earlier improvement in cryptococcal capsular antigen titers compared to those with comorbidities.
- Elevated C-reactive protein (CRP) levels were observed in fatal cases of pulmonary aspergilloma.
Impact:
- This research highlights the importance of drug resistance and host factors in deep-seated mycosis.
- Findings can inform diagnostic and therapeutic strategies for fungal infections in vulnerable populations.
- Improved understanding of prognostic indicators may lead to better patient outcomes.