BackgroundStudy of in vivo antifungal activity of the hydroalcoholic extract (HE) and n-BuOH extract (BUTE) of Sapindus saponaria against azole-susceptible and -resistant human vaginal Candida spp.MethodsThe in vitro antifungal activity of HE, BUTE, fluconazole (FLU), and itraconazole (ITRA) was determined by the broth microdilution method. We obtained values of minimal inhibitory concentration (MIC) and minimum fungicide concentration (MFC) for 46 strains of C. albicans and 10 of C. glabrata isolated from patients with vulvovaginal candidiasis (VVC). VVC was induced in hyperestrogenic Wistar rats with azole-susceptible C. albicans (SCA), azole-resistant C. albicans (RCA), and azole-resistant C. glabrata (RCG). The rats were treated intravaginally with 0.1 mL of HE or BUTE at concentrations of 1%, 2.5% and 5%; 100 μg/mL of FLU (treatment positive control); or distilled water (negative control) at 1, 24, and 48 h after induction of the infection, and the progress of VVC was monitored by culturing and scanning electron microscopy (SEM). The toxicity was evaluated in cervical cells of the HeLa cell line.ResultsThe extracts showed in vitro inhibitory and fungicidal activity against all the isolates, and the MIC and MFC values for the C. glabrata isolates were slightly higher. In vivo, the SCA, RCA, and RCG infections were eliminated by 21 days post-infection, with up to 5% HE and BUTE, comparable to the activity of FLU. No cytotoxic action was observed for either extract.ConclusionsOur results demonstrated that HE and BUTE from S. saponaria show inhibitory and fungicidal activity in vitro, in addition to in vivo activity against azole-resistant vaginal isolates of C. glabrata and azole-susceptible and resistant isolates of C. albicans. Also considering the lack of cytotoxicity and the low concentrations of the extracts necessary to eliminate the infection in vivo, HE and BUTE show promise for continued studies with purified antifungal substances in VVC yeast isolates.

Oropharyngeal candidiasis is the most common fungal infection among patients infected with the human immunodefi ciency virus (HIV), and is treated empirically with topical or systemic antifungals. The objective of the present study was to investigate the possible antifungal action of the hydroalcoholic extract of Curcuma zedoaria (Christm.) Roscoe, Zingiberaceae, on yeasts in this population. Samples were collected from HIV-positive patients who attended the Laboratory for Teaching and Research in Clinical Analysis at the Universidade Estadual de Maringá for routine exams. The isolated yeasts were identifi ed at the genus and species levels through classical methodology. Next, tests of microdilution in broth were carried out to determine the profi le of susceptibility of these yeasts towards the hydroalcoholic extract of C. zedoaria, following methodology standardised by the CLSI (2002). A total of 53 yeasts were identifi ed, 49 of them C. albicans, two C. tropicalis and two C. glabrata. These yeasts were inhibited by low concentrations of the extract of C. zedoaria (between 1.95 and 15.63 µg/mL). In addition, 7.82 µg/mL inhibited 90% of the yeasts. Our results indicate a potent antifungal action for C. zedoaria and suggest more detailed studies with a view towards the practical application of this phytomedicine in topical pharmaceutical forms for the treatment of oral candidosis or candidiasis.

b Sputum and sera from 134 patients screened for tuberculosis (TB) were analyzed to investigate TB and paracoccidioidomycosis (PCM). Of these patients, 11 (8.2%) were confirmed to have TB, but six (4.5%) were positive only for PCM. All patients with PCM presented anti-43-kDa-component antibodies in Western blotting (WB) assays, while in the TB-positive patients these antibodies did not appear. This preliminary study suggests WB as a potential tool for differential laboratory diagnosis between TB and PCM. P aracoccidioidomycosis (PCM) is a mycosis endemic to Latin America caused by Paracoccidioides brasiliensis and also by the recently described Paracoccidioides lutzii. It is an important systemic mycosis, which presents with a wide range of clinical signs and symptoms. Although PCM has been described for more than 100 years and is considered endemic in many countries, until now there have been serious problems in relation to differential diagnosis of this important systemic mycosis (11, 13). The lungs are affected in about 75% of cases, and the initial pulmonary lesions are similar to those of tuberculosis (TB) (7). Furthermore, the association between PCM and TB is not uncommon; it occurs at a frequency varying between 5.5 and 15.8% (10, 13), and so differential diagnosis between these two diseases as well as detection of coinfection with TB and PCM is very important.A characterization based only on clinical and radiological data can be difficult, especially in areas of endemicity, since the two diseases may occur simultaneously or sequentially. Diagnostic error can occur, especially in basic health units, as a consequence of the fact that the clinical history and radiological findings do not always allow a clear distinction between the two diseases (13). This is a serious public health problem, since incorrect treatment increases the risk of pulmonary sequelae such as fibrosis, bronchiectasis, and chronic respiratory insufficiency.The definitive diagnosis of PCM has been established by the finding of budding yeast cells of P. brasiliensis through direct mycological examination (DME) of fresh biological material such as sputum, by histopathological techniques, or, alternatively, by isolation and identification of the fungus in culture (15). Similarly, the diagnosis of TB is established by bacilloscopy, a direct investigation of the acid-fast bacilli (AFB), and by isolation and identification of Mycobacterium tuberculosis. However, these techniques have some important limitations that are inherent in the nature of each one: the low sensitivity of the direct techniques (DME and bacilloscopy) and the long time necessary for development and identification of the agents are the most common problems. Furthermore, the difficulty in obtaining the most appropriate samples of biological material means that sputum is routinely used to investigate AFB and P. brasiliensis. However, spontaneous or induced sputum is highly contaminated and may carry only a small number of pathogenic microorganisms, insufficient to provide a p...

; Terezinha Inez Estivalet Svidzinski 4É relatado o caso de um paciente portador de paracoccidioidomicose (PCM), supostamente há 15 anos, que, apesar de a baciloscopia sempre ser negativa, foi tratado empiricamente para tuberculose, por duas vezes sem melhora clínica. O diagnóstico de PCM após longo tempo, por meio de metodologia simples, chama atenção para a importância da investigação paralela de tuberculose e paracoccidioidomicose como diagnóstico diferencial em respiradores sintomáticos crônicos.