Primary Cutaneous Cryptococcosis

Baes, H.; Cutsem, J. Van

doi:10.1159/000249452

Cited by 24 publications

(3 citation statements)

References 16 publications

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“…This organ, together with brain and meninges, is the most difficult to clear of infection. In man the number of cases of primary cutaneous cryptococcosis, if not frequent, is increasing [58]. Assessment of the in uitro sensitivity of Cr.…”

Section: Discussionmentioning

confidence: 99%

Therapy of experimental meningeal and disseminated cryptococcosis

Cutsem

1993

Mycoses

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Summary. This study evaluated the efficacy of itraconazole, a broad‐spectrum triazole antifungal drug, which has previously been demonstrated to exhibit activity against Candida albicans C. krusei, C. glabrata, Aspergillus, Histoplasma and Blastomyces as a potential treatment for cryptococcosis. The susceptibility of 62 strains of Cryptococcus neoformans was tested in vitro. All strains were inhibited by itraconazole 0.1 μg ml‐1. Itraconazole was fungicidal after replenishment at a concentration that can easily be achieved in viva. When mice were infected intracerebrally with Cr. neoformans all control animals died, whereas only 11% and 26% of itra‐conazole‐treated animals died. In a group treated with ketoconazole, 67% died. After intravenous infection, 30% of control guinea pigs died, while other animals treated with itraconazole (5 or 10 mgkg‐1) or amphotericin B (1.25 or 2.5 mg kg‐1) all survived. Itraconazole 10 mg kg‐1 produced the best results, with brain and meningeal cultures becoming negative in 55–64% of animals. In addition, intravenously infected guinea pigs received oral or intraperitoneal treatment with itraconazole or fluconazole (each 5 or 10mgkg‐1) as monotherapy or in combination. Although both treatments were active, itraconazole 10 mg kg‐1 was the most effective. In two out of six immunosuppressed guinea pigs infected with Cr. neoformans oral itraconazole was effective, resulting in negative brain and meningeal cultures. A combination of itraconazole (5 mgkg‐1) with flucytosine or amphotericin B was more efficacious than monotherapy. Therefore, itraconazole is a potentially effective therapy for the treatment of Cyptococcus infection when administered either alone or in combination with other antifungal drugs. It may also be effective in immunocom‐promised patients. Zusammenfassung. Ziel dieser Studie war es, die Wirksamkeit von Itraconazol zu evaluieren. Hierbei handelt es sich um ein Breitband‐Antimykotikum aus der Gruppe der Triazole, dessen Aktivität gegen Candida albicans, C. krusei, C. glabrata, Aspergillus, Histoplasma und Blastomyces kürz‐lich nachgewiesen wurde und das damit als mögli‐ches Therapeutikum der Cryptococcose in Frage kommt. Es wurden 62 Stämme von Cyptococcus neofomans auf ihre Empfindlichkeit in vitro getestet, wobei alle durch 0.1 pg ml‐1 Itraconazol gehemmt wurden. Nach weiterer Zugabe wirkte Itraconazol fungizid in einer Konzentration, die sich in viva leicht erreichen läß. Wurden Mäuse intrazerebral mit Cr. neoformans infiziert, starben alle Tiere der Kontrollgruppe, während von den mit Itraconazol behandelten Tieren nur 11% und 26% starben. Bei einer Behandlung mit Ketoconzaol starben 67O/O. Nach einer intravenösen Infektion starben 30% einer Kontrollgruppe von Meerschweinchen, wogegen alle Tiere überlebten, die entweder mit Itraconazol (5 oder 10 mgkg‐1) oder Amphotericin B (1.25 oder 2.5 mgkg‐1) behandelt wurden. Die besten Ergebnisse zeigte Itraconazol in einer Konzentration von 10 mgkg‐1 im Falle von Erre‐gerkulturen aus Gehirn und Hirnhäuten: Diese wurden in...

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Section: Discussionmentioning

confidence: 99%

Therapy of experimental meningeal and disseminated cryptococcosis

Cutsem

1993

Mycoses

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“…Dermal and mucosal acquired hyperpigmentation may be caused by several endogenous and exogenous factors: hormonal disturbance during preg-nancy, systemic disorders like Addison's disease or neurofibromatosis and prolonged administration of different drugs like clofazimine, minocycline (7) or ketokonazole (8). Hyperpigmented lesions of the tongue and of finger-and toe-nails have been reported in heroin addicts as fixed drug eruptions (9).…”

Section: Discussionmentioning

confidence: 99%

Ultrastructural findings in oral hyperpigmentation of HIV‐infected patients

Zhang¹,

Langford

Gelderblom

et al. 1989

J Oral Pathology Medicine

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Oral hyperpigmentation has been observed in six HIV-infected patients, in two of whom systemic medication (ketokonazole, clofazimine) was supposed to be etiologically involved. Histologically, pigment was found in epithelial basal cells and particularly in subepithelial connective tissue. Ultrastructurally, the presence of premature melanosomes in subepithelial keratinocytes was of interest. Stimulation of melanocytes during HIV infection may occur in association with immunopathologic changes in the oral mucosa.

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“…3 Mucosal surfaces can be colonised by the capsulate strains of C. neoformans, from where they may cause systemic cryptococcosis.3 Asymptomatic infection in man and animals is common; the clinical manifestations become apparent in conditions of stress and immunosuppression. 4 Four serotypes of this yeast are known-A, B, C and D. All can cause systemic disease. Most infections in immunodeficient patients with AIDS are believed to be caused by C. neoformans var neoformans (serotypes A, D).5 Dissemination of infection becomes enhanced in cases associated with h ypogammaglo bulinaemia.…”

Section: Introductionmentioning

confidence: 99%

Virulence of Cryptococcus neoformans serotypes A, B, C and D for four mouse strains

Irokanulo

Akueshi

1995

Journal of Medical Microbiology

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Summary. The relative virulence of Cryptococcus neoformans serotypes A, B, C and D in four mouse strains was assessed by measuring their migration from the foot-pad of the animals to the spleen, lungs and brain in 6-week-old DBA/2, BALB/c, A/J and a hybrid mouse strain by re-isolating yeasts from the internal organs. Comparable doses of each C. neoforrnans serotype were inoculated into the foot-pads of the mice. C. neoformans var neoformans strains A68, D52, A-(IN) and D-(IN) were more virulent than C. neoformans var gatti strains B 112 and C18. However, the differences in the relative virulence of the var neoformans and the var gatti serotypes for the mouse strains were not significant (p > 0-05). Re-isolation of yeasts from mice showed that the BALB/c mice, in particular, and the DBA/2 mice were more susceptible to disseminated C. neoformans infection. The virulence of C. neoformans serotypes through foot-pad inoculation of mice was established.

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Primary Cutaneous Cryptococcosis

Cited by 24 publications

References 16 publications

Therapy of experimental meningeal and disseminated cryptococcosis

Therapy of experimental meningeal and disseminated cryptococcosis

Ultrastructural findings in oral hyperpigmentation of HIV‐infected patients

Virulence of Cryptococcus neoformans serotypes A, B, C and D for four mouse strains

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