SPOROTRICHOSIS

孢子丝菌病
  • 文章类型: Journal Article
    背景:特比萘芬已成功用于治疗人孢子丝菌病;然而,其在治疗猫孢子丝菌病中的有效性尚不清楚。因此,本研究旨在描述特比萘芬在治疗猫孢子丝菌病中的应用。
    方法:在孢子丝菌病的猫中进行了一项队列研究,以评估特比萘芬(30〜60mg/kg/天)的有效性和安全性。每月进行临床检查和实验室参数分析,直到临床症状消退或停用特比萘芬治疗。
    结果:在研究中纳入的54只孢子丝菌病猫中,19人在随访期间丢失,5人由于改用另一种处方药治疗而退出研究。剩下的30只猫,10取得临床治愈,中位治疗时间为18.5周。18例治疗失败,两只猫死了.二十二只猫对特比萘芬治疗有不良反应,和10只猫显示血清转氨酶升高。
    结论:随访期间的损失很高,这使得很难得出关于临床结果的准确结论。
    结论:观察到的临床治愈率低表明特比萘芬不是猫科动物孢子丝菌病病例的有效治疗选择。
    BACKGROUND: Terbinafine has been successfully used in the treatment of human sporotrichosis; however, its effectiveness in the treatment of feline sporotrichosis is unknown. Therefore, this study aimed to describe the use of terbinafine in the treatment of feline sporotrichosis.
    METHODS: A cohort study was conducted in cats with sporotrichosis to assess the effectiveness and safety of terbinafine (30‒60 mg/kg/day). Clinical examination and analysis of laboratory parameters were performed monthly until clinical signs resolved or terbinafine treatment was discontinued.
    RESULTS: Of the 54 cats with sporotrichosis included in the study, 19 were lost during follow-up and five were withdrawn from the study due to switching to treatment with another prescription drug. Of the remaining 30 cats, 10 achieved clinical cure, with a median treatment time of 18.5 weeks. Treatment failed in 18 cases, and two cats died. Twenty-two cats had adverse reactions to terbinafine treatment, and 10 cats showed elevation of serum transaminases.
    CONCLUSIONS: Loss during follow-up was high, which makes it difficult to draw accurate conclusions regarding clinical outcomes.
    CONCLUSIONS: The low rate of clinical cure observed suggests that terbinafine does not represent an effective treatment option for cases of feline sporotrichosis.
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  • 文章类型: Journal Article
    Introduction.孢子丝菌病是由嵌入临床进化枝的双态孢子丝菌引起的皮下感染。真菌有毒力因子,如生物膜和黑色素的产生,这有助于他们的生存,并与治疗失败病例数量的增加有关,这使得有必要搜索新的选项。差距声明。质子泵抑制剂(PPIs)已被证明可以抑制其他真菌的生长和黑素生成。瞄准.因此,这项研究旨在评估奥美拉唑(OMP)的效果,雷贝拉唑(RBP),埃索美拉唑,泮托拉唑和兰索拉唑对孢子丝菌的易感性和黑素生成,以及它们与伊曲康唑的相互作用,特比萘芬和两性霉素B.使用微量稀释法评估PPI的抗真菌活性,以及PPI与伊曲康唑的组合,使用棋盘法评估特比萘芬和两性霉素B.黑素生成抑制的评估使用灰度评估。结果。OMP和RBP分别显示了32至256µgml-1和32至128µgml-1的显着MIC结果。生物膜很敏感,在512µgml-1的浓度下,OMP的代谢活性显着降低了52%,RBP的代谢活性显着降低了50%,在512µgml-1的浓度下,OMP的生物量降低了53%,RBP的生物量降低了51%。至于黑素生成的抑制,只有OMP表现出抑制作用,减少54%。结论。结论是PPIsOMP和RBP在体外对孢子丝菌的浮游细胞和生物膜具有抗真菌活性,此外,OMP可以抑制孢子丝菌的黑化过程。
    Introduction. Sporotrichosis is a subcutaneous infection caused by dimorphic Sporothrix species embedded in the clinical clade. Fungi have virulence factors, such as biofilm and melanin production, which contribute to their survival and are related to the increase in the number of cases of therapeutic failure, making it necessary to search for new options.Gap statement. Proton pump inhibitors (PPIs) have already been shown to inhibit the growth and melanogenesis of other fungi.Aim. Therefore, this study aimed to evaluate the effect of the PPIs omeprazole (OMP), rabeprazole (RBP), esomeprazole, pantoprazole and lansoprazole on the susceptibility and melanogenesis of Sporothrix species, and their interactions with itraconazole, terbinafine and amphotericin B.Methodology. The antifungal activity of PPIs was evaluated using the microdilution method, and the combination of PPIs with itraconazole, terbinafine and amphotericin B was assessed using the checkerboard method. The assessment of melanogenesis inhibition was assessed using grey scale.Results. The OMP and RBP showed significant MIC results ranging from 32 to 256 µg ml-1 and 32 to 128 µg ml-1, respectively. Biofilms were sensitive, with a significant reduction (P<0.05) in metabolic activity of 52% for OMP and 50% for RBP at a concentration of 512 µg ml-1 and of biomass by 53% for OMP and 51% for RBP at concentrations of 512 µg ml-1. As for the inhibition of melanogenesis, only OMP showed inhibition, with a 54% reduction.Conclusion. It concludes that the PPIs OMP and RBP have antifungal activity in vitro against planktonic cells and biofilms of Sporothrix species and that, in addition, OMP can inhibit the melanization process in Sporothrix species.
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  • 文章类型: Journal Article
    背景:孢子丝菌病是皮肤和皮下组织的慢性肉芽肿性感染,可通过淋巴扩散影响任何器官。孢子丝菌病感染的患病率正在增加,其治疗具有挑战性,因为没有统一和标准的诊断技术或抗真菌药物。控制进一步传播需要快速诊断。临床症状评估,组织学分析,血清学检测,和病原体培养都是孢子丝菌病诊断所必需的。然而,这些程序无法识别物种。安全的发展,可靠,和特定物种的诊断技术是必不可少的。
    目的:建立一种新的实时荧光定量PCR快速诊断孢子丝菌病的方法并进行鉴定。
    方法:在定量实时PCR分析中使用钙调蛋白(CAL)基因序列和内部转录间隔区(ITS)的多态性来鉴定S.globosa,S.申克,和非目标物种。
    结果:实时定量PCR检测具有100%的灵敏度和特异性。检测限为6fg/μl。证实34份临床标本感染球藻,阳性检出率为100%。
    结论:本研究开发的定量PCR技术是一种快速,准确,以及基于CAL序列和ITS多态性的球藻的靶向鉴定方法。它可用于及时的临床诊断,以鉴定孢子丝菌病患者临床标本中的球形链球菌。
    BACKGROUND: Sporotrichosis is a chronic granulomatous infection of the skin and subcutaneous tissue that can affect any organ through lymphatic spread. The prevalence of sporotrichosis infections is increasing and its treatment is challenging as there are no unified and standard diagnostic techniques or antifungal medications. Controlling further spread requires a rapid diagnosis. Assessment of clinical symptoms, histological analysis, serological testing, and pathogen culture are all necessary for the diagnosis of sporotrichosis. However, these procedures are unable to identify the species. The development of safe, reliable, and species-specific diagnostic techniques is essential.
    OBJECTIVE: To establish and evaluate a new quantitative real-time PCR assay for the rapid diagnosis of sporotrichosis and to identify relevant species.
    METHODS: Polymorphisms in calmodulin (CAL) gene sequences and the internal transcribed spacer (ITS) were used in a quantitative real-time PCR assay to identify S. globosa, S. schenckii, and non-target species.
    RESULTS: The quantitative real-time PCR assay had 100% sensitivity and specificity. The limit of detection was 6 fg/µl. Thirty-four clinical specimens were verified to be infected with S. globosa with a 100% positive detection rate.
    CONCLUSIONS: The quantitative PCR technique developed in this study is a quick, accurate, and targeted method of identifying S. globosa based on polymorphisms in CAL sequences and ITS. It can be used for a prompt clinical diagnosis to identify S. globosa in clinical specimens from patients with sporotrichosis.
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  • 文章类型: Case Reports
    分枝杆菌(M.marinum),淡水和海水中生长缓慢的细菌,会引起皮肤和皮肤外感染。一名患有系统性红斑狼疮(SLE)的渔民妇女最初被误诊为孢子丝菌病,该妇女表现为慢性多形性皮疹。根据皮肤组织病理学证实了marinum和都柏林念珠菌共感染的最终诊断,脓包文化,MetaCAP测序和有效的抗生素联合治疗。
    Mycobacterium marinum(M. marinum ), a slow-growing bacterium in freshwater and seawater, can cause cutanous and extracutaneous infections. A fisher-woman with systemic lupus erythematosus (SLE) presented with chronic polymorphic rashes in a lymphangitic pattern was initially misdiagnosed as sporotrichosis. The final diagnosis of M. marinum and Candida dubliniensis co-infection was confirmed based on the skin histopathology, pustule culture, MetaCAP sequencing and effective antibiotic combination treatments.
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  • 文章类型: Journal Article
    本研究旨在通过分析孢子丝菌病的流行病学特征,提高对孢子丝菌病的认识,临床表现,真菌学特征,和中国东部疾病的病理特征。
    收集并回顾性分析了在皮肤科门诊20年间诊断为皮肤孢子丝菌病的49例患者的临床资料。分析包括患者的人口统计学,职业,临床类型,病变部位,误诊率,实验室调查,治疗和结果。
    该研究包括22名男性和27名女性患者,平均年龄52.4岁。农民(42.86%)和体力劳动者(28.57%)的感染风险较高。最常见的临床类型是淋巴皮肤(30.61%)和固定(69.39%),主要影响面部和上肢。误诊为其他感染性皮肤病35例(71.43%)。真菌培养和组织病理学检查是重要的诊断工具。口服伊曲康唑治疗3个月可使大多数患者的皮肤损伤得到缓解和消退,尽管经历了一些复发。
    皮肤孢子丝菌病主要影响从事农业和体力劳动的个人,以淋巴皮肤型和固定型为主要临床表现。高误诊率强调了早期识别的重要性,准确的诊断和规范化的治疗对孢子丝菌病的预后和治愈。真菌培养和组织病理学检查对诊断至关重要。口服伊曲康唑是一种有效的治疗选择。
    UNASSIGNED: This study aimed to improve the understanding of sporotrichosis by analyzing the epidemiological characteristics, clinical manifestations, mycological features, and pathological characteristics of the disease in eastern China.
    UNASSIGNED: Clinical data of 49 patients diagnosed with cutaneous sporotrichosis in dermatology clinics over a 20-year period were collected and analyzed retrospectively. The analysis included patient demographics, occupations, clinical types, lesion sites, misdiagnosis rates, laboratory investigations, treatment and outcomes.
    UNASSIGNED: The study included 22 male and 27 female patients, with a mean age of 52.4 years. Farmers (42.86%) and manual workers (28.57%) had a higher risk of infection. The most common clinical types were lymphocutaneous (30.61%) and fixed (69.39%), predominantly affecting the face and upper limbs. Misdiagnosis as other infectious skin diseases occurred in 35 patients (71.43%). Fungal culture and histopathological examination were important diagnostic tools. Treatment with oral itraconazole for three months led to relief and regression of the skin lesions in most patients, although a few experienced recurrences.
    UNASSIGNED: Cutaneous sporotrichosis mainly affects individuals working in agriculture and manual labour, with lymphocutaneous and fixed types being the predominant clinical manifestations. The high misdiagnosis rate emphasizes the importance of early recognition, accurate diagnosis and standardized treatment for the prognosis and cure of sporotrichosis. Fungal culture and histopathological examination are essential for diagnosis, and oral itraconazole is an effective treatment option.
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  • 文章类型: Journal Article
    我们旨在开发和验证对巴西孢子丝菌的环介导等温扩增(LAMP)测定。使用基于钙调蛋白基因设计的六个引物开发LAMP反应。在LAMP反应中,我们测试了来自动物和人类的二十种巴西链球菌分离株,以及从实验感染巴西链球菌的小鼠左脚垫中提取的10个组织样本。此外,它包括来自各种其他真菌物种的DNA样品用于特异性评估。所有巴西链球菌分离物在LAMP中都产生了阳性结果,DNA检测限为1ng/μL。测试中所有鼠类样本均为阳性,而其他真菌物种的DNA均为阴性,导致100%的敏感性和特异性的引物。LAMP诊断技术是孢子丝菌病诊断的一种有前途的替代方法。以一种简单且具有成本效益的方式。需要进一步的研究以使用从人类和动物获得的动物模型样品来验证该技术。
    We aimed to develop and validate a Loop-mediated Isothermal Amplification (LAMP) assay to Sporothrix brasiliensis. LAMP reaction was developed using six primers designed based on calmodulin gene. In the LAMP reaction, we tested twenty isolates of S. brasiliensis from animals and humans, along with ten tissue samples extracted from the left footpad of mice that had been experimentally infected with S. brasiliensis. In addition, it included DNA samples from various other fungal species for specificity evaluation. All S. brasiliensis isolates yielded positive results in the LAMP, and the limit of DNA detection was 1 ng/μL. All murine samples were positive in the test while DNA from other fungal species were all negative, resulting in 100% of sensitivity and specificity of primers. LAMP diagnosis technique is a promising alternative to sporotrichosis diagnosis, in a simple and cost-effective way. Further studies are warranted to validate this technique using animal model samples obtained from both humans and animals.
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  • 文章类型: Journal Article
    孢子丝菌病,由皮肤或皮下感染双态真菌孢子丝菌引起的真菌病,在中国有报道,特别是在东北地区。在这次审查中,我们对中国孢子丝菌病的最新进展进行了全面的研究,涵盖病因学等方面,流行病学,发病机制,临床表现,诊断和治疗策略。在中国的背景下,固定的皮肤孢子丝菌病代表了常见的临床表现。真菌培养是诊断孢子丝菌病的金标准,而聚合酶链反应技术可以提高诊断的特异性和敏感性。除了常规的全身抗真菌药物,替代方式,如中草药,光动力疗法和激光治疗显示了对孢子丝菌病的潜在疗效。
    孢子丝菌病是皮肤上的真菌感染。它是由一组称为孢子丝菌的真菌引起的。常见的症状是皮肤上的病变,炎性丘疹,结节和溃疡。这些真菌生活在自然环境中,并通过皮肤伤口进入体内引起感染。中国的孢子丝菌病患病率很高,东北是受影响最严重的地区。本文综述了中国孢子丝菌病的现状。
    Sporotrichosis, a mycosis resulting from cutaneous or subcutaneous infection with the dimorphic fungus Sporothrix, has been reported in China, particularly in the northeast region. In this review, we conducted a thorough examination of the recent advancements in sporotrichosis in China, encompassing aspects such as etiology, epidemiology, pathogenesis, clinical manifestations, diagnosis and treatment strategies. Within the Chinese context, fixed cutaneous sporotrichosis represents the prevailing clinical manifestation. Fungal culture stands as the gold standard for diagnosing sporotrichosis, while polymerase chain reaction techniques can enhance both the specificity and sensitivity of diagnosis. Besides conventional systemic antifungal agents, alternative modalities such as Chinese herbal medicines, photodynamic therapy and laser therapy show potential efficacy against sporotrichosis.
    Sporotrichosis is a fungal infection on the skin. It is caused by a group of fungi called Sporothrix. Common symptoms are lesions on the skin, inflammatory papules, nodules and ulcers. These fungi live in the natural environment and cause infection by entering the body through a wound in the skin. China has a high prevalence of sporotrichosis, with northeast China the most seriously affected region. This review looks at the state of sporotrichosis in China.
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  • 文章类型: Journal Article
    伊曲康唑(ITZ)是治疗猫孢子丝菌病最常用的药物;然而,对这种真菌病猫的药代动力学知之甚少。这项研究的目的是确定用ITZ作为单一疗法或与碘化钾(KI)联合治疗的孢子丝菌病猫的血浆ITZ浓度。在临床病情恶化或停滞的情况下,诊断为孢子丝菌病的猫接受口服ITZ(100mg/cat/天)或与ITZ(100mg/cat/天)和KI(2.5-5mg/kg/天)的联合治疗。在每个月的访问中,以4小时的间隔收集血液样品,以通过HPLC分析血浆ITZ的谷和峰浓度。在随访期间评估临床特征和实验室参数。研究中包括16只猫。所有猫的血浆ITZ浓度中位数为0.75μg/mL。接受ITZ单一疗法(n=12)的猫的血浆ITZ浓度中位数为0.5µg/mL,接受ITZKI治疗的猫(n=4)为1.0µg/mL。临床治愈率为56.3%(n=9),中位治疗时间为8周。9只猫(56.3%)出现临床不良反应,缺氧最常见(n=8;88.9%)。四只猫的血清丙氨酸转氨酶升高(25%)。在猫中检测到的血浆ITZ浓度中位数被认为是治疗性的(>0.5μg/mL),并在治疗4周后达到。与仅接受ITZ治疗的猫相比,接受ITZ+KI的猫的血浆ITZ浓度更高,提示这些药物之间的药代动力学协同作用。
    伊曲康唑是治疗猫孢子丝菌病最常用的疗法,在无反应的情况下使用与碘化钾的联合疗法。我们的研究表明,所有的猫都达到了伊曲康唑的治疗血浆浓度,在用联合疗法治疗的猫中水平较高。
    Itraconazole (ITZ) is the most used drug to treat feline sporotrichosis; however, little is known about its pharmacokinetics in cats with this mycosis. The aim of this study was to determine plasma ITZ concentrations in cats with sporotrichosis treated with ITZ as monotherapy or in combination with potassium iodide (KI). Cats diagnosed with sporotrichosis received orally ITZ (100 mg/cat/day) or combination therapy with ITZ (100 mg/cat/day) and KI (2.5-5 mg/kg/day) in the case of worsening or stagnation of the clinical condition. At each monthly visit, blood samples were collected at an interval of 4 h for analysis of trough and peak plasma ITZ concentrations by HPLC. Clinical features and laboratory parameters were evaluated during follow-up. Sixteen cats were included in the study. The median plasma ITZ concentration of all cats was 0.75 µg/mL. The median plasma ITZ concentration was 0.5 µg/mL in cats that received ITZ monotherapy (n = 12) and 1.0 µg/mL in those treated with ITZ + KI (n = 4). The clinical cure rate was 56.3% (n = 9) and the median treatment duration was 8 weeks. Nine cats (56.3%) developed adverse clinical reactions, and hyporexia was the most frequent (n = 8; 88.9%). Serum alanine aminotransferase was elevated in four cats (25%). The median plasma ITZ concentration detected in cats was considered to be therapeutic (>0.5 µg/mL) and was reached after 4 weeks of treatment. Plasma ITZ concentrations were higher in cats that received ITZ + KI compared to those treated only with ITZ, suggesting pharmacokinetic synergism between these drugs.
    Itraconazole is the most common therapy for feline sporotrichosis, and combination therapy with potassium iodide is used in nonresponsive cases. Our study showed that all cats achieved a therapeutic plasma concentration of itraconazole, with higher levels in cats treated with the combination therapy.
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  • 文章类型: Journal Article
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  • 文章类型: Journal Article
    由巴西孢子丝菌引起的人畜共患孢子丝菌病是拉丁美洲新兴的真菌病。快速治疗受感染的动物并打破传播链的问题之一与耗时的金标准诊断方法(培养)有关。我们旨在使用非侵入性样品评估物种特异性聚合酶链反应(PCR),以诊断由巴西链球菌引起的孢子丝菌病。我们使用从临床怀疑孢子丝菌病的人和猫的拭子收集的样本进行了回顾性横断面研究。DNA是用商业试剂盒提取的,并进行了用于巴西链球菌检测的物种特异性PCR。包括一百十个样本。PCR显示人和猫样品与培养物的良好一致性(一致性的86%)(Kappa系数分别为0.722和0.727)。总之,我们的数据表明,这种使用非侵入性样品的适应性PCR可以应用于孢子丝菌病的诊断,是一个很好的选择,主要是在缺乏真菌学家来鉴定培养中的真菌的地区,有助于控制这种新兴的人畜共患病。
    我们旨在评估诊断人和猫中由巴西孢子丝菌引起的孢子丝菌病的分子方法。我们观察到该技术与经典方法非常吻合,并且是协助诊断和控制这种人畜共患病的良好替代方法。
    Zoonotic sporotrichosis caused by Sporothrix brasiliensis is an emerging mycosis in Latin America. One of the problems to quickly treat infected animals and break the transmission chain is associated with the time-consuming gold-standard diagnosis method (culture). We aimed to evaluate a species-specific polymerase chain reaction (PCR) for the diagnosis of sporotrichosis caused by S. brasiliensis using non-invasive samples. We performed a retrospective cross-sectional study using samples collected with swabs from humans and cats with clinical suspicion of sporotrichosis. Deoxyribonucleic acid (DNA) was extracted using a commercial kit, and a species-specific PCR for S. brasiliensis detection was performed. One hundred ten samples were included. PCR showed a good concordance with culture (86% of agreement) for human and cat samples (Kappa coefficient = 0.722, and 0.727, respectively). In conclusion, our data shows that this adapted PCR using non-invasive samples can be applied to sporotrichosis diagnosis, being a good alternative mainly in regions with a lack of mycologists to identify the fungus in culture, contributing to the control of this emergent zoonosis.
    We aimed to evaluate a molecular method for diagnosing sporotrichosis caused by Sporothrix brasiliensis in humans and cats. We observed that the technique is in good agreement with the classic method and is a good alternative for assisting in the diagnosis and consequent control of this zoonosis.
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