dimorphic fungal infections

  • 文章类型: Journal Article
    与浅表真菌感染相比,例如皮肤癣菌病,侵袭性真菌感染(IFIs)的特征是真菌元素对组织的渗透。疾病可以在一个区域内局部传播,或者可以通过造血或通过淋巴管传播。环境是最常见的感染库。由于真菌孢子是空气传播的,室内猫也容易受到国际金融机构的影响。一些环境真菌普遍存在于全球,而其他人在特定地理区域内是地方性或高流行的。人畜共患病原体包括犬小孢子菌,申克孢子丝菌和巴西孢子丝菌。
    在由两部分组成的系列文章的第一部分中,对猫科动物IFIs和卵细胞病的调查方法进行了综述。以及诊断提示,以及有关真菌病原体的生态位和分布的信息,该综述涵盖了最常见的IFIs的临床表现,包括隐球菌病,组织胞浆菌病,芽生菌病,球孢子菌病,孢子丝菌病,phaeophyphysp真菌病,曲霉菌病和皮肤真菌假性细菌瘤,以及卵细胞性脓毒血症,lagenidizosis和副胚芽。在第二部分,活动谱,行动机制,对抗真菌药物的药代动力学和药效学特性以及不良反应进行了综述,并讨论了特定IFIs和卵细胞病的治疗和预后。
    该评论借鉴了已发表的证据和作者在猫科动物医学方面的综合专业知识,真菌学,皮肤病学,临床病理学和解剖学病理学。
    In contrast to superficial fungal infections, such as dermatophytosis, invasive fungal infections (IFIs) are characterised by penetration of tissues by fungal elements. Disease can spread locally within a region or can disseminate haematogenously or via the lymphatics. The environment is the most common reservoir of infection. Since fungal spores are airborne, indoor cats are also susceptible to IFIs. Some environmental fungi are ubiquitous and present globally, while others are endemic or hyperendemic within specific geographic regions. Zoonotic pathogens include Microsporum canis, Sporothrix schenckii and Sporothrix brasiliensis.
    In the first of a two-part article series, the approach to the investigation of feline IFIs and oomycoses is reviewed. As well as tips for diagnosis, and information on the ecological niche and distribution of fungal pathogens, the review covers clinical presentation of the most common IFIs, including cryptococcosis, histoplasmosis, blastomycosis, coccidioidomycosis, sporotrichosis, phaeohyphomycosis, aspergillosis and dermatophytic pseudomycetoma, as well as the oomycoses pythiosis, lagenidiosis and paralagenidiosis. In Part 2, the spectrum of activity, mechanisms of action, pharmacokinetic and pharmacodynamic properties and adverse effects of antifungal drugs are reviewed, and the treatment and prognosis for specific IFIs and oomycoses are discussed.
    The review draws on published evidence and the authors\' combined expertise in feline medicine, mycology, dermatology, clinical pathology and anatomical pathology.
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  • 文章类型: Journal Article
    侵袭性真菌感染(IFIs)和卵菌病(以下称为侵袭性真菌样感染[IFLIs])的特征在于真菌成分对组织的渗透。环境是最常见的感染库。IFIs和IFLIs治疗可能令人沮丧,因为通常需要较长的治疗时间,即使在达到临床治愈之后,可能有复发的风险。随着时间的推移,业主对药物管理和重新检查检查的依从性也会下降。此外,一些抗真菌药物很贵,具有可变的患者间药代动力学特性,只能肠胃外给药和/或具有常见的不良反应(AE)。尽管有这些限制,治疗可以是非常有益的,尤其是当一种进行性和致命的疾病被治愈时。
    在由两部分组成的文章系列的第二部分中,活动的频谱,行动机制,药代动力学和药效学特性,并对抗真菌药物的不良事件进行了综述,以及特异性IFIs/IFLIs的治疗和预后-皮肤癣菌假单胞菌瘤,隐球菌病,中国轨道曲霉病,球孢子菌病,组织胞浆菌病,孢子丝菌病,phaeophyphysp真菌病,毛霉菌病和卵菌病-进行了讨论。第1部分回顾了IFIs和IFLIs的诊断方法。
    抗真菌药物的信息来自猫的药代动力学研究。如果尚未进行此类研究,对来自“临床前”动物(非人类研究)和人类研究的数据进行了综述。该评论还借鉴了更广泛的已发表证据和作者在猫科动物医学方面的综合专业知识,真菌学,皮肤病学,临床病理学和解剖学病理学。
    AMB(两性霉素B);FC(氟胞嘧啶);FCZ(氟康唑);ISA(异氟康唑);ITZ(伊曲康唑);KCZ(酮康唑);PCZ(泊沙康唑);TRB(特比萘芬);VCZ(伏立康唑)。
    Invasive fungal infections (IFIs) and oomycoses (hereafter termed invasive fungal-like infections [IFLIs]) are characterised by penetration of tissues by fungal elements. The environment is the most common reservoir of infection. IFIs and IFLIs can be frustrating to treat because long treatment times are usually required and, even after attaining clinical cure, there may be a risk of relapse. Owner compliance with medication administration and recheck examinations can also decline over time. In addition, some antifungal drugs are expensive, have variable interpatient pharmacokinetic properties, can only be administered parenterally and/or have common adverse effects (AEs). Despite these limitations, treatment can be very rewarding, especially when an otherwise progressive and fatal disease is cured.
    In the second of a two-part article series, the spectrum of activity, mechanisms of action, pharmacokinetic and pharmacodynamic properties, and AEs of antifungal drugs are reviewed, and the treatment and prognosis of specific IFIs/IFLIs - dermatophytic pseudomycetoma, cryptococcosis, sino-orbital aspergillosis, coccidioidomycosis, histoplasmosis, sporotrichosis, phaeohyphomycosis, mucormycosis and oomycosis - are discussed. Part 1 reviewed the diagnostic approach to IFIs and IFLIs.
    Information on antifungal drugs is drawn from pharmacokinetic studies in cats. Where such studies have not been performed, data from \'preclinical\' animals (non-human studies) and human studies are reviewed. The review also draws on the wider published evidence and the authors\' combined expertise in feline medicine, mycology, dermatology, clinical pathology and anatomical pathology.
    AMB (amphotericin B); FC (flucytosine); FCZ (fluconazole); ISA (isavuconazole); ITZ (itraconazole); KCZ (ketoconazole); PCZ (posaconazole); TRB (terbinafine); VCZ (voriconazole).
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