Severe candidal infections: clinical perspective, immune defense mechanisms, and current concepts of therapy.

Abstract:

:Disseminated candidiasis has become an important infection, particularly in immunocompromised and postoperative patients. Although serologic tests may, in some settings, facilitate a premortem diagnosis, the disease is usually diagnosed by comprehensive clinical evaluation. Detection of the relatively newly recognized peripheral manifestations of candidemia may be vital to early diagnosis: endophthalmitis, osteomyelitis, arthritis, myocarditis, meningitis, and macronodular skin lesions. Studies in patients with chronic mucocutaneous candidiasis and in-vitro manipulations have begun to elucidate normal immune defense mechanisms against Candida, including serum factors, phagocytosis, intracellular killing mechanisms, and lymphocyte function (particularly T cell). The primary drugs for the treatment of disseminated candidiasis are still amphotericin B or amphotericin B plus 5-fluorocytosine; the mainstay of therapy for chronic mucocutaneous candidiasis is amphotericin B. Other antifungals and immune system-stimulating modalities (transfer factor, thymosin, thymus epithelial cell transplantation, and levamisol) may be useful for chronic mucocutaneous candidiasis in some settings and deserve further evaluation.

journal_name

Ann Intern Med

authors

Edwards JE Jr,Lehrer RI,Stiehm ER,Fischer TJ,Young LS

doi

10.7326/0003-4819-89-1-91

subject

Has Abstract

pub_date

1978-07-01 00:00:00

pages

91-106

issue

1

eissn

0003-4819

issn

1539-3704

journal_volume

89

pub_type

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