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- Title
Severe candidal infections: clinical perspective, immune defense mechanisms, and current concepts of therapy.
- Authors
Edwards, J E Jr; Lehrer, R I; Stiehm, E R; Fischer, T J; Young, L S
- 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.
- Subjects
CANDIDA diagnosis; CANDIDIASIS treatment; BRAIN diseases; AMPHOTERICIN B; ANIMAL experimentation; ANTIFUNGAL agents; ARTHRITIS; CANDIDIASIS; COMBINATION drug therapy; COMPARATIVE studies; DERMATOMYCOSES; IMMUNOTHERAPY; LEUCOCYTES; LYMPHOCYTES; MACROPHAGES; RESEARCH methodology; MEDICAL cooperation; CARDIOMYOPATHIES; OSTEOMYELITIS; PHAGOCYTOSIS; RESEARCH; SKIN diseases; UVEITIS; EVALUATION research; DISEASE complications
- Publication
Annals of Internal Medicine, 1978, Vol 89, Issue 1, p91
- ISSN
0003-4819
- Publication type
journal article
- DOI
10.7326/0003-4819-89-1-91