Medical Mycology Journal
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55 巻 , 1 号
選択された号の論文の9件中1~9を表示しています
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Medical Mycology Journal
Original Articles
  • Shinji Katsuragi, Makoto Sata, Yoshinari Kobayashi, Takekazu Miyoshi, ...
    55 巻 (2014) 1 号 p. E1-E7
    公開日: 2014/03/28
    ジャーナル フリー
    Species distribution and antifungal susceptibility of Candida isolates at one institution were evaluated. Detection rates of fungi were examined for 5 years between 2007 and 2011. Sensitivities of fungi to amphotericin B, flucytosine, fluconazole, micafungin, itraconazole, and voriconazole were evaluated in blood culture-positive patients. A total of 3,832 fungal isolates were detected, including Candida albicans 66.5%, Candida glabrata 20.3%, Candida parapsilosis 6.2%, Candida tropicalis 5.5%, and others 1.5%. Candidemia was diagnosed in 131 patients, and C. albicans, C. parapsilosis, C. glabrata, C. tropicalis, and others were present in 42.0%, 27.5%, 16.0%, 8.4%, and 6.1% of these patients, respectively. Voriconazole had the lowest MIC90s against C. albicans and C. parapsilosis (0.015 and 0.25). Micafungin had a low MIC90 against C. glabrata and C. tropicalis. C. albicans was the most common fungus in patients with candidemia. Voriconazole and micafungin were effective against C. albicans. Amphotericin B was effective for C. parapsilosis, and micafungin showed good efficacy against C. glabrata and C. tropicalis.
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  • Sanae A. Ishijima, Kazumi Hayama, Kentaro Ninomiya, Masahiro Iwasa, Ma ...
    55 巻 (2014) 1 号 p. E9-E19
    公開日: 2014/03/28
    ジャーナル フリー
    To develop a new therapy against oral candidiasis, a commensal microorganism, Enterococcus faecalis was tested for its ability to modulate Candida growth in vitro and its therapeutic activities against a murine model in vivo. Addition of heat-killed E. faecalis strain EF2001 (EF2001) isolated from healthy human feces to the culture of C. albicans strain TIMM1768 inhibited adherence of the latter to a microtiter plate in a dose dependent manner and Candida cells surrounded by EF2001 were increased. To examine the protective activities of EF2001 in vivo, heat-killed EF2001 was applied orally before and after inoculation of Candida to the tongue of mice previously immunosuppressed. Two days after inoculation this inoculation, both the symptom score and CFU from swabbed-tongue were significantly reduced in the EF2001-treated animals. Histological analysis indicated that EF2001 may potentiate the accumulation of polymorphnuclear cells near a Candida-infected region. These results suggest that oral administration of EF2001 has protective activity against oral candidiasis and that the in vivo activity may be reflected by direct interaction between EF2001 and Candida cells in vitro and the potentiation of an immunostimulatory effect of EF2001.
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  • Eiko Nagamoto, Akihiko Fujisawa, Yuichiro Yoshino, Kanako Yoshitsugu, ...
    55 巻 (2014) 1 号 p. E21-E27
    公開日: 2014/03/28
    ジャーナル フリー
    A 28-year-old man undergoing treatment for hemophagocytic syndrome developed Paecilomyces lilacinus infection in skin ulcers on the face and in the tracheotomy stoma. While his bone marrow was suppressed by chemotherapy with dexamethasone, cyclosporin and etoposide for hemophagocytic syndrome, dental infection led to subacute necrotizing fasciitis caused by Pseudomonas aeruginosa on the right side of the face, resulting in a large area of soft tissue defects. Etoposide was discontinued, and prophylactic treatment with itraconazole was initiated. The ulcers resulting from necrotizing fasciitis were treated conservatively using trafermin and alprostadil alfadex ointment 0.003 %, and near-complete re-epithelialization occurred, except on the right lower eyelid, right buccal mucosa and perioral area. However, 6 weeks later, pustules/crusts started to form and break down repeatedly, leading to expansion of tissue defects on the face. Direct microscopic examination revealed fungal elements, and fungal culture identified Paecilomyces lilacinus suspicious twice some other day. Based on DNA extraction from the isolated fungus, this fungal strain was identified as Paecilomyces lilacinus. Cyclosporin and itraconazole were discontinued, and treatment with liposomal amphotericin B and a tapering dose of steroids was initiated. Cure was achieved in approximately 2.5 months after treatment initiation, and no relapse has been observed. The most important factor that ultimately contributed to the resolution of fungal infection might have been release of immunosuppression by discontinuing cyclosporin and tapering steroids.
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Short Report
  • Rui Kano, Hideto Sobukawa, Minako Suzuki, Masataro Hiruma, Kazutoshi S ...
    55 巻 (2014) 1 号 p. E29-E32
    公開日: 2014/03/28
    ジャーナル フリー
    Protothecosis is a rare infection caused by pathogenic algae of the genus Prototheca. Prototheca wickerhamii causes cutaneous/subcutaneous opportunistic infections in humans and small animals. The diagnosis of protothecosis is based on histopathological examination of this organism, which can be confused with other fungi and inflammatory cells in infected tissues. In this study, immunohistopathological investigation was made of infected cutaneous human and animal tissues exhibiting protothecosis using rabbit antiserum against P. wickerhamii. Serum detected P. wickerhamii in human and feline protothecosis tissues, and did not react with Candida albicans in the human kidney tissues showing candidiasis. This antiserum can therefore differentiate P. wickerhamii cells from the yeast-like cells of C. albicans and Prototheca zopfii in target tissues.
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日本医真菌学会雑誌
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総説
原著
  • 池谷 由貴, 畑 康樹, 山本 奈緒, 小栗 豊子
    55 巻 (2014) 1 号 p. J19-J23
    公開日: 2014/03/28
    ジャーナル フリー
     58歳,女性.血小板減少性紫斑病,狭心症にて投薬加療中.初診の1週間前より左アキレス腱に虫刺症様皮疹あり.3,4日前より同部が浅い膿瘍となり,その後左下肢全体に発赤・腫脹を認め,圧痛を伴ってきたため他院を受診し,セフジニル(CFDN)カプセルを1日分処方され,当院を紹介受診した.初診時,発熱などの全身症状を認めず,左踵に膿瘍,左下肢にリンパ管に沿った線状の発赤・熱感を認め,左鼠径部リンパ節腫脹も認めた.この時点では臨床上,ノカルジア症は疑えなかった.血液検査では血小板減少性紫斑病のため血小板数が減少し,CRPは1.34mg/dl と軽度上昇を認めた.治療はセフカペンピボキシル塩酸塩水和物(CFPN-PI)錠と膿瘍部に先発品ゲンタマイシン硫酸塩(GM)軟膏を塗布とし,6日目には略治した.しかし,提出した培養結果でノカルジア属が分離されたことからスルファメトキサゾール・トリメトプリム(ST)合剤を1週間追加投与した.念のためCTによる全身検索を行ったが,内臓病変は認めなかった.分離された菌は Nocardia brasiliensis と同定され,膿瘍型皮膚ノカルジア症と診断した.β-ラクタム系抗菌薬の短期間内服とGMですみやかに治癒した.本症例はβ-ラクタム系抗菌薬もしくはGMが奏効した皮膚ノカルジア症と考え,一般的な細菌感染の治療で治癒している原発型皮膚ノカルジア症が存在している可能性を示唆するものと考えた.
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