scholarly journals COVID - 19 Presenting with Fungal Infections - The Hidden Pandemic within Pandemic?

2021 ◽  
Vol 10 (44) ◽  
pp. 3810-3814
Author(s):  
Vidyashree S. Hulkoti ◽  
Samarth Shukla ◽  
Sourya Acharya ◽  
Dhruv Talwar ◽  
Aditi Goyal
Keyword(s):  
Fungal Infection ◽  
Fungal Infections ◽  
Organ Damage ◽  
High Rate ◽  
Treatment Modalities ◽  
Medical Attention ◽  
Current State ◽  
Increasing Trend ◽  
Cellular Immunodeficiency ◽  
Immunocompetent Patients

As the pandemic continues to spread vigorously, it is being noted that the COVID 19 virus is associated with various complications during the disease and also a great deal of post disease sequel.1 These gruelling complications are integrated with the overwhelming infection caused by the cytokine storm produced by the virus. While the treatment modalities are still under trial, glucocorticoids seem to have played a pivotal role in putting a check to the inflammation caused by the virus and have forbidden the organ damage caused thereafter. However, the aftermath of glucocorticoids usage has its own benefits and risks. Glucocorticoids cause cellular immunodeficiency and thus have immunosuppressive effects, additionally the use of immunomodulators such as tocilizumab alters the immune system and it subsequently predisposes the host to various secondary opportunistic infective agents. In the current state, as the pandemic abstains from fading away, an increasing trend of secondary fungal infections has been seen with COVID-19, resulting in an outbreak of fungal infections such as mucormycosis and candidiasis. Mucormycosis refers to any infection caused by the fungi of the Order Mucorales. Mucormycosis has been documented in the literature to be associated with a high rate of mortality due to its potential to spread drastically.2 Altered immunity is an important risk factor for mucormycosis. Additionally, diabetes has been noted to be critical for the development of mucormycosis in immunocompetent patients. Candidiasis is an infection caused by the candida species due to the immunosuppressed state developed by the use of glucocorticoids, which results in secondary fungal infection requiring urgent medical attention. The objective of this case report is to highlight the impending secondary fungal infection outbreak in COVID-19 and the need to contain this emerging spread of fungal infections under the blanket of this deadly pandemic.

scholarly journals Estimated burden of fungal infections in Kenya

2016 ◽  
Vol 10 (08) ◽  
pp. 777-784 ◽  
Author(s):  
John Abuga Guto ◽  
Christine C Bii ◽  
David W Denning
Keyword(s):  
At Risk ◽  
Fungal Infection ◽  
Tinea Capitis ◽  
Opportunistic Infections ◽  
Fungal Infections ◽  
Allergic Bronchopulmonary Aspergillosis ◽  
Epidemiological Studies ◽  
High Rate ◽  
Asthma Prevalence ◽  
Populations At Risk

Introduction: Kenya is a developing country with a high rate of tuberculosis (TB) and a moderate HIV infection burden. No estimate of the burden of fungal diseases in Kenya is published. Methodology: We used specific populations at risk and fungal infection frequencies from the literature to estimate national incidence or prevalence of serious fungal infections. Used sources were: 2010 WHO TB statistics, Kenya Acquired Immunodeficiency Syndrome (AIDS) Epidemic Update 2012, Kenya Facts and figures 2012, Kenya Demographic and Health Survey 2008-2009. Results: Of Kenya’s population of ~40 million, 43% are under 15 years old and approximately 594,660 Kenyan women get >4 episodes Candida vulvovaginitis annually (2,988/100,000). The HIV/AIDS population at risk of opportunistic infections (OI) is 480,000 and the OI estimates include 306,000 patients with oral thrush (768/100,000), 114,000 with oesophageal candidiasis (286/100,000), 11,900 with cryptococcal meningitis (29/100,000) and 17,000 patients with Pneumocystis pneumonia (42/100,000). Chronic pulmonary aspergillosis following TB has a prevalence of 10,848 cases (32/100,000). The adult asthma prevalence is 3.1% and assuming 2.5% have allergic bronchopulmonary aspergillosis then 17,696 (44/100,000) are affected.  Invasive aspergillosis, candidaemia and Candida peritonitis are probably uncommon. Tinea capitis infects 9.6% of children in Kenya, while fungal keratitis and otomycoses are difficult to estimate. Conclusion: At any one time, about 7% of the Kenyan population suffers from a significant fungal infection, with recurrent vaginitis and tinea capitis accounting for 82% of the infections. These estimates require further epidemiological studies for validation.

scholarly journals Fungal Infection among Diabetic and Nondiabetic Individuals in Nepal

2020 ◽  
Vol 2020 ◽  
pp. 1-7
Author(s):  
Bhuvan Saud ◽  
Prajuna Bajgain ◽  
Govinda Paudel ◽  
Vikram Shrestha ◽  
Dipendra Bajracharya ◽  
...  
Keyword(s):  
Fungal Infection ◽  
Candida Species ◽  
Fungal Infections ◽  
Fungal Growth ◽  
Organ Damage ◽  
Multiple Organ ◽  
Hair Shaft ◽  
Yeast Cells ◽  
Aspergillus Species ◽  
The Status

Background. Low immunity, comorbid clinical conditions, and metabolic disorders may be the underlying factors that determine the severity of infection. Diabetes increases the risk of infection and multiple organ damage. In Nepal, the actual burden of fungal infections has not been estimated or is in a limited progress. This study aimed to investigate the status of fungal infection in diabetic and nondiabetic individuals in Bhaktapur, Nepal. Materials and Methods. A total of 670 samples were collected from 134 participants. From each participant, five samples were collected from different sites like an oral wash, toe swab, midstream urine, hair shaft, and nail scrapings. All samples were cultured on Sabouraud dextrose agar. Gram stain was used to observe yeast cells and lactophenol cotton blue stain was used for hyphae. Chlamydospore production by Candida species was observed in cornmeal agar medium by Dalmau Plate method. Candida species isolated were characterized by germ-tube test and differentiated using CHROM agar Candida medium. Candida species isolates were tested for antibiotic susceptibility. Results. Overall, 19.4% of the samples showed fungal growth. The prevalence of fungal infection was higher in diabetic (34.0%) than nondiabetic individuals (4.7%). Fungal growth was found to be higher in oral wash followed by toe, urine, hair, and nail samples. Predominant fungi were Candida species (57.5%), Aspergillus species (28.4%), and Trichophyton species (10.7%). Oral wash, toe, and urine samples in diabetics had a significantly higher fungal prevalence when compared between both groups, p value < 0.05. In Candida isolates, higher resistance was seen against fluconazole 36.8% and ketoconazole 28.9%, whereas other drugs showed low resistance. Conclusion. Diabetic participants are more susceptible to fungal infection than the nondiabetics. Overall, Candida species and Aspergillus species are highly predominant fungi. Candida species are highly resistant to fluconazole and ketoconazole.

To evaluate the efficacy of Jalaukavacharana followed by Khadira Prayoga in Vicharchika w.s.r to Eczema

2017 ◽  
Vol 2 (4) ◽  
Author(s):  
Kulkarni Sharad ◽  
Syeda Ather Fathima ◽  
Naveen B. S.
Keyword(s):  
Incidence Rate ◽  
Clinical Features ◽  
Skin Disease ◽  
Skin Disorder ◽  
Age Groups ◽  
High Rate ◽  
Main Line ◽  
Treatment Modalities ◽  
Skin Disorders

Vicharchika (Eczema) is a skin disorder with predominance of Pitta Kapha Dosha, with clinical features like Kandu, Srava, Pidaka, Shyavata, Rookshata, Raji, Ruja and Daha mainly in the extremities. It is the second commonest skin disease affecting all age groups, with incidence rate of 2-3% and high rate of recurrence. Ayurveda emphasizes Shodhana therapy as the main line of treatment in skin disorders. Raktamokshana is indicated as Rakta is mainly involved in Vicharchika. In the present study, two treatment modalities were selected to find out which is more appropriate.

scholarly journals Herbal Products and Their Active Constituents Used Alone and in Combination with Antifungal Drugs against Drug-Resistant Candida sp.

Antibiotics ◽  
2021 ◽  
Vol 10 (6) ◽  
pp. 655
Author(s):  
Anna Herman ◽  
Andrzej Przemysław Herman
Keyword(s):  
Biofilm Formation ◽  
Fungal Infections ◽  
Antifungal Drugs ◽  
Membrane Transporters ◽  
Drug Resistant ◽  
Herbal Products ◽  
Active Constituents ◽  
Over Expression ◽  
Candida Sp ◽  
Current State

Clinical isolates of Candida yeast are the most common cause of opportunistic fungal infections resistant to certain antifungal drugs. Therefore, it is necessary to detect more effective antifungal agents that would be successful in overcoming such infections. Among them are some herbal products and their active constituents.The purpose of this review is to summarize the current state of knowledge onherbal products and their active constituents havingantifungal activity against drug-resistant Candida sp. used alone and in combination with antifungal drugs.The possible mechanisms of their action on drug-resistant Candida sp. including (1) inhibition of budding yeast transformation into hyphae; (2) inhibition of biofilm formation; (3) inhibition of cell wall or cytoplasmic membrane biosynthesis; (4) ROS production; and (5) over-expression of membrane transporters will be also described.

scholarly journals The Prediction and Prognosis of Fungal Infection in Lung Transplant Recipients—A Retrospective Cohort Study in South Korea

2021 ◽  
Vol 7 (8) ◽  
pp. 639
Author(s):  
Yae-Jee Baek ◽  
Yun-Suk Cho ◽  
Moo-Hyun Kim ◽  
Jong-Hoon Hyun ◽  
Yu-Jin Sohn ◽  
...  
Keyword(s):  
Cohort Study ◽  
South Korea ◽  
Fungal Infection ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Lung Transplant ◽  
Fungal Infections ◽  
Transplant Recipients ◽  
Tertiary Center ◽  
Lung Transplant Recipients

(1) Background: Lung transplant recipients (LTRs) are at substantial risk of invasive fungal disease (IFD), although no consensus has been reached on the use of antifungal agents (AFAs) after lung transplantation (LTx). This study aimed to assess the risk factors and prognosis of fungal infection after LTx in a single tertiary center in South Korea. (2) Methods: The study population included all patients who underwent LTx between January 2012 and July 2019 at a tertiary hospital. It was a retrospective cohort study. Culture, bronchoscopy, and laboratory findings were reviewed during episodes of infection. (3) Results: Fungus-positive respiratory samples were predominant in the first 90 days and the overall cumulative incidence of Candida spp. was approximately three times higher than that of Aspergillus spp. In the setting of itraconazole administration for 6 months post-LTx, C. glabrata accounted for 36.5% of all Candida-positive respiratory samples. Underlying connective tissue disease-associated interstitial lung disease, use of AFAs before LTx, a longer length of hospital stay after LTx, and old age were associated with developing a fungal infection after LTx. IFD and fungal infection treatment failure significantly increased overall mortality. Host factors, antifungal drug resistance, and misdiagnosis of non-Aspergillus molds could attribute to the breakthrough fungal infections. (4) Conclusions: Careful bronchoscopy, prompt fungus culture, and appropriate use of antifungal therapies are recommended during the first year after LTx.

How we treat sickle hepatopathy and liver transplantation in adults

Blood ◽  
2014 ◽  
Vol 123 (15) ◽  
pp. 2302-2307 ◽  
Author(s):  
Kate Gardner ◽  
Abid Suddle ◽  
Pauline Kane ◽  
John O’Grady ◽  
Nigel Heaton ◽  
...  
Keyword(s):  
Liver Transplantation ◽  
Sickle Cell ◽  
Liver Dysfunction ◽  
Therapeutic Option ◽  
Organ Damage ◽  
Treatment Modalities ◽  
Cell Disease ◽  
Limited Evidence ◽  
Acute Form ◽  
Future Work

Abstract Sickle cell disease (SCD) has evolved into a debilitating disorder with emerging end-organ damage. One of the organs affected is the liver, causing “sickle hepatopathy,” an umbrella term for a variety of acute and chronic pathologies. Prevalence of liver dysfunction in SCD is unknown, with estimates of 10%. Dominant etiologies include gallstones, hepatic sequestration, viral hepatitis, and sickle cell intrahepatic cholestasis (SCIC). In addition, causes of liver disease outside SCD must be identified and managed. SCIC is an uncommon, severe subtype, with outcome of its acute form having vastly improved with exchange blood transfusion (EBT). In its chronic form, there is limited evidence for EBT programs as a therapeutic option. Liver transplantation may have a role in a subset of patients with minimal SCD-related other organ damage. In the transplantation setting, EBT is important to maintain a low hemoglobin S fraction peri- and posttransplantation. Liver dysfunction in SCD is likely to escalate as life span increases and patients incur incremental transfusional iron overload. Future work must concentrate on not only investigating the underlying pathogenesis, but also identifying in whom and when to intervene with the 2 treatment modalities available: EBT and liver transplantation.

The epidemiology of non-suicidal self-injury: lifetime prevalence, sociodemographic and clinical correlates, and treatment use in a nationally representative sample of adults in England

2021 ◽  
pp. 1-9
Author(s):  
Richard T. Liu
Keyword(s):  
Psychiatric Disorders ◽  
Suicide Attempts ◽  
Clinical Importance ◽  
High Rate ◽  
Lifetime Prevalence ◽  
Medical Attention ◽  
Treatment Needs ◽  
Self Injury ◽  
Biological Parents ◽  
Nationally Representative

Abstract Background Although the clinical importance of non-suicidal self-injury (NSSI) has received increasing recognition, relatively little is known about its epidemiology. The objective of this study was to estimate the lifetime prevalence of NSSI in adults and its association with sociodemographic characteristics, psychiatric disorders, and lifetime treatment for NSSI. Methods A nationally representative face-to-face survey was conducted with 7192 adults aged ≥18 years in England. Respondents were interviewed about engagement in NSSI, psychiatric illness, suicidal thoughts and behavior, and treatment history for this behavior. Results The estimated lifetime prevalence rate of NSSI was 4.86%. Younger age, growing up without biological parents in the household, being unmarried, and impoverished backgrounds were associated with NSSI. The majority of respondents with lifetime NSSI (63.82%) had at least one current psychiatric disorder. Most psychiatric conditions were associated with greater odds of lifetime NSSI in multivariate models. NSSI was strongly associated with suicidal ideation and suicide attempts, respectively, even after accounting for psychiatric disorders and sociodemographic covariates. A substantial proportion of respondents with NSSI history (30.92%) have engaged in medically severe self-harm, as indexed by requiring medical attention for this behavior. The majority of respondents with NSSI (56.20%) had not received psychiatric care for this behavior. Conclusions NSSI is prevalent in the general population and associated with considerable psychiatric comorbidity. A high rate of unmet treatment needs is evident among those with this behavior. Those at the greatest lifetime risk for NSSI may also be particularly limited in their resources to cope with this behavior.

scholarly journals Estimated Burden of Fungal Infections in Oman

2020 ◽  
Vol 7 (1) ◽  
pp. 5
Author(s):  
Abdullah M. S. Al-Hatmi ◽  
Mohammed A. Al-Shuhoumi ◽  
David W. Denning
Keyword(s):  
Fungal Infection ◽  
Fungal Infections ◽  
Epidemiological Studies ◽  
Vaginal Candidiasis ◽  
Skin Infections ◽  
Opportunistic Pathogens ◽  
Fungal Rhinosinusitis ◽  
Populations At Risk ◽  
Different Populations ◽  
Underlying Pathology

For many years, fungi have emerged as significant and frequent opportunistic pathogens and nosocomial infections in many different populations at risk. Fungal infections include disease that varies from superficial to disseminated infections which are often fatal. No fungal disease is reportable in Oman. Many cases are admitted with underlying pathology, and fungal infection is often not documented. The burden of fungal infections in Oman is still unknown. Using disease frequencies from heterogeneous and robust data sources, we provide an estimation of the incidence and prevalence of Oman’s fungal diseases. An estimated 79,520 people in Oman are affected by a serious fungal infection each year, 1.7% of the population, not including fungal skin infections, chronic fungal rhinosinusitis or otitis externa. These figures are dominated by vaginal candidiasis, followed by allergic respiratory disease (fungal asthma). An estimated 244 patients develop invasive aspergillosis and at least 230 candidemia annually (5.4 and 5.0 per 100,000). Only culture and microscopy are currently available for diagnosis, so case detection is suboptimal. Uncertainty surrounds these figures that trigger the need for urgent local epidemiological studies with more sensitive diagnostics.

scholarly journals Rapidly dissolving microneedle patch of amphotericin B for intracorneal fungal infections

2021 ◽  
Author(s):  
Alyaa A. Albadr ◽  
Ismaiel A. Tekko ◽  
Lalitkumar K. Vora ◽  
Ahlam A. Ali ◽  
Garry Laverty ◽  
...  
Keyword(s):  
Fungal Infection ◽  
Amphotericin B ◽  
Fungal Infections ◽  
Fungal Growth ◽  
Significant Inhibition ◽  
Corneal Tissue ◽  
Biodegradable Poly ◽  
Invasive Method ◽  
Poorly Soluble ◽  
Microneedle Patch

AbstractChronic fungal infection of the cornea could lead to blindness if not treated properly. Topical amphotericin B (AMP-B) is considered the first treatment of choice for ocular fungal infection. However, factors related to its poor solubility and penetration through intact cornea lead to poor bioavailability. Microneedles (MNs) are emerging as a minimally invasive method to enhance ocular drug delivery. This study aims to investigate the potential use of biodegradable poly(vinylpyrrolidone) (PVP) and hyaluronic acid (HA)–based rapidly dissolving MNs for delivery of AMP-B to treat fungal infection. The data obtained illustrates PVP/HA MN arrays’ reproducibility, good mechanical strength, and faster dissolution with 100% drug recovery. Multiphoton microscopic results revealed that MNs successfully penetrate the corneal tissue and enhance AMP-B permeation through corneal layers. Furthermore, PVP/HA MN arrays showed high solubility. Both PVP and HA successfully decreased AMP-B cytotoxicity when compared to free drug. More interestingly, the biocompatible MN formulations preserved the antifungal activity of AMP-B, as demonstrated by significant inhibition of fungal growth. Therefore, this study shows the feasibility of ocular delivery of the poorly soluble AMP-B using a fast-dissolving MN patch. Graphical abstract

Summary of the current state of the pathogenesis of glaucoma

1927 ◽  
Vol 23 (8) ◽  
pp. 839-845
Author(s):  
V. P. Roshchin
Keyword(s):  
Single Case ◽  
Disease Process ◽  
The Other ◽  
Medical Attention ◽  
Blind People ◽  
Current State ◽  
Constant State ◽  
The One

The problem of glaucoma has, for many reasons, occupied and continues to occupy a prominent place in the ophthalmic press. It is enough to recall that 19% of all blind people owe their misfortune to glaucoma to understand why interest in this affliction has never faded among ophthalmologists. Furthermore, no ophthalmologist is quite sure that a certain method of treatment, even if the patient has timely applied for medical attention, can definitely prevent a sad outcome in every single case. This plus the absence of a unified and correct view of the essence of glaucoma keeps ophthalmologists in a constant state of flux, constantly striving to uncover the hidden springs of the disease process on the one hand, and to find a more radical means to combat it on the other.

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