COVID-19 ASSOCIATED MUCORMYCOSIS (CAM) AND IT’S MANAGEMENT

2021 ◽  
pp. 35-37
Author(s):  
Sanjeev Tomar ◽  
Upma Tomar
Keyword(s):  
Fungal Infections ◽  
Suppressive Therapy ◽  
High Morbidity ◽  
Surgical Interventions ◽  
Wide Range ◽  
High Incidence ◽  
Immune Suppressive Therapy ◽  
Respiratory Pathology ◽  
Anti Fungal ◽  
Second Wave

AIM - The onset of COVID-19 pandemic second wave, there have been multiple reports across the country of high incidence of MUCORMYCOSIS among the recovered patients of COVID-19, especially those who are diabetics or those who have received steroids therapy extensively. In this paper, we review about COVID-19 ASSOCIATED MUCORMYCOSIS (CAM) and its management. DISCUSSION - COVID 19 infection may be associated with a wide range of bacterial as well as fungal infections, post- covid. These infections are result of complex interplay of factors such as pre-existing disease such as Diabetes, previous respiratory pathology, use of immune -suppressive therapy. Additionally, the wide spread use of steroids/broad spectrum antibiotics as part of the regimen against COVID-19, may exacerbate the opportunistic fungal infections. COVID-19 ASSOCIATED MUCORMYCOSIS (CAM) has been associated with high morbidity and mortality, resulting in exorbitant treatment cost and also leads to shortage of anti-fungal drugs. RESULT - Successful management of this fatal infection requires early identication of the disease and aggressive and prompt medical and surgical interventions. Therapeutic agents should be used cautiously and closely monitored to achieve desired results.

scholarly journals Aplastic anemia secondary to dual cancer immunotherapies a physician nightmare: case report and literature review

2021 ◽  
Vol 17 (1) ◽  
Author(s):  
Romy G. Younan ◽  
Roy A. Raad ◽  
Bassem Y. Sawan ◽  
Rabih Said
Keyword(s):  
Adverse Events ◽  
Cancer Treatment ◽  
Aplastic Anemia ◽  
Checkpoint Inhibitors ◽  
White Male ◽  
Suppressive Therapy ◽  
Heavy Smoker ◽  
Immune Mediated ◽  
Wide Range ◽  
Immune Suppressive Therapy

Abstract Background Treatment with immune checkpoint inhibitors has revolutionized cancer treatment over the past several years. Despite their clinical benefits, a wide range of immune-mediated toxicities can be observed including hematological toxicities. Although, the majority can easily be managed, immune-mediated adverse events rarely can be severe and difficult to approach. Herein, we are reporting a case of very severe aplastic anemia secondary to ipilimumab (I) and nivolumab (N) treatment that failed various treatment including intensive immune suppressive therapy. Case presentation We described a case of a 45-year old white male, heavy smoker presented to the clinic complaining of left flank pain. He was found to have a metastatic renal cell carcinoma for which he was treated with dual immunotherapy and later complicated by severe immune related adverse events. The patient later died after failing intensive immune suppressive therapy. Conclusion Immunotherapy has become an established pillar of cancer treatment improving the prognosis of many patients with variant malignancies. Yet, lethal adverse events can occur in rare cases. It is our duty, as physicians, to remain alert and cautious.

Current Pharmaceutical Aspects of Synthetic Quinoline Derivatives

2020 ◽  
Vol 20 ◽  
Author(s):  
Rukhsana Tabassum ◽  
Muhammad Ashfaq ◽  
Hiroyuki Oku
Keyword(s):  
Fungal Infections ◽  
Biological Activities ◽  
Chemical Properties ◽  
New Drugs ◽  
Quinoline Derivatives ◽  
Wide Range ◽  
Anti Cancer ◽  
Anti Fungal ◽  
Physical And Chemical ◽  
And Chemical Properties

Abstract:: Quinoline derivatives are considered as broad spectrum pharmacological compounds that exhibit wide range of biological activities. Integration of quinoline moiety can improve its physical and chemical properties and also pharmacological behavior. Due to its wide range of pharmaceutical applications it is very popular compound to design new drugs for treatment of multiple diseases like cancer, dengue fever, malaria, tuberculosis, fungal infections, AIDS, Alzheimer’s disease and diabetes . In this review our major focus is to pay attention on biological activities of quinoline compounds in treatment of these diseases such as, anti-viral, anti-cancer, anti-malarial, anti-bacterial, anti-fungal, anti-tubercular and anti-diabetic.

Prolonged voriconazole treatment in a patient with chronic lymphocytic leukemia resulting in a litany of chronic overlapping toxicities

2018 ◽  
Vol 25 (3) ◽  
pp. 747-753 ◽  
Author(s):  
Caitlin R Rausch ◽  
Dimitrios P Kontoyiannis
Keyword(s):  
Chronic Lymphocytic Leukemia ◽  
Antifungal Agents ◽  
Fungal Infections ◽  
Lymphocytic Leukemia ◽  
Suppressive Therapy ◽  
Prolonged Treatment ◽  
High Morbidity ◽  
Limited Experience ◽  
Continuous Use ◽  
Visual Disturbances

Voriconazole is a triazole antifungal with activity against a number of yeast and mold species including Candida, Aspergillosis, Fusarium, and Coccidioides. Invasive fungal infections are associated with high morbidity and mortality, prolonged treatment courses, and occasionally lifelong suppressive therapy. Voriconazole therapy can result in a number of acute toxicities that clinicians are frequently aware of including hepatotoxicity, visual disturbances, and hallucinations; however, there is limited experience with extended durations of voriconazole therapy. We describe the case of a 62-year-old man who developed Coccidioides meningitis as a result of prolonged neutropenia from treatment for chronic lymphocytic leukemia. He was initially treated with a number of different antifungal agents including voriconazole, liposomal amphotericin B, fluconazole, and itraconazole; however, he developed acute toxicity due to those agents. He was successfully re-challenged with voriconazole, and maintained therapeutic serum concentrations throughout treatment. As a result of prolonged voriconazole exposure of over 14 years, he has suffered a number of toxicities, most significantly including actinic keratosis, squamous cell carcinoma, and skeletal fluorosis. To our knowledge, this is the longest continuous use of voriconazole therapy currently in the literature.

scholarly journals Herbal conjugation for increased binding of zinc pyrithione on hair: new treatment approach

2018 ◽  
Vol 4 (1) ◽  
pp. 54
Author(s):  
Amruthavalli G. V. ◽  
Satarupa Mukherjee ◽  
Gayathri Rajagopal
Keyword(s):  
Targeted Delivery ◽  
Contact Time ◽  
Fungal Infections ◽  
Fungal Colonization ◽  
Zinc Pyrithione ◽  
Short Contact ◽  
Short Contact Time ◽  
Hair Samples ◽  
Wide Range ◽  
Anti Fungal

<p class="abstract"><strong>Background:</strong> Fungal infections of scalp and hair are common now-a-days and emerging. There are various medicaments for scalp mycosis. Shampoos attained importance due ease of use. But they underperform or perform poorly due to the likely short contact time as most of them are wash off products. Selective binding of the anti-fungal agents over hair in short contact time alone can address the problem of scalp mycosis.</p><p class="abstract"><strong>Methods:</strong> AAS was done to establish the adhesion of anti-fungal agents over hair and the rate of fungal colonization over hair and the extent of hair perforation were used to establish the effect of herbal conjugation in providing anti-fungal activity and blocking the parasitic conversion of fungi.<strong></strong></p><p class="abstract"><strong>Results:</strong> Zinc adhesion was significant in Verdura anti scaling scalp shampoo and zinc pyrithione treated and no colonization and perforation was observed in Verdura anti scaling scalp shampoo and zinc pyrithione treated hair samples.</p><p><strong>Conclusions:</strong> Present study deals with the importance of herbal conjugation technology in enhancing the targeted delivery of zinc pyrithione over hair. The present technology is important for achieving greater anti-fungal benefits from wide range of toiletry preparations due to their short contact time. </p>

scholarly journals Identifying Mucormycosis Severity in Indian COVID-19 Patients: A Nano-Based Diagnosis and the Necessity for Critical Therapeutic Intervention

Antibiotics ◽  
2021 ◽  
Vol 10 (11) ◽  
pp. 1308
Author(s):  
Syed Mohammed Basheeruddin Asdaq ◽  
Arya Rajan ◽  
Aswin Damodaran ◽  
Shivali R. Kamath ◽  
Krishnanjana S. Nair ◽  
...  
Keyword(s):  
Immune System ◽  
Early Diagnosis ◽  
Statistical Data ◽  
Point Of Care ◽  
Surgical Interventions ◽  
Clinical Presentations ◽  
Life Threatening ◽  
Anti Fungal ◽  
Point Of Care Tests ◽  
Second Wave

The COVID-19 infection caused by the new SARS-CoV-2 virus has been linked to a broad spectrum of symptoms, from a mild cough to life-threatening pneumonia. As we learn more about this unusual COVID-19 epidemic, new issues are emerging and being reported daily. Mucormycosis, also known as zygomycosis or phycomycosis, causes severe fungal illness to individuals with a weakened immune system. It is a devastating fungal infection, and the most frequent kind is the rhino cerebral type. As a devastating second wave of COVID-19 sweeps India, doctors report several instances involving a strange illness—sometimes known as the “black fungus”—among returning and recovered COVID-19 patients. This paper analyzes the existing statistical data to address the severity of prevalence and further notes the nano-based diagnostic parameters, clinical presentations, its connection with other conditions like diabetes, hypertension, and GI disorders, and the importance of anti-fungal therapy in treating the same. Anti-fungal therapies, as well as surgical interventions, are currently used for the treatment of the disease. Proper and timely diagnosis is necessary, along with the reduction in the spread of COVID-19. From the review, it was found that timely pharmacologic interventions and early diagnosis by using a nano-based diagnostic kit can help control the disease. Additionally, this paper provides novel information about the nanotechnology approaches such as fungal detection biosensors, nucleic acids-based testing, point-of-care tests, and galactomannans detection, in the diagnosis of mucormycosis, and thereby reinforces the need for further research on the topic.

Hallazgos oftalmológicos en enfermedad de Fabry: relación de su severidad en una familia mexicana

2019 ◽  
Vol 1 (1) ◽  
pp. 43-49
Author(s):  
Araceli Borja Borja ◽  
Gabriela Salas Pérez ◽  
Pablo Radillo Díaz
Keyword(s):  
Premature Mortality ◽  
Retinal Vessel ◽  
Multiple Organ ◽  
High Morbidity ◽  
Lysosomal Storage ◽  
Enzyme Replacement ◽  
Non Invasive ◽  
High Incidence ◽  
Cornea Verticillata ◽  
Gla Gene

Introduction. Fabry disease (FD) is a lysosomal storage disorder associated with multiple organ dysfunction which eventually leads to high morbidity and premature mortality. Ophthalmologic findings in FD are very common and have been described extensively. We describe the ophthalmologic findings of a family diagnosed with FD at Hospital de Especialidades de Puebla and establish their relationship with other phenotypic findings. Cases Presentation. A renal, cardiac, audiological, neurological, and ophthalmologic evaluation was carried out. The disease was confirmed by GLA gene sequencing. The ophthalmologic assessment was focused on the changes described in the literature, as well as the search for other anomalies possibly related to the disease. All the patients had the c.260delA (P.Glu87Glyfs*34) mutation in the GLA gene. The main ophthalmologic finding in our patients was cornea verticillata (in 100 % of the female patients). Other ophthalmologic manifestations were dry eye, retinal vessel tortuosity, ametropia, chromatic vision disorders, ocular annexes, eyelids, and conjuntiva disorders. Conclusions. Most of the assessed patients showed ophthalmologic changes, consistent with the results described in the literature. A remarkable finding in the sample was the high incidence of changes in women, in whom one would not expect the disease to be as severe because they are heterozygous. Ophthalmologic abnormalities in FD require deeper evaluation to establish their possible use as markers of disease progression and/or enzyme replacement therapy initiation due to the benefit of the non-invasive nature of ophthalmologic evaluations.

Heterocycle Compounds with Antimicrobial Activity

2020 ◽  
Vol 26 (8) ◽  
pp. 867-904 ◽  
Author(s):  
Maria Fesatidou ◽  
Anthi Petrou ◽  
Geronikaki Athina
Keyword(s):  
Heterocyclic Compounds ◽  
Bacterial Infections ◽  
Scientific Community ◽  
Antimicrobial Agents ◽  
Fungal Infections ◽  
Biological Activities ◽  
Literature Survey ◽  
New Findings ◽  
Wide Range ◽  
Number Of Microorganisms

Background: Bacterial infections are a growing problem worldwide causing morbidity and mortality mainly in developing countries. Moreover, the increased number of microorganisms, developing multiple resistances to known drugs, due to abuse of antibiotics, is another serious problem. This problem becomes more serious for immunocompromised patients and those who are often disposed to opportunistic fungal infections. Objective: The objective of this manuscript is to give an overview of new findings in the field of antimicrobial agents among five-membered heterocyclic compounds. These heterocyclic compounds especially five-membered attracted the interest of the scientific community not only for their occurrence in nature but also due to their wide range of biological activities. Method: To reach our goal, a literature survey that covers the last decade was performed. Results: As a result, recent data on the biological activity of thiazole, thiazolidinone, benzothiazole and thiadiazole derivatives are mentioned. Conclusion: It should be mentioned that despite the progress in the development of new antimicrobial agents, there is still room for new findings. Thus, research still continues.

scholarly journals Renal Manifestations of Covid-19: Physiology and Pathophysiology

2021 ◽  
Vol 10 (6) ◽  
pp. 1216
Author(s):  
Zaher Armaly ◽  
Safa Kinaneh ◽  
Karl Skorecki
Keyword(s):  
Viral Replication ◽  
Virus Disease ◽  
Multiorgan Failure ◽  
Critical Role ◽  
Kidney Injury ◽  
Small Sample ◽  
Renal Physiology ◽  
High Morbidity ◽  
Enzymatic Production ◽  
High Incidence

Corona virus disease 2019 (COVID-19) imposes a serious public health pandemic affecting the whole world, as it is spreading exponentially. Besides its high infectivity, SARS-CoV-2 causes multiple serious derangements, where the most prominent is severe acute respiratory syndrome as well as multiple organ dysfunction including heart and kidney injury. While the deleterious impact of SARS-CoV-2 on pulmonary and cardiac systems have attracted remarkable attention, the adverse effects of this virus on the renal system is still underestimated. Kidney susceptibility to SARS-CoV-2 infection is determined by the presence of angiotensin-converting enzyme 2 (ACE2) receptor which is used as port of the viral entry into targeted cells, tissue tropism, pathogenicity and subsequent viral replication. The SARS-CoV-2 cellular entry receptor, ACE2, is widely expressed in proximal epithelial cells, vascular endothelial and smooth muscle cells and podocytes, where it supports kidney integrity and function via the enzymatic production of Angiotensin 1-7 (Ang 1-7), which exerts vasodilatory, anti-inflammatory, antifibrotic and diuretic/natriuretic actions via activation of the Mas receptor axis. Loss of this activity constitutes the potential basis for the renal damage that occurs in COVID-19 patients. Indeed, several studies in a small sample of COVID-19 patients revealed relatively high incidence of acute kidney injury (AKI) among them. Although SARS-CoV-1 -induced AKI was attributed to multiorgan failure and cytokine release syndrome, as the virus was not detectable in the renal tissue of infected patients, SARS-CoV-2 antigens were detected in kidney tubules, suggesting that SARS-CoV-2 infects the human kidney directly, and eventually induces AKI characterized with high morbidity and mortality. The mechanisms underlying this phenomenon are largely unknown. However, the fact that ACE2 plays a crucial role against renal injury, the deprivation of the kidney of this advantageous enzyme, along with local viral replication, probably plays a central role. The current review focuses on the critical role of ACE2 in renal physiology, its involvement in the development of kidney injury during SARS-CoV-2 infection, renal manifestations and therapeutic options. The latter includes exogenous administration of Ang (1-7) as an appealing option, given the high incidence of AKI in this ACE2-depleted disorder, and the benefits of ACE2/Ang1-7 including vasodilation, diuresis, natriuresis, attenuation of inflammation, oxidative stress, cell proliferation, apoptosis and coagulation.

scholarly journals 322. Evaluation of the BioFire® Bone and Joint Infection (BJI) Panel for the Detection of Microorganisms and Antimicrobial Resistance Genes in Synovial Fluid Specimens

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S233-S234
Author(s):  
Corrin Graue ◽  
Bryan H Schmitt ◽  
Amy Waggoner ◽  
Frederic Laurent ◽  
Lelia Abad ◽  
...  
Keyword(s):  
Antimicrobial Resistance ◽  
Synovial Fluid ◽  
Resistance Genes ◽  
Clinical Care ◽  
Joint Infection ◽  
High Morbidity ◽  
Bone And Joint Infection ◽  
Microbiological Methods ◽  
Antimicrobial Resistance Genes ◽  
Wide Range

Abstract Background Bone and Joint Infections (BJIs) present with non-specific symptoms that may include pain, swelling, and fever and are associated with high morbidity and significant risk of mortality. BJIs can be caused by a variety of bacteria and fungi, including anaerobes and microorganisms that can be challenging to culture or identify by traditional microbiological methods. Clinicians primarily rely on culture to identify the pathogen(s) responsible for infection. The BioFire® Bone and Joint Infection (BJI) Panel (BioFire Diagnostics, Salt Lake City, UT) is designed to detect 15 gram-positive bacteria (including seven anaerobes), 14 gram-negative bacteria (including one anaerobe), two yeast, and eight antimicrobial resistance (AMR) genes from synovial fluid specimens in about an hour. The objective of this study was to evaluate the performance of an Investigational Use Only (IUO) version of the BioFire BJI Panel compared to various reference methods. Methods Remnant synovial fluid specimens, which were collected for routine clinical care at 13 study sites in the US and Europe, underwent testing using an IUO version of the BioFire BJI Panel. Performance of this test was determined by comparison to Standard of Care (SoC) consisting of bacterial culture performed at each study site according to their routine procedures. Results A total of 1544 synovial fluid specimens were collected and tested with the BioFire BJI Panel. The majority of specimens were from knee joints (77.9%) and arthrocentesis (79.4%) was the most common collection method. Compared to SoC culture, overall sensitivity was 90.2% and specificity was 99.8%. The BioFire BJI Panel yielded a total of 268 Detected results, whereas SoC yielded a total of 215 positive results for on-panel analytes. Conclusion The BioFire BJI Panel is a sensitive, specific, and robust test for rapid detection of a wide range of analytes in synovial fluid specimens. The number of microorganisms and resistance genes included in the BioFire BJI Panel, together with a reduced time-to-result and increased diagnostic yield compared to culture, is expected to aid in the timely diagnosis and appropriate management of BJIs. Disclosures Benjamin von Bredow, PhD, BioFire (Grant/Research Support) Jennifer Dien Bard, PhD, BioFire Diagnostic (Consultant, Scientific Research Study Investigator) Bart Kensinger, PhD, BioFire Diagnostics (Employee) Benedicte Pons, PhD, bioMerieux SA (Employee) Corinne Jay, PhD, bioMerieux SA (Employee)

scholarly journals 1174. Phase 2 STRIVE Clinical Trial of Rezafungin for Treatment of Candidemia and/or Invasive Candidiasis Demonstrates Consistent Trough Concentrations Across Diverse Patient Populations

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S612-S613
Author(s):  
Shawn Flanagan ◽  
Christopher M Rubino ◽  
Taylor Sandison
Keyword(s):  
Body Weight ◽  
Invasive Candidiasis ◽  
Fungal Infections ◽  
Standard Of Care ◽  
Geographic Region ◽  
Continuous Variables ◽  
Phase 2 ◽  
Double Blind ◽  
Wide Range ◽  
Diverse Patient Populations

Abstract Background Rezafungin is a novel echinocandin antifungal in development for treatment as well as prevention (prophylaxis) of invasive fungal infections. STRIVE (NCT02734862) is a global, randomized, double-blind, placebo-controlled, Phase 2 trial evaluating safety and efficacy of IV rezafungin once weekly (QWk) for treatment of candidemia and/or invasive candidiasis compared with standard-of-care (IV caspofungin once daily with optional oral stepdown). Here we report pharmacokinetic (PK) data from the completed STRIVE trial analyzed by patient demographics at baseline. Methods Rezafungin Day 8 trough (Cmin) concentrations from patients treated with rezafungin were summarized categorically by race (black or white), sex (male or female), and geographic region (North America [NA], or Europe [EU]), or plotted versus continuous variables of age, body weight, body mass index (BMI), and body surface area (BSA). As the first dose of rezafungin was 400 mg for all rezafungin-treated patients, data from both dose groups (Group 1: 400 mg QWk; Group 2: 400 mg in Week 1 followed by 200 mg QWk) were combined in this analysis. Results Rezafungin mean Cmin (SD) values were 1.8 (0.7) and 2.3 (1.2) in black and white patients, 1.9 (1.0) and 2.6 (1.2) in males and females, and 1.9 (0.6) and 2.4 (1.3) in patients from NA and EU. There were small differences in point estimates between the groups, but there was a great deal of overlap and the differences are not expected to be clinically meaningful (Figure). Similarly, no trends in Cmin values were observed across a range of ages (20-80 years), weights (~40-155 kg), BMI (~15-65 kg/m2), and BSA (~1.4-2.4 m2). Figure Conclusion No meaningful differences in rezafungin Cmin values were observed in patients grouped by sex, race, or geographic region, or across a wide range of patient factors, including age and body weight and size. These findings indicate that a single rezafungin dose regimen can be expected to provide consistent PK across diverse patient populations. Disclosures Shawn Flanagan, PhD, Cidara Therapeutics, Inc. (Employee, Shareholder) Christopher M. Rubino, PharMD, Institute for Clinical Pharmacodynamics, Inc. (Employee)Spero Therapeutics (Grant/Research Support) Taylor Sandison, MD, MPH, Cidara Therapeutics, Inc. (Employee, Shareholder)

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