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Reiss S, Kulker D, Laure B, Paré A. Reconstruction of the orbitozygomatic framework: State of the art and perspectives. JOURNAL OF STOMATOLOGY, ORAL AND MAXILLOFACIAL SURGERY 2024; 125:101788. [PMID: 38281701 DOI: 10.1016/j.jormas.2024.101788] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/24/2023] [Revised: 01/19/2024] [Accepted: 01/25/2024] [Indexed: 01/30/2024]
Abstract
The reconstruction of the whole orbitozygomatic framework (OZF) is complex and can be encountered in cases of congenital midface deformity, after tumor ablative surgery and in severe facial trauma. Nowadays, surgeon has a wide range of available techniques that have continually grown over the past years, optimizing the surgical management and the aesthetical outcomes. Among them, the autologous bone graft (ABG) remains one of the most suitable options : ABG is easy to harvest and has optimal biological properties for bone healing. It can be tailored to the patient anatomy thanks to the recent advances in computer-assisted surgery. However, substantial drawbacks remain such as the early resorption of the non-vascularized graft, the need of a donor site and its potential morbidity. Alloplastic reconstruction is another option that can resolve both the resorption issue and the donor site morbidity. Moreover, the 3D-printing technologies also allows the manufacturing of patient specific implants. However, alloplastic materials have a variable success, especially due to the high risk of infection or exposure. Consequently, regenerative medicine is a promising field that aims to find a procedure without the disadvantages of ABG or alloplastic based reconstructions, but displaying similar or even higher success rate. Indeed, recent tissue engineering strategies have demonstrated encouraging results for bone regeneration using natural or synthetic biomaterials, patient cells and synthetic bioactive substances. The objective of this review is to present the etiologies of OZF defect, the available reconstruction procedures as well as the current state of the research.
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Affiliation(s)
- Ségolène Reiss
- Department of Maxillofacial and Facial Plastic Surgery, Trousseau Hospital, University Hospital Center of Tours, Reference Center for rare Craniostenoses and Craniofacial Malformations CRANIOST, Avenue de la République, Tours, 37044, France
| | - Dimitri Kulker
- Department of Maxillofacial and Facial Plastic Surgery, Trousseau Hospital, University Hospital Center of Tours, Reference Center for rare Craniostenoses and Craniofacial Malformations CRANIOST, Avenue de la République, Tours, 37044, France
| | - Boris Laure
- Department of Maxillofacial and Facial Plastic Surgery, Trousseau Hospital, University Hospital Center of Tours, Reference Center for rare Craniostenoses and Craniofacial Malformations CRANIOST, Avenue de la République, Tours, 37044, France
| | - Arnaud Paré
- Department of Maxillofacial and Facial Plastic Surgery, Trousseau Hospital, University Hospital Center of Tours, Reference Center for rare Craniostenoses and Craniofacial Malformations CRANIOST, Avenue de la République, Tours, 37044, France.
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Gamaletsou MN, Rammaert B, Brause B, Bueno MA, Dadwal SS, Henry MW, Katragkou A, Kontoyiannis DP, McCarthy MW, Miller AO, Moriyama B, Pana ZD, Petraitiene R, Petraitis V, Roilides E, Sarkis JP, Simitsopoulou M, Sipsas NV, Taj-Aldeen SJ, Zeller V, Lortholary O, Walsh TJ. Osteoarticular Mycoses. Clin Microbiol Rev 2022; 35:e0008619. [PMID: 36448782 PMCID: PMC9769674 DOI: 10.1128/cmr.00086-19] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
Osteoarticular mycoses are chronic debilitating infections that require extended courses of antifungal therapy and may warrant expert surgical intervention. As there has been no comprehensive review of these diseases, the International Consortium for Osteoarticular Mycoses prepared a definitive treatise for this important class of infections. Among the etiologies of osteoarticular mycoses are Candida spp., Aspergillus spp., Mucorales, dematiaceous fungi, non-Aspergillus hyaline molds, and endemic mycoses, including those caused by Histoplasma capsulatum, Blastomyces dermatitidis, and Coccidioides species. This review analyzes the history, epidemiology, pathogenesis, clinical manifestations, diagnostic approaches, inflammatory biomarkers, diagnostic imaging modalities, treatments, and outcomes of osteomyelitis and septic arthritis caused by these organisms. Candida osteomyelitis and Candida arthritis are associated with greater events of hematogenous dissemination than those of most other osteoarticular mycoses. Traumatic inoculation is more commonly associated with osteoarticular mycoses caused by Aspergillus and non-Aspergillus molds. Synovial fluid cultures are highly sensitive in the detection of Candida and Aspergillus arthritis. Relapsed infection, particularly in Candida arthritis, may develop in relation to an inadequate duration of therapy. Overall mortality reflects survival from disseminated infection and underlying host factors.
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Affiliation(s)
- Maria N. Gamaletsou
- Laiko General Hospital of Athens and Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Blandine Rammaert
- Université de Poitiers, Faculté de médecine, CHU de Poitiers, INSERM U1070, Poitiers, France
| | - Barry Brause
- Hospital for Special Surgery, Weill Cornell Medicine, New York, New York, USA
| | - Marimelle A. Bueno
- Far Eastern University-Dr. Nicanor Reyes Medical Foundation, Manilla, Philippines
| | | | - Michael W. Henry
- Hospital for Special Surgery, Weill Cornell Medicine, New York, New York, USA
| | - Aspasia Katragkou
- Nationwide Children’s Hospital, Columbus, Ohio, USA
- The Ohio State University School of Medicine, Columbus, Ohio, USA
| | | | - Matthew W. McCarthy
- Weill Cornell Medicine of Cornell University, New York, New York, USA
- New York Presbyterian Hospital, New York, New York, USA
| | - Andy O. Miller
- Hospital for Special Surgery, Weill Cornell Medicine, New York, New York, USA
| | | | - Zoi Dorothea Pana
- Hippokration General Hospital, Aristotle University School of Health Sciences, Thessaloniki, Greece
- Faculty of Medicine, Aristotle University School of Health Sciences, Thessaloniki, Greece
| | - Ruta Petraitiene
- Weill Cornell Medicine of Cornell University, New York, New York, USA
| | | | - Emmanuel Roilides
- Hippokration General Hospital, Aristotle University School of Health Sciences, Thessaloniki, Greece
- Faculty of Medicine, Aristotle University School of Health Sciences, Thessaloniki, Greece
| | | | - Maria Simitsopoulou
- Hippokration General Hospital, Aristotle University School of Health Sciences, Thessaloniki, Greece
- Faculty of Medicine, Aristotle University School of Health Sciences, Thessaloniki, Greece
| | - Nikolaos V. Sipsas
- Laiko General Hospital of Athens and Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | | | - Valérie Zeller
- Groupe Hospitalier Diaconesses-Croix Saint-Simon, Paris, France
| | - Olivier Lortholary
- Université de Paris, Faculté de Médecine, APHP, Hôpital Necker-Enfants Malades, Paris, France
- Institut Pasteur, Unité de Mycologie Moléculaire, CNRS UMR 2000, Paris, France
| | - Thomas J. Walsh
- Hospital for Special Surgery, Weill Cornell Medicine, New York, New York, USA
- Weill Cornell Medicine of Cornell University, New York, New York, USA
- New York Presbyterian Hospital, New York, New York, USA
- Center for Innovative Therapeutics and Diagnostics, Richmond, Virginia, USA
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Datarkar AN, Daware S, Gadve V, Pardiwala AF, Pund M, Bhawalkar A, Purohit S, Relan P, Ghormade A. Zygomaticomaxillary Osteomyelitis due to COVID-19 Associated Mucormycosis (CAM): A Case Series of 10 Patients. J Maxillofac Oral Surg 2022:1-11. [PMID: 36267537 PMCID: PMC9568929 DOI: 10.1007/s12663-022-01809-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Accepted: 10/04/2022] [Indexed: 11/24/2022] Open
Abstract
Aim To highlight the incidence of osteomyelitis due to CAM and to elucidate the mode of spread of infection from maxilla to zygomatic bone, to highlight how that is distinct from other cases of zygomatic osteomyelitis due to other etiologies. Methods A standard protocol of treatment of the cases of CAM with zygomatic involvement based on our own outcomes was furnished. All 10 patients were treated with dual antifungal therapy and aggressive surgical resection via extraoral approach, in conjunction with functional endoscopic sinus surgery (FESS). Results Ten out of 116 patients of CAM reporting to our institute presented with zygomatic bone involvement with an incidence rate averaging at 8.6%, whereas in previous literature osteomyelitis of zygomatic bone was extremely rare with an incidence pattern of just 1.42%. Conclusions The treatment protocol followed by the authors gave good outcomes to all patients treated, with no mortalities.
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Affiliation(s)
- Abhay N. Datarkar
- Department of Oral and Maxillofacial Surgery, Government Dental College and Hospital, Hanuman Nagar, Medical Chowk, Nagpur, Maharashtra 440003 India
| | - Surendra Daware
- Department of Oral and Maxillofacial Surgery, Government Dental College and Hospital, Hanuman Nagar, Medical Chowk, Nagpur, Maharashtra 440003 India
| | - Vandana Gadve
- Department of Oral and Maxillofacial Surgery, Government Dental College and Hospital, Hanuman Nagar, Medical Chowk, Nagpur, Maharashtra 440003 India
| | - Arwa F. Pardiwala
- Department of Oral and Maxillofacial Surgery, Government Dental College and Hospital, Hanuman Nagar, Medical Chowk, Nagpur, Maharashtra 440003 India
| | - Mahesh Pund
- Department of Oral and Maxillofacial Surgery, Government Dental College and Hospital, Hanuman Nagar, Medical Chowk, Nagpur, Maharashtra 440003 India
| | - Amit Bhawalkar
- Department of Oral and Maxillofacial Surgery, Government Dental College and Hospital, Hanuman Nagar, Medical Chowk, Nagpur, Maharashtra 440003 India
| | - Subodh Purohit
- Department of Oral and Maxillofacial Surgery, Government Dental College and Hospital, Hanuman Nagar, Medical Chowk, Nagpur, Maharashtra 440003 India
| | - Priyanka Relan
- Department of Oral and Maxillofacial Surgery, Government Dental College and Hospital, Hanuman Nagar, Medical Chowk, Nagpur, Maharashtra 440003 India
| | - Ashlesha Ghormade
- Department of Oral and Maxillofacial Surgery, Government Dental College and Hospital, Hanuman Nagar, Medical Chowk, Nagpur, Maharashtra 440003 India
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Sharma S, Chauhan JS. An infant with a palatal fistula secondary to Candida infection. Arch Craniofac Surg 2020; 21:206-209. [PMID: 32630997 PMCID: PMC7349132 DOI: 10.7181/acfs.2020.00136] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2020] [Accepted: 06/19/2020] [Indexed: 11/16/2022] Open
Abstract
Candida osteomyelitis affecting maxillofacial bones has been scantly documented in the literature. Infantile osteomyelitis is an uncommon and life-threatening disease. Candida osteomyelitis causes significant morbidity. The present report describes a case of a 9-month-old infant with infantile osteomyelitis secondary to Candida infection. This report describes its presentation and the management of palatal fistula in an infant.
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Affiliation(s)
- Sarwpriya Sharma
- Department of Maxillofacial Surgery and 'Smile Train' Cleft Centre, CHL Hospitals, Indore, India
| | - Jaideep Singh Chauhan
- Department of Maxillofacial Surgery and 'Smile Train' Cleft Centre, CHL Hospitals, Indore, India
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Gamaletsou MN, Kontoyiannis DP, Sipsas NV, Moriyama B, Alexander E, Roilides E, Brause B, Walsh TJ. Candida osteomyelitis: analysis of 207 pediatric and adult cases (1970-2011). Clin Infect Dis 2012; 55:1338-51. [PMID: 22911646 DOI: 10.1093/cid/cis660] [Citation(s) in RCA: 115] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND The epidemiology, pathogenesis, clinical manifestations, management, and outcome of Candida osteomyelitis are not well understood. METHODS Cases of Candida osteomyelitis from 1970 through 2011 were reviewed. Underlying conditions, microbiology, mechanisms of infection, clinical manifestations, antifungal therapy, and outcome were studied in 207 evaluable cases. RESULTS Median age was 30 years (range, ≤ 1 month to 88 years) with a >2:1 male:female ratio. Most patients (90%) were not neutropenic. Localizing pain, tenderness, and/or edema were present in 90% of patients. Mechanisms of bone infection followed a pattern of hematogenous dissemination (67%), direct inoculation (25%), and contiguous infection (9%). Coinciding with hematogenous infection, most patients had ≥2 infected bones. When analyzed by age, the most common distribution of infected sites for adults was vertebra (odds ratio [OR], 0.09; 95% confidence interval [CI], .04-.25), rib, and sternum; for pediatric patients (≤18 years) the pattern was femur (OR, 20.6; 95% CI, 8.4-48.1), humerus, then vertebra/ribs. Non-albicans Candida species caused 35% of cases. Bacteria were recovered concomitantly from 12% of cases, underscoring the need for biopsy and/or culture. Candida septic arthritis occurred concomitantly in 21%. Combined surgery and antifungal therapy were used in 48% of cases. The overall complete response rate of Candida osteomyelitis of 32% reflects the difficulty in treating this infection. Relapsed infection, possibly related to inadequate duration of therapy, occurred among 32% who ultimately achieved complete response. CONCLUSIONS Candida osteomyelitis is being reported with increasing frequency. Localizing symptoms are usually present. Vertebrae are the most common sites in adults vs femora in children. Timely diagnosis of Candida osteomyelitis with extended courses of 6-12 months of antifungal therapy, and surgical intervention, when indicated, may improve outcome.
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Affiliation(s)
- Maria N Gamaletsou
- Division of Infectious Diseases, Weill Cornell Medical Center of Cornell University, New York, NY 10065, USA
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Bilateral polymicrobial osteomyelitis with Candida tropicalis and Candida krusei: a case report and an updated literature review. Int J Infect Dis 2012; 16:e16-22. [DOI: 10.1016/j.ijid.2011.10.001] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2011] [Revised: 06/20/2011] [Accepted: 10/03/2011] [Indexed: 11/21/2022] Open
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Basu S, Kumar A. Osteomyelitis as a manifestation of perinatal Human Immunodeficiency Virus disease. J Infect 2011; 63:163-6. [PMID: 21664933 DOI: 10.1016/j.jinf.2011.05.017] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2011] [Revised: 05/13/2011] [Accepted: 05/23/2011] [Indexed: 11/27/2022]
Abstract
We report a premature neonate born of Human Immunodeficiency Virus (HIV)-1 positive mother presenting with extensive osteomyelitis and massive periosteal reaction involving both femurs and left tibia. There was no collection of fluid in soft tissue or joints in ultrasonography and Doppler examination showed normal venous return in both the lower limbs. Blood culture revealed growth of Candida albicans sensitive to fluconazole. The mother did not take any antenatal care and her HIV status was evident only after delivery during routine screening. DNA PCR for HIV-1 of the neonate done on day 45 and day 48 were positive with a viral load of 12 million copies/mL and his CD4 count was 24%. He was diagnosed as severe HIV-associated clinical disease with severe immunosuppression as per WHO classification and was put on combination antiretroviral therapy, Pneumocystis chemoprophylaxis and fluconazole. He responded well to treatment, repeat x-ray done at 4 months was normal except mild bowing of both the femurs. In the present case we wanted to emphasize the need of proper antenatal care and universal HIV-testing as the key to prevent mother-to-child transmission and severe HIV disease as in this case.
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Affiliation(s)
- Sriparna Basu
- Division of Neonatology, Department of Pediatrics, Institute of Medical Sciences, Banaras Hindu University, Varanasi - 221005, India.
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Soriano I, Martín AY, Evora C, Sánchez E. Biodegradable implantable fluconazole delivery rods designed for the treatment of fungal osteomyelitis: influence of gamma sterilization. J Biomed Mater Res A 2007; 77:632-8. [PMID: 16514603 DOI: 10.1002/jbm.a.30657] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Fluconazole poly(D,L-lactic) acid (PLA) and poly(L-lactic) acid (L-PLA) implantable delivery rods were studied, in vitro and in vivo, as an alternative treatment of fungal osteomyelitis. Implantable rods loaded with 5% fluconazole (FLU) were prepared by the injection-molding method and sterilized by gamma-irradiation at a dose of 25 kGy. Loading efficiency, physical chemistry (high performance liquid chromatography, X-ray diffraction, gel permeation chromatography), and in vitro and in vivo release assays were performed to evaluate the novel delivery systems and the sterilization effect on implant characteristics. In spite of polymer degradation after gamma-irradiation, the loading efficiency, chemical stability, and crystallographic structure of FLU were not affected. In vivo studies were carried out in femoral bone marrow of rabbits. Approximately 85 and 80% of the total dose were released within 12 and 4 weeks from PLA and L-PLA rods, respectively. This showed a faster release rate of FLU in vivo than in vitro, showing almost zero-order kinetics from PLA rods.
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Affiliation(s)
- I Soriano
- Departamento de Ingeniería Química y Tecnología Farmacéutica, Facultad de Farmacia, Universidad de La Laguna, Tenerife, Spain.
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Arias F, Mata-Essayag S, Landaeta ME, Capriles CHD, Pérez C, Núñez MJ, Carvajal A, Silva M. Candida albicans osteomyelitis: case report and literature review. Int J Infect Dis 2004; 8:307-14. [PMID: 15325600 DOI: 10.1016/j.ijid.2003.12.006] [Citation(s) in RCA: 45] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2003] [Revised: 10/11/2003] [Accepted: 12/28/2003] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVE Osteomyelitis due to Candida species is an unusual but recognized entity. However, with the increasing occurrence of factors predisposing to candidemia and invasive candidiasis, candidal osteomyelitis is being diagnosed more frequently. An unusual case of Candida albicans osteomyelitis is reported here, along with a review of the published literature on previously reported cases of this disease. METHODS Report of the case and literature review. RESULTS In this case, Candida albicans was isolated from the talus; however, the diagnosis was made after several cultures were performed. Only one other case of Candida osteomyelitis located in foot bones was found in the review. CONCLUSIONS It is thought that this is the first case reported in Venezuela, and only the second in international literature.
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Affiliation(s)
- Félix Arias
- Servicio de Enfermedades Infecciosas del Adulto, Hospital Universitario de Caracas, Venezuela
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Wang J, Goodger NM, Pogrel MA. Osteonecrosis of the jaws associated with cancer chemotherapy. J Oral Maxillofac Surg 2003; 61:1104-7. [PMID: 12966490 DOI: 10.1016/s0278-2391(03)00328-8] [Citation(s) in RCA: 238] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- J Wang
- Department of Oral and Maxillofacial Surgery, University of California-San Francisco, 521 Parnassus Avenue, San Francisco, CA 94143-0440, USA
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Ellepola AN, Samaranayake LP. Oral candidal infections and antimycotics. CRITICAL REVIEWS IN ORAL BIOLOGY AND MEDICINE : AN OFFICIAL PUBLICATION OF THE AMERICAN ASSOCIATION OF ORAL BIOLOGISTS 2002; 11:172-98. [PMID: 12002814 DOI: 10.1177/10454411000110020301] [Citation(s) in RCA: 135] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The advent of the human immunodeficiency virus infection and the increasing prevalence of compromised individuals in the community due to modern therapeutic advances have resulted in a resurgence of opportunistic infections, including oral candidoses. One form of the latter presents classically as a white lesion of "thrush" and is usually easily diagnosed and cured. Nonetheless, a minority of these lesions appears in new guises such as erythematous candidosis, thereby confounding the unwary clinician and complicating its management. Despite the availability of several effective antimycotics for the treatment of oral candidoses, failure of therapy is not uncommon due to the unique environment of the oral cavity, where the flushing effect of saliva and the cleansing action of the oral musculature tend to reduce the drug concentration to sub-therapeutic levels. This problem has been partly circumvented by the introduction of the triazole agents, which initially appeared to be highly effective. However, an alarming increase of organisms resistant to the triazoles has been reported recently. In this review, an overview of clinical manifestations of oral candidoses and recent advances in antimycotic therapy is given, together with newer concepts, such as the post-antifungal effect (PAFE) and its possible therapeutic implications.
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Affiliation(s)
- A N Ellepola
- Division of Oral Bio-sciences, Faculty of Dentistry, University of Hong Kong, Prince Philip Dental Hospital, Hong Kong
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Abstract
Bacterial infection is one of several important causes of exacerbations of chronic obstructive pulmonary disease (COPD) that may coexist. COPD is a heterogeneous condition and the incidence of bacterial infection is not uniform; mucus hypersecretion may be an important risk factor. The bacteriology of infections varies depending on the severity of the underlying airway disease. There is now a much better understanding of the pathogenesis of bacterial infections of the respiratory mucosa. Lower airway bacterial colonization may be a stimulus for chronic inflammation and may influence the interval between exacerbations. Antibiotic resistance has increased in all the major pathogens. Antibiotics are an important part of the treatment of acute exacerbations of COPD and the decision about whether to give an antibiotic can be made on clinical grounds. It is more difficult to decide, on the available evidence, whether patient characteristics and the risk of antibiotic resistance should influence choice of empiric antibiotic treatment. Most new antibiotics are modifications of existing structures, suggesting that every effort should be made to conserve the sensitivity of current antibiotics by using them appropriately.
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Affiliation(s)
- R Wilson
- Royal Brompton Hospital, London, UK
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Abstract
We describe a case of a 57-year-old patient with osteomyelitis at a finger of his right hand caused by Candida guilliermondii. The strains isolated were highly resistant to fluconazole and itraconazole. Using the three methods, microdilution, agardilation and E-test, the highest minimum inhibitory concentrations (MICs) amounted to > 256 micrograms ml-1 for fluconazole and > 32 micrograms ml-1 for itraconazole. To our knowledge, this is the first time such high values have been described for C. guilliermondii. They correlated with the therapeutic non-response to a triazole therapy in our patient. The patient was cured by partial amputation of the affected finger.
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Turner DL, Johnson SA, Rule SA. Successful treatment of candidal osteomyelitis with fluconazole following failure with liposomal amphotericin B. J Infect 1999; 38:51-3. [PMID: 10090510 DOI: 10.1016/s0163-4453(99)90032-4] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
A case of multiple relapses of Candida albicans infection of deep tissues is described. Treatment was complicated by renal impairment, but therapy with a liposomal amphotericin product failed to eradicate the third recurrence which subsequently resolved after protracted exposure to oral fluconazole.
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Affiliation(s)
- D L Turner
- Department of Haematological Medicine, Taunton & Somerset NHS Trust, UK
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