In Vivo Susceptibility of Cryptococcus neoformans to Hamycin, Amphotericin B, and 5-Fluorocytosine

Combination chemotherapy of canine and feline cryptococcosis using subcutaneously administered amphotericin B

Six cases (3 cats, 3 dogs) of cryptococcosis were cured using combination chemotherapy that included amphotericin B. We developed a simple, practical and inexpensive method of administering amphotericin B as a subcutaneous infusion during the treatment of these patients. For this, the calculated dose of amphotericin B (0.5 to 0.8 mg/kg) was added to 400 mL, for cats, or to 500 mL, for dogs, of 0.45% saline containing 2.5% dextrose. These amounts were given subcutaneously 2 or 3 times weekly over several months, to a total cumulative dose of 8 to 26 mg/kg body weight. Subcutaneous infusions were generally well tolerated by the animals, although concentrations of amphotericin B in excess of 20 mg/L resulted in local irritation. This protocol enabled the administration of larger, and thus more effective, quantities of amphotericin B without producing marked azotaemia.

The genetics of medically important fungi

The present review is concerned with recent progress in basic genetic investigations with a variety of fungi which are pathogenic for man and animals. The principles and strategies involved in undertaking genetic investigations of sexual species and of asexual species are discussed. Progress in genetic analysis of Cryptococcus neoformans made possible by the discovery of its sexual phase is described in detail, as is progress in development of parasexual methods of analysis in Candida albicans. The genetic bases of virulence and drug resistance are discussed for those few species in which these phenotypes have been investigated. Suggestions for future research, including the application of recent advances in molecular biology to the study of pathogenic fungi, are presented.

Torulomas (cryptococcal granulomata) of the central nervous system

✓ Three new cases of cryptococcal granuloma of the central nervous system are reported and compared with 37 previously described cases. The lesion may appear with or without evidence of meningitis. Resection of the granuloma followed by prophylactic or therapeutic chemotherapy is recommended as the treatment of choice. Serial lumbar punctures and blood and CSF antigen levels are of value in determining response to treatment.