Primary cutaneous cryptococcosis

Cottonseed protein agar and a modified Tween-albumin casein hydrolysate (TAC) medium were compared for the yeast phase conversion of Blastomyces dermatitidis strains including fresh isolates as well as strains maintained in long-term storage. It was found that both media converted all the B. dermatitidis (mycelial phase) strains studied to yeast phase in three days. The TAC medium has the added advantage that it is clear and the growth can be recognized earlier than in the opaque cottonseed agar medium. The conversion in most cases was more than 95% and the morphology of the yeast cells was uniformly typical with broad base budding. There was a striking difference between the sensitivity of the yeast and mycelial phases of B. dermatitidis strains. The yeast phase was usually more sensitive to Amphotericin B than the mycelial phase of B. dermatitidis. Similarly, the yeast phases of four out of six strains were more sensitive to ketoconazole than their respective mycelial phases, while two strains showed identical sensitivity in cottonseed agar. The yeast phase organism was more susceptible to Amphotericin B when cottonseed medium was used whereas the yeast phase showed more susceptibility to ketoconazole in TAC medium. Since the sensitivity among the various strains differed, it is necessary to determine the antifungal susceptibility of the pathogenic phase of the organism for initiating proper therapy and monitoring effectiveness.Dr. Rose actively participated in this research; expired February 2, 1984.     

先天性皮肤念珠菌病

先天性皮肤念珠菌病是新生儿于子宫内获得的较为少见的感染性疾病.临床表现主要为皮肤受累,可以伴发或仅有甲改变,其病程良性,部分患者可以自愈.伴有系统感染时需系统给予抗真菌药物治疗,病情严重也可引起患儿死亡.现对该病的易感因素、发病机制、临床表现、诊断及治疗等做一简要综述.     

Unknown fixed cutaneous sporotrichosis

Sporotrichosis is the most frequent subcutaneous mycosis in Mexico. The clinical forms are commonly described as lympho-cutaneous and cutaneous-fixed. The case of a male patient who developed an eritematous plaque with radial growth is reported. The patient received empirical therapy and topic steroids which modified the clinical picture with vesicles to vesicles, ulcers and blood and honey crusts. Diagnosis of fixed cutaneous sporotrichosis incognito was established by clinical, mycological and histopathological studies. Delayed cellular immunity in vitro and in vivo were normal. The patient received oral itraconazole showing clinical and mycological cure after four months.     

伴播散性皮肤感染的系统性隐球菌病1例

患者女性,25岁,因发热咳嗽,全身皮肤丘疹、斑块、溃疡2个月于2005年8月13日住院。患者于2005年6月无诱因畏寒发热,无寒颤,体温39．0℃～40．0℃,为稽留热,继之出现咳嗽,伴少许黏液白痰,之后于上唇及右手腕皮肤出现丘疹、斑块,渐形成溃疡,皮损无明显痒痛,1个月后皮损泛发全身。     

Immunologic memory in cutaneous leishmaniasis

Leishmania major infections induce solid immunity to reinfection. Experimental studies in mice indicate that the CD4+ T cells responsible for this immunity include two populations: parasite-dependent T effector cells and parasite-independent central memory T (Tcm) cells. While there currently is no vaccine for leishmaniasis, the existence of a long-lived population of Tcm cells that does not require the continued presence of live parasites suggests that a vaccine that expands these cells might be efficacious.     

Miltefosine for disseminated cutaneous leishmaniasis

Disseminated cutaneous leishmaniasis is a rare presentation characterized by hematogenous dissemination of the parasite that causes the appearance of multiple nodules and plaques in the skin of the whole body and even including the nasal mucous membrane. It differs from diffuse cutaneous leishmaniasis because the alteration in cellular immunity is lower and the lesions may have epidermal desquamation. On the other hand, diffuse cutaneous leishmaniasis presents nodular lesions and a specific anergy in the immune response directed against the parasite. This article describes the case of a Colombian patient with disseminated cutaneous leishmaniasis caused by L. (V) panamensis. The initial treatments with Glucantime and Amphotericin B failed, but his lesions healed after treatment with miltefosine.     

Localized cutaneous nocardiosis in Japan

A turbidometric method was used to measure Candida albicans yeast cell growth and to quantitate the postantifungal effect (PAFE) after exposure to various concentrations of flucytosine and amphotericin B, alone and in combination, for 2 hr at 30°C. The drug concentrations used in the PAFE assays were determined by initial MIC and FIC (fractional inhibitory concentration) evaluations. The PAFE was calculated by the difference in time (hr) required for growth of the control and test cultures to reach the 0.5 absorbance level following removal of the drug by dilution. A synergistic PAFE was evidenced with combinations of the two drugs at concentrations below their individual MICs. Combinations of flucytosine (0.012 to 0.049 g ml^–1) and amphotericin B (0.195 to 0.39 g ml^–1) produced PAFEs ranging from 6.3 to 21.8 hr. These PAFEs persisted from 0.3 to 14.7 hr longer than those achieved when each of the two agents was assayed separately.     

Satiation in cutaneous saltation.

The extent of cutaneous saltation (the illusory displacement of a tap presented to one skin locus by another tap occurring close in time at another locus) was modified by a "preconditioning" stimulus presented prior to and at a site distant from the saltatory test pattern. The 10-sec vibratory preconditioning (PC) stimulus appears to be analogous to inspection figures that "satiate" the perceptual field in experiments on figural aftereffects, producing changes in the perceived size, position, or shape of subsequent stimuli. The direction of displacement of the saltatory phantom was always away from the locus of the prior PC stimulus, consistent with results observed in studies of visual and kinesthetic aftereffects. Th- amount of repulsion and the rate at which the saltatory phantom returned to its initial position depend on the intensity, locus, and number of PC stimuli. As with figural aftereffects, these results resist explanation by peripheral mechanisms such as adaptation.