Two cases of disseminated Trichosporon beigelii infection treated with combination antifungal therapy

Article Abstract:

One of the problems facing patients undergoing chemotherapy for cancer is the suppression of the bone marrow which occurs as a side effect. Since the bone marrow provides the white blood cells necessary for the body's defense, the chemotherapy patient is temporarily immunosuppressed and vulnerable to numerous infections. One such infection that may occur is with the fungus Trichosporon beigelii. This fungus is commonly found in soil, and often peacefully coexists with other natural flora in the human skin and mouth. However, in immunocompromized patients the organism has occasionally been reported to cause disseminated infection. Two cases of T. beigelii infection are reported in patients undergoing treatment for leukemia. One patient was treated with amphotericin B, a commonly used antifungal agent. The patient developed varicella pneumonia and progressive renal failure; he died as a result of an intracranial hemorrhage. Autopsy revealed fungal infection of the thyroid, heart muscle, esophagus, ileum, liver, spleen, and kidneys. The second patient was treated with miconazole and norfloxacin when blood cultures revealed the fungus, but his fever persisted. Ultrasonogram revealed numerous defects in the spleen. When low-grade fever and evidence of splenic disease continued as other indications of infection subsided, the patient's spleen was removed. Evidence of fungus was found in the spleen, but the living organisms could not be cultured from the organ. The patient's leukemia has relapsed, but the patient remains on preventative miconazole and norfloxacin and has no evidence of fungal disease. (Consumer Summary produced by Reliance Medical Information, Inc.)

Drug therapy, Immunodeficiency, Antifungal agents, Mycoses

---

Adjuvant systemic therapy for patients with node-negative tumors

Article Abstract:

Adjuvant therapy was introduced to improve the survival of patients found to have early stages of tumor spread. For example, if a breast cancer patient is found to have cancer cells in the lymph nodes of her armpit during surgery, adjuvant chemotherapy is likely to be added to her treatment regimen. In general, the therapy will not be applied to patients who do not have positive nodes. However, studies have recently begun to examine the potential usefulness of adjuvant chemotherapy in patients with negative nodes. The results of these studies have raised as many questions as they have answered. No major trial has shown a survival benefit to the use of adjuvant therapy in node negative patients, and in most studies not enough time has passed to determine how many patients will eventually experience relapse. If only a small fraction of node-negative patients will benefit, can the toxicity of chemotherapeutic treatment be justified? Although physicians may prefer the safety margin of extra treatment, node-negative patients have a right to be informed of the present state of knowledge before consenting to adjuvant chemotherapy: most node-negative patients will derive no benefit. For patients whose cancer recurs, the average length of time to recurrence is likely to be longer. For those who will die of breast cancer, survival time is likely to be prolonged. There is no evidence that this therapy can cure breast cancer, and it is possible that any benefits of adjuvant treatment will be outweighed by toxic effects. (Consumer Summary produced by Reliance Medical Information, Inc.)

Breast cancer, Adjuvant chemotherapy

---

A controlled evaluation of an allopurinol mouthwash as prophylaxis against 5-fluorouracil-induced stomatitis

Article Abstract:

Mucositis, or inflammation of the oral mucosa (the tissue inside the mouth), is a common side effect of chemotherapy drugs, such as 5-fluorouracil. Although not generally life-threatening, the resulting sores can cause pain, interfere with eating, and reduce the quality of life for the patient. There has been some indication, based on small numbers of patients, that a mouthwash containing allopurinol might, at least partially, alleviate this side effect. This theory was tested among 77 patients who were about to receive chemotherapy containing 5-fluorouracil. The patients were randomly assigned to rinse their mouths with either a solution containing allopurinol or the equivalent mixture minus the allopurinol (control group). The severity of mucositis following chemotherapy was rated by the attending physician and the patients, who completed questionnaires. Both patient and physician ratings reported less mucositis among the placebo control group than among the patients who rinsed with allopurinol, although the difference was not statistically significant. These results indicate that there was no protective effect afforded the chemotherapy patients by the allopurinol mouthwash. (Consumer Summary produced by Reliance Medical Information, Inc.)

Fluorouracil, Oral mucosa, Allopurinol

Similar abstracts:

• Abstracts: Fulminant hepatitis as a consequence of reactivation of hepatitis B virus infection after discontinuation of low-dose methotrexate therapy
• Abstracts: The association of genital ulcer disease and HIV infection at a dermatology-STD clinic in Uganda. High-titer positive nontreponemal tests with negative specific treponemal serology in patients with HIV infection and/or intravenous substance use
• Abstracts: Neonatal growth assessment score: a new approach to the detection of intrauterine growth retardation in the newborn
• Abstracts: Serologic tests for Lyme disease; Interlaboratory variability. Serologic tests for antibody to Borrelia burgdorferi. Another Pandora's box for Medicine?
• Abstracts: Ki-67 immunostaining in human breast tumors and its relationship to prognosis

This website is not affiliated with document authors or copyright owners. This page is provided for informational purposes only. Unintentional errors are possible.