Disease relevance of Blastomycosis

• INTERVENTIONS: Itraconazole was administered orally at doses of 200 to 400 mg/d. Patients in whom treatment was considered a success were treated for a median duration of 6.2 months (blastomycosis) and 9.0 months (histoplasmosis) [1].
• A previously healthy patient who had received oral prednisone, 30 mg/day for 12 days, was initially seen with acute respiratory failure caused by miliary blastomycosis [2].
• The efficacy and safety of intravenously administered miconazole nitrate was examined in eight patients with the following infections: cutaneous North American blastomycosis (one), extensive dermatophytosis(one), and chronic mucocutaneous candidiasis (six) [3].
• OBJECTIVE: To assess the efficacy and toxicity of orally administered itraconazole in the treatment of nonmeningeal, nonlife-threatening forms of blastomycosis and histoplasmosis [1].
• A new triazole, Bay R 3783, was compared with ketoconazole, itraconazole, and fluconazole, which were given via the alimentary tract at three dosages, and amphotericin B, which was given at 1 mg/kg intraperitoneally, in murine models of the systemic mycoses coccidioidomycosis, histoplasmosis, and blastomycosis [4].

High impact information on Blastomycosis

• Cloned cDNA was used to express a 30-kD fusion protein strongly recognized in western blots by rabbit anti-WI-1 antiserum, and by sera from all 35 blastomycosis patients studied [5].
• Initial therapy with amphotericin B is appropriate in patients with AIDS and presumptive blastomycosis [6].
• RESULTS: Twelve of 15 patients had a previous or concomitant AIDS-defining illness at the time of diagnosis of blastomycosis, and only one patient had a CD4 lymphocyte count of greater than 200 cells/mm3 [6].
• Ketoconazole therapy for endemic blastomycosis [7].
• In contrast to these findings, neutralization of elevated TGF-beta levels during experimental pulmonary blastomycosis did not restore BAD1-suppressed TNF-alpha levels in the lung or ameliorate disease [8].

Chemical compound and disease context of Blastomycosis

• Amphotericin B is effective in therapy for blastomycosis but causes a number of serious adverse reactions [7].
• Of 72 individuals with blastomycosis who were patients at the Vanderbilt School of Medicine affiliated hospitals during the period 1957-1983, 6 (8%) had arthritis at presentation [9].
• CONCLUSIONS: Itraconazole is a highly effective therapy for nonmeningeal, nonlife-threatening blastomycosis and histoplasmosis [1].
• SCH 39304 was tested for treatment of acute or established murine pulmonary blastomycosis and was compared with ketoconazole and fluconazole in a model of acute infection [10].
• Treatment of murine pulmonary blastomycosis with SCH 51048, a broad-spectrum triazole antifungal agent [11].

Biological context of Blastomycosis

• However, both complement activation and the capacity for C3 binding by the wild-type yeast were enhanced in normal human serum supplemented with an anti-BAD1 monoclonal antibody (MAb) or in immune sera from blastomycosis patients [12].
• In an assessment of the usefulness of anti-WI-1 serology in the diagnosis of blastomycosis, the RIA was used to test four panels of sera from residents of Wisconsin, a state in which blastomycosis is endemic [13].
• Because of the severity of the disease, initial therapy with amphotericin B is advised for most immunocompromised patients with blastomycosis to gain control of the disease [14].

Anatomical context of Blastomycosis

• These findings indicate that one basis for the efficacy of itraconazole versus ketoconazole in treating blastomycosis could be synergy of a fungistatic concentration of itraconazole with macrophages in killing of B. dermatitidis [15].
• Recurrent central nervous system blastomycosis in an immunocompetent child treated successfully with sequential liposomal amphotericin B and voriconazole [16].
• Patients with pulmonary blastomycosis prior to therapy had a smaller TH/S ratio than the other groups in peripheral blood primarily due to a reduction in the circulating TH fraction in both absolute numbers of cells and in the percentage of total T lymphocytes [17].
• Patients with treated extrapulmonary blastomycosis had similar T helper (TH) to T suppressor (TS) ratios compared to recovering pulmonary patients and control subjects; this ratio gives a false impression because extrapulmonary blastomycosis patients had a reduced absolute number of lymphocytes with either marker [17].

Gene context of Blastomycosis

• Treatment of murine pulmonary blastomycosis with SCH 39304, a new triazole antifungal agent [18].
• Nikkomycins X and Z, competitive inhibitors of fungal chitin synthase, were evaluated as therapeutic agents in vitro and in mouse models of coccidioidomycosis, histoplasmosis, and blastomycosis [19].
• PCR-generated CF/chitinase cDNA fragments were cloned and examined for their reactivity in enzyme-linked immunosorbent assays using sera from patients with coccidioidomycosis, histoplasmosis, or blastomycosis [20].
• Blastomycosis appears to be prevalent in states around the Great Lakes. However, its incidence in these states has not been reported [21].
• Pulmonary blastomycosis patients re-evaluated after at least four weeks of antifungal therapy had TH/S ratios that were similar to normal persons [17].

Analytical, diagnostic and therapeutic context of Blastomycosis

• Both patients were treated successfully with itraconazole with no evidence of recurrent infection after 1 year These cases illustrate the importance of considering blastomycosis in the differential diagnosis of bony lesions, even though the patient may live outside an endemic area for B dermatitidis [22].
• The antiserum can be used as a reference serum in the immunodiffusion test for identyfying antibodies to the A antigen in sera from patients thought to have blastomycosis [23].
• Successful treatment of systemic blastomycosis with high-dose ketoconazole in a renal transplant recipient [24].
• The EIA, however, was not absolutely specific, since some sera from patients with confirmed blastomycosis and some from patients with noncoccidioidal disease produced false-positive reactions [25].
• Apparent diminution of the blastomycin skin test; follow-up of an epidemic of blastomycosis [26].

References