Search

Copyright of Rechtsmedizin is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.) more...

The article focuses on advancements in rapid tests and laboratory diagnostics in mycology, emphasizing their role in promptly identifying fungal infections through immunological and molecular methods. It states that these technologies allow for quicker detection and differentiation of pathogens like Aspergillus and Candida, crucial for timely intervention, especially in immunocompromised patients undergoing treatments such as organ transplants or immunosuppressive therapies. more...

The article focuses on the increasing prevalence of Candida auris infections in German hospitals, highlighting concerns over its resistance patterns and the necessity for stringent prevention measures since its notification became mandatory in 2023. It states that despite primarily causing colonizations, the fungus poses significant challenges due to high mortality rates associated with invasive infections and its resistance to multiple antifungal classes. more...

Until recently Nymphaea candida was thought to have become extinct in Styria. During short visits in July 2015 and 2016 to the Furtner Teich Natura 2000 Protected Area in the Zirbitzkogel-Grebenzen Natural Park near Neumarkt in the Murau District of Styria, Nymphaea blossoms of water lilies were also observed and the occurrence of N. candida was suspected by W.R. Franz. In 2020 P. Hochleitner was able to confirm the occurence of both N. alba and N. candida species at the Furtner Teich site. Morphological features of both Nymphaea species are listed and compared and the currently knwon distribution in Austria of N.candida is discussed. [ABSTRACT FROM AUTHOR] more...

In this essay, I wish to elucidate the specific function architectural photography has for the experience of buildings. With photographs, the image character of buildings can be discovered and represented, and thereby the nature of habitation can be revealed as well. Taking or contemplating pictures of habitable rooms one could learn that habitation is primarily perceptional—a character mostly concealed by the dominance of everyday practice. In order to give an impression of the manifold possibilities architectural photography holds, I discuss the work of five quite different photographic artists, namely Julius Shulman, Yutaka Saito, Candida Höfer, Cy Twombly, and Yasuhiro Ishimoto. [ABSTRACT FROM AUTHOR] more...

Copyright of Der Gynäkologe is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.) more...

Copyright of Der Hautarzt is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.) more...

Endogenous Candida endophthalmitis is a rare but vision-threatening disease. In most cases, endogenous endophthalmitis caused by Candida species has a better prognosis than endogenous endophthalmitis caused by other fungal species or bacteria but the prognosis still depends heavily on the time required for diagnosis and subsequent treatment as well as the initial visual acuity. Suggestions for treatment algorithms have already been made in the past but binding guidelines in ophthalmology only exist sporadically due to the rarity of the disease. This review discusses the current knowledge on endogenous Candida endophthalmitis and draws conclusions from the current study situation., (© 2024. The Author(s).) more...

Copyright of Der Ophthalmologe is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.) more...

Background: Invasive fungal infections caused by Candida or Aspergillus are associated with a high mortality. Knowledge about the risk factors, diagnosis and treatment management is crucial for improving the survival of those affected., Objective: To give a practical overview about risk factors and treatment management of Candida and Aspergillus infections as well as providing an outlook on new antifungal agents., Material and Methods: Summary of the relevant literature and recommendations on candidemia and invasive candidiasis as well as invasive and chronic pulmonary aspergillosis., Results: The first line treatment of candidemia and invasive candidiasis are echinocandins including caspofungin, anidulafungin and micafungin. Regular blood cultures have to be taken to determine the duration of treatment. After the first negative control blood culture treatment should be continued for another 14 days. The first line treatment of invasive pulmonary aspergillosis is azoles including voriconazole and isavuconazole. The duration of treatment depends on disease severity and is recommended for 6-12 weeks. The duration of treatment for chronic pulmonary aspergillosis is 6-12 months. Therapeutic drug monitoring is recommended for voriconazole and for posaconazole. New antifungal agents including olorofim, fosmanogepix, opelconazole, rezafungin or ibrexafungerp will broaden the therapeutic spectrum in the foreseeable future., Conclusion: Knowledge about risk factors and the correct treatment management is crucial for the survival of patients with invasive fungal infections., (© 2023. The Author(s), under exclusive licence to Springer Medizin Verlag GmbH, ein Teil von Springer Nature.) more...

Background: Yeasts are found in urine specimens relatively often, especially in the elderly and patients under treatment with broad spectrum antibiotics, i. e. especially in intensive care unit (ICU) patients. In some cases, the number of pathogens is very high, i. e. >105/ml. The clinical relevance of detecting Candida in urine is difficult to assess. In the German S3 guidelines it is apodictically stated that an ascending infection of the urinary tract by yeasts does not occur but this may undoubtedly happen in certain instances in patients at risk, for example in the elderly, in diabetic persons and in the case of foreign bodies in the urinary tract. A hematogenous spread of yeasts can lead to pyelonephritis, which accompanies candiduria. In rare cases this can be induced by prostatitis and epididymitis. Therapy is indicated in all cases when a urological manipulation is planned, particularly those with injury to the mucosal barrier, in order to prevent an intraoperative spread of pathogens.Aim: The antimicrobial agents suitable for therapy of candiduria are limited, namely flucytosine, amphotericin B, which is also used for irrigation and fluconazole.Material and Methods: The in vitro effect of nitroxoline on 100 isolates of yeasts from urine was tested by an agar diffusion test.Results: Nitroxoline exerted a good activity against all yeast isolates.Discussion: The antibiotic nitroxoline has a good antifungal activity. It achieves high concentrations in urine and in addition, it is effective at low pH as well as against pathogens in biofilms, which most antimycotics cannot achieve. Hence, nitroxoline is suitable for termination of candiduria. Foreign bodies in the urinary tract, on which biofilms are formed, should be removed whenever possible. [ABSTRACT FROM AUTHOR] more...

Copyright of Colo-Proctology is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.) more...

Copyright of Der Hautarzt is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.) more...

Dermatomycoses affect free skin, hairy scalp, fingernails and toenails. In addition, oral mucosa and genital mucosa can also be affected by fungal infections. The most common pathogens causing skin fungal infections are dermatophytes. They are responsible for, among others, tinea corporis, tinea capitis and onychomycosis (tinea unguium). Mainly anthropophilic dermatophytes are found as pathogens. In the case of tinea capitis-at least in Europe and in German-speaking countries-zoophilic skin fungi must also be considered. Rarely, geophilic dermatophytes can also be isolated. Yeast infections of the skin, mostly caused by Candida albicans, primarily affect the intertriginous skin areas, for example, the groin region, but also the submammary area and the spaces between the fingers and toes. Elderly patients are often affected, but also infants and, in particular, immunocompromised patients. These patient groups are also more frequently affected by oral mucosal infections caused by Candida albicans and other Candida species. Pseudomembranous candidiasis of the oral mucosa and tongue typically affects patients with HIV/AIDS. Mold infections in dermatology are relevant in onychomycosis of the big toenail. The causative agent is usually Scopulariopsis brevicaulis. Cutaneous mold infections are rare and only occur in immunocompromised patients. The mycological diagnosis of dermatomycoses is based on the microscopic, if possible fluorescence-optical detection of fungal hyphae and spores from skin scales, nail shavings and hair roots. The culture detection of dermatophytes, yeasts and molds allows the identification of the causative fungal species, but often fails, especially in patients who have already been treated with antifungal agents. In view of the high sensitivity and specificity of the molecular methods for fungal detection compared to culture, polymerase chain reaction (PCR) must realistically be regarded as the gold standard for dermatophytosis diagnostics. However, it should not be neglected that the three pillars of diagnostics-preparation, culture, PCR-currently deliver the best results., (© 2023. The Author(s), under exclusive licence to Springer Medizin Verlag GmbH, ein Teil von Springer Nature.) more...

Background: This study was a pre-planned country-specific secondary analysis of results in Germany from a multinational multicenter observational study to retrospectively evaluate clinical outcomes with caspofungin in patients with probable and proven invasive fungal infection following solid organ transplantation (SOT). Methods: Data were retrospectively collected on a single episode of invasive fungal infection (IFI) in patients who had a SOT between January 2004 and June 2007. Effectiveness was reported as the proportion of patients who received at least five doses of caspofungin with a favorable (complete or partial) response. Safety was assessed for patients who received at least one dose of caspofungin. Descriptive statistics were employed for all evaluations. Results: A total of 41 SOT patients (27 male, 14 female; median age 56 years, median APACHE II score at start of caspofungin therapy 23) were enrolled from 5 sites in Germany. Organs transplanted were mainly heart (51%) and liver (46%). Prevalent risk factors for IFI at baseline were use of central venous catheter (37 out of 41 patients, 90%), steroid use (37 out of 41 patients, 90%), recent stay in intensive care (36 out of 41 patients, 88%),and duration of SOT procedure >5 hours (21 out of 41 patients, 51%). Candidiasis was diagnosed in 34 patients (83%) and aspergillosis in 10 patients (24%). The lungs were the most common site of IFI (21 out of 41, 51%). Caspofungin as monotherapy was received by 28 patients (68%); 6 patients (15%) received caspofungin as salvage therapy for IFI, in most cases because they were refractory to prior antifungal drugs. Immunosuppressants were administered with caspofungin in 39 out of 41 patients (95%). In subjects with at least 5 doses of caspofungin (modified intention to treat population) the favorable response rate at the end of caspofungin therapy was 88% overall, 29 out of 33 patients; 95% confidence interval (95%-CI) 72-97%), 86% (19 out of 22 patients) with monotherapy and 91% (10 out of 11 patients) with combination therapy. No (serious) adverse events or drug interactions related to treatment with caspofungin were reported. The overall survival rate was 79% (26 out of 33 patients; 95%-CI 61-91%) at 7 days after completion of caspofungin treatment. Conclusion: Caspofungin was found to be an effective treatment of probable and proven invasive fungal infections in patients following SOT in Germany. [ABSTRACT FROM AUTHOR] more...

A patient with a red, painful eye and gradual visual impairment is examined ophthalmologically. Culture of the vitreal aspirate yields Candida tropicalis. Subsequent medical evaluation reveals that during an acute hospitalization eight weeks prior positive blood cultures for Candida had been reported but not acted on, despite a high risk constellation of operative therapy, intensive care unit treatment, central catheters, parenteral nutrition and broad spectrum antibiotics. Diagnosis and treatment of candidemia with a focus on candida endophthalmitis is discussed. [ABSTRACT FROM AUTHOR] more...

In a secondary care hospital in Germany with an in-house microbiology laboratory, an 84-year-old female patient with candidemia was selected for determination of the time periods required for each diagnostic step preceding the application of the first dose of antimycotic treatment. The total time from the beginning of fever to the first dose of fluconazole was 25 hours and 10 minutes. The largest delay occurred between the positive signal of the blood culture bottle during the night and the start of the work-up of the positive blood culture bottle in the morning. Improvements appear to be possible in both clinical and laboratory settings by optimizing pre-analytical, analytical, and post-analytical procedures. [ABSTRACT FROM AUTHOR] more...

Patients with haematological malignancies are at high risk for developing invasive Candida infections. They are often colonised with Candida spp. in the gastrointestinal (GI) tract. In order to prevent infection, the prophylactic use of antifungal agents has been established. The widespread use of fluconazole may lead to the emergence of resistant Candida isolates. We studied the yeast colonisation of the GI tract in patients with haematological malignancies receiving antifungal prophylaxis (AP) in comparison with healthy controls. The study cohort included 46 neutropenic patients with 52 stool samples under 52 episodes of AP and 110 healthy controls. The patients received amphotericin B orally ( n = 8), amphotericin B and fluconazole ( n = 7), amphotericin B and itraconazole ( n = 5), fluconazole orally ( n = 15) and itraconazole orally ( n = 17). Yeasts were cultured from the stool samples of 63.5% of the patients and 60% of the controls with a mean yeast load of 1.6 × 103 and 0.4 × 103 cfu g−1, respectively ( P = 0.045). Patients and controls had a low faecal yeast load of 103 to 104 cfu g−1 in 19.3% and 37.3%, respectively ( P = 0.021), and yeast overgrowth of >105 cfu g−1 in 28.9% and 10.9%, respectively ( P = 0.004). The rate of Candida albicans was 32.6% and 54.1% in the patients and controls, respectively ( P = 0.021). The rates of fluconazole-resistant yeast species were higher in the patient group than in the control group: C. glabrata 20.9% vs. 11.7% ( P = 0.168), C. krusei 25.6% vs. 4.7% ( P = 0.001). Not a single patient under AP suffered from proven or probable invasive candidosis. In conclusion, oral AP in haematological patients resulted in a higher colonisation rate with fluconazole-resistant Candida species but efficiently prevented invasive candidosis. [ABSTRACT FROM AUTHOR] more...

Copyright of Der Gynäkologe is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.) more...

Systemic mycoses, especially pulmonary diseases and septicemia are observed increasingly at intensive care units. Essential risk factors for development of candidosis are the expanded use of antibiotics and immunocompromised patients, caused either as a result of a severe underlying disease or iatrogenicly induced after organ transplantation.Candida albicansis the most frequent pathogen in microbiological findings. Blood cultures are only positive in massive fungemia.We report a 50-year-old patient with recurrentCandida-septicemia: rupture of the distal esophagus after dilatation because of cardiac achalasia with mediastinal emphysema and mediastinitis. Severe acute respiratory distress syndrome after aspiration with septic shock and acute renal failure at the beginning. Long-term mechanical ventilation, continuous renal replacement therapy and multifarious antibiotic therapy. Early microbiological samples of several positive blood cultures and bronchoalveolar lavages revealed the presence ofCandida albicans. In the further clinical course, detection ofPseudomonasspecies in bronchoalveolar lavages andStaphylococcias well asEnterococciin a number of positive blood cultures. Later on development of a severe liver dysfunction with test results that showed an intrahepatic cholestasis. Because of coagulation failure commencement of artificial liver support with the MARS®-system (molecule adsorbent recirculating system). Decrease of high bilirubin levels was accompanied by improvement of clinical condition of the patient. In the following course, repeated severe systemic infections with phases of septicemia or rather septic shock and detection ofCandidain several positive blood cultures and bronchoalveolar lavages. In each case increasing bilirubin levels with signs of intrahepatic cholestasis and each time improvement with antimycotic therapy (voriconazol, caspofungin and fluconazol). The patient showed more and more signs of immunodeficiency in the sequel.The clinical appearance of candidosis is manifold. SystemicCandidainfections are frequent in patients with immunodeficiency. A recurrentCandidasepticemia with prolonged respiratory failure and severe liver dysfunction in form of cholestatic hepatosis, that improved several times with antimycotic therapy in combination with evidence based intensive care measures and artificial organ support is a comparatively rare event. [ABSTRACT FROM AUTHOR] more...

In the case of a 53-year-old woman with acute myeloid leukaemia and fever in late aplasia after chemotherapy, invasive mycosis with characteristic involvement of liver and spleen was diagnosed. For the serological identification ofCandidain the early phase of the infection, methods for the detection of antibodies againstCandidaantigens were compared. By ELISA-based detection of IgM and IgG antibodies against a mixture ofCandidaantigens (ESR 117G and 117M, Virion-Serion, Würzburg, Germany) evidence for invasive candidosis was obtained significantly earlier (22 days) when compared with the immunofluorescence detection of IgG antibodies againstCandida albicansgerm tube antigens (Vircell, Granada, Spain). In the case of this patient, the detection of a humoral response againstCandidagerm tube antigens was of little diagnostic value. [ABSTRACT FROM AUTHOR] more...

We retrospectively analysed the results ofCandidaserological testing of 126 surgical intensive care patients. There were high numbers of patients which were mycoserologically positive (haemagglutination test HAT 86.4%, immunoglobulin subclasses 85.3%). Positive microbiological cultures ofCandidaspp. were found in 43.7% of the patients. Patients with positive cultural findings had an increased HAT titre in 83.9% and increased immunoglobulins in 74.2%. These patients were suspected to have aCandidainfection. The correlation to higher titres was much closer in patients with an invasiveCandidainfection like candidaemia and oesophagitis. [ABSTRACT FROM AUTHOR] more...

In order to diagnose systemicCandidainfection in ICU patients, several methods were compared. In the first round, antigens and antibodies of 104 patients were investigated. Seventeen patients were infected; in nine of these patients a positive antigen was detected; elevated antibodies were detected in 11 patients. Only 42 patients were colonized. In this group, one positive antigen and six elevated antibody titres were detected. Combining these results, the sensitivity of the antigen only (58.5%) or the antibodies only (52.9%) increased to 100%. In the second round (n = 83 patients) the D-arabinitol/L-arabinitol quotient was also determined in the urine. 18.1% of the patients had elevated antibodies and 26.5% elevated D-arabinitol/L-arabinitol quotients. In the third round, PCR was also applied (n = 27 patients). Five patients had elevated D-arabinitol/L-arabinitol quotients and one of these had a positive PCR result. In conclusion, serological methods (antigen and antibody detection) should only be applied in strictly selected patients. In uncertain cases, the addition of PCR or determination of D-arabinitol/L-arabinitol might be helpful. [ABSTRACT FROM AUTHOR] more...

Based on the ELISA results of more than 15000 serum samples of clinical mycological routine diagnostics, the expected frequency of positive antibody ELISA results within the immunoglobulin classes IgM, IgG and IgA was determined, to optimize the diagnostic assessment of first or single result ofCandidaorAspergillusantibody ELISA. In general diagnostics the expected frequency of positive antibody ELISA results of the first sample within the immunoglobulin classes were as follows:Candidaantibody IgM 6.1%; IgG 6.0%; IgA 2.1% andAspergillusantibody IgM 11.4%; IgG 22.1% and IgA 5.1%, respectively. Using theCandidaantibody ELISA as confirmation test only, percentages of positive antibody results in the first sample were 2.5 to 3 times higher than in general diagnostics. In follow-up examinations theCandidaantibodies showed different kinetics within the immunoglobulin classes compared to those of theAspergillusantibodies. [ABSTRACT FROM AUTHOR] more...

The titres of indirect anti-Candidahaemagglutination test (C-HAT) and specific immunoglobulins C-IgM, C-IgG and C-IgA in 328 intensive care (IT) patients and 166 non-intensive care (NIT) patients were compared by statistical test methods. Positive correlations were found between values of C-HAT and all threeCandida-specific immunoglobulins. At an interval of≤7 days in the first patient group only, the changes in the course of titres were statistically highly significant. For C-IgM the short-term increase of titres can be interpreted in the sense of happened mycotic infection in connection with the clinical picture. In IT patients we found an average increase of C-IgM at 259.3, C-IgG at 174.7, C-IgA at 59.8 U ml−1 and of three titre steps in C-HAT. In our experience of diagnostics ofCandidainfections in intensive care area with non-neutropenic patients the short-term determination of the anti-Candidaimmunoglobulin subclasses C-IgM and C-IgG and of C-HAT as screening test should not be neglected. [ABSTRACT FROM AUTHOR] more...

For several years, the Platelia® Candidamannan antigen enzyme immunoassay (CandidaEIA) has been commercially available as a diagnostic test for invasive candidosis. We evaluated theCandidaEIA with patients with proven fungemia caused by yeasts from which at least one serum sample was available. Fifty-nine patients with 121 serum samples were included in the study. Sixty-one different yeast strains were isolated from positive blood-cultures. TheCandidaEIA was positive (n = 35) or borderline positive (n = 8) in 43 of 59 patients with fungemia, resulting in an overall sensitivity of 73%. For the different yeast species, the following sensitivities were calculated:Candida albicans30 of 39 (77%),Candida glabrata7 of 11 (64%),Candida parapsilosis1 of 3,Candida tropicalis2 of 2,Candida kefyr2 of 2,Candida lipolytica0 of 1,Candida lusitaniae1 of 1,Candida krusei1 borderline positive of 1,Saccharomyces cerevisiae1 of 1. In six patients the antigen levels over time were evaluable. In three cases the antigen was positive 3–4 days before the day the blood culture was drawn, in one case on the same day, and in two cases 2 and 5 days afterwards. In conclusion, theCandidaEIA was suitable for the detection of fungemia due to the major facultatively pathogenic yeast species. The test was positive in about half of the patients before blood cultures became positive. In these cases, it contributed to an early diagnosis of invasive candidiasis. [ABSTRACT FROM AUTHOR] more...

InvasiveCandidainfections (IC) belong to the most important opportunistic fungal infections in immunocompromised patients. IC is difficult to diagnose, because clinical symptoms are nonspecific and cultural methods lack sensitivity or specificity. We evaluated the Platelia® Candidaenzyme immunoassay (CandidaEIA) for the diagnosis of IC in patients with haematological malignancies. A total of 62 neutropenic patients with 469 serum samples were included in the study.Candidacolonization was monitored by weekly cultures of mouth washings, urine, and stool samples. Yeasts were grown from samples of 42 patients (68%), mainlyCandida albicans(50%), followed byCandida glabrata(23%) andCandida krusei(20%). According to the criteria of the EORTC/NIH, the patients were categorized: (1) 3 patients with proven IC; (2) 6 patients with probable IC; (3) 34 patients colonized withCandida; (4) 19 patients withoutCandidacolonization and without IC. In the patient categories (1) to (4), 3/3 (100%), 3/6 (50%), 20/34 (59%), and 7/19 (37%) patients wereCandidaEIA positive (>0.5 ng/ml) in at least one serum sample. The sensitivity of the assay for the detection of proven IC was 100%, for proven and probable IC 67%, the specificity was 49% for both groups. An increase of the cut-off value to 2.0 ng/ml raised the specificity to 61%, but lowered the sensitivity to 56%. In conclusion, the Platelia® CandidaEIA does not discriminate betweenCandidacolonization and probable invasive infection in haematological patients. [ABSTRACT FROM AUTHOR] more...

We examined 104 patients with chronic recurrent vulvovaginal candidosis; 41 healthy women were selected for the control group. Vaginal samples were taken, and yeasts were grown and tested forCandidastrains: 29.8% of samples containedCandidaspp.; two of the control women were infected. We also identified interleukin IL-4, 5 and 13, but there was only significant increase in IL-4. In addition, prostaglandin E2, whole IgE andCandida-specific-IgE was identified. Also here prostaglandin E2 and theCandidaIgE were significantly higher in comparison with the control group, while whole IgE showed no significant increase. This resulted in an allergic component in the chronic recurrent vulvovaginal candidosis, which suggested that therapy should be reconsidered. [ABSTRACT FROM AUTHOR] more...

The article reviews the state of the art in detecting anti-Candidaantibodies directed against cell wall mannans. Experience in this field was collected over more than four decades. The mannan antigens ofCandidaspp. are well characterized serologically and biochemically.Candidamannans are immunogenically potent antigens to which the host's immune system reacts regularly. The human host is not immunologically naïve towardsCandida albicans. Clinical and laboratory evaluation of methodologies detecting anti-Candidaantibodies must essentially regard the pathogenetic particularities of candidaemia and candidosis with their opportunistic characters. [ABSTRACT FROM AUTHOR] more...

Copyright of Der Internist is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.) more...

Microecology looks for the relationships between microorganisms and their natural environment in definite sites and their physiological and pathological effects. From birth Candida spp. are often but not always detectable in the human gastrointestinal tract. In cases of reduced defense the tract may be a source of infection to the macroorganism. In healthy subjects the incidence of Candida is between 23% and 76% in quantities between 10²-104 CFU/ml or g dependent on site. Evidence is most frequent in oral cavity and faeces. Tolerance for Candida spp. is different in the stomach and duodenum due to differences in acidity. Changes in the occurrence of Candida spp. are possible depending on age, different diseases and exogenous influences as nutrition, stress and drugs. In an endocrine stress model we found no yeasts in the duodenal juices of 7 subjects before and after stress situation, but a clear decrease of yeasts in the faeces. The formation of metabolic products by Candida is secondary to the whole of microbial fermentation in the human orointestinal tract. Colonizing strains of C. albicans are normally present in small or moderate numbers and only they are regarded as part of the resident gastrointestinal microflora [ABSTRACT FROM AUTHOR] more...

Candida is a heterogeneous genus which contains about a quarter of all yeast species. It includes not only species of uncertain affiliation but also unrelated strains whose phylogenetic relationships have not been resolved. A great variety of CoQ types are present in the genus, the mol % G+C ranges from 30-63%, and species that were found to sporulate have teleomorphic counterparts in 11 different genera. Candida species are mainly associated with plants, rotting vegetation, with insects which feed on plants or with food. In line with this, 71% of Candida species utilize xylose (wood degradation), 57% of species use cellobiose (cellulose degradation), 29% oxidize aliphatic hydrocarbons (components of plant cuticula), 27% of species degrade starch as a plant storage material, and 7% utilize methanol as a possible metabolite from pectin catabolism, 85% of species require individual vitamins produced mainly in plant materials. 65% of Candida species are not able to grow at temperatures of 37° C. In comparison only relatively few species occur normally in humans and other warm blooded animals. About 16% of type strains and selected strains for comparative purposes (CBS) were isolated from human specimens. Perhaps up to 10% of Candida species may be of medical importance, though this has so far only been clearly demonstrated for less than 5% of currently known species. [ABSTRACT FROM AUTHOR] more...

The at present acknowledged 163 species of the genus Candida are living in different habitats. Agents of human candidosis have a comparatively restricted natural distribution, and have been discovered primarily in association with men and animals. Candida albicans holds and exceptional position opposite to the nearly 20 non-C. albicans-species with medical importance. Primary habitat is the digestive tract of men and warm-blooded animals. C. albicans is not ubiquitously distributed in the nature. Carriers of Candida may contaminate their immediate environment with yeasts, but that contamination does not usually spread far. C. albicans survives poorly on dry surfaces, a little bit longer in moist materials. Some non-C. albicans-species have their habitat also in the digestive tracts of men and animals, but different to C. albicans they are also ubiquitously distributed in the surroundings (soil, plants, foods, forages) and are much more resistent to environment influences. The most important source of Candida species in human diseases is endogenous. The via exogen contamination arising mycoses are involved above all by non-C. albicans-species. The different habitats of the Candida species are decisive for the direct and indirect transmission of yeasts to humans and also for the preventive measures against endogenous and exogenous nosocomial Candida mycoses. [ABSTRACT FROM AUTHOR] more...

The multiplicity of information which electronmicroscopy has contributed to our knowledge of Candida albicans and its relationship to the human host is reviewed and by means of examples presented. [ABSTRACT FROM AUTHOR] more...

Copyright of Archiv für Gynäkologie is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.) more...

Copyright of Langenbecks Archiv fuer Chirurgie is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.) more...

We report on a 28-year-old female patient who had no history of diseases and who was brought to our intensive care unit in a comatose state by the ambulance service. The clinical picture corresponded to sepsis with a massively increased blood sugar concentration (> 2000 mg/dl) as well as a pronounced skin mycosis in the groin region of the very obese patient (body mass index [BMI]: 33.7 kg/m 2 ) in the physical examination. The treatment of sepsis was initially supplemented by a calculated antifungal treatment. The blood culture diagnosis confirmed the presence of Candida albicans and Candida glabrata. Despite adequate anti-infective treatment, the patient developed a septic shock in the further course, so that the additional escalation of treatment was initiated by renal replacement therapy on the second day and venovenous extracorporeal membrane oxygenation because of an ARDS. Despite all of these measures and maximum intensive care treatment, the patient developed a progressive multiple organ failure. When the pupils became rigid to light, a cerebral computed tomography was carried out. This showed evidence of a severe cerebral edema without signs of cerebral bleeding. Multiple examinations of somatosensory evoked potentials and electroencephalograms showed signs of irreversible brain damage. In view of this poor prognosis the therapeutic measures were limited. The patient died on day 24 after admission to the intensive care unit. The case study shows that antifungal treatment should definitely be considered in the context of sepsis treatment if there is a clinically justified suspicion.The role of the severely altered metabolic situation with massive hyperglycemia and ketoacidosis cannot be finally assessed., (© 2021. The Author(s), under exclusive licence to Springer Medizin Verlag GmbH, ein Teil von Springer Nature.) more...

Copyright of Der Ophthalmologe is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.) more...