HUMAN INFECTIONS DUE TO TRICHOPHYTON EQUINUM VAR. AUTOTROPHICUM IN VICTORIA

Two cases of human ringworm caused by the dermatophyte Trichophyton equinum var. autotrophicum are reported from victoria. This fungus has been recorded as a cause of ringworm in horses in Australia but infections in man are rare and this is the first report giving details of human infections in Australia. In one of these cases the fungus was also isolated from the patient's horse. Treatment with econazole nitrate was successful in this case.     

临床疑诊甲真菌病1036例真菌学分析

目的　了解近 5年本院甲真菌病病原菌的种类和构成 ,观察流行病学特点。方法　对近 5年临床疑诊的10 3 6例甲真菌病患者的真菌学实验室检查情况进行系统分析、总结。结果　共培养出真菌 63 1株 ,其中酵母菌占49.60 % ,以克柔念珠菌、红酵母、近平滑念珠菌为主 ;皮肤癣菌占 2 1.71% ,主要菌种为须癣毛癣菌和红色毛癣菌 ;其他丝状真菌占 19.81% ,主要菌种为曲霉和青霉 ;污染真菌占 8.87%。结论　本院近 5年甲真菌病患者病原菌依次为酵母菌、皮肤癣菌、其他丝状真菌 ,排前 5位的真菌分别是须癣毛癣菌 (11.2 5 % ) ,克柔念珠菌 (10 .14 % ) ,红酵母 (9.98% ) ,红色毛癣菌 (9.5 1% ) ,曲霉 (8.87% )。     

The antibacterial efficacy of econazole nitrate in interdigital toe web infections

Twenty-four patients with severe interdigital toe web infections and no evidence of dermatophyte colonization received randomized treatment with either econazole nitrate (Spectazole) or its vehicle. Of the patients treated with econazole nitrate, 88% had good to excellent responses, whereas no patient treated with the vehicle showed improvement. The total aerobic flora in the econazole group decreased 93%, with decreases in the large-colony diphtheroids, lipophilic diphtheroids, and gram-negative bacteria. The results of this study demonstrate that the antibacterial activity of econazole nitrate makes it an effective agent for the treatment of severe interdigital bacterial infections uncomplicated by dermatophyte colonization.     

抗真菌药物单独和联合应用对曲霉体外药敏试验研究

目的:探讨两性霉素B(AmB)、特比萘芬(TBF)、伊曲康唑(ICZ)、氟胞嘧啶(5-FC)和氟康唑(FCZ)在单独和联合用药时对曲霉的敏感性.方法:应用美国临床实验室标准化委员会制定的M38-A方案,单独用药时AmB、TBF和ICZ取100%生长抑制为最小抑菌浓度(MiC),5-FC和FCZ取50%生长抑制为最小抑菌浓度,联合用药时取100%生长抑制为最小抑菌浓度,以部分抑菌浓度(FIC)来判定药物间的相互作用,药物间的相互作用解释为FIC≤0.5为协同作用,0.5＜FIC≤1.0为相加作用,1.0＜FIC≤2.0为无关作用,FIC＞2.0为拮抗作用.结果:TBF对烟曲霉的MIC值明显高于黄曲霉和黑曲霉,ICZ对黄曲霉的MIC值较低,AmB对黑曲霉的MIC值较低,而对黄曲霉MIC值较高,差异具有统计学意义.TBF联合ICZ、AmB联合ICZ对曲霉菌属产生较好的协同相加作用.AmB联合TBF对曲霉主要表现为相加作用,5-FC和FCZ与其他药物联合应用对曲霉菌属表现为拮抗和无关作用.结论:单独用药时不同抗真菌药物对曲霉菌种的敏感性具有差异.TBF联合ICZ、AmB联合ICZ在体外对曲霉具有协同和相加作用,其效果优于其他药物的联合应用.     

银屑病皮损鳞屑中两种微生物的检测及外用派瑞松效果

目的探讨银屑病发病与金黄色葡萄球菌(简称金葡菌)、糠秕孢子菌感染的关系及观察外用派瑞松治疗效果。方法对银屑病病人皮损进行细菌培养及真菌真接镜检,并外用派瑞松治疗。结果银屑病患者金葡菌和糠秕孢子菌带菌率均高于正常对照(P<0.01;P<0.05),治疗后带菌率明显下降;治愈率和有效率分别为18.0%,72.0%。结论金葡菌、糠秕孢子菌在银屑病的发病和发展中起一定作用,派瑞松是治疗银屑病较好的药物之一。     

国产联苯苄唑（白呋唑）治疗皮肤真菌病的疗效观察

用联苯苄唑和益康唑等对照治疗皮肤真菌病９７例。治疗体股癣的痊愈率，联苯苄唑为８９．４７％，益康唑为８４％。虽然二者间无统计学差异（Ｐ＞０．０５），但联苯苄唑每日只需用药１次，方便、清洁，且无显著副作用。可作为外治皮肤真菌病的首选药物之一。     

外喷中药制剂联合曲安奈德益康唑乳膏治疗念球菌性龟头炎效果的临床观察

目的：观察中药汤剂改颗粒剂外喷联合曲安奈德益康唑乳膏治疗念球菌性龟头炎的临床疗效。方法：135例患者随机分为治疗组和对照A组和对照B组,每组45例。治疗组给予中药基本方取颗粒剂兑成中药汤液,装入专用容器外喷,2次/d,联合曲安奈德益康唑乳膏外涂,2次/d。对照A组,基本方水煎外洗,2次/d,联合曲安奈德益康唑乳膏外涂,2次/d。对照B组,单独使用曲安奈德益康唑乳膏,2次/d,连用14d。结果：联合用药组治疗念珠菌性包皮龟头炎的方法无论在治疗1周与2周时临床有效率（痊愈＋显效）均高于单独使用曲安奈德益康唑乳膏组,两组真菌学疗效无差异。而中药外喷组与中药外洗组在疗效上无明显差异。结论：中药汤剂外洗改颗粒剂外喷联合曲安奈德益康唑乳膏外涂治疗念球菌性龟头炎安全有效,可行。     

Cutaneous aspergillosis

We report a cutaneous infection by Aspergillus flavus in a tetraplegic but otherwise healthy young man. He presented with multiple erythematous to violaceous indurated papules and plaques which had progressed to central ulcers or black eschars. Lesional scrapings, biopsies and cultures demonstrated a fungus, Aspergillus flavus, as the aetiological agent. As the patient had to leave for his home country before diagnosis had been established, we cannot report on the results of therapy in this case.     

Treatment of vaginal candidosis with econazole nitrate and nystatin: A comparative study

A study carried out to compare the efficacy of econazole nitrate and nystatin in the treatment of vaginal candidosis showed that a three-day course of econazole nitrate pessaries was as effective as a 14-day course of nystatin pessaries and is more acceptable to patients.     

曲安奈德益康唑乳膏长疗程间歇疗法治疗局限性慢性湿疹

目的 探讨外用糖皮质激素长疗程间歇疗法治疗局限性慢性湿疹的疗效、安全性及复发情况,以指导临床用药.方法 选取门诊局限性慢性湿疹患者,外用曲安奈德益康唑乳膏短程治疗.症状积分下降指数(SSRI)≥190%的患者进入长疗程,随机分两组,分别外用曲安奈德益康唑乳膏和润肤霜,间歇用药,共治疗8周.长疗程治疗4周、8周时及长疗程治疗停药12周时各随访1次.结果 长疗程治疗8周及停药12周时,曲安奈德益康唑组SCORAD评分均显著低于润肤霜组(t值分别为3.076和2.367,P值均<0.05).长疗程治疗4周、8周及停药12周时,曲安奈德益康唑组复发率均显著低于润肤霜组(x2值分别为4.426、7.683、8.199,P值均<0.05).治疗期间不良反应发生率3.1%,无严重不良事件.结论 外用糖皮质激素长疗程间歇治疗慢性湿疹,有防止症状加重、延缓湿疹复发的作用.     

曲安奈德益康唑乳膏长疗程间歇疗法治疗局限性慢性湿疹

目的 探讨外用糖皮质激素长疗程间歇疗法治疗局限性慢性湿疹的疗效、安全性及复发情况,以指导临床用药.方法 选取门诊局限性慢性湿疹患者,外用曲安奈德益康唑乳膏短程治疗.症状积分下降指数(SSRI)≥190%的患者进入长疗程,随机分两组,分别外用曲安奈德益康唑乳膏和润肤霜,间歇用药,共治疗8周.长疗程治疗4周、8周时及长疗程治疗停药12周时各随访1次.结果 长疗程治疗8周及停药12周时,曲安奈德益康唑组SCORAD评分均显著低于润肤霜组(t值分别为3.076和2.367,P值均<0.05).长疗程治疗4周、8周及停药12周时,曲安奈德益康唑组复发率均显著低于润肤霜组(x2值分别为4.426、7.683、8.199,P值均<0.05).治疗期间不良反应发生率3.1%,无严重不良事件.结论 外用糖皮质激素长疗程间歇治疗慢性湿疹,有防止症状加重、延缓湿疹复发的作用.     

曲安奈德益康唑乳膏长疗程间歇疗法治疗局限性慢性湿疹

目的 探讨外用糖皮质激素长疗程间歇疗法治疗局限性慢性湿疹的疗效、安全性及复发情况,以指导临床用药。方法 选取门诊局限性慢性湿疹患者,外用曲安奈德益康唑乳膏短程治疗。症状积分下降指数（SSRI）≥90％的患者进入长疗程,随机分两组,分别外用曲安奈德益康唑乳膏和润肤霜,间歇用药,共治疗8周。长疗程治疗4周、8周时及长疗程治疗停药12周时各随访1次。结果 长疗程治疗8周及停药12周时,曲安奈德益康唑组SCORAD评分均显著低于润肤霜组（t值分别为3.076和2.367,P值均 < 0.05）。长疗程治疗4周、8周及停药12周时,曲安奈德益康唑组复发率均显著低于润肤霜组（χ2值分别为4.426、7.683、8.199,P值均 < 0.05）。治疗期间不良反应发生率3.1％,无严重不良事件。结论外用糖皮质激素长疗程间歇治疗慢性湿疹,有防止症状加重、延缓湿疹复发的作用。     

曲安奈德益康唑乳膏治疗脂溢性皮炎78例临床观察

目的观察曲安奈德益康唑乳膏治疗微生物相关皮肤病脂溢性皮炎的临床疗效及安全性。方法治疗组78例脂益性皮炎患者，予早、晚各1次外用曲安奈德益康唑乳膏，并轻揉搓片刻，疗程4周。对照组80例予外搽皮炎平，用药方法及疗程同前。每周复诊时观察皮损情况。结果治疗组有效率89．3％，对照组为66．6％；治疗组出现不良反应3例，占3．8％，均予对症处理，与对照组（8例）比较差异有统计学意义（P〈0．05）。结论曲安奈德益康唑乳膏治疗脂溢性皮炎疗效确切，不良反应少。     

强力脉痔灵联合曲安奈德益康唑乳膏治疗肛周湿疹疗效观察

目的观察强力脉痔灵联合曲安奈德益康唑乳膏治疗肛周湿疹的临床疗效。方法采用随机法将99例患者分为两组,治疗组50例,予强力脉痔灵2片口服,同时外用曲安奈德益康唑乳膏,均2次/d,连用3周。对照组49例,仅外用曲安奈德益康唑乳膏,连用3周。两组均治疗结束时观察近期疗效,痊愈者随访3个月观察远期疗效。结果治疗组近期疗效有效率80.00%,对照组为71.43%,差异无显著性(P>0.05);痊愈病例随访3个月,治疗组复发率20.0%,对照组57.9%,差异有显著性(P<0.01)。结论强力脉痔灵联合曲安奈德益康唑乳膏治疗肛周湿疹疗效好。     

Histological aspects of mycoses provoked by opportunistic fungi]

The histological study with Hotchkiss-Mc Manus staining and Grocott silver impregnation of tissues invaded by opportunistic fungi is a rapid and easy means of diagnosis. The inflammatory reactions around the fungus give the certitude that it is a pathogen and not a contaminant. The major opportunists among Canidida, Aspergillus, Mucor, Absidia and Cryptococcus species are presented in local and disseminated lesions, but all fungi, saprophytic in the normal host, can become pathogens in the immunodepressed patient.     

Clotrimazole and econazole in the treatment of vaginal candidosis. A single-blind comparison

Clotrimazole and econazole used as treatment for vaginal candidosis are both effective when given for three days. In a single-blind controlled study of 110 women followed for 14 days the efficacy of treatment with clotrimazole and econazole for three days was equal. Eighty-six per cent of the group treated with clotrimazole were mycologically clear at 14 days compared with 90% of those treated with econazole. Both treatment regimens were equally acceptable to the patients and no side effects were reported.     

少见真菌致海洋作业人员甲真菌病2例首报

患者均为男性,渔民和海洋航道工人,分别出现指甲和趾甲病变,时间不一。病甲屑真菌直接镜检阳性,真菌培养有棕黑色和灰白色绒毛样丝状真菌生长,经形态学和分子生物学鉴定分别为对半新柱顶孢和帚状曲霉。药敏试验显示对半新柱顶孢对伏立康唑MIC值最低(0.25μg/mL);帚状曲霉对伊曲康唑和泊沙康唑以及棘白菌素类抗真菌药MIC较低。提示这几类药物可以做为临床治疗的首选药物。     

Comparison of econazole and isoconazole as single dose treatment for vaginal candidosis.

In a single blind trial there was no significant difference between econazole (2 X 150 mg pessaries) and isoconazole (2 X 300 mg pessaries) given as a once only treatment for vaginal candidosis. Cure rates at 14 days were 70.4% for econazole and 77.6% for isoconazole, and at 28 days were 63.8% and 64.5% respectively. Though isoconazole was formulated for single dose usage, econazole was formulated for a regimen of one pessary a night for three nights.     

Clotrimazole and econazole in the treatment of vaginal candidosis. A single-blind comparison.

Clotrimazole and econazole used as treatment for vaginal candidosis are both effective when given for three days. In a single-blind controlled study of 110 women followed for 14 days the efficacy of treatment with clotrimazole and econazole for three days was equal. Eighty-six per cent of the group treated with clotrimazole were mycologically clear at 14 days compared with 90% of those treated with econazole. Both treatment regimens were equally acceptable to the patients and no side effects were reported.     

Contact allergy to imidazoles used as antimycotic agents

The present article reviews the literature (up to 1994) on contact sensitivity to imidazoles and presents the results obtained from 15 patients observed at the Contact Allergy Unit in Leuven. The frequency as well as the cross-reaction patterns described are analyzed. Although allergic contact reactions may have been missed in the past (mainly because of problems with the correct choice of vehicle for patch testing), they seem to be relatively infrequent in view of their widespread use. The imidazole derivatives most frequently reported 10 be allergens are miconazole, econazole, tiocanozole, and isoconazole. As far as cross-reactivity is concerned, statistically significant associations were found in the patient data between miconazole, econazole, and isoconazole: between isoconazole and miconazole and econazole: and also between isoconazole and tioconazole. Patients sensitive to phenylethyl imidazoles (except ketoconazole) needing antimycotic therapy should be advised to use ketoconazole, clotrimazole, bifonazole, or, perhaps, the new flutrimazole. Clearly, non-imidazole antifungals can also be used.