Malcolm D. Richardson, David W. Warnock's Fungal Infection: Diagnosis and Management (2003) PDF

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Additional resources for Fungal Infection: Diagnosis and Management (2003)

Example text

All specimen containers should be clearly labelled. 1 Skin, nails and hair Skin, nails and hair should be collected into folded squares of black paper (about 10 x 10 cm). The use of paper permits the specimen to dry out, which helps to reduce bacterial contamination, and also provides a convenient means of storing specimens for long periods (12 months or longer). It is often helpful to clean superficial lesions with 70% alcohol prior to sampling as this will improve the chances of detecting fungus on microscopic examination, as well as reducing the likelihood of bacterial contamination of cultures.

Less than 10% of the dose remains in the blood 12h after ANTIFUNGAL DRUGS /31 administration, and more than 90% of this is proteinbound. Most of the remainder can be found in the liver (up to 40% of the dose), lungs (up to 6%) and kidneys (up to 2%). Levels in cerebrospinal fluid (CSF) are less than 5% of the simultaneous blood concentration. Amphotericin B binds to tissues for prolonged periods of time, re-entering the circulation slowly from these storage sites. The conventional formulation has a second-phase half-life of about 24-48 h and a thirdphase half-life of about 2 weeks.

Most of these infections have occurred among persons returning to European countries, Australia or Japan. However, with increasing numbers of visitors and immigrants to the USA from Asia, travel- and migration-related infections are now being reported from countries such as India. In many respects the current pattern of fungal infection in developing countries is quite different from that seen in developed countries. Throughout the developed world, the widespread use of combination antiretroviral treatment regimens has led to a marked reduction in the rates of AIDS-associated opportunistic infections.

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