E. Richard Harrell

North American blastomycosis

Abstract There is increasing evidence of occurrence of a subclinical pulmonary form of North American blastomycosis, resembling the benign pulmonary form of coccidioidomycosis and histoplasmosis, which may be more prevalent than is generally thought. It is probable that North American blastomycosis is acquired by inhalation of the organism and that all patients with the disease so acquired have the potential for systemic spread. The only true cutaneous form of the disease is that rare type which is acquired by primary inoculation of the B. dermatitidis through the skin. Such an instance is recorded. The results of intravenous amphotericin B therapy in eight patients with systemic North American blastomycosis are recorded. The first four of these patients were previously reported, and this report constitutes a follow-up. Five of the eight patients had proved resistant to massive aromatic diamidine therapy. All eight patients responded to amphotericin B therapy. Three of the patients have had recurrences following amphotericin B therapy, although they have been clinically free of recurrence for over one year at the time of this writing. Five of the eight patients received a total dose of 1 gm. of amphotericin B, one patient received 1.5 gm. of the antibiotic, one each received 4.0 and 4.5 gm. This amount is less than is used with the other deep mycoses. Seven of the eight patients exhibited some evidence of toxicity during the administration of amphotericin B. Azotemia is the most serious of the toxic effects encountered during the administration of this drug. Fever, nausea, emesis and malaise, which accompany the administration of amphotericin B, can be reduced by the concomitant administration of judicious amounts of the corticosteroids. It also seems advisable to administer amphotericin B every other day in order to lessen the untoward toxic effect.

Modern treatment of the systemic fungus diseases.

For many years the systemic fungus diseases received little attention from the members of the medical profession and in the curriculum of the medical schools in the United States. Recently there has been a gradual awakening to their importance. The introduction of increasing numbers of antifungal chemotherapeutic agents attest this new interest in the mycotic diseases. Beneficial or curative specific therapy is now possible for many of these diseases which previously were without effective means of treatment.

Systemic candidiasis (moniliasis) complicating treatment of bacterial endocarditis, with review of literature and report of apparent cure of one case with parenteral mycostatin.

Excerpt With the advent of antibiotics, acute bacterial endocarditis, which once was nearly always fatal, has been successfully treated. However, with antibiotic therapy there is an increasing numb...

A STUDY OF NORTH AMERICAN BLASTOMYCOSIS AND ITS TREATMENT WITH STILBAMIDINE AND 2-HYDROXYSTILBAMIDINE

Excerpt Stilbamidine and 2-hydroxystilbamidine are now widely accepted as the treatment of choice for the systemic fungus disease, North American blastomycosis. Schwarz and Goldman1recently reporte...

STAPHYLOCOCCAL SKIN INFECTIONS: TREATMENT OF IMPETIGO AND OF ACUTE AND CHRONIC FURUNCULOSIS.

Treatment of impetigo consists primarily of topical use of an antibiotic ointment; the combination of neomycin, bacitracin and polymyxin B is preferred. Systemic antibiotic therapy is seldom indicated.In cases of furunculosis, a program of home hygiene will lessen the likelihood of auto-inoculation and of spread to other persons. Chronic furunculosis may resist all therapeutic efforts. A neomycin-containing ointment is applied intranasally. Autogenous vaccine has produced good results.

Azaribine in the Treatment of Psoriasis

Excerpt To the editor: In the December 1970 issue of the ANNALSVogler and Olansky (1) presented a double-blind study of azaribine (6-azauridine triacetate) in the treatment of psoriasis. They showe...

In vitro Study of Antifungal Activity of Nitrostyrenes.

Summary In screening 53 compounds with chemical formulae related to the stilbene nucleus for antifungal activity by the serial dilution agar method, a number of nitrosty-renes were found to exhibit a high degree of activity against pathogenic fungi.

Molecular and clinical pharmacology of psoriasis

Psoriasis appears in most cases to be a genetic disease8 in which stratified squamous epithelium (epidermis) of skin in involved versus normal‐appearing uninvolved areas has the following prototypic features: (1) excessive cell proliferation and an accelerated cell cycle of the proliferating cells21; (2) incomplete epidermal specialization (keratinization) for tissue function; and (3) marked increase in glycogen content.7 It has been widely held that the relative lack of epidermal specialization is due to the rapid transit of cells through the epidermis (i.e., the cells are shed from the patient without sufficient time for normal keratinization to occur). However, an alternate explanation is that the excessive cell proliferation is the result of an inability of differentiated basal cells to make the commitment of specialization. For this reason we have listed incomplete specialization as one of the three characteristic findings in psoriasis lesions.

The Fungous Diseases of Man

It was with genuine enjoyment that I read for review the new book entitled The Fungous Diseases of Man , by J. Walter Wilson, MD, and Orda A. Plunkett, PhD. Both authors have had previous experience at writing and editing mycology texts, so they were exceptionally well qualified to write this most comprehensive mycology text. The book is divided into four parts: part 1 covers the systemic mycoses; part 2, the intermediate mycoses; part 3, the superficial mycoses; and part 4, the fundamentals of medical mycology. Each of the four sections is complete to a degree that is not currently matched by any other mycology text. The coverage of the clinical aspects of the mycoses is especially comprehensive and includes detailed discussion of the immunology of the individual diseases, as well as the modern therapy of each disease. The two initial chapters on comparative pathogenesis and comparative immunologic aspects of the