Wednesday, April 5, 2017
The endemic mycoses compared
Histoplasmosis:
Prevalence: Most common
Sx:Caves. Small yeast forms in neutrophils, patients on TNF-alpha inhibitors, hypoadrenalism. Pancytopenia, tongue ulcer,
Dx: Urinary antigen, narrow-based multiple budding reproduction.
Tx: Itraconazole, but beware of heart failure, in which case, or in pregnancy, use Amphotericin B.
Coccidioidomycosis:
Prevalence: 150,000 cases a year, Second Most common
Sx: mucosal lesions in 25% of cases, "Valley fever", "desert bumps" = erythema nodosum, most often in anterior tibia region
Dx: with serology, biopsy with granulomas, no budding reproduction, CS fluid shows high eosinophils, pathognomonic.
Tx: 1 month fluconazole and serial serology q2-4 months, for meningitis requires life-long fluconazole for prophylaxis: Relapse extremely common. Amphotericin 2nd line and for pregnant.
Blastomycosis:
Prevalence: Third most common
Sx: Ohio River Valley, acute PNA, miliary lung lesions, affects skin, bone, GU tract, prostatitis, verrucous lesions in head/neck region.
Dx: with culture. broad-based single budding reproduction.
Paracoccidiomycosis:
Prevalence: 80% cases in Brazil.
Dx: Captain's wheel on microscopy
Generally (except yeast), mold in cold (environment), yeast in heat (host organism).
Always: Mold-hyphae, yeast-spherical unicellular
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Irrespective of receiving daily oral or future injectable depot therapies, these require health care visits for medication and monitoring of safety and response. If patients are treated early enough, before a lot of immune system damage has occurred, life expectancy is close to normal, as long as they remain on successful treatment. However, when patients stop therapy, virus rebounds to high levels in most patients, sometimes associated with severe illness because i have gone through this and even an increased risk of death. The aim of “cure”is ongoing but i still do believe my government made millions of ARV drugs instead of finding a cure. for ongoing therapy and monitoring. ARV alone cannot cure HIV as among the cells that are infected are very long-living CD4 memory cells and possibly other cells that act as long-term reservoirs. HIV can hide in these cells without being detected by the body’s immune system. Therefore even when ART completely blocks subsequent rounds of infection of cells, reservoirs that have been infected before therapy initiation persist and from these reservoirs HIV rebounds if therapy is stopped. “Cure” could either mean an eradication cure, which means to completely rid the body of reservoir virus or a functional HIV cure, where HIV may remain in reservoir cells but rebound to high levels is prevented after therapy interruption.Dr Afrid Herbal Medicine makes me believes there is a hope for people suffering from,Parkinson's disease,Schizophrenia,Cancer,Scoliosis,Fibromyalgia,Fluoroquinolone Toxicity
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Thank you for your time
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R.buckler11 ((@ gmail. com)),,
United States