[Clinical study of patients with deep-seated fungal infection associated with hematological diseases].
An assessment has been made regarding usefulness of measuring beta-D-glucan (beta-glucan) as fungal serodiagnosis in 50 cases of fungal infection with hematological diseases. Further, an assessment has been made regarding relation between hematological findings and therapeutic effect by administering miconazole, an antifungal agent (MCZ: Florid, clinically to the subjects. Positivity of beta-glucan (beta-glucan > or = 10 pg/ml) was observed in 54.5% (24/44), and the effective rate of MCZ in the positive cases was 75.0% (18/24). In the cases in whom fungus was detected, beta-glucan-positive rate was 50.0% (8/16), and MCZ-effective rate in beta-glucan-positive cases was 62.5% (5/8). The total effective rate of MCZ was 80% (40/50). Side effects were observed in 3 cases, but continual administration of MCZ was possible in all of the 3 cases. By the assessment regarding the relation between hematological findings and therapeutic effect of MCZ, it was found that the effective rates in the cases who underwent a transition with neutrophil and lymphocyte counts less than 500/microliters during the period of MCZ administration were 64.7% (11/17) and 50% (5/10), respectively, and large effects were observed in the cases who underwent a transition with the neutrophil and lymphocyte counts more than 500/microliters was 86.7% (19/22) and 91.7% (22/24), respectively. These results suggested that lymphocytes rather than neutrophils had an important role in the morbidity of fungal infection. It was noteworthy that MCZ was effective for the treatment of deep seated mycosis and significant effective rate was obtained in the group of patients who had neutrophils and lymphocytes less than 500/microliters.
Sasada
M
M
First Department of Internal Medicine, Faculty of Medicine, Kyoto University.
Sawada
H
H
Yamamoto
K
K
Tashima
M
M
Ohkuma
M
M
Uchino
H
H
Okada
H
H
Okada
T
T
Suzuki
T
T
Yasuda
N
N
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D005260:Female; D005936:Glucans / Q000097:blood; D006402:Hematologic Diseases / Q000150:complications*; D006801:Humans; D008297:Male; D008825:Miconazole / Q000627:therapeutic use*; D008875:Middle Aged; D009181:Mycoses / Q000175:diagnosis / Q000188:drug therapy*; D012698:Serologic Tests; D047071:beta-Glucans
D005936:Glucans; D047071:beta-Glucans; D008825:Miconazole; C033363:beta-1,3-glucan