Development Of Resistance For Patients With Hiv / Aids Globally

Patient, JD, is a 50-year-old Caucasian male with a past medical history of polysubstance abuse who presented to outside hospital with shortness of breath and chest pain who developed cardiogenic shock complicated by shock liver and renal failure and was transferred to Henry Ford Hospital for elevation of care. The patient was admitted to the intensive care unit (ICU) upon arrival. While in the ICU, patient developed a fever with leukocytosis and patchy infiltrate on CXR and was treated for HCAP. Blood cultures were drawn at that time that grew yeast, possibly related to a line infection. Lines were removed and patient was started on fluconazole. Fungal cultures drawn grew Candida krusei and Fluconazole was switched to anidulafungin. Infectious Disease was consulted suggesting total duration of anti-fungals of 2 weeks for candidemia. Repeat blood cultures drawn after treatment were negative and patient’s clinical status improved on anidulafungin treatment. This patient had spent a total of 21 days in the ICU. C. krusei is known to have intrinsic resistance to fluconazole5, which is why treatment was switched to anidulafungin, a semisynthetic echinocandin. However, invasive candidiasis and candidemia with other strains of Candida species are prevalent in severely ill patients and the proper treatment of such infections should be investigated.

The condition mostly occurs in people with a compromised or weakened immune system, known as immunocompromised, such as AIDS sufferers, that are more prone to infections and diseases. Fungal meningitis is moderately rare and outbreaks are noticed to occur when airborne yeast cells are inhaled.

Oral white patches suggest a yeast infection of the mouth named candidiasis (trush), and it is the most common oral condition in people with HIV infection. Researches estimated that 9 in 10 people with HIV present at least one oral condition related to HIV disease. This may be the first sign of immune suppression and the reason why physicians recommended HIV testing. The immune system weakens progressively over time and becomes susceptible to bacterial, viral, fungal and parasitic (opportunistic) infections. Another infection (viral) with oral white patches manifestation is the hairy leukoplakia, which is believed to be caused by Epstein-Barr virus mononucleosis, also very common in HIV-related oral conditions(“HIV and the mouth”, 2011).

Candidiasis is known as a fungal infection that can affect many areas of the body from younger children to senior citizens. Candidiasis has the ability to affect areas such as throat, blood, mouth, skin and genitals. Candidiasis is caused by an overgrowth of the yeast type of Candida. In the human body yeast is typically found in small amounts. Yeast has the ability of increasing growth in areas that are moist and warm on body parts. Symptoms can become very dangerous in some cases and this can also cause a uncomfortable feeling. Since Candidiasis can be affect in many areas medications and treatment varies according to the affected location.

Fungal infections: these affect the skin, nails and hair. They are common and indications are usually mild. However, in individuals with debilitated immune systems, they can be more serious.

Vaginal Thrush is an infection caused by yeast called candida albicans. Candida albicans are among the twenty species of Candida yeast that cause infections in humans. Candida yeasts are usually harmless and typically live around the vaginal area and on the skin; nevertheless an overgrowth can cause symptoms to develop. In most cases vaginal thrush symptoms are obvious, common symptoms include pain, itching and vaginal discharge. Vaginal thrush is a condition that interferes with the sexual function and sense of wellbeing of a woman. Women who have vaginal thrush often experience pain during sexual intercourse or when urinating. Thrush that is symptomatic are categorized as either uncomplicated or complicated. Uncomplicated thrush occurs occasionally and is mild while complicated thrush is recurrent and becomes more severe over time.

and skin conditions like athlete foot . Candia can however proliferate and cause problems in the

Candida vulvovaginitis because of the adherent to vaginal side walls with a “cottage cheese-like” discharge and a pH </= 4.5

HIV corrupts the CD4 cells or T –cells, which weaken the immune system disabling the T-cells from detecting invaders such as viruses and bacteria. As more and more T-cells are destroyed, the immune system weakens and eventually progresses to Acquired Immunodeficiency Syndrome. HIV/AIDS thrives in the blood, semen, vaginal fluids, or breast

Anidulafungin is a semi-synthetic echinocandin with antifungal activity. This agent is selective for fungal cells as it inhibits glucan sythase enzyme and therefore inhibits the synthesis of 1, 3 beta D glucan which is essential for the fungal cell wall. According to Micromedix anidulafungin is approved for adults and pediatrics older than 16 years to treat candida related infections. Anidulafungin is administered as a continuous IV infusion and has good efficacy against Candida species and Aspergillus species. It is suitable to be used in immuno-compromised patients, patients with azoles refractory infections and in those with renal impairment. However, this agent is not approved by the FDA to be used in pediatric population younger than 16 years; yet some limited studies have been done on this population to examine the safety and efficacy of anidualfungin; the results of these trials are promising although more studies are needed.

Candidiasis of the oral mucosa, also called thrush, is a condition in which the fungus Candida albicans accumulates in the lining of the mouth. Thrush causes creamy white lesions, usually on the tongue or cheeks. The lesions can be painful and may bleed. Sometimes thrush can spread to the palate, gums, tonsils and back of the throat.

Candidiasis is a disease in which a fungal infection of the mucous membranes is found in the mouth and throat. The organism may cause infections in other locations, such as nails, skin (diaper rash), vagina, and the gastrointestinal tract. There are many types of fungus that live in the human body including candida. Candida is a type of yeast that normally lives in small amounts in areas like your mouth and belly, or skin without causing any issues. The immune system and the body’s bacteria usually keep Candida in balance. When this balance is interrupted, it can result in an overgrowth of the Candida fungus, causing it to get infected. The infection is called Candidiasis. There are several different types of candidiasis, such as Thrush (Oropharyngeal Candidiasis), Genital Yeast Infection (Genital Candidiasis), Diaper Rash From Yeast Infection, and Invasive Candidiasis.

This condition is caused by a change in the normal balance of the bacteria and yeast that live on the skin. This causes an overgrowth of the yeast, which causes the inflammation. Many types of yeast can cause this infection, but candida is the most common.

Candida species frequently contaminate the psoriatic nail and bed, but dermatophytes are rare. In one series, 19 of 105 patients with candidal paronychia were found to have psoriasis (Ganor 1977).

Although we live surrounded by this yeast, only individuals with compromised immune systems are at risk for developing invasive candidiasis. Invasive candidiasis is the fourth most common bloodstream infection in hospitalized patients, and the U. S. Centers for Disease Control and Prevention report that eight out of every 100,000 persons develop blood