J.Jpn. Surg. Soc.. 90(4): 489-495, 1989
Original article
INVASIVE CANDIDIASIS : ITS PREDISPOSING FACTORS, USEFULNESS AND LIMITATION OF CULTURAL STUDY IN ITS DIAGNOSIS, AND CONSIDERATION ON THE APPROPRIATE AMPHOTERICIN B THERAPY
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Department of Traumatology, Osaka University School of Medicine, Osaka, Japan Keiichi Ikegami, Takashi Tabata, Shigeru Shiono, Hisashi Sugimoto, Toshiharu Yoshioka, Tsuyoshi Sugimoto |
Invasive candidiasis was diagnosed in 2. 4% of the patients admitted during the past 5 years. The one of the most important predisposing factors for development of invasive candidiasis was extensive use of antibiotics. Destruction of the mechanical barrier against bacteria and fugi caused by endotracheal intubations and various catheterization was another important factor. Mucosal lesion of the gastrointestinal tract, including stress ulcer, non-specific inflammatory bowel disease and esophageal ulcer, was seen in 30% of the patients. These lesions were thought to be the portal of entry for caidida to systemic dissemination. AMPH is the most effective antifungal agent. Total dose of 300 to 1000mg was effective in the patients. Dosage over 1000mg was associated with progressive decrease in creatinine clearance. This decrease was irreversible even after discontiuation of AMPH. Candidal overgrowth within the Gl tract was considered to precede invasive canidiasis. Oral AMPH administration was effective in such conditions.
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