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Biomedical subjects

W A Schell

Publications and source records attributed to W A Schell.

30 records · Page 2Linked to original sources
PubMed1994

First report of involvement of Nodulisporium species in human disease.

Allergic fungal sinusitis is a common disease that results from a hypersensitivity reaction mounted by the host against fungi living in the paranasal sinuses. We have recently treated a patient with allergic fungal sinusitis due to a Nodulisporium species. This is the first description of a Nodulisporium species involved in human disease. The genus Nodulisporium contains both dematiaceous and nondematiaceous members. These fungi occur worldwide in nature, often as accompanying conidial anamorphs of certain wood decay ascomycetes. Clinical mycology laboratories may encounter this new agent of phaeohyphomycosis.

Adult↗
PubMed1993

Uncommon invasive fungal pathogens in the acquired immunodeficiency syndrome.

This communication lists fungi reported to cause invasive infection in patients with AIDS. It excludes the well known and common fungi that infect these patients such as Candida, Cryptococcus, Histoplasma, Coccidioides and Aspergillus. It is likely that these less common fungal pathogens will be seen more frequently in the enlarging AIDS population as it is continuously exposed to many of these potentially opportunistic fungi.

AIDS-Related Opportunistic Infections↗
PubMed1993

Correlation of in vitro fluconazole resistance of Candida isolates in relation to therapy and symptoms of individuals seropositive for human immunodeficiency virus type 1.

Yeast strains isolated from the oropharynx of 87 consecutive patients infected with human immunodeficiency virus type 1 were examined for in vitro susceptibility to fluconazole. Candida albicans was isolated from 73 patients. Fifty-one patients had received antifungal therapy in the month preceding the yeast infection. Thirty-two patients had symptomatic oropharyngeal candidiasis. The MICs were correlated with azole use and with clinical symptoms and signs. Although there is overlap between groups, in vitro testing identified a large group of patients for whose yeast isolates the fluconazole MICs were high and who remained symptomatic while receiving azole therapy. This study supports the ability of in vitro testing to predict the clinical outcome of mucosal fungal infections. The study also demonstrates that azole resistance of oropharyngeal yeasts is a common problem in patients infected with human immunodeficiency virus type 1 and that this azole resistance has clinical relevance.

Adult↗
PubMed1992

A nationwide survey of clinical laboratory methodologies for fungal infections.

Many hospitalized patients are at risk for fungal infections. In order to characterize present clinical laboratory experience and facilities for diagnosis and management of fungal infections, a nationwide survey of laboratory diagnostic methodologies was conducted. Data from calendar year 1988 were collected from 71 institutions (52 university teaching hospitals and 19 community hospitals) enrolled in the Drug Surveillance Network. Surveyed hospitals received 75,828 specimens for fungal culture in 1988, representing 18,705 positive cultures from 7373 patients. About 1.3% of patients admitted to teaching or community hospitals had positive fungal cultures, the most common isolates being Candida species. Yeast identification was most commonly performed by the germ tube test and carbohydrate assimilation testing. Dimorphic fungi were identified to the species level at 67% of hospitals. Cryptococcal antigen testing was available at all hospitals, and Candida serology testing was done at 55 institutions. A small number of hospitals performed antifungal drug concentration determinations for amphotericin B (n = 9), ketoconazole (n = 7) and flucytosine (n = 12). Fungal susceptibility testing was available at 77% of hospitals, either within the institution or at an external laboratory. Laboratory testing for diagnosis and management of fungal infections represents a major laboratory investment. Proficiency in this area, along with expert clinical advice, will be needed to advance therapy of patients complicated with fungal infections during the next decade.

Fungi↗
PubMed1991

Issues in cerebrospinal fluid management. Acid-fast bacillus smear and culture.

Meningeal tuberculosis is an uncommon disease in the United States with an annual incidence of fewer than 200 cases. This study evaluates three approaches to improving the use of the cerebrospinal (CSF) acid-fast bacillus (AFB) smear and culture procedure: (1) education alone; (2) optional screening by which physicians can select to have the AFB analysis stopped if the initial CSF findings are unremarkable; and (3) mandatory screening before the performance of all CSF AFB analyses. With education alone, the CSF AFB culture rate decreased from 20.6% of all CSF acquisitions to 15.7% (P less than 0.001); however, the effect may have been related to a decrease in all types of AFB testing. Optional screening had no impact on the AFB testing rate. Mandatory screening significantly decreased the CSF AFB rate to 6.7% (P less than 0.001), unrelated to changes in other types of AFB testing. Laboratories that employ mandatory screening should report the screening results immediately and have a mechanism whereby physicians can bypass the screen, providing CSF AFB analysis on unremarkable fluid from high-risk patients.

Adolescent↗
PubMed1986

Primary intranasal Fusarium infection. Potential for confusion with rhinocerebral zygomycosis.

Fusarium species are saprophytic fungi that may colonize human skin and nails and may rarely cause invasive infections in traumatized tissue and in debilitated and immunocompromised patients. We report herein a case of invasive intranasal Fusarium oxysporum infection in a diabetic patient. This unusual presentation potentially can be confused with early rhinocerebral zygomycosis clinically and histologically. Distinguishing morphologic features and the possible role of diabetes in promoting this infection are discussed.

Adenocarcinoma↗
PubMed1985

Phaeoannellomyces and the Phaeococcomycetaceae, new dematiaceous blastomycete taxa.

Phaeoannellomyces McGinnis et Schell gen. nov., which is based upon P. elegans McGinnis et Schell sp. nov., is proposed for dematiaceous yeasts which produce percurrently proliferating conidiogenous cells. Cladosporium werneckii Horta is transferred to Phaeoannellomyces as P. werneckii (Horta) McGinnis et Schell comb. nov. because the most stable and distinctive synanamorph produced by this fungus consists of annellidic yeast cells. The Phaeococcomycetaceae McGinnis et Schell fam. nov. is proposed in the class Blastomycetes, division Fungi Imperfecti for the dematiaceous yeast genera Phaeoannellomyces and Phaeococcomyces de Hoog.

Mitosporic Fungi↗
PubMed1982

Zygomycosis caused by Cunninghamella bertholletiae: mycologic aspects.

Two isolates of Cunninghamella bertholletiae from confirmed cases of human zygomycosis were studied, and their sexual, asexual, and physiologic characteristics described. Minimal inhibitory concentrations for these two isolates, as well as for six other clinical isolates of C bertholletiae, were determined for amphotericin B, flucytosine, and miconazole using a standardized agar dilution technique. All isolates were found to be susceptible to miconazole, but resistant to flucytosine and amphotericin B.

Amphotericin B↗
PubMed1981

Fusarium infection in burned patients.

The incidence of fungal infections of burn wounds is increasing because of the dramatic improvement in antibacterial chemotherapy and burn wound care. Species of Fusarium, common soil fungi and plant pathogens, are rarely isolated from burn wounds, and invasive disease due to these organisms is also rare. Therefore, a case of burn wound infection with dissemination due to F. oxysporum is reported; three other cases of burn wound colonization by Fusarium sp. are also reported. The literature on fungal infections of burn wounds is reviewed, and the importance of combined histologic and mycologic studies in the evaluation of such wounds is discussed.

Adolescent↗
PubMedDate not supplied

The use of amphotericin B in nosocomial fungal infection.

The use of potent broad-spectrum antibacterial agents, the increasing number of immunocompromised hosts, and the use of invasive treatment modalities have exacerbated the problems involved in the management of nosocomial fungal infection. The hospital records at a tertiary-care medical center were retrospectively reviewed in an effort to determine the magnitude of these problems. A plethora of fungal species were isolated from patients. Hospital infection surveillance revealed between 30 and 40 nosocomial yeast infections per month, with 20% of nosocomial urinary tract infections caused by yeasts rather than by bacterial pathogens and one or two cases of fungemia per week. Although these figures represent a large number of nosocomial fungal infections, a significant increase in the number of such infections over the last several years could not be documented. The use of amphotericin B was found to have increased each year. The patterns of use of amphotericin B changed little between 1983 and 1987, but the number of patients treated with this agent increased dramatically.

Administration, Intravesical↗