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#2
24.05.2003, 23:49
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Для лечения кандидоза применяют флюконазол в дозе 10 мг на кг или амфотерицин-В 0,5 мг на кг в/в на 10 -14 дней однаконадо найти причину снижения иммунитета т.к кандидоз указывает на снижение защитной функции иммунной системы
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#3
26.05.2003, 00:31
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1). Pediatrics in Review Volume 22 • Number 6 • June 2001
Otitis Externa Emma Hughes . MD Otomycosis Otomycosis, fungal OE, accounts for 10% of cases of OE. The percentage is higher in tropical climates. The patient may have a history of diabetes or immune dysfunction or recent use of systemic or topical antibiotics or steroids. The signs and symptoms are more insidious than those of bacterial OE. Physical examination reveals mild inflammation and thick otorrhea, with black, gray, bluish green, yellow, or white fungal growth and debris. The most common pathogens are Aspergillus and Candida sp. Aspergillus niger accounts for 90% of infections and typically presents with a cottony base and a black powdery covering. Treatment consists of cleansing the canal and using acidifying agents and antifungal drops, such as clotrimazole. Gentian violet also can be used because it has both acidifying and antimicrobial properties. 2) Rakel: Conn's Current Therapy 2003, 55th ed Otomycosis Otitis externa may be caused not by bacteria, but rather by a fungus. These fungi are more prevalent in hot, humid environments. The most common fungi are Aspergillus and Candida. Like otitis externa, patients complain of intense pruritus, otalgia, and otorrhea, along with hearing loss or fullness. On examination, one may see spores that are either white, black, or gray. Treatment of otomycosis is similar to that of otitis externa; however, antibiotic ear drops, with or without steroids, are contraindicated, the reason being that they will have no effect on the otomycosis. Rather, an acidifying agent should be used, such as acetic acid/alcohol drops with hydrocortisone. If these drops do not work, antifungal agents such as clotrimazole (Lotrimin) solution or ketoconazole cream (Nizoral) may be beneficial as well. Occasionally, drying agents such as gentian violet or even Cresylate (m-cresyl acetate, chlorobutanol, and alcohol) may be helpful if painted on by an experienced otologist under the microscope. Occasionally, a drying powder such as boric acid may be used. When the fungi are very recalcitrant to these topical measures, a trial of an oral agent such as fluconazole (Diflucan) may sometimes prove useful.
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