Opportunistic Infections

, by Georgiev, Vassil St.; St Georgiev, Vassol

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ISBN: 9781588290090 | 1588290093
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This book is a comprehensive text on the prophylaxis and treatment of opportunistic infections in a fast growing population of immunocompromised hosts. To this end, the array of diseases covered includes not only opportunistic infections exclusively associated with immunocompromised patients but also infectious diseases which even though benign and self-resolving in immunocompetent hosts, have the potential of becoming serious illnesses in immunocompromised patients. These diseases may quickly develop into fulminant or disseminated illness characterized by high morbidity and mortality rates. Opportunistic Infections: Treatment and Prophylaxis is organized into four major parts covering bacterial, viral, parasitic, and fungal infections. In addition to well-known opportunistic pathogens, each part includes new and emerging species that may be either taxonomically related to a major disease-causing microorganism or microorganisms not until recently considered to be human pathogens. The information contained in this book will include widely accepted prophylactic and treatment regimens based on well-planned large-scale clinical trials, as well as reports from individual cases. To facilitate the quick and convenient access to this information, tables containing recommended prophylactic and therapeutic regimens are included, thus making this an essential resource for all physicians treating these infections.

Dedication

Preface

vii

PART I. VIRAL INFECTIONS

CHAPTER 1 CYTOMEGALOVIRUS

1. Introduction

(1)

2. HCMV Infection in Immunocompromised Hosts

(1)

3. Studies on Therapeutics

(3)

3.1. Ganciclovir

(1)

3.1.1. Toxicity of Ganciclovir

(1)

3.2. Foscarnet

(1)

3.2.1. Toxicity of Foscarnet

(91)

3.3. Cidofovir

(1)

3.4. Fomivirsen

(1)

3.5. Valaciclovir

(1)

4. Treatment of HCMV Infections

(3)

4.1. Management of HCMV Disease in AIDS Patients

(2)

4.2. Management of HCMV Disease in Solid Organ and Bone-Marrow Transplant Recipients

(14)

5. Prophylaxis and Maintenance Therapy of HCMV Disease

(2)

6. Ganciclovir Versus Foscarnet in the Treatment of HCMV Infection

(1)

7. Effects of HAART on HCMV Disease

(1)

8. Application of Immunotherapy for HCMV Infections

(9)

CHAPTER 2 VARICELLA-ZOSTER VIRUS (HERPES ZOSTER INFECTIONS

1. Introduction

(1)

2. Studies on Therapeutics

(1)

2.1. Acyclovir

(1)

2.2. Famciclovir

(1)

2.3. Sorivudine

(1)

3. Treatment of Varicella-Zoster Infections

(8)

3.1. Herpes Zoster in Organ-Transplant Recipients

(1)

3.2. Herpes Zoster in HIV-Infected Patients

(1)

3.3. Management of Drug-Resistant Varicella-Zoster Virus Infections

(1)

3.4. Varicella-Zoster Virus Pneumonitis

(1)

3.5. Herpes-Zoster Ophthalmicus

(7)

CHAPTER 3 HERPES SIMPLEX VIRUS

1. Introduction

(1)

2. Treatment of Herpes Simplex Virus Infections

(9)

2.1. Vidarabine

(1)

2.2. Acyclovir (Aciclovir)

(1)

2.3. Valaciclovir

(1)

2.4. Famciclovir/Penciclovir

(1)

2.5. Foscarnet

(1)

2.6. Cidofovir

(1)

2.7. Brivudine (Bromovinyldeoxyuridine, BVDU)

(1)

2.8. Drug-Resistant Herpes Simplex Virus and Evolving Therapeutic Strategies

(14)

3. Prophylaxis of Herpesvirus Infections

(12)

PART II. BACTERIAL INFECTIONS

CHAPTER 4 NOCARDIA SPP.

1. Introduction

(1)

2. Nocardiosis in Immunocompromised Hosts

(2)

2.1. Nocardiosis in HIV-Positive Patients

(1)

2.2. Co-Infections With Other Pathogens

(1)

3. Treatment of Nocardiosis

(14)

3.1. Sulfonamides

(1)

3.2. Sulfonamide-Trimethoprim Combinations

(1)

3.3. Antibiotics

(1)

3.4. Acquired Drug Resistance of Nocardia spp

(22)

CHAPTER 5 OERSKOVIA SSP.

1. Introduction

(1)

2. Treatment of Oerskovia Infections

(2)

CHAPTER 6 RHODOCOCCUS EQUI

1. Introduction

(1)

2. Treatment of Rhodococcus equi Infection

(5)

CHAPTER 7 TSUKAMURELLA SSP.

1. Introduction

(1)

2. Treatment of Tsukamurella Infections

(2)

CHAPTER 8 MYCOBACTERIUM TUBERCULOSIS

1. Introduction

(1)

2. Mycobacterium tuberculosis Infections an AIDS Patients

(1)

3. Evolution of Therapies and Treatment of Mycobacterium tuberculosis Infections

(9)

3.1. Drug Interactions in HIV-Infected Patients

(1)

3.2. Drug Resistance in Tuberculosis

(1)

3.3. Highly Active Antiretroviral Therapy (HAART) and

Mycobacterial Infections in HIV-Infected Patients

(1)

3.4. Prophylaxis of Tuberculosis in HIV-Infected Patients

(1)

3.5. Adjunctive Immunotherapy of Tuberculosis

(1)

3.6. Vaccine Development Against Tuberculosis

(11)

CHAPTER 9 MYCOBACTERIUM BOVIS

1. Introduction

(1)

2. Treatment of Mycobacterium bovis Infections

(1)

3. BCG Vector-Based Vaccines in Immunotherapy Against HIV Infection

(3)

CHAPTER 10 NONTUBERCULOUS MYCOBACTERIAL INFECTIONS

1. Introduction

(1)

2. Nontuberculous Mycobacterial Infections and AIDS

(1)

3. Mycobacterium avium Complex (MAC)

(11)

3.1. Introduction

(1)

3.2. Treatment of Mycobacterium avium-intracellulare Complex (MAC) Infections

(10)

3.2.1. Immunotherapy of MAC Infections

103

(1)

3.2.2. Prophylaxis of Mycobacterium avium-intracellulare

Infections in AIDS Patients

103

(4)

3.2.3. MAC Infections and Highly Active Antiretroviral Therapy (HAART)

107

(58)

4. Mycobacterium kansasii

107

(3)

4.1. Introduction

107

(1)

4.2. Treatment of M. kansasii Infections

108

(2)

5. Mycobacterium xenopi

110

(2)

5.1. Introduction

110

(1)

5.2. Treatment of M. xenopi Infections

111

(1)

6. Mycobacterium haemophilum

112

(2)

6.1. Treatment of M. haemophilum Infections

112

(24)

7. Mycobacterium genavense

114

(15)

CHAPTER 11 LISTERIA MONOCYTOGENES

1. Introduction

129

(1)

2. Listeriosis in AIDS Patients

130

(1)

3. Treatment of Listeriosis

131

(4)

CHAPTER 12 GASTROINTESTINAL INFECTIONS IN THE IMMUNOCOMPROMISED HOST

1. Introduction

135

(1)

2. Therapeutic Strategies for Enteric Infections

136

(7)

2.1. Prevention of Enteric Infections

137

(7)

PART III. PARASITIC INFECTIONS

CHAPTER 13 CRYPTOSPORIDIUM SPP.

1. Introduction

143

(1)

2. Treatment of Cryptosporidiosis

144

(15)

2.1. Macrolide Antibiotics

144

(1)

2.2. Paromomycin

145

(1)

2.3. Rifaximin

146

(1)

2.4. Nitazoxanide (NTZ, Cryptaz)

146

(1)

2.5. Somatostatin and Analogues

147

(1)

2.6. Immunotherapy of Cryptosporidiosis

148

(2)

2.7. Antiretroviral Therapies and Cryptosporidiosis

150

(1)

2.8. Alternative Therapies for Cryptosporidiosis

150

(14)

CHAPTER 14 Isospora SPP.

1. Introduction

159

(1)

2. Treatment of Isosporiasis

160

(3)

CHAPTER 15 TOXOPLASMA GONDII

1. Introduction

163

(1)

2. Treatment of Toxoplasmosis

164

(9)

2.1. Pyrimethamine-Sulfonamide Combinations

165

(3)

2.1.1. Acute Renal Failure to Sulfadiazine Therapy in AIDS Patients

167

(1)

2.1.2. Adverse Cutaneous Reactions to Pyrimethamine

combinations in AIDS Patients

167

(1)

2.2. Trimethoprim-Sulfonamide Combinations

168

(1)

2.3. Antibiotic Therapy of Toxoplasmosis

168

(3)

2.3.1. Spiramycin

168

(1)

2.3.2. Clindamycin and Clindamycin-Pyrimethamine Combinations

169

(1)

2.3.3. Clarithromycin

170

(1)

2.3.4. Azithromycin

171

(1)

2.3.5. Doxycycline

171

(45)

2.4. Atovaquone

171

(1)

2.5. Trimetrexate

172

(1)

2.6. Management of Ocular Toxoplasmosis

172

(25)

3. Prophylaxis of Cerebral Toxoplasmosis

173

(2)

4. Prophylaxis Against Toxoplasmosis and HAART in HIV-Infected Patients

175

(1)

5. Immunotherapy of Toxoplasmosis

175

(8)

CHAPTER 16 MICROSPORIDIA

1. Introduction

183

(1)

2. Enterocytozoon bieneusi

184

(1)

3. Encephalitozoon spp

185

(1)

4. Pleistophora spp

185

(1)

5. Trachipleistophora hominis

185

(1)

6. Nosema spp

185

(1)

7. Brachiola vesicularum

186

(1)

8. Treatment of Microsporidiosis

186

(9)

CHAPTER 17 STRONGYLOIDES STERCORALIS

1. Introduction

195

(1)

2. Strongyloidiasis as Opportunistic Infection in Immunocompromised Hosts

195

(2)

3. Corticosteroid Therapy as a Predisposing Factor for Strongyloidiasis

197

(1)

4. Treatment of Strongyloidiasis

197

(8)

4.1. Comparative Studies

198

(16)

CHAPTER 18 CYCLOSPORA SPP.

1. Introduction

205

(1)

2. Treatment of Cyclosporiasis

206

(7)

PART IV. FUNGAL INFECTIONS

CHAPTER 19 CRYPTOCOCCUS NEOFORMANS

1. Introduction

213

(1)

2. Treatment of Cryptococcosis

214

(12)

2.1. Amphotericin B

216

(2)

2.1.1. Toxicity of Amphotericin B

218

(1)

2.2. Combinations of Amphotericin B with 5-Fluorocytosine and Other Drugs

218

(3)

2.2.1. Toxicity of Amphotericin B-5-Fluorocytosine Combinations

220

(1)

2.3. 5-Fluorocytosine (5-FC)

221

(1)

2.4. Azole Derivatives

221

(18)

2.4.1. Miconazole

221

(1)

2.4.2. Ketoconazole

222

(1)

2.4.3. Fluconazole

222

(3)

2.4.4. Itraconazole

225

(20)

3. Prophylaxis and Maintenance Therapy of Cryptococcosis

226

(1)

4. Cryptococcus neoformans var. gattii

226

(1)

5. Cryptococcus albidus

227

(1)

6. Cryptococcus laurentii

227

(12)

CHAPTER 20 CANDIDA ALBICANS

1. Introduction

239

(1)

2. Human Candidiasis

239

(2)

2.1. Candidal Infections in HIV-Infected Patients

240

(1)

3. Treatment of Candidiasis

241

(14)

3.1. Cutaneous Candidiasis

241

(1)

3.2. Chronic Mucocutaneous Candidiasis

242

(1)

3.3. Candidal Onychomycosis

242

(1)

3.4. Oropharyngeal and Esophageal Candidiasis

242

(3)

3.5. Systemic Candidiasis

245

(24)

3.5.1. Endogenous (Hematogenous) Candidal Endophthalmitis (HCE)

248

(1)

3.5.2. Candidal Meningitis

249

(1)

3.5.3. Candidal Endocarditis

249

(1)

3.5.4. Vulvovaginal Candidiasis

250

(1)

3.5.5. Urinary and Peritoneal Candidiasis

251

(2)

3.5.6. Candidal Arthritis and Osteomyelitis

253

(1)

3.5.7. Neonatal Candidiasis

253

(17)

4. Azole Drug Resistance and Refractory Candidiasis

255

(1)

5. HAART Therapy and Candidiasis

256

(1)

6. Drug Activities and Candida Virulence

256

(1)

7. Prophylaxis of Candida Infections

257

(12)

CHAPTER 21 EMERGING CANDIDA SPP. INFECTIONS

1. Introduction

269

(1)

2. Candida glabrata

269

(4)

2.1. Treatment of C. glabrata Infections

270

(2)

2.1.1. Fluconazole in the Treatment of C. glabrata Infections

271

(1)

2.1.2. C. glabrata-Induced Vulvovaginal Candidiasis

271

(5)

2.2. Candida glabrata Prophylaxis

272

(1)

3. Candida krusei

273

(1)

3.1. Prophylaxis Against C. krusei Infections and Azole Resistance

273

(2)

4. Candida lusitaniae

274

(1)

5. Candida dubliniensis

275

(2)

5.1. Molecular and Phenotypic Characterization of C. dubliniensis

276

(1)

5.2. Treatment of C. dubliniensis Candidiasis

276

(17)

5.2.1. C. dubliniensis Resistance to Fluconazole

277

(32)

6. Candida rugosa

277

(1)

7. Candida zeylanoides

278

(1)

8. Candida famata

278

(1)

9. Candida guilliermondii

279

(1)

10. Candida norvegensis

279

(1)

11. Candida lipolytica

280

(1)

12.. Candida viswanathii

280

(1)

13. Candida haemulonii

280

(1)

14. Pichia jadinii (Candida utilis)

281

(1)

15. Candida ciferrii

281

(10)

CHAPTER 22 TRICHOSPORON BEIGELII

1. Introduction

291

(1)

2. Treatment of Trichosporonosis

292

(1)

3. Blastoschizomyces capitatus

293

(6)

3.1 Treatment of B. capitatus Infections

294

(14)

CHAPTER 23 RHODOTORULA SPP.

1. Introduction

299

(1)

2. Treatment of Rhodotorula Infections

299

(4)

CHAPTER 24 HANSENULA (PICHIA) SPP.

1. Introduction

303

(1)

2. Treatment of Hansenula spp. Infections

303

(4)

CHAPTER 25 DEMATIACEOUS FUNGAL INFECTIONS: PHAEOHYPHOMYCOSIS AND CHROMOBLASTOMYCOSIS

1. Introduction

307

(1)

2. Phaeohyphomycosis

308

(18)

2.1. Treatment of Phaeohyphomycosis

309

(13)

2.1.1. Bipolaris spp. and Exserohilum spp. Phaeohyphomycosis

309

(2)

2.1.2. Exophiala (Wangiella) dermatitidis and Exophiala spp. Phaeohyphomycosis

311

(2)

2.1.3. Alternaria spp. Phaeohyphomycosis

313

(1)

2.1.3.1. THERAPY OF ALTERNARIOSIS

314

(2)

2.1.4. Phaeosclera dematioides Phaeohyphomycosis

316

(1)

2.1.5. Curvularia spp. Phaeohyphomycosis

316

(2)

2.1.6. Ochroconis gallopava Phaeohyphomycosis

318

(1)

2.1.7. Phialophora spp. Phaeohyphomycosis

319

(1)

2.1.8. Phaeoacremonium spp. Phaeohyphomycosis

320

(1)

2.1.9. Hormonema dermatioides Phaeohyphomycosis

320

(1)

2.1.10. Aureobasidium spp. Phaeohyphomycosis

320

(1)

2.1.11. Colletotrichum spp. Phaeohyphomycosis

321

(1)

2.1.12. Mycoleptodiscus indicus Phaeohyphomycosis

321

(1)

2.1.13. Phoma spp. Phaeohyphomycosis

321

(1)

2.1.14. Pleurophomopsis spp. Phaeohyphomycosis

322

(1)

2.1.15. Pyrenochaeta spp. Phaeohyphomycosis

322

(1)

2.1.16. Geniculosporium spp. Phaeohyphomycosis

322

(1)

2.1.17. Veronaea bothryosa Phaeohyphomycosis

322

(1)

2.2. Cerebral Phaeohyphomycosis

322

(3)

2.2.1. Nodulisporium spp. Phaeohyphomycosis

323

(1)

2.2.2. Scopulariopsis spp. Phaeohyphomycosis

323

(1)

2.2.3. Ramichloridium spp. Phaeohyphomycosis

323

(1)

2.2.4. Cladophialophora spp. Phaeohyphomycosis

323

(1)

2.2.4.1. CLADOPHIALOPHORA BANTIANA

(XYLOHYPHA BANTIANA, CLADOSPORIUM BANTIANUM)

324

(35)

2.3. Fungal Peritonitis in Continuing Ambulatory Peritoneal Dialysis (CAPD)

325

(22)

3. Chromoblastomycosis

326

(17)

CHAPTER 26 HYALOHYPHOMYCOSIS

1. Introduction

343

(1)

2. Pseudallescheria boydii Infections

343

(4)

3. Scedosporium spp. Infections

347

(2)

3.1. Scedosporium apiospermum

347

(1)

3.2. Scedosporium prolificans (S. inflatum)

348

(1)

4. Fusarium spp. Infections

349

(5)

4.1. Treatment of Fusariosis

350

(3)

4.2. Fusarium napiforme

353

(2)

5. Phialemonium spp. Infections

354

(1)

6. Acremonium spp. Infections

354

(1)

7. Scopulariopsis spp. Infections

355

(2)

7.1. Scopulariopsis brevicaulis

355

(2)

7.2. Scopulariopsis acremonium

357

(1)

8. Microascus spp. Infections

357

(1)

8.1. Microascus cinereus

357

(1)

8.2. Microascus cirrosis

357

(1)

9. Paecilomyces spp. Infections

357

(3)

9.1. Treatment of Paecilomyces Infections

359

(24)

9.1.1. Paecilomyces lilacinus

359

(1)

9.1.2. Paecilomyces variotii

360

(1)

9.1.3. Post-Transplantation Therapy of Paecilomyces Infections

360

(58)

10. Acrophialophora fusispora Infections

360

(1)

11. Engyodontium album Infections

361

(1)

12. Beauveria bassiana Infections

361

(1)

13. Non-Candida Mycoses After Solid Organ and Bone-Marrow Transplantations

362

(2)

14. Pharmacokinetic Interactions of Cyclosporin A with Azole Antimycotics

364

(19)

CHAPTER 27 HISTOPLASMA SPP.

1. Introduction

383

(1)

2. Evolution of Therapies and Treatment of Histoplasmosis

383

(13)

2.1. Prophylaxis in Histoplasmosis

386

(1)

2.2. Histoplasmosis in AIDS Patients

386

(3)

2.3. Histoplasmosis in Transplant Recipients

389

(1)

2.4. Skin Manifestations of Histoplasmosis

389

(1)

2.5. Gastrointestinal Histoplasmosis

390

(1)

2.6. Orofacial Manifestations of Histoplasmosis

390

(1)

2.7. Ocular Histoplasmosis

391

(1)

2.8. Rheumatic Manifestations of Histoplasmosis

391

(1)

2.9. Mediastinal Histoplasmosis

392

(1)

2.10. Pulmonary Histoplasmosis and Pleural Effusions

393

(1)

2.11. Histoplasmosis of the Central Nervous System

393

(1)

2.12. Adrenal Histoplasmosis

394

(1)

2.13. Musculoskeletal Histoplasmosis

394

(1)

2.14. Histoplasmosis of the Thyroid

394

(1)

2.15 Genitourinary Histoplasmosis

394

(1)

2.15.1. Prostatic Histoplasmosis

395

(1)

2.16. Childhood Histoplasmosis

395

(20)

3. Host Immune Defense Against Histoplasmosis

396

(13)

CHAPTER 28 AFRICAN HISTOPLASMOSIS

1. Introduction

409

(1)

2. Management of African Histoplasmosis and Evolution of Therapies

409

(4)

CHAPTER 29 BLASTOMYCES DERMATITIDIS

1. Introduction

413

(1)

2. African Blastomycosis

414

(1)

3. Role of Host Immune Response Against Blastomyces dermatitidis

415

(1)

4. Evolution of Therapies and Treatment of Blastomycosis

415

(14)

4.1. Amphotericin B

415

(3)

4.2. Azole Derivatives

418

(2)

4.2.1. Ketoconazole

418

(1)

4.2.2. Itraconazole

419

(1)

4.2.3. Fluconazole

420

(1)

4.2.4. Miconazole

420

(12)

4.3. Treatment of Adult Respiratory Distress Syndrome (ARDS) Secondary to Blastomycosis

420

(9)

CHAPTER 30 ASPERGILLUS SPP.

1. Introduction

429

(2)

1.1. Aspergillus-Related Spondylodiscitis

431

(1)

2. Host Immune Response to Aspergillosis

431

(1)

3. Therapies and Treatment of Aspergillosis

432

(15)

3.1. Amphotericin B

432

(7)

3.1.1. Liposome-Encapsulated and Lipid-Based Formulations of Amphotericin B

434

(2)

3.1.2. Routes of Administration

436

(1)

3.1.3. Combinations of Amphotericin B With Other Drugs

437

(2)

3.2. Azole Derivatives

439

(5)

3.2.1. Clotrimazole

439

(1)

3.2.2. Miconazole

439

(2)

3.2.3. Ketoconazole

441

(1)

3.2.4. Fluconazole

441

(1)

3.2.5. Itraconazole

441

(26)

3.3. Terbinafine

444

(1)

3.4. Caspofungin

444

(1)

3.5. Sodium (Potassium) Iodide Therapy of Aspergilloma

445

(1)

3.6. Therapy of Allergic Bronchopulmonary Aspergillosis (ABPA)

445

(1)

3.7. Therapy of Aspergillus-Induced Otomycosis

446

(1)

3.8. Therapy of Aspergillus-Induced Onychomycosis

447

(15)

4. Prophylaxis Against Aspergillosis

447

(1)

5. Aspergillus chevalieri

448

(13)

CHAPTER 31 COMMODES IMMITIS

1. Introduction

461

(1)

2. Immune Responses to Human Coccidioidomycosis

462

(1)

3. Evolution of Therapies and Treatment of Coccidioidomycosis

462

(10)

3.1. Coccidioidomycosis in Immunocompromised Hosts and AIDS Patients

464

(2)

3.2. Cutaneous Manifestations

466

(1)

3.3. Coccidioidomycosis in Pregnancy and Early Infancy

466

(1)

3.4. Coccidioidomycosis in Transplant Recipients

467

(2)

3.4.1. Cardiac Transplant Recipients

467

(1)

3.4.2. Renal Transplant Recipients

468

(1)

3.4.3. Liver Transplant Recipients

468

(1)

3.4.4. Bone-Marrow Transplant Recipients

468

(3)

3.5. Ocular Coccidioidomycosis

469

(1)

3.6. Acute Respiratory Failure

469

(1)

3.7. Coccidioidal Peritonitis and Gastrointestinal Dissemination

469

(1)

3.8. Coccidioidal Infections of Bones and Joints

470

(1)

3.9. Genitourinary Coccidioidomycosis

471

(1)

3.9.1. Coccidioidomycosis of the Prostate

471

(1)

3.9.2. Infection of Intrascrotal Contents With or

Without Prostatic Involvement

471

(1)

3.9.3. Bladder Involvement

471

(1)

3.9.4. Other Coccidioidal Genitourinary Involvement

471

(16)

3.10. Coccidioidal Infection of Arterial Prosthesis

471

(1)

3.11. Coccidioidal Infections of CNS

471

(15)

4. Prophylaxis of Coccidioidomycosis

472

(1)

5. Vaccine Studies in Humans

472

(11)

CHAPTER 32 PARACOCCIDIOIDES BRASILIENSIS

1. Introduction

483

(1)

2. Host Immune Response to Paracoccidioidomycosis

484

(1)

3. Paracoccidioidomycosis in the Immunocompromised Host

485

(1)

4. Treatment of Paracoccidioidomycosis

486

(9)

4.1. Sulfonamides

486

(1)

4.2. Amphotericin B

486

(1)

4.3. Azole Derivatives

487

(2)

4.3.1. Adrenocortical Dysfunction in Paracoccidioidomycosis and Azole Therapy

488

(1)

4.4. Immunostimulants in the Treatment of Paracoccidioidomycosis

489

(13)

CHAPTER 33 PENICILLIUM MARNEFFEI

1. Introduction

495

(1)

2. Treatment of Penicillium marneffei Infections

496

(1)

3. Prophylaxis and Maintenance Therapy

Against Penicillium marneffei

497

(4)

CHAPTER 34 ZYGOMYCOSIS (MUCORMYCOSIS, PHYCOMYCOSIS)

1. Introduction

501

(1)

2. Treatment of Zygomycosis

502

(5)

2.1. Amphotericin B Therapy

502

(8)

CHAPTER 35 PNEUMOCYSTIS CARINII

1. Introduction

507

(1)

2. Genetic Diversity of P. carinii and Clinical Outcome

508

(1)

3. Subclinical P. carinii Infection

508

(1)

4. Atypical P. carinii Pulmonary Disease

508

(1)

5. Extrapulmonary P. carinii Infection

508

(1)

6. P. carinii Pneumonia Secondary to Methotrexate-Treated Rheumatoid Arthritis

509

(1)

7. Evolution of Therapies and Treatment of P. carinii Pneumonia

510

(25)

7.1. Adjunctive Corticosteroid Therapy for P. carinii Pneumonia

514

(1)

7.2. Toxicity of Sulfonamides

515

(1)

7.3. Toxicity of Pentamidine

516

(1)

7.4. Toxicity of Dapsone

516

(1)

7.5. Synergistic Anti-P. carinii Activity

517

(1)

8. Prophylaxis Against P. carinii Pneumonia

517

(18)

Index

535

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Opportunistic Infections

Summary

Table of Contents

Supplemental Materials