Where all your ID needs are met! Sort of.
I’ve been reading quite a bit about antifungals lately and one of the things I realized is the many formulations of amphotericin. Actually, the realization I had was I didn’t know the differences between them. It is a polyene antifungal that has broad spectrum antifungal activity (including Leshmania spp) but it is limited by its
Galactomannan is a component of the cell wall of both Aspergillus spp and Penicillium spp. This component is secreted during the growth phase of the fungus, and higher galactomannan levels are correlated with fungal load in tissues. This is the general structure of the galactomannan: The test of choice is a sandwich ELISA. The double-sandwich
The timely diagnosis of invasive pulmonary aspergillosis is incredibly important. Non-invasive modalities of diagnosis such as beta-D glucan and galactomannan can take a few days to come back and much of the time, we rely on chest imaging to guide treatment decision. The classic finding that has been attributed to invasive pulmonary aspergillosis has been
The ACTIVE trial! This is a phase III, RCT, double blind, multicenter, non-inferiority trial comparing isavuconazole vs caspofungin in invasive candidiasis. Folks, in ID, it doesn’t get any better than this (look at all these studies!) Exclusion criteria were Candida in any body part (i.e. osteomyelitis, IE, meningitis), severe immunodeficiency, >48hrs of other antifungal therapy.
Dr. Germophile 