Voriconazole-associated periostitis presenting as hypertrophic osteoarthropathy following lung transplantation report of two cases and review of the literature. (Elmore et al., 2019)
Hypertrophic osteoarthropathy (HOA) is a condition that combines periostitis of the small hand joints and digital clubbing. It is usually associated with intrathoracic malignancies, congenital heart disease and chemotherapy but recently, HOA and periostitis has been reported as a side effect of using antifungal therapy (voriconazole) in lung transplant recipients. This paper reports two such cases and notes the rapid improvement of the painful symptoms of HOA following removal of voriconazole treatment. The paper also gives a review of the medical literature around this subject.
Clinical pattern of fungal balls in the paranasal sinuses: our experience with 70 patients. (Seo et al., 2019)
This interesting study charts the growth characteristics of paranasal sinus (PNS) fungal balls via sinus imaging techniques. The authors looked at 70 patients and investigated changes in symptoms and lesion size, as well as any new occurrences. Where a fungal ball was found at the initial examination, the authors found an increase in size in about two-thirds of the lesions and confirmed that the size increment was present within five months. No case of local invasion was observed during the follow-up period of more than 17 years in this study, suggesting that surgery to remove fungal balls should not be performed routinely without thorough consideration of other clinical features of symptoms, any changes in the lesion and the immune-competence of the patient.
Design, synthesis, and structure-activity relationship studies of l-amino alcohol derivatives as broad-spectrum antifungal agents (Zhao et al., 2019)
This paper describes the antifungal activities of a novel class of L-amino alcohol derivatives which have been designed and synthesised to try and discover broad spectrum antifungal agents. It follows previous work on a series of azole derivatives with an ester group which were found to be inactive against Aspergillus fumigatus due to a steric clash. This paper sought to overcome that clash by replacing the bulky ester group with smaller alkyl side chains. These changes resulted in increased activity against A. fumigatus but reduced the activity against other fungi such as Candida albicans, Cryptococcus neoformans and Candida tropicalis.
Burden of hospitalisations over time with invasive aspergillosis in the United States, 2004-2013. (Zilberberg et al., 2019)
Invasive aspergillosis (IA) is associated with high crude and attributable mortality, and by some estimates, the economic costs of IA approaches $600 million annually in the US. This paper seeks to describe in detail the epidemiology and outcomes associated with IA. It explores time trends in the prevalence, mortality and hospital resource utilisation associated with IA among a diverse cohort of hospitalised patients.