LAY SUMMARY: Candida virulence factors (VFs) including mainly enzymes and proteins play vital roles in breaching the human intestinal barrier and causing deadly invasive candidiasis. Limited VFs' structural studies hinder deeper comprehension of their mechanisms and thus the design of vaccines and antifungal drugs against fungal infections.
PATIENT CONCERNS: A 64-year-old man with underlying well controlled diabetes mellitus was treated with 2 weeks' course of intravenous antifungal fluconazole for pyelonephritis as his blood culture grew Candida albicans. Concurrently, he complained of 3 months of bilateral painless progressive blurring of vision. At presentation, his visual acuity (VA) was light perception both eyes. Ocular examination revealed non granulomatous inflammation with dense vitritis of both eyes.
DIAGNOSIS: He was diagnosed with EFE but the condition responded poorly with the medications.
INTERVENTIONS: He was treated with intravitreal (IVT) amphotericin B and fluconazole was continued. Vitrectomy was performed and intraoperative findings included bilateral fungal balls in the vitreous and retina with foveal traction in the left eye. Postoperatively, vision acuity was 6/24, N8 right eye and 2/60, N unable for left eye with extensive left macular scar and hole. Vitreous cultures were negative. He received multiple IVT amphotericin B and was started on topical steroid eye drops for persistent panuveitis with systemic fluconazole. Ocular improvement was seen after switching to IVT and topical voriconazole. Despite this, his ocular condition deteriorated and he developed neovascular glaucoma requiring 3 topical antiglaucoma agents. Panretinal photocoagulation was subsequently performed.
OUTCOMES: At 3 months' follow-up, his vision acuity remained at 6/24 for right eye and 2/60 for the left eye. There was no recurrence of inflammation or infection in both eyes.
LESSONS: Voriconazole could serve as a promising broad spectrum tri-azole agent in cases of failure in first-line treatment or drug-resistant fungus.
METHODS: the potential of developing natural disinfectant while using watermelon rinds (WR), pineapple (PP), orange peels (OP), palm kernel cake (PKC), and rice bran (RB), via lacto-fermentation was investigated. The obtained lactic acid bacteria (LAB) metabolites were then employed and the in vitro antifungal activity toward five spoilage fungi of mango was tested through liquid and solid systems. Besides, the effect of the produced disinfectant on the fungal growth inhibition and quality of mango was investigated.
RESULTS: the strains Lactobacillus plantarum ATCC8014 and Lactobacillus fermentum ATCC9338 growing in the substrates PKC and PP exhibited significantly higher in vitro antifungal activity against Colletotrichum gloeosporioides and Botryodiplodia theobromae as compared to other tested LAB strains and substrates. The in-situ results demonstrated that mango samples that were treated with the disinfectant produced from PKC fermented with L. plantarum and L. fermentum had the lowest disease incidence and disease severity index after 16 days shelf life, as well as the lowest conidial concentration. Furthermore, PKC that was fermented by L. fermentum highly maintained the quality of the mango.
CONCLUSIONS: lactic acid fermentation of PKC by L. fermentum demonstrated a high potential for use as a natural disinfectant to control C. gloeosporioides and B. theobromae on mango.
METHODS: Microbiological samples from 71 subjects with infected root canals were aseptically collected, and cultured on Sabouraud dextrose agar, and C. albicans was identified using multiplex polymerase chain reaction, and the isolates were further subtyped using ABC genotyping system. Their relative virulence was compared using further four archival samples of endodontic origin from another geographical region, and four more salivary isolates, as controls. The virulence attributes compared were biofilm formation, and production of phospholipase and haemolysin, and the susceptibility to nystatin, amphotericin B, ketoconazole, and fluoconazole was also tested.
RESULTS: 4 out of 71 samples (5.6%) yielded Candida species. On analysis of variance among the groups, the intracanal isolates, mainly Genotype A, possessed a high degree of phospholipase and haemolysin activity (p