Feline sporotrichosis has been reported in Malaysia since the 1990's. Since then, studies have revealed that clinical clade D, Sporothrix schenckii sensu stricto, of a single clonal strain is the most common cause of this disease in Malaysia. The prevalence of a single clonal strain from a clinical clade was never before reported in Asia in a specific geographical niche. This raises the possibility of a process of purifying selection and subsequent clonal proliferation. While agricultural practices may serve as the selective pressure, direct causality has yet to be established. Studies into the thermo-tolerability of the Malaysian clonal strain of S. schenckii sensu stricto revealed that a small minority of clinical isolates have the capacity to grow at 37℃, while the majority displayed low susceptibility to commonly used antifungals in clinical practice, such as itraconazole (ITZ) and terbinafine (TRB). Despite unestablished breakpoints, suspected resistance (MIC > 4 mg/mL) towards amphotericin B (AMB) and fluconazole (FLC) was recorded in the isolates. This explains the often lack of clinical response in feline patients treated with recommended doses of antifungals, including ITZ. Coupled with the potential zoonotic transmission to clients and veterinarians, protracted treatment period, and subsequent cost of treatment, prognosis of feline sporotrichosis is often regarded to be poor. The use of a higher dose of ITZ has been reported, and an adoption of this high-dose treatment regime is reported in this manuscript, with complete cure achieved in cases of recalcitrant and/or unresponsive feline sporotrichosis, which would otherwise be euthanized.
The fungicidal activity of Cassia spectabilis leaf extracts was investigated using the disk diffusion technique and the broth dilution method. The extract showed a favorable antimicrobial activity against Candida albicans with a minimum inhibition concentration(MIC) value of 6.25 mg / ml. Apart from the fungicidal effects, imaging using scanning electron microscopy (SEM) was done to determine the major alterations in the microstructure of the C. albicans. The main abnormalities noted in the SEM studies were the alterations in morphology and complete collapse of the yeast cells after 36 h of exposure to the extract. The in vitro time-kill study performed using the leaf extract at 1/2, 1 or 2 times of the MIC significantly inhibited the yeast growth with a noticeable drop in optical density (OD) of yeast culture, thus confirming the fungicidal effect of the extract on C. albicans. In addition, in vivo antifungal activity studies on candidiasis in mice showed a 5-fold decrease in Candida in kidneys and blood samples in the groups of animals treated with the extract (2.5 g / kg body weight). In an acute toxicity study using mice, the acute minimum fatal dose of the extract was greater than 2000 mg / kg, and we found no histopathological changes in macroscopic examination by necropsy of mice treated with extract. We conclude that the extract may be safely used as an anticandidal agent.