• 한국임상수의학회지
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• 제36권3호
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• pp.172-175
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• 2019

A young slaty-backed gull was found dead nearby Seongsan harbor, Seogwipo-si, Jeju. Grossly, focal ulceration and a protuberant nodule were observed in intermediated zone between proventriculus and gizzard. Numerous discrete or confluent white-yellowish nodules were scattered on the surface of liver. Caudal portion of left kidney was replaced by a white-yellowish nodule. Three raised masses were observed in the spleen. Histologically, there were severe ulceration with hemorrhage in the gizzard and multifocal granulomatous inflammations in liver, kidney, spleen, and lungs. Pink to dark-red, round to oval fungal spores and pseudohyphae in granulomatous lesions were confirmed by periodic acid-Schiff stain. Candida albicans were isolated from the lesions of liver, kidney, spleen and gizzard using fungal culture and confirmed by VITEK 2 system. Based on the gross, histopathological findings, and fungal examination, this case was diagnosed as systemic candidiasis of a wild slaty-backed gull. In our best knowledge, this is the first report for systemic candidiasis characterized by multifocal granulomatous lesions in internal organs of a wild gull in Korea.

• Clinical and Experimental Pediatrics
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• 제45권7호
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• pp.847-854
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• 2002

목 적: 신생아 집중치료실에 장기간 입원 중인 환아는 입원중 전신성 감염을 일으킬 위험이 있다. 이미 항생제를 투여 받고 있는 환아에서 전신 감염 증상이 발현하면, 전신성 칸디다증은 장기간의 amphotericin B의 투여가 필요하며 세균 감염증은 감수성 있는 항생제로의 교체를 필요로 한다. 본 연구에서는 미숙아인 저출생 체중아를 대상으로 전신성 칸디다증의 임상증상과 증상 발현시의 검사 소견을 전신성 세균 감염증과 비교함으로써 이들 소견의 조기 감별 진단 상의의를 조사하였다. 방 법 : 1997년 1월부터 2001년 6월까지 경북대학교병원 신생아 집중치료실에 입원했던 미숙아 중 저출생 체중아 중에서 배양검사로 확인된 전신성 칸디다증 20례와 전신성 세균 감염증 23례를 대상으로 하여 이들의 의무 기록을 후향적으로 조사하였다. 결 과: 전신성 칸디다증 환아(이하 칸디다군)의 출생시 체중은 $1,290{\pm}290g$으로 전신성 세균 감염증 환아(이하 세균군)의 $1,530{\pm}430g$보다 유의하게 작았으며, 총 정맥 영양, 항생제 투여, 중심 카테테르, 기관 삽관, $H_2$ 차단제 사용의 빈도가 더 높았다. 임상 양상에 있어서는 서맥 동반 무호흡 및 호흡 곤란이 두 군의 주된 발현시 증상으로, 발현 빈도는 칸디다군(90%)에서 세균군(61%)에 비해 높았다. 증상 발현시 시행한 검사 소견에서 혈소판 감소증과 백혈구 감소증이 동반된 경우가 칸디다군 7례(35%), 세균군 2례(9%)로 두 군 사이에 유의한 차이를 보였다(P=0.03). 균은 대부분 혈액에서 배양되었으며(칸디다군 19례, 세균군 19례), 그 외에 요, 중심 카테테르, 뇌척수액 등에서 배양되었다. 감염균은 칸디다군은 Candida albicans가 15례, 세균군은 Klebsiella pneumoniae와 Enterobacter cloacae가 각각 5례로 가장 빈번하였다. 결 론 : 신생아 집중치료실에 장기 입원 중 전신 감염증 증상을 보이는 환아에서 호흡기 증상과 함께 검사상 혈소판 감소 단독 또는 혈소판 감소증과 백혈구 감소증이 동반된 경우에는 전신성 칸디다 감염증 가능성이 높을 것으로 사료된다.

• Journal of Oral Medicine and Pain
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• 제46권2호
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• pp.33-40
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• 2021

Purpose: Oral candidiasis is the most common fungal infection in the oral cavity which is usually diagnosed from clinical findings. A retrospective study was conducted to identify risk factors for oral candidiasis and to characterize the demographic and clinical features of affected patients. Methods: From January 1, 2019 to December 31, 2019, it consisted of 90 oral candidiasis patients diagnosed based on clinical finding and treated with antifungal drugs. As a retrospective study of those people, surveys were conducted on sex, age, systemic disease, a use of dentures, complaints of dry mouth, smoking and alcohol consumption, culture on potato dextrose agar (PDA) medium, culture on chromogenic agar (CA) medium and a duration of antifungal treatment. Results: Among 90 selected patients, the male and female ratio was 41:49. Overall, female had a higher infection rate than male in all age groups. In this study, oral candidiasis was not clearly susceptible to dry mouth, smoking or drinking, wearing dentures and association with systemic disease. Among 90 patients with oral candidiasis, 83 had colonies formed on PDA medium and 53 had colonies formed on CA medium. The duration of antifungal treatment was highest between 5 and 8 weeks. In addition, there was statistical significance between the culture results in CA medium and the duration of antifungal treatment. Conclusions: Generally, old age or infants, dry mouth, smoking, a use of dentures and endocrine abnormalities are risk factors to increase oral candidiasis; however, in this study, it was mainly found in the elderly aged 60 or older regardless of sex and the incidence of oral candidiasis was not obviously related with patients with dry mouth, smoking or drinking, denture wearers and endocrine abnormalities. Interestingly, when the fungi were cultured in CA medium, the duration of antifungal treatment was increased.

• 대한후두음성언어의학회지
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• 제28권1호
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• pp.48-51
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• 2017

Candida exists in the oral cavity as normal flora, which is cultured in 7% of the population. And the development of candidiasis is usually related to the systemic or local immunosuppressed status such as diabetes, long-term antibiotics, steroid, radiation therapy or chemotherapy. However, isolated laryngeal candidiasis in immunocompetent patients is a rare entity with fewer than 40 cases reported in the world. Symptoms of laryngeal candidiasis are variable such as hoarseness, dysphagia, or odynophagia according to its extent, but it has clinical importance because of its resemblance with laryngeal premalignant or malignant lesions. Diagnosis is made by biopsy under direct laryngoscopy with special staining to identify the hyphae. In this article, we report a case of laryngeal candidiasis presented as leukoplakia localized on vocal fold with literature reviews.

• Journal of Microbiology
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• 제43권spc1호
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• pp.65-84
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• 2005

Invasive candidiasis is associated with high morbidity and mortality. Clinical diagnosis is complicated by a lack of specific clinical signs and symptoms of disease. Laboratory diagnosis is also complex because circulating antibodies to Candida species may occur in normal individuals as the result of commensal colonization of mucosal surfaces thereby reducing the usefulness of antibody detection for the diagnosis of this disease. In addition, Candida species antigens are often rapidly cleared from the circulation so that antigen detection tests often lack the desired level of sensitivity. Microbiological confirmation is difficult because blood cultures can be negative in up to 50% of autopsy-proven cases of deep-seated candidiasis or may only become positive late in the infection. Positive cultures from urine or mucosal surfaces do not necessarily indicate invasive disease although can occur during systemic infection. Furthermore, differences in the virulence and in the susceptibility of the various Candida species to antifungal drugs make identification to the species level important for clinical management. Newer molecular biological tests have generated interest but are not yet standardized or readily available in most clinical laboratory settings nor have they been validated in large clinical trials. Laboratory surveillance of at-risk patients could result in earlier initiation of antifungal therapy if sensitive and specific diagnostic tests, which are also cost effective, become available. This review will compare diagnostic tests currently in use as well as those under development by describing their assets and limitations for the diagnosis of invasive candidiasis.

• Journal of Genetic Medicine
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• 제15권2호
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• pp.92-96
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• 2018

Chronic mucocutaneous candidiasis (CMC) is characterized by increased susceptibility to chronic and recurrent infections of the skin, mucous membranes, and nails by Candida species. It is a primary immunodeficiency disorder that is difficult to diagnose because of its heterogeneous clinical manifestations and genetic background. A 20-month-old boy who did not grow in height for 3 months was diagnosed as having hypothyroidism and he had hepatitis which was found at 5 years old. He presented with persistent oral thrush and vesicles on the body, the cause of which could not be identified from laboratory findings. No microorganism was detected in the throat culture; however, the oral thrush persisted. Immunological tests showed that immunoglobulin (Ig) subclass IgG and cluster of differentiation (CD)3, CD4, and CD8 levels were within normal limits. We prescribed oral levothyroxine and fluconazole mouth rinse. The patient was examined using diagnostic exome sequencing at the age of 6 years, and a c.1162A>G (p.K388E) STAT1 gene mutation was identified. A diagnosis of CMC based on the STAT1 gene mutation was, thus, made. At the age of 8 years, the boy developed a malar-like rash on his face. We conducted tests for detection of antinuclear antibodies and anti-dsDNA antibodies, which showed positive results; therefore, systemic lupus erythematosus (SLE) was also suspected. Whole exome sequencing is important to diagnose rare diseases in children. A STAT1 gene mutation should be suspected in patients with chronic fungal infections with a thyroid disease and/or SLE.

• Archives of Pharmacal Research
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• 제19권3호
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• pp.197-200
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• 1996

6-[(N-2,3-Dichlorophenyl)aminol-7-chloro-5,8-quinolinedione (RCK1 1) was tested for in vivo antifungal activities in the treatment of systemic infection with Canclicla albicans in normal mice compared with ketoconazole. The therapeutic potential of RCK11 had been assessed by evaluating their activities (survival rates) against systemic infections in normal mice. $ED_{50}$ of intraperitoneally administered RCK11 was $0.10\pm0.01 mg/kg$ but that of ketoconazole had $8.00\pm0.73 mg/kg$ respectively. When RCK11 was administered intravenously at the $ED_{50}$(0.10 mg/kg), the colony counts of Canoliola albicans in the liver after 7 days and 14 days were reduced as likely as ketoconazole at the $ED_{50}$ (8.00 mg/kg), and the better survival rates than ketoconazole were achieved after 14 days. The results suggest that RCK11 may be a potent antifungal agent.

• 동의생리병리학회지
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• 제20권4호
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• pp.799-806
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• 2006

Fungi cause a number of plant and animal diseases. Because fungi are more chemically and genetically similar to animals than other organisms, this makes fungal diseases very difficult to treat. Human fungal infections are uncommon in normally healthy persons, being confined to conditions such as candidiasis (thrush) and dermatophyte skin infections such as athlete's foot. However, in the immunocompromised host, a variety of normally mild or nonpathogenic fungi can cause potentially fatal infections. Furthermore, the relative ease with which people can now visit 'exotic' countries provides the means for unusual fungal infections to be imported into this country. Fungal infections or mycoses are classified depending on the degree of tissue involvement and mode of entry into the host. These are Cutaneous, Subcutaneous, Systemic, and Opportunistic. As listed above, in superficial mycoses infection is localised to the skin, the hair, and the nails. An example is 'ringworm' or 'tinea', an infection of the skin by a dermatophyte. Ringworm refers to the characteristic central clearing that often occurs in dermatophyte infections of the skin. Dermatophyte members of the genera Trycophyton, Microsporum and Epidermophyton are responsible for the disease. Tinea can infect various sites of the body, including the scalp (tinea capitis), the beard (tinea barbae) the foot (tinea pedis: 'athlete's foot') and the groin (tinea cruris). All occur in the United Kingdom although tinea infections, other than pedis, are now rare. Candids albicans is a yeast causing candidiasis or 'thrush' in humans. As a superficial mycoses, candidiasis typically infects the mouth or vagina. C. albicans is part of the normal flora of the vagina and gastrointestinal tract and is termed a 'commensal' However, during times of ill health or impaired immunity the balance can alter and the organism multiplies to cause disease. Antibiotic treatment can also alter the normal bacterial flora allowing C. albicans to flourish. If we study mycoses of the orient medicine, we can improve the medical skills about mycoses.

• Journal of Oral Medicine and Pain
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• 제47권3호
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• pp.109-116
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• 2022

Purpose: This study was conducted to analyze the clinical characteristics and distribution of the tongue-related diagnoses in patients with tongue symptoms. Methods: The subjects were patients who visited Chosun University Dental Hospital with tongue symptoms from January 1, 2021, to December 31, 2021. We analyzed 491 patients (139 males and 352 females) with tongue-related diagnostic code names in the Korean Standard Classification of Disease (KCD) in the Electronic Medical Record (Dentopinformation Technology Co., Seoul, Korea). Results: On analyzing the diagnoses of tongue diseases using the KCD, glossopyrosis (44.8%) and painful tongue (15.2%) showed high rates. Of the 491 patients, 139 (28.3%) were males and 352 (71.7%) were females, and the average age was 58.1 years. As for systemic diseases, there were many patients with diseases of the circulatory system (27.0%) and endocrine, nutritional, and metabolic diseases (13.7%). Tongue symptoms were discomfort in 58 patients, pain in 329 patients, paresthesia in 10 patients, burning sensations in 222 patients, dysgeusia in 25 patients, dryness in 110 patients, fissures in 57 patients, and other symptoms in 72 patients. Areas with tongue symptoms were the anterior area in 102 patients, the lateral area in 140 patients, the posterior area in 12 patients, the dorsal area in 140 patients, the ventral area in 42 patients, and which area in 126 patients overall. Patients with burning mouth syndrome and oral candidiasis had significantly more tongue symptoms. Conclusions: Patients with tongue symptoms exhibited a variety of tongue diseases. Tongue symptoms were more common in women over 50 years of age and were frequently seen in patients with burning mouth syndrome and oral candidiasis.

• 대한후두음성언어의학회지
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• 제27권1호
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• pp.5-10
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• 2016

Variable systemic diseases affect larynx and vocal fold and result in voice change. Asthma and chronic obstructive pulmonary disease make increase of intra-abdomimal pressure followed by reflux of gastric acid, which stimulate vagal-bronchopulomary reflex aggravating cough and respiratory disturbance. Fungal laryngitis in the general population is extremely rare, but can occur in immunocompromised AIDS patients. Although, initially, empirical antifungal therapy for candidiasis is often given without biopsy, diagnostic direct laryngoscopy and biopsy is imperative if a substantial clinical response is not rapidly achieved. In the highly active anti-retroviral therapy era, HIV-positive patients are living longer and are at higher risk for developing non-AIDS-defining malignancies. The incidence of head and neck cancer (HNC) which is related with human papilloma virus infection has increased. The survival is significantly lower among the AIDS-HNC patients with CD4 counts ${\leq}200cells/{\mu}L$. Rheumatoid arthritis (RA) cause voice disturbance by developing cricoarytenoid joints fixation or nodule on vocal fold. Post-menopausal voice disorder (PMVD) is caused by decreased secretion of estrogen-progesterone resulting in decrease of fundamental frequency (F0). Hormonal replacement therapy is helpful to reduce F0 decrease. RA and PMVD result in slight voice change, but it could crucial in professional voice user.