Date: 3 May 2013
Yamik catheter for rinsing nasal and paranasal cavities. Image C
Copyright:
These images were kindly given by Andreas Neher of the Department of Otorhinolaryngology, Innsbruck Medical University, Anichstr. 35, Innsbruck, Austria. For further details of the procedure please refer to the PDF link above. (C) Fungal Research Trust
Notes:
Rinsing of the nasal and paranasal cavities applied via a novel catheter system (YAMIK). The cavities were rinsed with 10–20 ml of 1% aqueous N-Chlorotaurine (NCT) solution, treatment consisted of three lavages per week for 4 weeks. N-Chlorotaurine is a mild endogenous oxidant with broad-spectrum antimicrobial activity. The use of the catheter proved to be a successful way of rinsing the nasal and paranasal cavities. Link to PDF with further details.
C,D X-ray set up of a healthy volunteer rinsed with 10 ml of radio-opaque solution via YAMIK catheter demonstrating sufficient filling of the paranasal sinuses.
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After 3 weeks of posaconazole given for chronic pulmonary aspergillosis, patient NC had a remarkable exacerbation of psoriasis. He had had psoriasis for years, with little trouble and almost no treatment. After taking posaconazole 400mg twice daily, he developed psoriatic plaques on his hands for the first time ever. The plaques on his lower legs became confluent. This occurred in association with worsening chest symptoms, notably increased coughing, more breathlessness and increasing oxygen requirement.
Posaconazole was stopped after 3 weeks, and 2 weeks later he was still very symptomatic with his chest. This responded to a 2 week course of corticosteroids, and his psoriasis also improved.
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Patient PC: An example of localised caspofungin rash and phlebitis related to caspofungin infusion.
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This 55 year old man with asthma, ABPA, severe bronchiectasis and lung fibrosis was treated with voriconazole, starting in June 2010. He had developed increasing dyspnoea on itraconazole for over 7 years, and his total IgE remained at 1100 KIU/L. He had marked photopsia (visual hallucinations) and facial erythema in the first 3 weeks of therapy. His trough voriconazole concentration was 1.17 mg/L. Over 3 months, he had minor improvement in his breathlessness but continued facial erythema, despite factor 50 sunblock. After 5 months of therapy his facial rash has altered to show acneiform lesions with localised crusting and background severe erythema. His face effectively crusted over, and he stopped therapy.
Over the next 3 weeks his facial appearance slowly improved .
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