Tineal skin infections are a very common dermatological presentation in a country like ours. Patients who has compromised hepatic function and extensive tinea corporis, which oral anti-fungal would be the drug of choice?
Anfotericin product in correcto dosage for every patiente according to Oliver and renal function
Patients with liver cirrhosis are susceptible to infections due to various mechanisms, including abnormalities of humoral and cell-mediated immunity and occurrence of bacterial translocation from the intestine. Fungal infections, mainly caused by Candida spp., are often associated to delayed diagnosis and high mortality rates. The data emphasize the importance of performing fungal cultures and maintaining a high level of suspicion in patients with LC, especially those with impaired renal function and/or receiving antimicrobial treatment with limited clinical response, to ensure early treatment and ultimately reduce mortality. Echinocandins as first-line treatment (e.g., fungemia, nosocomial SFP or critically ill with CA-SFP). Fluconazole indicated if less severe infections.
The best way is to culture the fungos and to treat with the most sensible and aprieta funfal antibióticos
I am thankful to Luis Rodrigo and Zaim Gashi for their suggestions.
Try to avoid systemic antifungal but if no way , do culture first and according the result you can start the treatment
In systemic mycoses with symptoms such as temperature and compromited of the function of the corresponding organ, the parenteral route is preferable and with stabilization the condition can be continued with therapy per os.
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