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Reasons for delayed diagnosis and related factors of the refractory infection are also discussed.
It is important to differentiate between a replacement of first-line therapy with another substance because of toxicity from change of substance due to refractory infection.
This strain was isolated from a refractory infection in Estonia and claimed to be drug resistant in vitro (Teras, personal communication).
Another problem with azoles therapy is the acquired resistance of many pathogens to these drugs, which is the most common cause of refractory infection.
These cases frequently result in refractory infection with recurrent or relapsing episodes, despite aggressive and prolonged treatment with 3 or more anti-mycobacterial agents.
It initiates host immune, inflammatory, and coagulation responses that cause tissue injury, hypoxia and organ dysfunction and predispose patients to refractory infection [ 1].
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Methicillin-resistant Staphylococcus aureus (MRSA) commonly causes refractory infections and has recently become a serious public health concern.
In addition, bacteria can penetrate into dentinal tubules and persist after the completion of the endodontic therapy resulting in refractory infections years later (Vieira et al. 2012).
In addition to haematopoietic stem cell (HSC) based therapy, refractory infections in CGD patients can be successfully treated using repeated infusions of functional allogeneic neutrophils, although this strategy often results in exaggerated inflammation and allo-immunisation[11] [14] allo-immunisation[11] [14]
Gum swelling and refractory infections may also be the presenting complaint.
Amphotericin B regimens typically produce high cure rates (close to 100%) for both antimony-sensitive and refractory infections.
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