Mucocutaneous candidiasis, anergy and a plasma inhibitor of cellular immunity: reversal after amphotericin B therapy

Abstract

A patient with chronic mucocutaneous candidiasis and cutaneous anergy has been studied and found to have a circulating plasma factor capable of quenching in vitro lymphocyte responses of leucocytes of clinically well donors to monilia and other specific mitogenic stimulants. After instituting systemic amphotericin B therapy, the patient exhibited rapid clearing of cutaneous and mucosal lesions and the plasma inhibitor was no longer demonstrable. Loss of the plasma inhibitor was followed by appearance of strong cutaneous hypersensitivity and in vitro leucocyte responses to Candida albicans and streptococcal products. These clinical immunologic studies have pointed meaning in relationship to current views regarding immunologic reconstitution vis-à-vis systemic antifungal therapy in treatment of chronic candidiasis.