Pythiosis

A granulomatous disease caused by the aquatic organism PYTHIUM insidiosum and occurring primarily in horses, cattle, dogs, cats, fishes, and rarely in humans. It is classified into three forms: ocular, cutaneous, and arterial.

Also Known As:

Networked: 122 relevant articles (22 outcomes, 23 trials/studies)

Relationship Network

Disease Context: Research Results

Related Diseases

1.	Infections
2.	Margins of Excision
3.	Wounds and Injuries (Trauma)
4.	Zygomycosis (Phycomycosis)
5.	beta-Thalassemia (Cooley's Anemia)

Experts

1.	Krajaejun, Theerapong: 22 articles (02/2022 - 03/2002)
2.	Mendoza, Leonel: 14 articles (12/2019 - 05/2003)
3.	Santurio, Janio M: 13 articles (04/2020 - 05/2009)
4.	Chindamporn, Ariya: 12 articles (03/2022 - 05/2006)
5.	Yingyong, Wanta: 12 articles (06/2021 - 08/2010)
6.	Alves, Sydney H: 11 articles (04/2020 - 05/2009)
7.	Lohnoo, Tassanee: 10 articles (06/2021 - 07/2013)
8.	Worasilchai, Navaporn: 9 articles (03/2022 - 01/2015)
9.	Santurio, Janio Morais: 9 articles (01/2021 - 11/2007)
10.	Rujirawat, Thidarat: 7 articles (06/2021 - 08/2010)

Drugs and Biologics

Drugs and Important Biological Agents (IBA) related to Pythiosis:

1.	Azithromycin (Zithromax)FDA LinkGeneric 01/01/2016 - "This study demonstrates that azithromycin possesses potent curative efficacy against subcutaneous pythiosis in the rabbit model." 10/01/2020 - "Recently, azithromycin or clarithromycin plus doxycyclin were used in two relapsed vascular pythiosis patients with good outcomes." 02/04/2021 - "Adjunctive use of azithromycin and doxycycline preliminarily improved survival in vascular pythiosis patients with residual disease. " 01/01/2019 - "We evaluated the efficacy of azithromycin (50 mg/kg, every 12 h [q12h] orally) and miltefosine (25 mg/kg, q24h orally) treatments in an experimental model of vascular/disseminated pythiosis in immunosuppressed mice. " 01/01/2019 - "Efficacy of Azithromycin and Miltefosine in Experimental Systemic Pythiosis in Immunosuppressed Mice."
2.	AntigensIBA 06/01/2019 - "In this study, the Pi-Ab levels in 140 serum samples from patients with pythiosis were evaluated by ELISA using antigens from 10 P. " 08/01/2009 - "The present study provided evidence that the 40 to 35-kDa antigens were reactive specifically with all sera from both treated and active pythiosis patients. " 01/01/2018 - "insidiosum antigens as a new therapeutic strategy in the treatment and acquisition of immunity against pythiosis." 05/01/2006 - "Identification of a novel 74-kiloDalton immunodominant antigen of Pythium insidiosum recognized by sera from human patients with pythiosis." 09/09/2004 - "insidiosum-antigen (PIA) formulation had already saved a young boy with life-threatening arterial pythiosis. "
3.	miltefosine (Impavido)IBA 04/01/2020 - "This study indicates that miltefosine has limited efficacy against pythiosis and furthers in vitro and in vivo studies are necessary to determine the possible potential of this drug in the treatment of pythiosis." 04/01/2020 - "We evaluated the in vitro activity of miltefosine against 29 Pythium spp. and the in vivo therapeutic response of 2mg/kg/day of miltefosine given orally to rabbit with pythiosis induced experimentally. " 04/01/2020 - "Efficacy of miltefosine therapy against subcutaneous experimental pythiosis in rabbits." 01/01/2019 - "We evaluated the efficacy of azithromycin (50 mg/kg, every 12 h [q12h] orally) and miltefosine (25 mg/kg, q24h orally) treatments in an experimental model of vascular/disseminated pythiosis in immunosuppressed mice. " 01/01/2019 - "Efficacy of Azithromycin and Miltefosine in Experimental Systemic Pythiosis in Immunosuppressed Mice."
4.	Dimethyl Sulfoxide (DMSO)FDA LinkGeneric 01/01/2020 - "The combination of surgical excision and topical DMSO is found an effective treatment for cutaneous pythiosis in horses." 01/01/2020 - "Evaluating the efficacy of surgical excision and topical dimethyl sulphoxide (DMSO) in the treatment of equine cutaneous pythiosis." 01/01/2020 - "The objective of the present study was to evaluate the response of cutaneous pythiosis in horses to surgical excision and topical dimethyl sulphoxide (DMSO). " 01/01/2020 - "The cutaneous pythiosis lesions were completely recovered at 35 ± 7 and 60 ± 5 days after the surgical excision with topical DMSO and surgical excision alone, respectively. " 01/01/2020 - "The size of wounds and the clinical features of pythiosis lesions decreased more after surgical debridement with DMSO application than surgical excision alone. "
5.	Amphotericin B (Amphotericin)FDA LinkGeneric 08/01/2012 - "To evaluate the effects of intravenous regional limb perfusion (IRLP) administration of amphotericin B in horses to treat pythiosis after surgical excision and thermocautery. " 08/01/2012 - "Treatment of pythiosis in equine limbs using intravenous regional perfusion of amphotericin B." 06/01/1983 - "Five horses with pythiosis of the limbs were treated unsuccessfully by surgery or topical application of amphotericin B, or both. " 08/01/2012 - "IRLP administration of amphotericin B was effective for treating pythiosis in equine limbs, resolving infection with manageable side effects." 07/16/2015 - "Evaluation of intravenous regional perfusion with amphotericin B and dimethylsulfoxide to treat horses for pythiosis of a limb."
6.	VaccinesIBA 06/20/2003 - "An improved Pythium insidiosum-vaccine formulation with enhanced immunotherapeutic properties in horses and dogs with pythiosis." 03/01/2017 - "Pythium insidiosum immunomodulatory vaccine (PiV) has been tested in clinical and experimental pythiosis. " 06/20/2003 - "The immunotherapeutic properties of a new Pythium insidiosum-vaccine formulation (PIV), was evaluated in 18 horses and 6 dogs with proven pythiosis from different enzootic areas in the United States. " 08/01/1992 - "Evaluation of two vaccines for the treatment of pythiosis insidiosi in horses." 08/01/1992 - "Immunotherapy using SCAV can thus be used as the vaccine of choice in early cases of equine cutaneous pythiosis insidiosi."
7.	Proteins (Proteins, Gene)FDA Link 05/12/2020 - "Here, we demonstrated that cell-free protein synthesis was useful for the production of multiple proteins to facilitate functional studies and identify a potential target for diagnosis and treatment of pythiosis." 06/11/2021 - "We proposed that the 55 kDa I06 protein is an excellent candidate for developing a more specific serodiagnostic test for pythiosis." 06/11/2021 - "Immunological Cross-Reactivity of Proteins Extracted from the Oomycete Pythium insidiosum and the Fungus Basidiobolus ranarum Compromises the Detection Specificity of Immunodiagnostic Assays for Pythiosis." 05/12/2020 - "Of the 18 proteins, one was a secreted immunoreactive protein, called I06, that triggered host immunity and was recognized explicitly by all tested sera from pythiosis patients. " 05/12/2020 - "We employed a cell-free protein synthesis system to rapidly and simultaneously generate multiple proteins from genetic codes of the oomycete Pythium insidiosum, which causes the life-threatening disease called pythiosis, in humans and animals worldwide. "
8.	SolutionsIBA 06/01/2022 - "Pythiosis was reproduced in rabbits (n = 9) that were divided into groups: group 1 (control), cutaneous lesions with daily topical application of a non-ionizable gel-based formulation and intralesional application of sterile distilled water every 48 h; group 2 (topical formulation), lesions treated daily with topical application of a non-ionizable gel-based formulation containing 5 mg/ml of NEMA; and group 3 (intralesional formulation), lesions treated with NEMA at 5 mg/ml in aqueous solution applied intralesionally/48 h. " 07/16/2015 - "This study aims to evaluate the effects of administering amphotericin B in a 10 % solution of dimethylsulfoxide by intravenous regional limb perfusion (IRLP) to treat horses for cutaneous pythiosis of a limb. " 07/16/2015 - "IRLP administration of amphotericin B in a 10 % DMSO solution was easily performed, relatively inexpensive and an effective treatment for treating horses for pythiosis of a limb and resolved the infection with no complications." 07/01/2009 - "An orally administered saturated solution of potassium iodide, amphotericin B-oral solution, and terbinafine has succeeded only in the cutaneous form but had no favorable effect on vascular pythiosis. "
9.	mefenoxamIBA 07/01/2011 - "Additional studies are needed to evaluate the pharmacokinetics of mefenoxam and to further assess its tolerability and potential efficacy for the treatment of pythiosis in dogs." 06/30/2023 - "The results of this retrospective study, with some limitations, are promising and should prompt further investigation into the use of mefenoxam in the treatment of both gastrointestinal and cutaneous pythiosis." 06/30/2023 - "In both gastrointestinal and cutaneous pythiosis groups, the administration of mefenoxam was associated with a survivability rate of approximately 51%. " 06/30/2023 - "Since 2013, mefenoxam had been administered to 25 dogs with cutaneous pythiosis and 16 dogs with gastrointestinal pythiosis. " 06/30/2023 - "The Use of Mefenoxam to Treat Cutaneous and Gastrointestinal Pythiosis in Dogs: A Retrospective Study."
10.	Clarithromycin (Biaxin)FDA LinkGeneric 10/01/2020 - "Recently, azithromycin or clarithromycin plus doxycyclin were used in two relapsed vascular pythiosis patients with good outcomes." 01/01/2018 - "We found that miltefosine, azithromycin, clarithromycin, josamycin, linezolid, sutezolid, retapamulin, tiamulin, and valnemulin had inhibitory and cidal activity against the pathogens at concentrations ranging from 0.25 to 64 μg/ml. Our results suggest that these antimicrobials are promising candidates for future studies on pythiosis in animals and humans."

Therapies and Procedures

1.	Immunotherapy 11/28/2023 - "Extensive surgical resection combined with antifungal treatment and immunotherapy have proven to be effective in patients with vascular pythiosis in our findings." 07/01/2009 - "It is likely that immunotherapy, successfully used in animal pythiosis, may be beneficial in the treatment of human vascular pythiosis." 09/09/2004 - "Our findings provide further evidence that immunotherapy using PIA is a safe and effective method to treat pythiosis in humans." 12/01/2019 - "Despite reports of unsuccessful treatment results of feline pythiosis using Pythium-immunotherapy, this report suggests this approach might be helpful in similar feline cases." 12/01/2016 - "Cutaneous pythiosis in a Red Brangus beef calf cured by immunotherapy."
2.	Therapeutics 11/01/2022 - "Successful management of colonic pythiosis in two dogs in Thailand using antifungal therapy." 03/26/2022 - "Current data support using antimicrobial combination therapy for the pharmacotherapeutic management of human pythiosis. " 03/26/2022 - "A Review: Antimicrobial Therapy for Human Pythiosis." 11/01/2019 - "This prospective study was conducted to evaluate treatment outcomes of the combination therapy protocol and the potential use of serum (1→3)-β-glucan (BG) and Pythium insidiosum-specific antibody (Pi-Ab) as an aid to diagnosis and monitoring of ocular pythiosis. " 11/01/2019 - "Clinical outcomes in ocular pythiosis patients treated with a combination therapy protocol in Thailand: A prospective study."
3.	Surgical Amputation (Amputations) 12/01/1999 - "The only dog to survive underwent amputation of the affected limb; thus, the prognosis for cutaneous pythiosis in the dog is poor." 08/01/2016 - "Achieving adequate disease-free surgical margins-especially the arterial margin-at amputation or débridement is the most important prognostic factor in patients with vascular pythiosis. " 09/01/2006 - "Regarding treatment outcomes, all patients with disseminated infection died; 78% of patients with vascular disease required limb amputation, and 40% of these patients died; and 79% of patients with ocular pythiosis required enucleation/evisceration. " 05/01/2006 - "Human pythiosis is endemic in Thailand, and most patients present with arteritis, leading to limb amputation and/or death, or cornea ulcer, leading to enucleation. "
4.	Intradermal Injections 10/01/2019 - "Intradermal injection of Pythium insidiosum protein antigens for improved diagnosis and treatment of pythiosis in an experimental model."
5.	Penetrating Keratoplasty 01/01/2020 - "Ocular pythiosis is a serious condition and earliest therapeutic penetrating keratoplasty with wide surgical margin is the mainstay treatment. " 06/01/2017 - "A patient with ocular pythiosis was successfully treated with penetrating keratoplasty and 2 months of treatment with intracameral and oral minocycline."