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Pseudallescheria boydii brain abscess: association with near-drowning and efficacy of high-dose, prolonged miconazole therapy in patients with multiple abscesses.

AbstractBrain abscess caused by Pseudallescheria boydii is a highly lethal infection, usually seen in immunosuppressed patients. Five patients with P. boydii brain abscesses are described. Four of these patients acquired their infection after near-drowning; 1 patient developed an abscess after penetrating head trauma. Two patients survived their infections, which included involvement of other body sites (lung, eye, bone) as well as multiple undrained brain abscesses, after prolonged courses of high-dose parenteral miconazole (80-90 mg/kg/d). Progressive increases in miconazole dosage during the treatment periods were required to produce serum levels above the minimum inhibitory concentrations of the fungal isolates.
AuthorsD L Dworzack, R B Clark, W J Borkowski Jr, D L Smith, M Dykstra, M P Pugsley, E A Horowitz, T L Connolly, D L McKinney, M K Hostetler (Affiliation: Department of Medical Microbiology, Creighton University School of Medicine, Omaha, Nebraska 68178.)
JournalMedicine (Medicine (Baltimore)) Vol. 68 Issue 4 Pg. 218-24 (Jul 1989) ISSN: 0025-7974 UNITED STATES
PMID2739563 (Publication Type: Case Reports, Journal Article)
Chemical References
  • Miconazole
Topics
  • Adult
  • Brain Abscess (drug therapy, etiology, radiography)
  • Child, Preschool
  • Drowning
  • Female
  • Humans
  • Maduromycosis (drug therapy, etiology, radiography)
  • Male
  • Miconazole (therapeutic use)
  • Middle Aged
  • Orbit (injuries)
  • Resuscitation
  • Tomography, X-Ray Computed
  • Wounds, Penetrating (complications)