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Itraconazole in human histoplasmosis.

Abstract
A non-comparative open trial with itraconazole in progressive forms of human histoplasmosis was carried out. Thirty two patients who completed 6 months of treatment were included; 29 suffered the chronic disseminated form; 2 exhibited a chronic pulmonary histoplasmosis and one patient presented a subacute disseminated form. Thirty patients were males and 2 females; their ages ranged from 37 to 78 years old (average 56.9). The following underlying diseases were registered: hepatopathies: 12 cases; endocrinopathies and steroid therapy: 13 cases; chronic obstructive pulmonary disease: 10 patients; malignancies: 3 cases; long treatment with psychotropic drugs; 2 cases and 1 immunodeficiency of unknown origin. The therapeutic schedule applied was: 100 mg/day, orally, during 2 months, followed by 50 mg/day for another four months. Twenty-nine patients achieved clinical cure, two showed a striking improvement (both had the chronic pulmonary form) and the treatment could not be evaluated in 1 case. A follow-up of longer than a year was registered in 23 cases, one died as a consequence of mesothelioma and another due to renal impairment, and no relapses were observed. A decreasing complement fixation titer (of more than 2-fold) was observed in 19 cases; 8 of 10 patients with negative skin tests turned positive and the erythrocyte sedimentation rate was reduced to more than a half in 24 cases. Concerning side-effects, a mild, transient and asymptomatic rise of the hepatic enzymes was registered in 9 patients. It seems that itraconazole will be the drug of choice in the treatment of human histoplasmosis in immunocompetent patients.
AuthorsR Negroni, A M Robles, A Arechavala, A Taborda
JournalMycoses (Mycoses) Vol. 32 Issue 3 Pg. 123-30 (Mar 1989) ISSN: 0933-7407 [Print] Germany
PMID2543924 (Publication Type: Clinical Trial, Journal Article)
Chemical References
  • Antifungal Agents
  • Itraconazole
  • Ketoconazole
Topics
  • Adult
  • Aged
  • Antifungal Agents (therapeutic use)
  • Clinical Trials as Topic
  • Female
  • Histoplasmosis (drug therapy)
  • Humans
  • Itraconazole
  • Ketoconazole (analogs & derivatives, therapeutic use)
  • Male
  • Middle Aged

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