Posaconazole as rescue therapy in African histoplasmosis
Posaconazole Histoplasmosis Salvage therapy African histoplasmosis is a granulomatous mycosis caused by Histoplasma capsulatum var. duboisii. Treatment is usually extrapolated from guidelines for classical histoplasmosis, and includes 2-4 weeks of amphotericin B followed by a step-down maintenance t...
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| Format: | Article |
| Language: | English |
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Elsevier
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| Series: | Brazilian Journal of Infectious Diseases |
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| Online Access: | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1413-86702013000100018&lng=en&tlng=en |
| _version_ | 1819268057162317824 |
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| author | Daniel Gonçalves Catarina Ferraz Luisa Vaz |
| author_facet | Daniel Gonçalves Catarina Ferraz Luisa Vaz |
| author_sort | Daniel Gonçalves |
| collection | DOAJ |
| description | Posaconazole Histoplasmosis Salvage therapy African histoplasmosis is a granulomatous mycosis caused by Histoplasma capsulatum var. duboisii. Treatment is usually extrapolated from guidelines for classical histoplasmosis, and includes 2-4 weeks of amphotericin B followed by a step-down maintenance therapy with itraconazole. Pediatric usage of posaconazole, an oral second-generation azole, remains off-label, but recent surveys show that it is safe and well tolerated in children. We report a case of disseminated African histoplasmosis in a 12-year-old boy from Guinea-Bissau. Therapy with amphotericin B and itraconazole led to a progressive clinical deterioration. A dramatic and lasting improvement was observed using posaconazole. He completed 12 months of therapy. No relapse was noted during or 3 months after treatment. We report that posaconazole may be a safe and efficacious drug in the salvage management of disseminated AH, either in patients with disease refractory to conventional anti-fungal therapy, or in patients whose serious adverse effects of first-line drugs preclude its use. |
| first_indexed | 2024-12-23T21:27:00Z |
| format | Article |
| id | doaj.art-b5a3db2bffe944da8a19080a7cba25a3 |
| institution | Directory Open Access Journal |
| issn | 1678-4391 |
| language | English |
| last_indexed | 2024-12-23T21:27:00Z |
| publisher | Elsevier |
| record_format | Article |
| series | Brazilian Journal of Infectious Diseases |
| spelling | doaj.art-b5a3db2bffe944da8a19080a7cba25a32022-12-21T17:30:35ZengElsevierBrazilian Journal of Infectious Diseases1678-439117110210510.1016/j.bjid.2012.06.027S1413-86702013000100018Posaconazole as rescue therapy in African histoplasmosisDaniel Gonçalves0Catarina Ferraz1Luisa Vaz2Centro Hospitalar de São JoãoCentro Hospitalar de São JoãoCentro Hospitalar de São JoãoPosaconazole Histoplasmosis Salvage therapy African histoplasmosis is a granulomatous mycosis caused by Histoplasma capsulatum var. duboisii. Treatment is usually extrapolated from guidelines for classical histoplasmosis, and includes 2-4 weeks of amphotericin B followed by a step-down maintenance therapy with itraconazole. Pediatric usage of posaconazole, an oral second-generation azole, remains off-label, but recent surveys show that it is safe and well tolerated in children. We report a case of disseminated African histoplasmosis in a 12-year-old boy from Guinea-Bissau. Therapy with amphotericin B and itraconazole led to a progressive clinical deterioration. A dramatic and lasting improvement was observed using posaconazole. He completed 12 months of therapy. No relapse was noted during or 3 months after treatment. We report that posaconazole may be a safe and efficacious drug in the salvage management of disseminated AH, either in patients with disease refractory to conventional anti-fungal therapy, or in patients whose serious adverse effects of first-line drugs preclude its use.http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1413-86702013000100018&lng=en&tlng=enPosaconazoleHistoplasmosisSalvage therapy |
| spellingShingle | Daniel Gonçalves Catarina Ferraz Luisa Vaz Posaconazole as rescue therapy in African histoplasmosis Brazilian Journal of Infectious Diseases Posaconazole Histoplasmosis Salvage therapy |
| title | Posaconazole as rescue therapy in African histoplasmosis |
| title_full | Posaconazole as rescue therapy in African histoplasmosis |
| title_fullStr | Posaconazole as rescue therapy in African histoplasmosis |
| title_full_unstemmed | Posaconazole as rescue therapy in African histoplasmosis |
| title_short | Posaconazole as rescue therapy in African histoplasmosis |
| title_sort | posaconazole as rescue therapy in african histoplasmosis |
| topic | Posaconazole Histoplasmosis Salvage therapy |
| url | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1413-86702013000100018&lng=en&tlng=en |
| work_keys_str_mv | AT danielgoncalves posaconazoleasrescuetherapyinafricanhistoplasmosis AT catarinaferraz posaconazoleasrescuetherapyinafricanhistoplasmosis AT luisavaz posaconazoleasrescuetherapyinafricanhistoplasmosis |