Posaconazole as rescue therapy in African histoplasmosis

• Type: Article in International Scientific Journal
• Date: 2013

Authors

Goncalves, D (Author) FMUP; Ferraz, C (Author) Other; Vaz, L (Author) Other

Journal

Title: Brazilian Journal of Infectious Diseases

Vol. 17 No. 1

Pages: 102-105

ISSN: 1413-8670

Publisher: Elsevier

Indexing

ISI Web of Knowledge - 8 Citations

Scopus - 16 Citations

Other information

Authenticus ID: P-002-1GF

DOI: 10.1016/j.bjid.2012.06.027

Abstract (EN): 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.

Language: English

Type (Professor's evaluation): Scientific

No. of pages: 4