Blastomycosis medical therapy
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: ; Vidit Bhargava, M.B.B.S [2]
Overview
As per the guidelines given by the Infectious Diseases Society of America the appropriate regimen must be guided by the clinical form and severity of disease, as well as the immune status of patient and toxicity of antifungal agents. Only asymptomatic infections are left treated, otherwise all cases need therapy.
- Immuno-competent patient.(Non-Life threatening infection)
- Drug of choice in this cases is usually Itraconazole or Lipid Amphotericin B. Alternatively, daily fluconazole or ketaconazole may also be used.
- Immuno-competent patient.(Life threatening infection)
- Pulmonary cases - These warrant treatment primarily with Lipid Amphotericin B or Deoxycholate Amphotericin B. Once the condition has been stabilized the patient may be switched to oral Itraconazole therapy.
- Disseminated cases - Drug of choice is same, however patients non tolerant to Amphotericin B can be treated with fluconazole or Itraconazole.
- Immuno-compromised patients.
- All patients warrant treatment with Lipid Amphotericin B as the drug of choice and Itraconazole once the disease has shown clinical improvement.