Coccidioidomycosis medical therapy: Difference between revisions
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==Treatment== | ==Treatment== | ||
The drug therapy is guided by the severity of symptoms and the immune status of the patient. Since most patients are asymptomatic or mildly affected, no treatment or a single drug | The drug therapy is guided by the severity of symptoms and the immune status of the patient. Since most patients are asymptomatic or mildly affected, no treatment or a single drug azole therapy (fluconazole or itraconazole) may be sufficient in these cases. More recently resistant cases are being treated with voriconazole or posaconazole.<ref name="Chen-2011">{{Cite journal | last1 = Chen | first1 = S. | last2 = Erhart | first2 = LM. | last3 = Anderson | first3 = S. | last4 = Komatsu | first4 = K. | last5 = Park | first5 = B.| last6 = Chiller | first6 = T. | last7 = Sunenshine | first7 = R. | title = Coccidioidomycosis: knowledge, attitudes, and practices among healthcare providers--Arizona, 2007. | journal = Med Mycol | volume = 49 | issue = 6 | pages = 649-56 | month = Aug | year = 2011 | doi = 10.3109/13693786.2010.547995 | PMID = 21247229}}</ref>. However patients with HIV, immune-compromised, those on steroids or pregnant females need much more aggressive approach. More severe cases may require intravenous amphotericin B, with or without simultaneous oral azole therapy. Meningitis or vasculitis often need initial in-patient treatment with oral azoles plus intravenous amphotericin B with or without intrathecal amphotericin B. Untreated cases may sometimes be fatal. | ||
Pregnant females are treated by Intravenous amphotericin B only. | |||
==References== | ==References== | ||
Revision as of 21:59, 19 November 2013
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Coccidioidomycosis Microchapters |
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Coccidioidomycosis medical therapy On the Web |
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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]
Treatment
The drug therapy is guided by the severity of symptoms and the immune status of the patient. Since most patients are asymptomatic or mildly affected, no treatment or a single drug azole therapy (fluconazole or itraconazole) may be sufficient in these cases. More recently resistant cases are being treated with voriconazole or posaconazole.[1]. However patients with HIV, immune-compromised, those on steroids or pregnant females need much more aggressive approach. More severe cases may require intravenous amphotericin B, with or without simultaneous oral azole therapy. Meningitis or vasculitis often need initial in-patient treatment with oral azoles plus intravenous amphotericin B with or without intrathecal amphotericin B. Untreated cases may sometimes be fatal.
Pregnant females are treated by Intravenous amphotericin B only.
References
- ↑ Chen, S.; Erhart, LM.; Anderson, S.; Komatsu, K.; Park, B.; Chiller, T.; Sunenshine, R. (2011). "Coccidioidomycosis: knowledge, attitudes, and practices among healthcare providers--Arizona, 2007". Med Mycol. 49 (6): 649–56. doi:10.3109/13693786.2010.547995. PMID 21247229. Unknown parameter
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