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Tropical mycoses.
1Department of Dermatology, King Edward VIII Hospital and Medical School, University of Natal, Durban, South Africa.
Chemotherapy
|January 1, 1992
Summary
Itraconazole shows promise for treating tropical mycoses like sporotrichosis and blastomycosis, with encouraging results in histoplasmosis and chromomycosis. While not a cure-all, it represents a significant advancement in managing these fungal infections with a good safety profile.
Area of Science:
- Medical Mycology
- Infectious Diseases
- Pharmacology
Background:
- Tropical mycoses, including chromomycosis, sporotrichosis, and mycetoma, are prevalent in subtropical regions.
- Blastomycosis and African histoplasmosis are rare in Natal, presenting with atypical features.
- Paracoccidioidomycosis is geographically restricted to Latin America.
Observation:
- Itraconazole has been evaluated over eight years for treating various mycoses.
- Clinical trials assessed itraconazole's efficacy in sporotrichosis, blastomycosis, histoplasmosis, chromomycosis, and mycetoma.
- A combination of flucytosine and itraconazole demonstrated enhanced efficacy in three patients.
Findings:
- Itraconazole is suggested as a potential drug of choice for sporotrichosis, non-meningeal blastomycosis, and paracoccidioidomycosis.
- Encouraging results were observed in histoplasmosis and chromomycosis, especially with Cladosporium carrionii.
- Management of mycetomas and chromomycosis caused by Fonsecaea pedrosoi remains challenging.
- Itraconazole exhibited an excellent safety profile with no observed side-effects or adverse reactions in 41 patients.
Implications:
- Itraconazole represents a significant therapeutic improvement over previous antifungal drugs for deep mycoses.
- Further research may be needed to optimize treatment for specific mycoses like mycetoma.
- The safety and efficacy of itraconazole support its role in managing a range of tropical fungal infections.