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Refractory coccidioidomycosis treated with posaconazole.
Gregory M Anstead1, Gavin Corcoran, James Lewis
1University of Texas Health Science Center at San Antonio, San Antonio, Texas 78229-3900, USA.
Summary
Posaconazole salvage therapy demonstrated success in treating disseminated coccidioidomycosis when conventional antifungals failed. This approach offers a well-tolerated, effective option for managing this severe fungal infection.
Area of Science:
- Mycology
- Infectious Diseases
- Clinical Pharmacology
Background:
- Disseminated coccidioidomycosis, caused by Coccidioides fungi, is a severe systemic infection.
- Conventional antifungal treatments may be ineffective or poorly tolerated, leading to challenges in disease management.
- Relapses are common, necessitating alternative therapeutic strategies.
Observation:
- This study evaluated posaconazole salvage therapy in six patients with refractory coccidioidomycosis.
- Patients received oral posaconazole 800 mg/day in divided doses.
- Disease burden was assessed using a modified Mycoses Study Group Coccidioides scoring system.
Findings:
- Posaconazole therapy led to rapid improvements in coccidioidomycosis signs and symptoms.
- Five out of six patients achieved successful outcomes with posaconazole treatment.
- The drug was well-tolerated during long-term use (1-2 years), with two patients continuing maintenance therapy.
Implications:
- Posaconazole shows promise as an effective salvage therapy for disseminated coccidioidomycosis.
- This finding is significant given the limitations of standard antifungal treatments.
- Further research into posaconazole for Coccidioides infections is warranted.