[Tropical mycoses].

Area of Science:

• Mycology
• Infectious Diseases
• Pharmacology

Context:

• Tropical subcutaneous and deep mycoses, including chromomycosis, sporotrichosis, and mycetoma, are prevalent in subtropical regions.
• Rare occurrences of blastomycosis and African histoplasmosis in Natal highlight geographical variations in mycoses.
• Paracoccidioidomycosis, common in Latin America, is notably absent in South Africa.

Purpose:

• To evaluate the efficacy and safety of itraconazole in treating various tropical mycoses.
• To compare itraconazole's effectiveness against different fungal pathogens and disease presentations.
• To assess itraconazole as a potential drug of choice for specific mycoses.

Summary:

• Itraconazole demonstrated positive outcomes in clinical trials for sporotrichosis, non-meningeal blastomycosis, and paracoccidioidomycosis.
• Encouraging results were observed for histoplasmosis and chromomycosis, particularly cases involving C. carrionii.
• Management of mycetomas and chromomycosis caused by F. pedrosoi remains challenging despite itraconazole use.
• Itraconazole exhibited an excellent safety profile, with no observed side effects or adverse reactions in 42 patients.

Impact:

• Itraconazole emerges as a potentially superior treatment option for several tropical mycoses compared to existing therapies.
• The drug's favorable safety profile supports its consideration for long-term management of deep fungal infections.
• Further research may be needed to optimize itraconazole treatment for challenging fungal species and conditions.