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PARACOCCIDIOIDOMYCOSIS TREATMENT
Maria Aparecida Shikanai-Yasuda1
1Departamento de Doenças Infecciosas e Parasitárias, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brasil.
Revista Do Instituto De Medicina Tropical De Sao Paulo
|October 15, 2015
Summary
Paracoccidioidomycosis, an emerging endemic mycosis, presents chronic, multi-organ involvement, especially in immunocompromised individuals. Treatment varies by severity, with ongoing research for new drugs and immune response modulators.
Area of Science:
- Mycology
- Infectious Diseases
- Immunology
Background:
- Paracoccidioidomycosis is an emerging endemic mycosis in Latin America.
- It typically follows a chronic course and affects multiple organs, particularly in immunocompromised hosts.
- Sequelae often involve pulmonary and adrenal insufficiency.
Purpose of the Study:
- To review current understanding of paracoccidioidomycosis.
- To discuss treatment strategies for mild, moderate, and severe forms of the disease.
- To highlight existing challenges and future research directions in managing this mycosis.
Main Methods:
- Review of controlled studies and case series on paracoccidioidomycosis treatment.
- Analysis of host-parasite interactions influencing disease presentation.
- Synthesis of data on azole and sulfa derivative efficacy.
Main Results:
- Azoles and sulfa derivatives show promise for milder paracoccidioidomycosis forms.
- Moderate to severe cases necessitate prolonged treatment, potentially parenteral, due to absorption issues.
- Shorter itraconazole regimens may achieve cure in chronic infections.
Conclusions:
- Treatment of paracoccidioidomycosis requires tailored approaches based on disease severity and host factors.
- Further controlled studies, especially for acute cases, are needed.
- Development of novel drugs, combinations, and immune-modulating compounds is crucial for severe and complicated cases, including paradoxical reactions.
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