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Orbital histoplasmosis due to Histoplasma capsulatum var. duboisii: successful treatment with Septrin
Abstract:
Four children with orbital histoplasmosis caused by Histoplasma capsulatum var. duboisii (one of whom had been unsuccessfully treated with amphotericin-B) were treated with a combination of trimethoprim and sulphamethoxazole (Septrin) and surgical drainage. All patients improved markedly during therapy with resolution of the lesions, and with no recurrence of infection in three patients, 1 year later. The fourth patient was lost to follow-up. Treatment was devoid of side effects. These findings clearly indicate that Septrin could be a safe alternative to amphotericin-B for the treatment of African histoplasmosis, especially in patients presenting with solitary or localized lesions.
Insights
Trimethoprim-sulfamethoxazole (Septrin) offers a safe alternative for treating orbital histoplasmosis in children. This combination therapy, alongside surgical drainage, showed significant improvement and no recurrence in most cases.
Area of Science:
- Mycology
- Infectious Diseases
- Ophthalmology
Background:
- Orbital histoplasmosis, caused by Histoplasma capsulatum var. duboisii, presents a treatment challenge.
- Traditional treatments like amphotericin-B may have limitations or be ineffective in some cases.
Observation:
- Four pediatric patients with orbital histoplasmosis were treated.
- One patient had previously shown an inadequate response to amphotericin-B therapy.
Findings:
- A combination of trimethoprim-sulfamethoxazole (Septrin) and surgical drainage was administered.
- All treated patients exhibited marked clinical improvement with lesion resolution.
- Three out of four patients showed no recurrence of infection at one-year follow-up.
- The treatment regimen was well-tolerated, with no reported side effects.
Implications:
- Septrin represents a potentially safe and effective alternative to amphotericin-B for African histoplasmosis.
- This therapeutic approach is particularly promising for managing solitary or localized orbital lesions.
- Further research may validate Septrin as a primary treatment option, improving patient outcomes.