Miconazole treatment of relapsed pulmonary blastomycosis

Two patients with second relapses of pulmonary blastomycosis after successful treatments with adequate doses of amphotericin B were retreated with miconazole. One patient had experienced an acute intrabronchial spread of disease to the contralateral lung before miconazole therapy. Marked clinical and roentgenographic improvement occurred with treatment, followed by mycologic relapse 1 month later. The other patient sustained a more indolent relapse of disease. A favorable response to treatment with miconazole was demonstrated by improvement in abnormalities noted on a chest roentgenogram and a [67]gallium-citrate scan.