Systemic miconazole treatment of a patient with chronic granulomatous mucocutaneous candidiasis

Miconazole given intravenously and orally was evaluated in the treatment of a patient with drug-resistant, chronic, widespread horny candida lesions. Marked clinical improvement occurred after 4 weeks of the first course of treatment, in which 400 mg of miconazole per day was given intravenously. After 3 months no signs of the disease were apparent. The patient remained free of symptoms for 3 months, after which the lesions recurred and a second course of treatment, with 200 mg of miconazole per day intravenously, was started. A prompt clinical clearing was seen within 3 weeks, after which the miconazole (1 000 mg per day) was given orally. During oral administration of the drug a limited degree of recurrence of horny patches occurred. Systemic miconazole seems to be the drug of choice in the treatment of systemic chronic mucocutaneous candidiasis.