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Fluconazole-resistant Candida albicans after long-term suppressive therapy
A Sanguineti1, J K Carmichael, K Campbell
1Department of Internal Medicine, Hospital Medical Education Program, Tucson, Ariz.
Archives of Internal Medicine
|May 10, 1993
Summary
Fluconazole resistance in Candida albicans can emerge with prolonged use, even in patients with HIV. This case highlights the development of fluconazole-resistant C albicans esophagitis after extended prophylactic treatment.
Area of Science:
- Mycology
- Infectious Diseases
- Pharmacology
Background:
- Candida albicans is typically susceptible to fluconazole in vivo.
- Human immunodeficiency virus (HIV) patients often experience recurrent candidiasis, necessitating long-term fluconazole prophylaxis.
- Prolonged antifungal therapy raises concerns about the development of drug resistance.
Observation:
- A case of fluconazole-resistant Candida albicans esophagitis is presented.
- The patient had a history of prolonged fluconazole use exceeding 600 days.
- This resistance emerged in the context of managing recurrent oral and esophageal candidiasis in an HIV-infected individual.
Findings:
- Development of fluconazole resistance in Candida albicans.
- Clinical manifestation as severe esophagitis.
- Resistance occurred despite initial susceptibility and standard treatment protocols.
Implications:
- Highlights the potential for antifungal resistance with extended fluconazole use.
- Suggests the need for monitoring resistance in HIV patients undergoing long-term prophylaxis.
- May inform alternative treatment strategies for recurrent candidiasis in immunocompromised populations.