The adrenal gland functional reserve was studied in a group of 22 patients with active paracoccidioidomycosis before therapy and in 18 of the same patients after termination of six months of ketoconazole treatment. 22 control subjects were also tested. Serum cortisol was measured before and after i.v. infusion of 250 micrograms of corticotropin given over a period of two hours. Basal cortisol levels were subnormal in only one patients before treatment and in four of 18 patients after therapy. Overt Addison's disease was found in 14% of the patients before treatment. However, corticotropin stimulation revealed diminished adrenal reserve in 23% of patients before, and in 44% of the patients after treatment. Although decreased adrenal cortex function after therapy may be influenced by ketoconazole, more studies are needed to determine the role of this agent after prolonged use. The high frequency of subclinical adrenal failure in paracoccidioidomycosis should alert clinicians in charge of such patients, should they face physiological stress.

Adrenal Glands↗

PubMedDate not supplied

Ketoconazole: a new drug for the treatment of paracoccidioidomycosis.

Ketoconazole was administered orally to 13 patients with paracoccidioidomycosis. Therapy consisted of 200 mg per day for periods ranging from three to 12 months. All patients improved markedly, with healing of pulmonary, mucosal, and skin lesions. Patients exhibiting the latter two manifestations began to improve two weeks after therapy, and healing occurred within three months. Pulmonary lesions regressed at a slower pace and healed by fibrosis. Mycologic tests have corroborated the clinical improvement. Adverse effects were not observed; monitoring of renal, hematologic, and hepatic functions did not reveal any abnormalities. Five patients completed a year of therapy and were free of symptoms when therapy was discontinued. Of these patients, four were followed for several months and had no relapses; the fifth patient developed tuberculosis and died. The results indicate that ketoconazole is a safe and effective drug for therapy in the treatment of paracoccidioidomycosis.

Adult↗

PubMedDate not supplied

Itraconazole in the treatment of paracoccidioidomycosis: a preliminary report.

The preliminary results of itraconazole therapy in 16 patients with active paracoccidioidomycosis were evaluated. The course of therapy--itraconazole administration for six months at a dose of 100 mg per day--was completed in 13 cases. This new triazole appeared as effective as ketoconazole in reducing the symptoms and arresting the progression of the mycosis. The scoring system employed to evaluate the effect of the drug showed that the condition of no patient worsened or remained the same during therapy. On the contrary, 11 (84.6%) of the 13 patients experienced major improvement and the other two (15.4%), minor improvement. No adverse reactions were reported by the patients, and there were no toxic effects on bone marrow or liver. Although experience with itraconazole is still limited, results to date indicate that this new drug is safe and effective for the treatment of paracoccidioidomycosis. Further trials with shorter periods of therapy seem warranted.

Adult↗

PubMedDate not supplied

A study of fluorescent treponemal antibody absorption (FTA-ABS) and VDRL tests in Pintal.

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Adolescent↗