title: Coccidioidomycosis of the first cuneiform: successful treatment utilizing local debridement and long-term ketoconazole therapy.
abstract: Although intravenous amphotericin B is generally considered to be the standard treatment for coccidioidomycosis, the treatment of monostotic coccidioidomycosis is controversial. Long-term intravenous and oral antifungal chemotherapy has been utilized alone and in conjunction with local surgical debridement. We present a case of coccidioidal osteomyelitis of a tarsal bone successfully treated with local surgical debridement and oral ketoconazole and propose clinical guidelines for selecting the proper chemotherapeutic agent and for following the efficacy of the treatment regimen.
mesh_terms: D003047:Coccidioidomycosis / Q000188:drug therapy / Q000601:surgery / Q000628:therapy*; D003646:Debridement; D005534:Foot Diseases / Q000188:drug therapy / Q000601:surgery / Q000628:therapy*; D006801:Humans; D007654:Ketoconazole / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D010019:Osteomyelitis / Q000188:drug therapy / Q000601:surgery / Q000628:therapy*
chemical_list: D007654:Ketoconazole