Entomophthoramycosis by Conidiobolus coronatus. Report of a case successfully treated with the combination of itraconazole and fluconazole.
Rhinoentomophthoramycosis caused by Conidiobolus coronatus in a 61-year old woman was unsuccessfully treated during 8 years with all the antifungals available in the Brazilian market, including potassium iodide for 1 month, sulfamethoxazole plus trimethoprim for 2 months, amphotericin B, total dose of 1130 mg, cetoconazole, 400 mg/day for 6 months, fluconazole, 200 mg/day, for at least 2 months and, itraconazole, 400 mg/day for 2 months, followed by 200 mg/day for 4 more months. Complete clinical and mycological cure was achieved using itraconazol 400 mg/day in association with fluconazol 200 mg/day during 24 months. After cure she was submitted to plastic surgery to repair her facial deformation. Today she remains clinically and mycologically cured after 59/60 months (5 years!) without any specific antifungal. We thus suggest the use of the combination of itraconazole and fluconazole as an additional option for the treatment of this mycosis.
Valle
A C
AC
Laboratory of Clinical Research, Research Center Evandro Chagas Hospital, Fundação Oswaldo Cruz, Rio de Janeiro, RJ, Brazil. afvalle@cpqhec.fiocruz.br
Wanke
B
B
Lazéra
M S
MS
Monteiro
P C
PC
Viegas
M L
ML
D000935:Antifungal Agents / Q000627:therapeutic use*; D020092:Conidiobolus; D005260:Female; D015725:Fluconazole / Q000627:therapeutic use*; D006801:Humans; D017964:Itraconazole / Q000627:therapeutic use*; D008875:Middle Aged; D009667:Nose Deformities, Acquired / Q000188:drug therapy / Q000382:microbiology / Q000601:surgery; D009668:Nose Diseases / Q000188:drug therapy* / Q000382:microbiology; D013997:Time Factors; D016896:Treatment Outcome; D020096:Zygomycosis / Q000188:drug therapy*
D000935:Antifungal Agents; D017964:Itraconazole; D015725:Fluconazole