Successful discontinuation of secondary prophylaxis for histoplasmosis after highly active antiretroviral therapy.
Whether maintenance antifungal prophylaxis against histoplasmosis should be continued life-long in patients with immune restoration after highly active antiretroviral therapy (HAART) remains unclear. We report a case of disseminated histoplasmosis involving the skin, lung, gastrointestinal tract, mesentery, and retroperitoneum in a 33-year-old man with acquired immunodeficiency syndrome. His symptoms improved after use of amphotericin B and itraconazole in addition to ileostomy to relieve the intestinal obstruction. After the start of HAART, he was able to discontinue itraconazole as maintenance therapy without relapse for 24 months.
Department of Internal Medicine, National Taiwan University Hospital, Taipei.
Hsin-Yun
HY
Sun
Mao-Yuan
MY
Chen
Szu-Min
SM
Hsieh
Chien-Ching
CC
Hung
Shan-Chwen
SC
Chang
D017088:AIDS-Related Opportunistic Infections / Q000517:prevention & control*; D000328:Adult; D000666:Amphotericin B / Q000627:therapeutic use; D000935:Antifungal Agents / Q000627:therapeutic use; D023241:Antiretroviral Therapy, Highly Active; D006660:Histoplasmosis / Q000517:prevention & control*; D006801:Humans; D017964:Itraconazole / Q000627:therapeutic use; D008297:Male
D000935:Antifungal Agents; D017964:Itraconazole; D000666:Amphotericin B