[Disseminated histoplasmosis treated by boluses of fluconazole].
We report a case in which an HIV-infected man was cured of disseminated histoplasmosis (Histoplasma capsulatum var duboisii) after treatment by high-dose fluconazole (1,600 mg taken four times daily) for 2 months, combined with active antiretroviral therapy. The choice of fluconazole at this dosage was motivated by its availability as a generic and thus inexpensive medication, the patient's precarious status, and his critical clinical condition. At the end of the second month of treatment, the patient chose to stop the fluconazole, which he could no longer afford, while continuing the antiretroviral treatment, which was free. The clinical and laboratory improvement observed from the first week has continued to progress for more than 8 months after fluconazole treatment stopped. This single case needs - and deserves - to be confirmed in a series of patients. Nonetheless it makes it possible to envision fluconazole as a low-cost and efficacious antifungal agent for the treatment of disseminated histoplasmosis in AIDS patients in sub-Saharan Africa.
Unité de dermatologie, cliniques universitaires des Montagnes, Bangangté, Cameroun, Médecine interne, Hôpital général de Yaoundé, Yaoundé, Cameroun.
C
C
Mandengue Ebenye
Médecine interne, Hôpital général de Yaoundé, Yaoundé, Cameroun.
B
B
Takuefou Mfangam
Médecine interne, Hôpital général de Yaoundé, Yaoundé, Cameroun.
C
C
Nouédoui
Laboratoire d'anatomie-histo-pathologie, Yaoundé, Cameroun.
P J A
PJ
Atangana
D000328:Adult; D044966:Anti-Retroviral Agents / Q000627:therapeutic use; D000935:Antifungal Agents / Q000191:economics / Q000627:therapeutic use*; D002163:Cameroon; D015725:Fluconazole / Q000191:economics / Q000627:therapeutic use*; D015658:HIV Infections / Q000150:complications / Q000188:drug therapy; D006660:Histoplasmosis / Q000150:complications / Q000188:drug therapy*; D006801:Humans; D008297:Male
D044966:Anti-Retroviral Agents; D000935:Antifungal Agents; D015725:Fluconazole
AIDS; Cameroon; disseminated histoplasmosis; fluconazole