Fungal infections blastomycosis

Two of the most common endemic fungal infections (histoplasmosis and North American blastomycosis) are found in... 

North American blastomycosis is a systemic fungal infection caused by Blastomyces dermatitidis. 

Indications Treatment of the following systemic fungal infections Candidiasis Chronic mucocutaneous candidiasis Oral thrush Candiduria Blastomycosis Coccidioidomycosis Histoplasmosis Chromomycosis Paracoccidioidomycosis... 

Itraconazole is a triazole antifungal agent that inhibits the C-demethylation step in the synthesis of ergosterol, which is a vital component of fungal cell membranes. Injection used in treatment of aspergillosis, blastomycosis, histoplasmosis, and the empiric treatment of febrile neutropenic patients with suspected fungal infections. Capsules used in treatment of asper-gillosis, blastomycosis, histoplasmosis, and... 

Clinical Experience - Amphotericin B continued to be the drug of choice in treatment of serious or systemic fungal infections. It was reported earlier that while either 2-hydroxystilbamidine or amphotericin B was effective in treatment of noncavltary pulmonary blastomycosis, the latter drug was the more effective agent in treatment of this infection in those cases with cavitary disease or with systemic organ involvement.Amphotericin B also was described as useful in the treatment of canine blastomycosis. 

Therapy for coccidioidomycosis is difficult, and the results are unpredictable. Guidelines are available for treatment of this disease however, optimal treatment for many forms of this disease still generates debate. The efficacy of antifungal therapy for coccidioidomycosis is often less certain than that for other fungal etiologies, such as blastomycosis, histoplasmosis, or cryptococcus, even when in vitro susceptibilities and the sites of infections are similar. The refractoriness of coccidioidomycosis may relate to the ability of C. immitis spherules to release hundreds of endospores, maximally challenging host defensesFortunately, only approximately 5% of infected patients require therapy. ... 

Systemic fungal diseases (e.g. histoplasmosis and blastomycosis) are uncommon but, if untreated, often fatal. They usually take the form of lung infections or meningitis. The best treatment is still the polyene antibiotic, amphotericin B 5.14) whose mode of action is described in Section 5.4.1 (p. 192). It is usually administered intravenously. Flucytosine 4.23) is an excellent synergist (Section 4.0, p. 131), seldom given alone. Intravenous miconazole 6.23) provides alternative therapy, but there are frequent adverse reactions. An orally active analogue, ketoconazole ( Nizoral ) was introduced in 1981, and looks promising. 

Some rare, but often fatal, systemic fungal diseases, such as histoplasmosis and North American blastomycosis yield to injections of amphotericin B (5.7, p. 166), but its selectivity is only moderate (for mode of action, see Section 14.2). A related substance, nystatin, is used for superficial candiasis and for those infections of the gut with Candida albicans that sometimes follow tetracycline therapy. 

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