Background: Several modalities have been used for the treatment of cutaneous leishmaniasis (CL) with various results. In vitro and in vivo studies have shown inhibitory effects of azole drugs on Leishmania parasites. ...Background: Several modalities have been used for the treatment of cutaneous leishmaniasis (CL) with various results. In vitro and in vivo studies have shown inhibitory effects of azole drugs on Leishmania parasites. Objectives: To evaluate the efficacy and tolerability of oral itraconazole in the treatment of CL caused by L. major. Methods: A total of 200 patients with parasitologically confirmed CL with a duration of less than 45 days from a well known L. major endemic area were included in a randomized, double-blind, placebo-controlled clinical trial. The patients received either itraconazole 200 mg daily (100 patients) or placebo (100 patients) for 8 weeks. The primary outcome measures were clinical cure (complete re-epithelization of all lesions) and parasitological cure at the end of the treatment. Results: Eighty-three patients in the itraconazole and 75 patients in the placebo group completed the treatment course. After 8 weeks of treatment, clinical cure was observed in 59% and 53% and parasitological cure was observed in 83% and 76% of patients in the itraconazole and placebo groups, respectively, which were not significantly different. There was no difference in the rate of adverse events. Conclusions: An 8-week course of oral itraconazole was not more effective than placebo in the treatment of CL.展开更多
Introduction. Paracoccidio-domycosisis a deep mycosis due to a dimorphic fungus: Paracoccidioides brasiliensis. The principle endemic country is Brazil. We describe the first case of paracoccidio-domycosis, in its cut...Introduction. Paracoccidio-domycosisis a deep mycosis due to a dimorphic fungus: Paracoccidioides brasiliensis. The principle endemic country is Brazil. We describe the first case of paracoccidio-domycosis, in its cutaneous-mucosal form, diagnosed in French Guiana. Observation. A 20 year-old Brazilian man, having mover to French Guiana a few months earlier, presented with multiple disseminated cutaneous lesions, predominating on the face, and composed of multiple nodules and two ulcerations. The clinical examination also revealed voluminous superficial lymph nodes and ulcerations of the pharynx and larynx. Direct examination, anatomopathology and culture of cutaneous biopsies revealed specific images of Paracoccidioides brasiliensis. HIV serology was negative. Treatment combining cotrimoxazole and itraconazole eliminated the lesions in one month. Discussion. Because the patient had just moved to Guiana, this observation probably corresponded to an imported disease. The principle differential diagnosis was leishmaniosis.展开更多
We describe a case of concurrent double infection with phaeohyphomycosis and lymphocutaneous nocardiosis in an immunocompromised host. The episode occurred almost simultaneously with an incident of insect bites. Exoph...We describe a case of concurrent double infection with phaeohyphomycosis and lymphocutaneous nocardiosis in an immunocompromised host. The episode occurred almost simultaneously with an incident of insect bites. Exophiala spinifera was isolated from lesions on the left arm and Nocardia asteroides was isolated from lesions on the right hand. Clinical resolution occurred within 5 months after initiation of antimicrobial treatment with oral itraconazole and minocycline. We believe that this case represents a novel episode of previously unreported concurrent infections with phaeohyphomycosis and lymphocutaneous nocardiosis in human beings.展开更多
文摘Background: Several modalities have been used for the treatment of cutaneous leishmaniasis (CL) with various results. In vitro and in vivo studies have shown inhibitory effects of azole drugs on Leishmania parasites. Objectives: To evaluate the efficacy and tolerability of oral itraconazole in the treatment of CL caused by L. major. Methods: A total of 200 patients with parasitologically confirmed CL with a duration of less than 45 days from a well known L. major endemic area were included in a randomized, double-blind, placebo-controlled clinical trial. The patients received either itraconazole 200 mg daily (100 patients) or placebo (100 patients) for 8 weeks. The primary outcome measures were clinical cure (complete re-epithelization of all lesions) and parasitological cure at the end of the treatment. Results: Eighty-three patients in the itraconazole and 75 patients in the placebo group completed the treatment course. After 8 weeks of treatment, clinical cure was observed in 59% and 53% and parasitological cure was observed in 83% and 76% of patients in the itraconazole and placebo groups, respectively, which were not significantly different. There was no difference in the rate of adverse events. Conclusions: An 8-week course of oral itraconazole was not more effective than placebo in the treatment of CL.
文摘Introduction. Paracoccidio-domycosisis a deep mycosis due to a dimorphic fungus: Paracoccidioides brasiliensis. The principle endemic country is Brazil. We describe the first case of paracoccidio-domycosis, in its cutaneous-mucosal form, diagnosed in French Guiana. Observation. A 20 year-old Brazilian man, having mover to French Guiana a few months earlier, presented with multiple disseminated cutaneous lesions, predominating on the face, and composed of multiple nodules and two ulcerations. The clinical examination also revealed voluminous superficial lymph nodes and ulcerations of the pharynx and larynx. Direct examination, anatomopathology and culture of cutaneous biopsies revealed specific images of Paracoccidioides brasiliensis. HIV serology was negative. Treatment combining cotrimoxazole and itraconazole eliminated the lesions in one month. Discussion. Because the patient had just moved to Guiana, this observation probably corresponded to an imported disease. The principle differential diagnosis was leishmaniosis.
文摘We describe a case of concurrent double infection with phaeohyphomycosis and lymphocutaneous nocardiosis in an immunocompromised host. The episode occurred almost simultaneously with an incident of insect bites. Exophiala spinifera was isolated from lesions on the left arm and Nocardia asteroides was isolated from lesions on the right hand. Clinical resolution occurred within 5 months after initiation of antimicrobial treatment with oral itraconazole and minocycline. We believe that this case represents a novel episode of previously unreported concurrent infections with phaeohyphomycosis and lymphocutaneous nocardiosis in human beings.
