Youle M, Midgley J, Shanson D, Campbell C, Gazzard B; International Conference on AIDS.
Int Conf AIDS. 1989 Jun 4-9; 5: 235 (abstract no. M.B.P.81).
St. Stephen's Hospital, London, England
OBJECTIVE: Histoplasmosis has been described in AIDS cases in endemic areas. We report a case which developed in a severely immunocompromised patient resident in the U.K. METHODS: A 34 year old HIV antibody positive patient with a previous AIDS diagnosis of cerebral toxoplasmosis and Mycobacterium tuberculosis in the lung and neck nodes, presented with a two month history of skin lesions on the face and back and painful, swollen left foot. Biopsy of the fifth metatarsal and also of a heaped granulomatous skin lesion showed the large tuberculate macroconidia of Histoplasmosis capsulatum. The patient was Argentinian but had not been in that country for ten years. RESULTS: He was already being treated with ketoconazole 200mg twice daily for oesophageal candidiasis but has since been switched to the triazole itraconazole 200mg daily in an attempt to eradicate the fungus. His lesions have healed completely and feels much better since commencing therapy, he remains well at six months follow up. Treatment in the past has been with intravenous amphotericin B and flucytosine or oral ketoconazole. It is interesting that this patient was already on ketoconazole when he developed the skin and bone lesions suggesting poor drug absorption or a resistant strain. CONCLUSIONS: We believe this to be the first AIDS patient to develop this infection in the United Kingdom and to be successfully treated with itraconazole.
Publication Types:
Keywords:
- Acquired Immunodeficiency Syndrome
- Amphotericin B
- Argentina
- Candidiasis
- Flucytosine
- Great Britain
- HIV Infections
- Histoplasmosis
- Humans
- Itraconazole
- Ketoconazole
- Skin
- Toxoplasmosis, Cerebral
Other ID:
UI: 102176935
From Meeting Abstracts