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Treatment of the Midwestern Endemic Mycoses, Blastomycosis and Histoplasmosis

  • Current Management of Fungal Infections (M Miceli, Section Editor)
  • Published:
Current Fungal Infection Reports Aims and scope Submit manuscript

Abstract

Purpose of Review

The purpose of this review is to assess the recommended treatment regimens for the major endemic mycoses, histoplasmosis and blastomycosis, which occur in the Midwestern USA and to provide information about the use of newer antifungal agents for these diseases.

Recent Findings

The basic approach to treatment of histoplasmosis and blastomycosis outlined in the IDSA Guidelines is helpful in managing these diseases. However, changes since these guidelines were published provide safer and better tolerated treatment regimens. Prolonged treatment with amphotericin B is rarely required, and lipid formulations of this drug have largely replaced the amphotericin B deoxycholate formulation. Although no clinical trials have been performed and the data are anecdotal, voriconazole and posaconazole are increasingly used in patients who cannot tolerate itraconazole. Voriconazole is especially useful when central nervous system infection is present. Posaconazole tablets provide consistently appropriate serum levels and the drug is well tolerated.

Summary

New azole agents provide alternative therapeutic options for histoplasmosis and blastomycosis.

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  1. Division of Infectious Diseases, Veterans Affairs Ann Arbor Healthcare System, University of Michigan Medical School, 2215 Fuller Road, Ann Arbor, MI, 48105, USA

    Carol A. Kauffman

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Correspondence to Carol A. Kauffman.

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This article is part of the Topical Collection on Current Management of Fungal Infections

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Kauffman, C.A. Treatment of the Midwestern Endemic Mycoses, Blastomycosis and Histoplasmosis. Curr Fungal Infect Rep 11, 67–74 (2017). https://doi.org/10.1007/s12281-017-0281-x

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  • DOI: https://doi.org/10.1007/s12281-017-0281-x

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