علاج داء باراكوكسيديويدس الخفيف مع إصابة رئوية وجلدية محدودة

References

• Mild forms present less than 5% of weight loss; counter immunoelectrophoresis titers less than 1/16; and exclusive involvement of the lungs, upper digestive, respiratory tract and skin, associated with a positive intradermic paracoccidioidin.
• In our out-patient clinic, sulfadiazine and SMX-TMT have been the choice for non-life threatening PCM, with favorable outcomes.
• Doses from 100-400 mg a day were effective when administered for 6-24 months, and associated with 91% of clinical improvement.
• A disadvantage of sulfadiazine is posology (two or three 500 mg tablets every six hours, or 100 mg/kg/d, maximum 6 g).
• The recommended posology is 480-960 mg every 8-12 hours, and the combination is available for oral or parenteral administration.
• Involution of active lesions and resolution of signs and symptoms should occur within 1-8 weeks of starting therapy.
• Acute phase tests: decreased erythrocyte sedimentation rates and normalization of acute phase proteins should occur in the first 4-12 weeks (C-reactive protein and alpha1 acid glycoproteins).
• With respect to the serological parameters, antibody titers should decrease 4-6 months after the beginning of treatment, reaching stabilization after 10 months (1/4 of initial titers detected by CIE or negative results in undiluted serum tested by DID).