داء الباراكوكسيديويدوميكوسيس: العلاج الخطي التالي عند عدم تحقيق أمفوتيريسين ب الوريدي أو سلفاميثوكسازول-تريميثوبريم الوريدي للأهداف السريرية

References

• In severe or moderate acute cases, the patient has three or more of the following criteria: total body weight loss ≥ 10%; counter immunoelectrophoresis (CIE) titers ≥ 1/64; presence of tumor-like lesions or suppurative lymph nodes; multiple organ involvement (central nervous system, adrenal, bones); and lack of intradermal reaction to paracoccidioidin.
• As low levels are found in CNS, some authors prescribe AmB intrathecally (0.1–10 mg) in patients unresponsive to intravenous therapy when the fungus is susceptible to AmB.
• In this case, hydrocortisone 25–30 mg, or the equivalent dose of dexamethasone, can be administered to avoid arachnoiditis, and could be prescribed to pregnant women as it is not teratogenic.

DOI: 10.1590/S0036-46652015000700007