Histoplasmosis is well-characterized as a fungal disease that more commonly occurs in North America, mostly endemic in Ohio and Mississippi river valleys. The clinical spectrum of histoplasmosis ranges from asymptomatic infection to a fatal disease. Progressive disseminated histoplasmosis is typically seen in immunocompromised individuals and presents with non-specific systemic symptoms associated with cutaneous manifestations of papules and nodules.? We report a case of a 28-year old Filipino female with a history of exposure to soil activities months before consult. The patient presented with a 3-week history of erythematous macules, vesicles, and pustules over the face, arms, and trunk, which evolve into papules and plaques with hemorrhagic crusting. Patient was initially diagnosed and treated as a case of varicella but had no improvement with initial management. Histopathologic findings were consistent with histoplasmosis. The patient was started with oral itraconazole, but unexpectedly expired before any improvement in cutaneous symptoms were noted.
Disseminated histoplasmosis ; Itraconazole

We report a case of eumycetoma in a Filipino patient who presented with a solitary reddish brown, moist, multinodular tumor on the dorsum of the left foot of 2 years duration. Biopsy with Periodic acid Schiff (PAS) & Gomori methenamine silver (GMS) staining, fungal culture, ultrasound and X-ray of the foot were done in our institution which confirmed the diagnosis of eumycetoma. The patient was successfully treated with itraconazole 400/day for 3 months, followed by 200mg/day for the succeeding 9 months, leading to complete resolution of the lesion leaving an atrophic hypopigmented scar. A high index of suspicion supported by diagnostic tests aided in the early detection of the disease which also resulted to complete resolution of the disease.
Mycetoma ; Mycoses ; Itraconazole

In the Endoscopy Department of ENT National Institute from July 1999 to April 2003, 76 cases of fungal laryngititis were treated. Two isolated types of fungi were Aspergillus (73.63%) and Candida (22.36%) and the mixe of both two type (2.63). In 59 cases of Aspergillus infection, the treatment with itraconazole gave good results in 100%. Patients’ voice had totally recovered and fugal test showed negative results first before stopping treatment. The average duration of treatment lasts 6.27 weeks with no relapse after 6 months.
Therapeutics ; Laryngitis ; Aspergillus ; Itraconazole ; drugs

A 35-year-old housewife was diagnosed with onychomycosis and treated by oral terbinafine, 250mg/day, for 4 months. Clinically all infected nails improved gradually. However, her left great toe-nail was not improved thereafter. At that time the proximal end of the onychomycotic lesion was marked with surgical blade, and terbinafine therapy was continued for four weeks. However, the onychomycotic nail was not improved, and the scratch mark passed by the proximal end of the infected nail. Therefore, we detected the resistance to the therapy and switched the medication to itraconazole 100 mg/day and then another scratch mark was done at the proximal end of the onychomycotic lesion. After another 2 weeks the infected nail went along with the scratch mark distally, and showed clinical improvement. After 8 weeks therapy of itraconazole, she was cured clinically and mycologically. The fungal culture was identified as Aspergillus sydowii.
Adult ; Aspergillus* ; Humans ; Itraconazole ; Onychomycosis*

Tuberculosis (TB) remains a very common disease in most of the low- and middle-income countries. As a result of high disease burden, TB control measures in these countries are usually concentrated on intensifying active disease case-finding and early treatment of infectious TB. On the contrary, in countries with low disease burden, the focus is on contact investigation to identify latently infected individuals and prophylactically treating them to prevent disease reactivation and transmission. These two strategies are deemed important for the effective TB control. Nonetheless, WHO cautions that targeted contact investigation and latent TB infection (LTBI) treatment should only be undertaken by countries that have the operational capacity/resources and have achieved ≥ 85% treatment success rate of active TB. The screening of LTBI is further challenged by the lack of a “gold standard” test to identify and validate individuals with this condition. Tuberculin skin test (TST) is still the preferred investigation as it is cheap, widely available and validated in many trials. The sensitivity and specificity of the newer test—interferon gamma release assay (IGRA) for LTBI screening has been encouraging in low prevalence countries. However, the evidence supporting such usage remains uncertain in high burden settings. Diagnosis of LTBI should adhere to the strict criteria outlined in the guidelines to avoid misdiagnosing active TB as LTBI. The treatment of the latter involved only one or two anti-TB drugs. It has been demonstrated that in the properly conducted contact screening and LTBI treatment, chances of the emergence of multi-drug-resistant TB is very low.
Tuberculosis ; Poverty ; Antifungal Agents ; Itraconazole

Chromoblastomycosis is an endemic mycoses which has been misdiagnosed or underdiagnosed in the past. This may be due to the clinicopathologic characteristics that it shares with other neglected tropical diseases such as leprosy and cutaneous tuberculosis. Correlating clinical findings with histopathologic cues will lead clinicians to correct diagnosis and subsequent treatment success.
Chromoblastomycosis ; Invasive Fungal Infections ; Itraconazole

BACKGROUND: Onychomycosis is one of the most common diseases of nails, accounting for 50% of all nail problems and a recent rise in the prevalence of onychomycosis has been noted. It has been known that the growth rate of nails is influenced by age, sex, seasonal factor, individual health and familial tendency. Several drugs, also, have been known to influence the growth rate of nails. OBJECTIVE: We want to know the influence of antifungal drug, itraconazole and terbinafine that used widespread recently, to the growth rate of nail. METHODS: This study was performed the 41 patients with distal subungal onychomycosis affecting only one sided great toenail and affected area more than 50%. The growth rate of the affected and the unaffected toenails in the same patients according to the medication of itraconazole or terbinafine was measured. Also, the growth rate of nails in 36 people with normal toenail was measured. RESULTS: No growth rate differences were seen in comparing the great toenails affected to onychomycosis in itraconazole and terbinafine group (p> 0.05). Also no growth rate differences were seen in great toenails not affected to onychomycosis in itraconazole and terbinafine group and no growth rate differences with the toenails of normal control (p> 0.05). CONCLUSION: There was no difference of itraconazole or terbinafine to the growth rate of nail. Even though there was no statistical significance, the possibility of the drug effect as normal nail growth became faster with the antifungal medication can not be excluded. So study with comparison of nail growth rate before and after antifungal medication will be needed in the future.
Humans ; Itraconazole ; Nails* ; Onychomycosis* ; Prevalence ; Seasons

Chromoblastomycosis, a chronic fungal infection of the skin and subcutaneous tissue, is known to be difficult to treat. Recently itraconazole has proved effective for treatment of this infection, but requires a prolonged treatment course. We experienced a case of chromoblastomycosis caused by Fonsecaea pedrosoi in a 68-year-old Korean man showing a complete resolution with a short course of oral itraconazole, 200 mg daily, for six weeks.
Aged ; Chromoblastomycosis* ; Humans ; Itraconazole* ; Skin ; Subcutaneous Tissue

In vitro sensitivity of T. mentagrophytes against antifungal agents was investigated. The 20 strains of T. mentagrophytes were tested. They were 5 strains of granilar form, 5 of powdery form, 5 of persicolor form, and 5 of downy for m. The tested antifungal agents were griseofulvin, ket,oconazole and it,raconazole. The results were as follows : 1. Minimal inhibitory concintration(MIC) of antifungal agents against, T. mentagrophytes : MIC of griseofulvin was 3.13-25 ug/ml, the highest level, that of ketoconazole was 0.05-12 ug/ml, and that of itraconazole was 0.025 6.25 ug/ml, the lowest one. 2. MIC of antifungal agents against T. mentagrophytes strains. MlC of griseofulvin was 12-25 ug/ml on granular form and 3.13-25 ug/ml on the other forms. MIC of ketoconazole was 0.39-12 ug/ml on granular form, 0,05 0.78 ug/ml on powdery form, 0.05 12 ug/ml on persicolor form, and 0.1-12 ug/ml on downy form. MIC of itraconazole was 0.39-6.25 ug/ml on granular form, 0.05-0.39 ug/ml on powdevy form, 0.025-0.05 ug/ml on persicolor form, and 0.05-0.1 ug/ml on downy form. Granular form showed the highest level of MIC among antifungal agents. These findings suggesed that, itraconazole was the most arctive drug against T. mentagrophytes and the pranular form showed the lowest, sensirivity against antifungal agents.
Antifungal Agents* ; Griseofulvin ; Itraconazole ; Ketoconazole ; Trichophyton*

Fusarium species are known as ubiquitous soil saprophytes and human skin comtaminants. Occasionally, however, they have been reported to cause a variety of infections in humans. We report herein a case of cutaneous infection by Fusarium sokmi in a patient with Burger's disease involving his right lower leg. He was treated with itraconazole 200 mg p.o. per day for 5 weeks and the skin lesion resolved without any noticeable side effects. Furthermore, there has been no evidence of recurrence of the disease 9 months after discontinuing the itraconazole. This is the first reported case of cutaneous infection by Fusarium sokmi in a patient with Burger's disease and itraconazole was an effective drug in our case.
Fusarium* ; Humans ; Itraconazole ; Leg ; Recurrence ; Skin ; Soil