African histoplasmosis is a granulomatous mycosis caused by Histoplasma capsulatum var. duboisii. Treatment is usually extrapolated from guidelines for classical histoplasmosis, and includes 2-4 weeks of amphotericin B followed by a step-down maintenance therapy with itraconazole. Pediatric usage of posaconazole, an oral second-generation azole, remains off-label, but recent surveys show that i...

OBJECTIVES We investigated the in vitro activity of various triazoles in two-drug combinations with the echinocandin caspofungin against clinical isolates of Aspergillus fumigatus. METHOD Conidial suspensions were prepared from 20 clinical isolates of A. fumigatus highly susceptible to itraconazole, voriconazole, posaconazole and ravuconazole (MIC-0 range 0.125-1 mg/L), and caspofungin (MIC-0...

Posaconazole is a highly lipophilic drug. It is one of the more recent triazole antifungals critical in the treatment of invasive mycoses [1]. It disturbs fungi growth by inhibiting cytochrome P450 lanosterol 14α-demethylase (CYP51A1) that leads to blockage of ergosterol synthesis in the fungal cell membranes. The end result of this reaction is the increase of fungi cell membrane permeability a...

We document the first case of haematogenous cerebral spread in Rhizopus arrhizus rhino-orbital mucormycosis, and of posaconazole related adrenal insufficiency. A patient presenting with diabetic ketoacidosis and sinusitis was treated with right medial maxillectomy, ethmoidectomy and IV liposomal amphotericin. Orbital exenteration was performed after intraorbital spread of infection. IV caspofun...

This report presents two cases of invasive rhino-orbital mucormycosis who had life-threatening reactions to amphotericin B. Both cases were treated with a combination of posaconazole-caspofungin favorably with no evidence of recurrence upon long-term follow-up. To our knowledge, this is the first report of successful treatment of invasive mucormycosis with azole-echinocandin combination. It may...

A 64-year-old male with Aspergillus fumigatus infection that had disseminated from the lung to the ankle and adjacent bone was treated successfully with posaconazole after therapy with itraconazole and amphotericin B lipid complex failed. Marked clinical improvement occurred within 6 weeks of initiation of posaconazole therapy; after 6 months, infection had resolved at all sites. The patient ha...

BACKGROUND Zygomycosis is a difficult to treat and frequently fatal infection affecting immunocompromised and (rarely) immunocompetent patients. It requires a multifaceted approach involving elimination of predisposing factors, surgical debridement, and antifungal therapy. CASE REPORT We report the case of a postrenal transplant patient who developed disseminated zygomycosis with vascular ane...

Currently available drugs for Chagas' disease are limited by toxicity and low efficacy in the chronic stage. Posaconazole, the most advanced new anti-chagasic drug candidate, did not fully confirm its initial potential in a Phase II clinical trial for chronic Chagas' disease. Given that posaconazole is highly active against Trypanosoma cruzi in vitro, and was very well tolerated in clinical tri...

OBJECTIVES A murine model of chromoblastomycosis caused by Cladophialophora carrionii was used to compare the efficacy of posaconazole and voriconazole with that of terbinafine and itraconazole, the currently used drugs in the management of chromoblastomycosis. METHODS Athymic nude mice were infected with 2 × 10(7) cfu of a clinical isolate of C. carrionii. When typical lesions were establish...