Denning D W, Tucker R M, Hanson L H, Stevens D A
Department of Medicine, Santa Clara Valley Medical Center, San Jose, CA 95128.
J Am Acad Dermatol. 1990 Sep;23(3 Pt 2):602-7. doi: 10.1016/0190-9622(90)70262-g.
Striking results were obtained with oral itraconazole therapy in two opportunistic mycoses. Of 28 patients with cryptococcal meningitis, 18 achieved complete responses, including 16 of 24 patients with acquired immunodeficiency syndrome. Other manifestations of cryptococcosis were similarly responsive. In aspergillosis 12 of 15 patients responded, including 8 of 10 immunocompromised hosts. These patients included those with invasive pulmonary disease (4/5), skeletal disease (2/2), pleural disease (1/2), and pericardial, sinus, mastoid, hepatosplenic, or nail disease (1/1). These results with itraconazole compare favorably to conventional (parenteral) therapy, and toxicity was minimal. This suggests that comparative trials are now in order.
口服伊曲康唑治疗两种机会性真菌病取得了显著效果。在28例隐球菌性脑膜炎患者中，18例获得完全缓解，其中24例获得性免疫缺陷综合征患者中有16例。隐球菌病的其他表现同样有反应。在曲霉病中，15例患者中有12例有反应，其中10例免疫功能低下宿主中有8例。这些患者包括侵袭性肺部疾病患者（5例中的4例）、骨骼疾病患者（2例中的2例）、胸膜疾病患者（2例中的1例）以及心包、鼻窦、乳突、肝脾或指甲疾病患者（1例中的1例）。伊曲康唑的这些结果与传统（胃肠外）治疗相比更具优势，且毒性极小。这表明现在需要进行对比试验。
