Ketoconazole Therapy for AIDS Patients With Disseminated Histoplasmosis-Reply

L. Joseph Wheat, MD
Arch Intern Med. 1985;145(12):2272. doi:10.1001/archinte.1985.00360120144046.
Text Size: A A A
Published online

In Reply.  —Ketoconazole failed to prevent clinical relapse with disseminated histoplasmosis in the patient with AIDS described by Drs Gustafson and Henson. Their patient also failed amphotericin B therapy, presumably because of the severe immune incompetence associated with AIDS. Based on the encouraging experience of Dr Bonner and co-workers, I have used ketoconazole to prevent relapse in two patients with AIDS and histoplasmosis.1 Both patients subsequently suffered a relapse. The first patient, a 29-year-old male drug addict, developed recurrent disseminated histoplasmosis manifested as fever and chronic meningitis while receiving 400 mg/day of ketoconazole. Histoplasma capsulatum was isolated from the cerebrospinal fluid, but blood and bone marrow cultures were negative. His meningitis initially responded to amphotericin B therapy, but he eventually died with persistent central nervous system histoplasmosis. Neither ketoconazole nor amphotericin B cross the blood-brain barrier well, perhaps explaining the patient's relapse with chronic meningitis. The second patient, a


Sign In to Access Full Content

Don't have Access?

Register and get free email Table of Contents alerts, saved searches, PowerPoint downloads, CME quizzes, and more

Subscribe for full-text access to content from 1998 forward and a host of useful features

Activate your current subscription (AMA members and current subscribers)

Purchase Online Access to this article for 24 hours

First Page Preview

View Large
First page PDF preview





Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).
Submit a Comment


Some tools below are only available to our subscribers or users with an online account.

Sign In to Access Full Content

Related Content

Customize your page view by dragging & repositioning the boxes below.