rifampin and Histoplasmosis

We report two patients treated with the combination of itraconazole plus rifampin for more than 4 months. While on itraconazole plus rifampin, patient 1 lost weight at a rate of 30 g/d. After stopping rifampin, he gained 14 g/d. While on itraconazole plus rifampin, patient 2 lost 41 grams/day. After stopping rifampin, he gained 33 g/d. Weight loss while taking the combination of itraconazole plus rifampin, followed by weight gain after stopping rifampin, suggests the possibility of a clinically significant drug interaction between itraconazole and rifampin.

Topics: Adult; AIDS-Related Opportunistic Infections; Antibiotics, Antitubercular; Antifungal Agents; Drug Interactions; Drug Therapy, Combination; Histoplasmosis; Humans; Itraconazole; Male; Middle Aged; Mycobacterium avium-intracellulare Infection; Rifampin; Weight Loss

Topics: Adult; AIDS-Related Opportunistic Infections; Drug Interactions; Histoplasmosis; Humans; Itraconazole; Male; Rifampin; Tuberculosis, Pulmonary

An immunocompromised patient with severe hypoxemia was found by transbronchial lung biopsy to have Torulopsis glabrata as the sole pathogen in lung. An antibody response to this organism was demonstrated, confirming its role as a pathogen and indicating a role for serodiagnosis of T glabrata infection.

Topics: Adult; Amphotericin B; Candida; Drug Therapy, Combination; Histoplasmosis; Humans; Immunosuppression Therapy; Kidney Failure, Chronic; Lung Diseases, Fungal; Male; Pneumonia; Rifampin

In a patient who had been receiving digitoxin therapy, the serum digitoxin level decreased markedly when rifampin was added to the therapeutic regimen. The serum digitoxin level returned to the pretreatment level when rifampin therapy was discontinued.

Topics: Aged; Digitoxin; Drug Interactions; Female; Histoplasmosis; Humans; Rifampin

The authors present 10 cases of histoplasmosis, 3 due to H. capsulatum, and 7 to H. duboisii. The presenting signs were stomatological or laryngeal with H. capsulatum, and ganglionic, cutaneous, or skeletal with H. duboisii. Diagnosis was confirmed by the discovery of histoplasms in the lesions: 7 times the examination of a needle biopsy sample was positive; in 8 cases out of 10, culture on Sabouraud's medium was positive; in 3 cases out of 4 the inoculated hamster showed the presence of a histoplasmosis. Histological examination of lesions biopsies demonstrated histoplasms in the 9 cases studied. The intradermal reaction to histogical examination of lesion biopsies demonstrated histoplasms in the 9 cases studied. The intradermal reaction to histoplasmin, positive in only 1 out of 7 cases, and serological tests which showed precipitating antibodies in only 4 cases out of 10, are of very little diagnostic value. All patients were treated with amphotericin B, sometimes associated with clotrimazole (3 cases), miconazole (1 case), and rifampicin (2 cases). Two relapses occurred, one, after too soon an interruption of treatment relapsed two months later, and the other followed 18 months after a total dose of 4,200 mg of amphotericin. Surgical treatment of active subcutaneous ganglionic and bony foci may be necessary, and was employed in three cases, with a favourable result in a case of severe disseminated histoplasmosis.

Topics: Adolescent; Adult; Africa; Aged; Amphotericin B; Child; Child, Preschool; Clotrimazole; Female; Histoplasmosis; Humans; Infant; Lymph Node Excision; Male; Miconazole; Middle Aged; Mouth Diseases; Rifampin

A patient with oesophageal stenosis caused by Histoplasma granulomas is reported. He was treated with an initial combined course of intravenous amphotericin B and oral rifampicin. Complications included adrenal insufficiency, operative perforation of the oesophagus, amphotericin nephrotoxicity and tuberculosis. The histoplasmosis has not recurred for over 3 years.

Topics: Aged; Amphotericin B; Drug Therapy, Combination; Esophageal Stenosis; Granuloma; Histoplasmosis; Humans; Male; Rifampin

Amphotericin B in combination with rifampicin was more effective in the treatment of murine histoplasmosis and blastomycosis than either agent alone. The increased therapeutic effects were not accompanied by an increase in toxicity.

Topics: Amphotericin B; Animals; Blastomycosis; Dose-Response Relationship, Drug; Drug Therapy, Combination; Female; Histoplasmosis; Mice; Rifampin

Topics: Abscess; Adult; Diagnosis, Differential; Ethambutol; Fluorescent Antibody Technique; Histoplasma; Histoplasmosis; Humans; Isoniazid; Male; Rifampin; Skin Tests; Thorax; Tuberculosis