Ketoconazole for Treatment of Chronic Pulmonary Coccidioidomycosis

Abstract

Patients (21) with chronic pulmonary coccidioidomycosis were treated with ketoconazole. In 16 patients with chronic cavitary disease, 9 improved, 4 showed no change and the condition of 3 deteriorated; 3 of 9 patients had culture conversion. Roentgenograms showed improvement in 2 patients, no change in 12 and deterioration in 2. Serologic improvement was not noted. In 5 patients with persistent infiltrative disease, the response was more favorable. Radiographic improvement culture conversion and serologic improvement were seen in most patients. Ketoconazole-induced side effects were mild and of short duration, ending in the 1st days of therapy. Ketoconazole seems to be of significant value in infiltrative pulmonary disease, but seems unable, at the doses used, to change findings in the sputum or to change radiographic findings in chronic cavitary disease. Further long-term observation is necessary to evaluate fully the role of this drug in chronic pulmonary coccidioidomycosis.