The Treatment of North American Blastomycosis with Amphotericin B

Abstract

The many reports in the medical literature on the treatment of North American blastomycosis with the aromatic diamidines attest to the beneficial effect obtained by the use of these compounds in this specific fungus infection.^1-13 There is increasing evidence, however, that stilbamidine and 2-hydroxystilbamidine are not effective in curing all instances of the systemic type of North American blastomycosis.^9,14,15 This systemic form of the disease, which was usually fatal¹⁶ prior to the use of the aromatic diamidines, has been beneficially influenced by this therapy, but often not cured. The relapses which have occurred following the proper administration of the stilbenes would appear to have developed in that group of patients exhibiting the immunological status comprising a negative blastomycin skin test and a persistently positive complement-fixation test, a type of blastomycosis which Smith¹⁷ has categorized as having the poorest prognosis. Relapse following stilbamidine