CONDITIONS ASSOCIATED WITH RELAPSE OF AMPHOTERICIN-B-TREATED DISSEMINATED HISTOPLASMOSIS

Abstract

Progressive disseminated histoplasmosis (PDH) is a rare consequence of infection with Histoplasma capsulatum. Usually fatal if untreated, PDH generally is cured by appropriate amphotericin B treatment. Of 31 persons with uncomplicated PDH treated with amphotericin B, relapse occurred in 5 (16%) after an interval of up to 9 yr after initial therapy. Review of these 5 cases and 31 additional relapsing cases from the literature indicates that fungal endocarditis or endarteritis without surgical treatment, underlying lymphoreticular neoplasm and amphotericin B dosage < 2 g appear to be associated with relapse of PDH.