RESUMO
BACKGROUND: Tinea capitis is a fungal infection in which topical therapy is often unsuccessful. Griseofulvin has been considered to be a first-line therapy. Other antifungal agents are the azole derivatives. Among these, itraconazole was compared with griseofulvin in children in a double-blind study. PATIENTS AND METHODS: Thirty-four children and one adult with clinical signs and symptoms of tinea capitis and with positive culture and microscopy for dermatophytes have been included in a double-blind comparison between itraconazole, 100 mg daily, and ultramicronized griseofulvin, 500 mg daily. Both drugs were given for 6 consecutive weeks. The final evaluation was made 8 weeks after the end of treatment to allow the hairs to regrow. Seventeen itraconazole- and 15 griseofulvin-treated patients received the complete 6-week treatment course. Fifteen of these 17 itraconazole patients and 14 of the 15 griseofulvin patients had infections caused by Microsporum canis. Fifteen of 17 patients were cured by itraconazole (88%) and 15 of 17 patients by griseofulvin (88%). One of the patients who discontinued griseofulvin therapy after 4 weeks was clinically and mycologically cured. Two of the original 17 griseofulvin patients discontinued therapy because of vomiting. None of the itraconazole-treated children experienced side effects. CONCLUSIONS: Itraconazole is the first azole derivate that matches griseofulvin for the treatment of tinea capitis in children. The drug also appears to be better tolerated than griseofulvin.
Assuntos
Griseofulvina/uso terapêutico , Itraconazol/uso terapêutico , Tinha do Couro Cabeludo/tratamento farmacológico , Criança , Pré-Escolar , Método Duplo-Cego , Resistência Microbiana a Medicamentos , Tolerância a Medicamentos , Feminino , Seguimentos , Griseofulvina/administração & dosagem , Griseofulvina/efeitos adversos , Humanos , Itraconazol/administração & dosagem , Itraconazol/efeitos adversos , Masculino , Microsporum/efeitos dos fármacos , Microsporum/isolamento & purificação , Pessoa de Meia-Idade , Indução de Remissão , Tinha do Couro Cabeludo/microbiologia , Trichophyton/efeitos dos fármacos , Trichophyton/isolamento & purificaçãoRESUMO
BACKGROUND: F. solani fungemia is unusual. Patients at risk are immunosuppressed, have underlying malignancy or severe debilitating diseases. METHODS: We report two cases of F. solani fungemia in two non neutropenic patients who had been treated with wide-spectrum antibiotics an/or systemic corticosteroids, parenteral nutrition and intravenous lines. Bactec NR-860 (Becton-Dickinson) system was used, and growth was detected in aerobic conditions (between 3-7 days of incubation). RESULTS: Removal of the catheters with or without i.v. amphotericin B were used successfully. CONCLUSION: The spectrum of Fusarium sp. fungemia is discussed. Current available antifungal therapy is also reviewed.
