Experiences in the Treatment of North American Blastomycosis with 2-Hydroxystilbamidine

doi:10.1059/0003-4819-57-4-553

Experiences in the Treatment of North American Blastomycosis with 2-Hydroxystilbamidine

Requests for reprints should be addressed to Fred Allison, Jr., M.D., Department of Medicine, The University of Mississippi Medical Center,
2500 North State Street, Jackson 6, Mississippi
.

Excerpt

The dramatic antifungal effect of stilbamidine in control of systemic blastomycosis in human beings, reported by Schoenbach, Miller, Ginsberg, and Long in 1951, represented the first substantial and effective therapy for this disease (1). Their observations were confirmed by others, but a significant incidence of peripheral neuropathy associated with use of the drug led to investigation of other, though structurally similar, agents. Shortly thereafter, 2-hydroxystilbamidine was found to exhibit similar antimycotic properties although it was less active than stilbamidine on a weight basis (2). Furthermore, 2-hydroxystilbamidine was clearly less toxic than stilbamidine and soon replaced it as the treatment of

Summario in Interlingua

Inter 1955 e le fin de 1961, 26 patientes con blastomycosis nord-american esseva recognoscite. De istes, 23 esseva tractate preferentialmente con 2-hydroxystilbamidina, resultante in solmente 2 non-successos therapeutic. Per contrasto con le therapia con classic stilbamidina e amphotericina B, il occurreva nulle caso de major reaction toxic. Minor reactiones de febrilitate e de nausea con vomito esseva complicationes de occurrentia occasional, sed illos non requireva un interruption del therapia. Le quantitate medie de 2-hydroxystilbamidina usate esseva 8,67 gramma, administrate usualmente per via intravenose in doses diurne de 225 milligramma. Multiple cursos therapeutic esseva infrequente. Resection esseva executate in solmente un caso de cavitation pulmonar. Adequate observationes post-therapeutic esseva possibile in omne le casos. Nulle del 21 successosemente tractate patientes suffreva un recidiva infectiose. Solmente 2 casos remaneva sub observation durante minus que 12 menses. Le altere 19 remaneva ben durante al minus 2 annos. In 9, iste periodo esseva plus que 4 annos. Le 2 non-successos de therapia a 2-hydroxystilbamidina occurreva in patientes con extense infection. Un esseva un juvene de 9 annos de etate que esseva criticamente malade al tempore del prime examine e qui moriva subsequentemente. Le altere patint suffreva recidivas post plure cursos de classic stilbamidina, sed arresto clinic esseva finalmente effectuate con amphotericina B. In vista de iste favorabile experientias, il es recommendate que 2-hydroxystilbaminidina es usate como pharmaco de prime election in le tractamento de generalisate blastomycosis nord-american.

Article and Author Information

From the Departments of Medicine and Pediatrics, University of Mississippi Medical Center, and Jackson Veterans Administration Hospital, Jackson, Mississippi.
Dr. Lockwood is a Post Doctoral Fellow of the National Heart Institute, United States Public Health Service.
- Received March 12, 1962.
- Accepted May 17, 1962.