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Combination therapy hope for conidiobolomycosis sufferers

September 15 2015

Conidiobolomycosis is rare and very difficult to treat. It can affect any part of the body, but is particularly conspicuous on the face - rhinofacial conidiobolomycosis. Conidiobolus coronatus is the most common pathogenic species; Conidiobolus incongruus is also reported. Both are commonly present in soil and decaying leaves notably in the rain forests of Africa. 

The infection is only encountered in tropical countries. Late stage infection leads to so called ‘facial elephantiasis’.

Manish Gupta and colleagues from Patiala and Chandigarh in India report experience with 10 cases who they treated with the combination of itraconazole and potassium iodide for at least 3 months.  Seven patients responded, five with complete resolution and two major improvement (50–75%). In two patients the response was minimal (<25% regression of the swelling) and one patient failed despite 6 months of treatment. These are stunningly better results than any seen previously.  Responses were better in those treated early. 

Itraconazole was used at a dose of 200mg twice daily. Saturated potassium iodide solution (1g/mL) dose was gradually increased to minimize nausea. The initial dose was 5 drops three time daily and then gradually increased to a maximum of 30 drops twice daily. 

Article ; Image:  S Agrawal, Department of Microbiology, Government Medical College, Nagpur.