Successful Primary Therapy With Posaconazole for Fulminant Progressive Disseminated Histoplasmosis in a Renal Transplant Recipient.

For severe cases of progressive disseminated histoplasmosis (PDH), Infectious Diseases Society of America recommends treatment with liposomal amphotericin B for 2 weeks followed by itraconazole. In patients who are at risk for renal failure and for renal transplant patients on multiple nephrotoxic medications, there are no alternatives currently in clinical use. Posaconazole has shown promise in the animal experiments and also as salvage therapy in patients who have failed therapy with polyene and azole antifungal agents. Posaconazole has seldom been used as an initial drug for severe cases of PDH. We report a case of a renal transplant patient with severe PDH, on immunosuppressive therapy, successfully treated with posaconazole. Copyright (C) 2017 Wolters Kluwer Health, Inc. All rights reserved.

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