SYSTEMIC MYCOSIS COMPLICATING HIGH-DOSE CORTICOSTEROID TREATMENT OF CHRONIC ACTIVE LIVER-DISEASE

  • 1 January 1980
    • journal article
    • research article
    • Vol. 74  (5) , 428-432
Abstract
Four patients with severe chronic active liver disease, treated with 30-200 mg, of prednisone daily for 0.5-7 mo. because of lack of response to smaller doses, developed systemic mycosis. Presentation was variable, consisting of cryptococcal meningitis, cryptococcal pneumonia, Aspergillus cerebral vasculitis and disseminated histoplasmosis originating from a Histoplasma pneumonia. None of 114 patients in the Mayo Clinic trials on conventional treatment for at least 6 mo., and only 1 of 25 patients (4%) on high dose prednisone, developed systemic mycosis. Low dose prednisone or its equivalent can be maintained to control hepatic inflammation during vigorous antifungal therapy without jeopardizing cure of the fungal infection. Systemic mycosis is infrequently associated with corticosteroid therapy for severe chronic active liver disease but can occur on high dose regimens as a subtle, progressively debilitating and potentially fatal complication that justifies prompt recognition and aggressive treatment with amphotericin-B alone or in combination with 5-fluorocytosine.

This publication has 1 reference indexed in Scilit: