The Treatment of Deep Mycotic Infections with Amphotericin B1

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Abstract
Seven cases of chronic pulmonary coccidioidomycosis, one case of disseminated blastomycosis, and one case of chronic pulmonary histoplasmosis treated with amphotericin B are presented. Definite clinical improvement was attained in 4 of the cases of chronic pulmonary coccidioidomycosis and in the one case of disseminated blastomycosis. Four of these patients have not had recurrence of disease. Albuminuria and cylindruria were frequently noted during the course of therapy. Of particular interest is the significant elevation of blood urea N which occurred during each course of therapy. More elaborate urinary function tests showed an inability to concentrate urine, excrete phenolsulfonphthalein dye, and clear blood urea and creatinine during therapy. All renal abnormalities cleared after the completion of therapy. Acute toxic reactions frequently occurred during the period of intravenous infusion of amphotericin B. Not all reactions were of equal severity. The severe reactions occurred during the first weeks of administration, and subsequent reactions were of decreasing severity. There were no residual clinical stigmata following the completion of therapy.