ENDEMIC MYCOSIS COMPLICATING HUMAN-IMMUNODEFICIENCY-VIRUS INFECTION

Persons infected with the human immunodeficiency virus are prone to th e development of many fungal diseases. Normal hosts with intact immuni ty usually recover from infection by these less-invasive fungi. In per sons with compromised T-cell-mediated immunity, however, widespread di ssemination from a pulmonary focus occurs. In this review, we discuss the epidemiology, clinical manifestations, diagnosis, and treatment of the three major North American mycoses, histoplasmosis, blastomycosis , and coccidioidomycosis. In most cases, amphotericin B is the initial drug of choice, followed by one of the azoles for lifelong maintenanc e therapy.