CLINICALLY SIGNIFICANT MUCOSAL CANDIDIASIS RESISTANT TO FLUCONAZOLE TREATMENT IN PATIENTS WITH AIDS

Eight cases of severe mucosal candidiasis in patients with AIDS who we re taking fluconazole at a dosage of 400-800 mg/d are described. Candi da albicans alone or in conjunction with Torulopsis glabrata or Candid a stellatoidea was isolated from each patient. In vitro susceptibility testing demonstrated resistance to fluconazole in all eight cases. Al l tested isolates were susceptible to amphotericin B, and six of eight isolates tested were susceptible to itraconazole. All individuals wer e severely immunocompromised (CD4 lymphocyte counts: mean, 15/mm(3); r ange, 6-39/mm(3)) and had been receiving prophylaxis with fluconazole for a mean of only 3 months (range, 1-7 months). The occurrence of can didal mucositis in patients receiving high doses of fluconazole is a m atter of concern that requires further study in regard to the causes, prevention, and treatment of the disease.