Case Report. Successful therapy of disseminated histoplasmosis in AIDS with liposomal amphotericin B

A 36-year-old HIV-infected male patient presented with relapsing fever epis odes to 39 degrees C, night sweats and weight loss. Computerized tomography of the abdomen showed enlarged multiple lymph nodes. After surgical resect ion of multiple lymph nodes, disseminated infection with Histoplasma capsul atum was diagnosed. Amphotericin B desoxycholate was initiated for 24 days. Fourteen days after therapy was discontinued, the patient suffered similar symptoms again. Subsequent treatment with liposomal amphotericin B led to rapid improvement within 3 days. Upon discharge, maintenance therapy with 6 00-mg itraconazole capsules was initiated and decreased to 400-mg 14-days l ater. Itraconazole therapy was continued until the patient died more than 2 years later because of complications of the underlying disease. At autopsy there were no signs of histoplasmosis.