Miconazole in coccidioidomycosis.

The epidemiology of Coccidioides immitis is described with respect to annual infection rates and differing ethnic susceptibilities to the infection. A trial of miconazole in infected mice produced 100% survival in conditions which normally kill 100% of animals, probably by drastically reducing the rate of fungal multiplication in the lung. The fungal endospore, the form of the dimorphic fungus found predominantly in host tissue is more sensitive to miconazole than is the mycelial form. Data are presented from 14 human patients, some moribund and comatose, all of whom had failed to respond to existing therapy. There was objective evidence of improvement in eight, and a subjective impression of improvement in the majority. One patient failed to respond and three have equivocal results.