Ketoconazole: a new drug for the treatment of paracoccidioidomycosis.

Ketoconazole was administered orally to 13 patients with paracoccidioidomycosis. Therapy consisted of 200 mg per day for periods ranging from three to 12 months. All patients improved markedly, with healing of pulmonary, mucosal, and skin lesions. Patients exhibiting the latter two manifestations began to improve two weeks after therapy, and healing occurred within three months. Pulmonary lesions regressed at a slower pace and healed by fibrosis. Mycologic tests have corroborated the clinical improvement. Adverse effects were not observed; monitoring of renal, hematologic, and hepatic functions did not reveal any abnormalities. Five patients completed a year of therapy and were free of symptoms when therapy was discontinued. Of these patients, four were followed for several months and had no relapses; the fifth patient developed tuberculosis and died. The results indicate that ketoconazole is a safe and effective drug for therapy in the treatment of paracoccidioidomycosis.