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April 1984

Systemic Blastomycosis Treated With Ketoconazole

Author Affiliations

From the Division of Dermatology, University of Louisville School of Medicine.

Arch Dermatol. 1984;120(4):536-538. doi:10.1001/archderm.1984.01650400118026

Ketoconazole is finding increased usefulness in the treatment of systemic fungal infections.1 Recent reports document both the successful and unsuccessful treatment of blastomycosis with ketoconazole.2-6 We describe a patient who responded remarkably and promptly to ketoconazole therapy.

Report of a Case  A 48-year-old male garbage collector was seen in October 1981, because of a two-month history of a right scrotal mass, which had been diagnosed as epididymitis and treated unsuccessfully with several antibiotics. Just prior to hospital admission, several papules and pustules developed on the patient's trunk and lower extremities. These rapidly developed into draining abscesses. The patient denied fever, malaise, headache, weight loss, or other systemic symptoms. He took no medicines. A stab wound to the abdomen one year prior to admission had healed uneventfully after surgical exploration and repair. His medical history was otherwise negative.Physical examination disclosed multiple pustules and abscesses, some actively draining over

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