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November 1964

Coccidioidomycosis: Long-Term Treatment With Amphotericin B of Disseminated Disease in a Three-Month-Old Baby

Author Affiliations

From the Pediatric Service, Fresno County General Hospital.

Am J Dis Child. 1964;108(5):454-459. doi:10.1001/archpedi.1964.02090010456003

The antibiotic, amphotericin B, is an important breakthrough in the therapy of disseminated coccidioidomycosis and other systemic fungus infections. Nonetheless, it causes significant systemic, vascular, hematologic, and especially renal toxicity, thereby causing a therapeutic dilemma to the therapist. Two specific questions which confront the physician in treating an infant with this form of the disease are (a) is the patient more susceptible to irreversible renal toxicity than older children; and (b) how long and in what amount can the drug be safely used? Recently we treated disseminated coccidioidomycosis in a Mexican infant male with amphotericin B over an 18-month period covering two hospital admissions (Fig 1). Our search through the available literature suggests that he is the youngest patient ever thus successfully treated.1

Report of a Case  The infant was born on June 12, 1961, in Salinas, Calif, the product of a normal pregnancy and delivery. His birth weight