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October 1978

Amphotericin B and Maduromycosis

Author Affiliations

Veterans Administration Hospital Lexington, Ky 40507

Am J Dis Child. 1978;132(10):1045. doi:10.1001/archpedi.1978.02120350113032

Sir.—Let me react to the clinical memorandum on the treatment of Maduromycosis with amphotericin B by Hayden et al in the Journal (131:927, 1977). We would point out that our case, to which they refer in their third reference, also had "apparent remission," but recurred thereafter. I believe strongly that the word "cure" is usually inappropriate in chronic fungal disease, and certainly so if only short-term follow-up is available. For Hayden and his colleagues, as for us, intra-articular administration of amphotericin B was "something to do." I doubt very much that it was considerably better than the policy of no action whatsoever. I would refer the interested reader to our article on coccidioidal arthritis1 for yet another look at how imperfect is our treatment of chronic fungal disease by amphotericin B, whether by the topical or intravenous route.