Terbinafine Blastomycosis Treatment

Blastomycosis is a systemic fungal infection caused by Blastomyces dermatitidis, which lives in soil and wood. A similar infection, called South American blastomycosis, is caused by paracoccidioides brasiliensis. Initially, the infection may not produce symptoms, but as it spreads, it may cause damage to internal organs, lesions on the skin and bones,and many other problems. One treatment for blastomycosis is the anti-fungal medication Terbinafine.

Infection

• Many people inhale the fungi that cause blastomycosis with no ill effects. In most cases, the fungus turns into yeast cells in the lungs, producing few to no symptoms. In patients with compromised immune systems, however, the fungus may be more serious. It can reactivate several weeks to years after going dormant and spread through the body, causing disease in many different areas. Anti-fungal medications such as Terbinafine are recommended if the fungus leaves the lungs.

Risks

• Blastomycosis may occur in anyone who has visited a forested area where the fungi are present. People with compromised immune systems are the most likely to have serious symptoms, though. If this condition goes untreated, the prognosis is poor. Both adult and pediatric forms of the disease have a high mortality rate without anti-fungal treatments. Treatment with Terbinafine or other anti-fungal medications can produce rapid improvement. Treated patients may persist without infection for years afterward.

Terbinafine

• Terbinafine, also sold under the brand name Lamisil, is an anti-fungal antibiotic used to treat systemic fungal infections. Patients who have an autoimmune disorder or disease of the liver or kidney may need a dose adjustment or special testing. Terbinafine is still a relatively new treatment for blastomycosis, though it has been used to treat other infections, such as toenail fungus, for years. Doctors have not yet established the ideal dose of terbinafine for blastomycosis, though a dose of 250 mg twice a day has been effective in the past.

Effectiveness

• According to the American Society for Microbiology, Terbinafine tested as effective against blastomycosis when compared to the current drug of choice, Itraconazole. Lab tests showed that Terbinafine had potent anti-fungal activity against a number of fungal organisms, including P. brasiliensis, which causes one type of blastomycosis. These tests were performed in vitro, and human trials must be performed before the drug can officially be approved for use against blastomycosis.

Considerations

• Terbinafine has not been thoroughly tested for use against blastomycosis. It has been shown to be effective in a patient who did not respond to conventional treatment for the disease, but more testing is required before its safety and effectiveness can be confirmed. Because of this, doctors should attempt treatment using more conventional drugs before turning to Terbinafine.