Journal Article

Successful Medical Therapy for Deeply Invasive Facial Infection Due to <i>Pythium insidiosum</i> in a Child

Jerry L. Shenep, B. Keith English, Leo Kaufman, Ted A. Pearson, Jerome W. Thompson, Robert A. Kaufman, Glenn Frisch and Michael G. Rinaldi

in Clinical Infectious Diseases

Published on behalf of Infectious Diseases Society of America

Volume 27, issue 6, pages 1388-1393
Published in print December 1998 | ISSN: 1058-4838
Published online December 1998 | e-ISSN: 1537-6591 | DOI: http://dx.doi.org/10.1086/515042
Successful Medical Therapy for Deeply Invasive Facial Infection Due to Pythium insidiosum in a Child

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Pythiosis occurs in animals and humans who encounter aquatic habitats that harbor Pythium insidiosum. Drug therapy for deeply invasive infections with this organism has been ineffective in humans and animals; patients have been cured only by radical surgical debridement. A 2-year-old boy developed periorbital cellulitis unresponsive to antibiotic and antifungal therapy. The cellulitis extended to the nasopharynx, compromising the airway and necessitating a gastrostomy for feeding. P. insidiosum was isolated from surgical biopsy specimens of the affected tissue. On the basis of in vitro susceptibility studies of the isolate, the patient was treated with a combination of terbinafine and itraconazole. The infection resolved over a period of a few months. The patient remained well 1.5 years after completing a 1-year course of therapy. Cure of deep P. insidiosum infection is feasible with drug therapy.

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Subjects: Infectious Diseases ; Immunology ; Public Health and Epidemiology ; Microbiology

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