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A Clinical-Pathologic Study

GINO IOVINE, MD; LEONARD B. BERMAN, MD; DEMETREOS N. HALIKIS, MD; FRED H. MOWREY, MD; E. H. CHAPPELLE, MD; H. W. GIERSON, MD

Arch Intern Med. 1963;112(6):853-862.

	Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings.

Introduction

The nephrotoxicity associated with amphotericin B has beeen the greatest deterrent to its effective use^1-6 in the treatment of systemic mycoses. The precise nature of this toxicity is obscure, and the available descriptions are conflicting.

The present report is a study of renal function and morphology during amphotericin B therapy for Coccidioides immitis infections.

Material and Methods

Six patients with clinical and serologic evidence of disseminated coccidioidomycosis were studied before, during, and after therapy. Two of the patients had no previous treatment. The other four had prior amphotericin B therapy. Clinical details, including cumulative dosages, appear in Tables 1 and 2.

Diagnosis of dissemination was based on isolation of C immitis from an extrapulmonary site or a maximum complement fixation titer of at least 1:32 (see Table 1). The diagnosis of coccidioidal meningitis was confirmed by the criteria employed by Einstein et al,⁷ ie, spinal fluid findings . . . [Full Text PDF of this Article]

Author Affiliations
LOS ANGELES

Head Physician, Chest Service, Los Angeles County General Hospital, Assistant Clinical Professor of Thoracic Diseases, Loma Linda University School of Medicine (Dr. Iovine); Director, Renal Laboratory, Loma Linda Service, Los Angeles County General Hospital, Associate Professor of Medicine, Loma Linda University School of Medicine (Dr. Berman); Instructor, Department of Pathology, University of Southern California School of Medicine (Dr. Halikis); Director of Graduate Training, Los Angeles County General Hospital, Associate Professor of Medicine, Loma Linda University School of Medicine (Dr. Mowrey); Fellow, Renal Diseases, Department of Internal Medicine, Loma Linda University School of Medicine (Dr. Chappelle); Associate Clinical Professor of Thoracic Diseases, Loma Linda University School of Medicine, Assistant Clinical Professor of Medicine, University of Southern California School of Medicine (Dr. Gierson).

Footnotes
Received for publication June 4, 1963; accepted Aug 1.

This study was conducted at the Los Angeles County General Hospital, supported in part by the Attending Staff Association of the Los Angeles County General Hospital, and by NIH grants AMO 6743-01 and HEO 7009-03.

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