Chronic Mucocutaneous Candidiasis: Immunologic and Antibiotic Therapy

Abstract

Ten patients with chronic mucocutaneous candidiasis were studied immunologically and treated with either intravenous amphotericin B, transfer factor, or both of the agents. Five patients (late-onset cases) developed candidiasis after they were 5 years old, had less severe immunologic deficits, and responded to treatment with amphotericin B. Four of these patients have had remissions of 12 to 38 months, and in two patients negative, delayed candida skin tests became positive, suggesting recovery of immunologic function. The other five patients (early-onset cases) developed candidiasis during infancy or early childhood and had severe impairments of cellular immunity, often with complete anergy. Transfer factor from donors with positive skin tests caused conversion of delayed responses in these patients but did not produce beneficial or detrimental clinical effects. Two early-onset, anergic patients then received amphotericin and chronic transfer factor therapy; both have been free of cutaneous candidiasis for more than 2 years.