Systemic fungal infections, including endemic infections, may be difficult to diagnose

Fungal infections pose a significant threat for some patients1

Many patients may be exposed to the fungi without ever presenting symptoms2,3

Patients may present with sepsis or persistent fever (despite antibiotics), pulmonary infiltrates, nodular skin lesions, and other signs4

Histoplasma fungus

Histoplasma

Blastomyces fungus

Blastomyces

Aspergillus fungus

Aspergillus

Community-acquired infections are caused by fungi that live in specific areas5,6

Tap each infection below to see areas endemic for:

Histoplasmosis

Blastomycosis

Areas with high percentage of infection
  • Highly endemic
  • Moderately endemic
  • Mildly endemic
  • Suspected endemic
Areas with high percentage of infection
  • Mildly endemic

Aspergillosis is a systemic fungal infection that is common across the US

Aspergillus is very common both indoors and outdoors. While not contained to a certain geographic area, Aspergillus continues to be an important cause of life-threatening infections in immunocompromised patients

Immunocompromised patients may be at risk1,7:

  • Organ transplant
  • Hematopoietic stem cell transplant
  • HIV/AIDS
  • Hematologic malignancies
  • Surgery
  • ICU stay
  • Chemotherapy
  • High-dose corticosteroids
  • Prolonged antibiotic therapy
  • TPN = total parenteral nutrition (IV nutrition)
  • ESRD = end-stage renal disease (kidney failure)
  • Mechanical ventilation

IDSA recommends itraconazole for certain infections8,9

IDSA guidelines describe using antifungals, including itraconazole, for treating cases of histoplasmosis, blastomycosis, and aspergillosis

Histoplasmosis

Acute pulmonary histoplasmosis

Preferred treatment per IDSA Guidelines


Moderately severe or severe


  • Lipid AmB or deoxycholate AmB for 1–2 weeks, followed by itraconazole for a total of 12 weeks
  • Methylprednisone for 1–2 weeks

Mild to moderate


  • For symptoms <4 weeks, none
  • For symptoms >4 weeks, itraconazole for 6–12 weeks

Chronic cavitary pulmonary histoplasmosis

Preferred treatment per IDSA Guidelines


  • Itraconazole for at least 12 months

Pericarditis

Preferred treatment per IDSA Guidelines


Moderately severe to severe


  • Itraconazole for 6-12 weeks only if prednisone used

Mediastinal lymphadenitis

Preferred treatment per IDSA Guidelines


  • Symptoms warranting treatment with prednisone, and itraconazole for 6–12 weeks
  • Symptoms >4 weeks, itraconazole for 6–12 weeks

Mediastinal fibrosis

Preferred treatment per IDSA Guidelines


  • Itraconazole for 6–12 weeks

Progressive disseminated histoplasmosis

Preferred treatment per IDSA Guidelines


Moderately severe to severe


  • Liposomal AmB, AmB lipid complex or deoxycholate AmB for 1–2 weeks, followed by itraconazole for at least 12 months

Mild to moderate


  • Itraconazole for at least 12 months

CNS histoplasmosis

Preferred treatment per IDSA Guidelines


  • Liposomal AmB followed by itraconazole for at least 12 months

More information about prevalence and treatment can be found at the Centers for Disease Control and Prevention website.

Blastomycosis

Pulmonary

Preferred treatment per IDSA Guidelines


Moderately severe to severe


  • Lipid AmB or deoxycholate AmB for 1–2 weeks, followed by itraconazole for 12 months

Mild to moderate


  • Itraconazole for 6-12 months

Disseminated

Preferred treatment per IDSA Guidelines


Moderately severe to severe


  • Lipid AmB or deoxycholate AmB for 1–2 weeks, followed by itraconazole for 12 months

Mild to moderate


  • Itraconazole for at least 12 months

Immunosuppressed patients

Preferred treatment per IDSA Guidelines


  • Itraconazole for 6–12 weeks only if prednisone used

More information about prevalence and treatment can be found at the Centers for Disease Control and Prevention website.

Aspergillosis

Most cases of aspergillosis

Preferred treatment per IDSA Guidelines


  • Itraconazole suspension can be used as an alternative treatment

ABPA

Preferred treatment per IDSA Guidelines


  • Itraconazole

Aspergilloma

Preferred treatment per IDSA Guidelines


  • Itraconazole or voriconazole (as an alternative medication)

More information about prevalence and treatment can be found at the Centers for Disease Control and Prevention website.

FOR ENDEMIC SYSTEMIC FUNGAL INFECTIONS

TOLSURA 65 mg capsules offer the efficacy of itraconazole capsules with improved absorption and less variability in plasma levels13

Discover what makes TOLSURA different

SUBA™ technology

See the consistent delivery of TOLSURA

TOLSURA bioavailability