Fusarium infection is known to cause major morbidity and mortality in immunocompromised hosts. We report the successful treatment of disseminated Fusarium infection with skin manifestations in a severely neutropenic, immunocompromised host with voriconazole, a new second-generation triazole. Voriconazole might be an alternative therapy for patients with neutropenia who have fusariosis that is refractory or unresponsive to amphotericin B or its liposomal formulation.

Bactericidal activities of HMR 3647 (HMR), moxifloxacin (MXFX), and rifapentine (RPT) againstMycobacterium leprae, measured by the proportional bactericidal technique in the mouse footpad system, were compared with those of the established antileprosy drugs clarithromycin (CLARI), ofloxacin (OFLO), and rifampin (RMP). Administered in five daily doses of 100 mg/kg of body weight, HMR appeared slightly more bactericidal than CLARI. In a single dose, MXFX at 150 mg/kg was more active than the same dose of OFLO and displayed exactly the same level of activity as RMP at 10 mg/kg; the combination MXFX-minocycline (MINO) (MM) was more bactericidal than the combination OFLO-MINO (OM); RPT at 10 mg/kg was more bactericidal than the same dose of RMP and even more active than the combination RMP-OFLO-MINO (ROM); the combination RPT-MXFX-MINO (PMM) killed 99.9% of viable M. leprae and was slightly more bactericidal than RPT alone, indicating that the combination PMM showed an additive effect against M. leprae. Currently, leprosy is treated with multidrug therapy (MDT).Patients with paucibacillary (PB) leprosy are treated for 6 months with two drugs-dapsone (DDS) daily plus rifampin (RMP) monthly, and those with multibacillary (MB) leprosy are treated for 12 or 24 months with a combination of three drugs-DDS and clofazimine (CLO) daily plus RMP and a larger supplemental dose of CLO monthly (18,19). The monthly drug administration is under supervision, whereas the daily drugs are self-administered. Since 1982, more than 10 million leprosy patients in the world have been cured by the treatment (20).Despite the great success of the first MDT regimens, newer regimens are required that are more efficient or operationally less demanding (11). One of the concerns with regard to the current regimens is that it is difficult to persuade patients to comply with the self-administered daily component (3), which is intended to ensure elimination of the spontaneously occurring RMP-resistant mutants before stopping chemotherapy, suggesting that resistance to RMP may still develop among MB patients if the daily DDS-CLO component is not taken regularly. The risk of resistance might be significantly reduced if a fully supervisable, monthly administered MDT regimen were developed, so that all of the components may be administered once monthly under supervision. The recent demonstration of the promising bactericidal activities against Mycobacterium leprae of ofloxacin (OFLO) (6) and minocycline (MINO) (4, 9) led to the development of the monthly administered combined regimen of RMP-OFLO-MINO (ROM) (13). A single dose of ROM exhibited impressive bactericidal activity against M. leprae both in the mouse footpad system and in clinical trial (13); it was only marginally less effective, in terms of clinical improvement, for treatment of single-lesion PB leprosy than the standard 6-month MDT (17,19), and it was well tolerated by the patients (13, 17). The enormous operational advantages of single-dose treatment, especially in a country such as India, ...