Pythiosis can range from a minor to life-threatening infection. Proper management can improve the patient's outcome.
Early diagnosis and aggressive treatment is important in minimizing complications. Delays in diagnosis, failed drug therapy and inadequate surgery can contribute to persistent infection.
Pythium insidiosum does not respond to most antifungal agents because it does not contain ergosterol in its cell wall.
Management Options
Comments
surgery
identifying the advancing edge of the infection can be difficult, making recurrence an issue
saturated solution of potassium iodide (SSKI)
works for some infections but may not work in the more serious infections
immunotherapy
see previous section; takes some time to develop so better for an indolent infection
minocycline or tigecycline therapy
in vitro susceptibility; limited in vivo experience
where:
• Tigecycline is a glycylcycline and is a derivative of minocycline.
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