In Vitro Activities of Eight Antifungal Drugs against 55 Clinical Isolates of Fonsecaea spp.

The in vitro activities of eight antifungal drugs against clinical isolates of Fonsecaea pedrosoi (n 21), Fonsecaea monophora (n 25), and Fonsecaea nubica (n 9) were tested. The resulting MIC90s for all strains (n 55) were as follows, in increasing order: posaconazole, 0.063 g/ml; itraconazole, 0.125 g/ml; isavucon-azole, 0.25 g/ml; voriconazole, 0.5 g/ml; amphotericin B, 2 g/ml; caspofungin, 2 g/ml; anidulafungin, 2 g/ml; and fluconazole, 32 g/ml. Fonsecaea spp., anamorph members of the order Chaetothy-riales (black yeasts and other melanized fungi), are principal agents of human chromoblastomycosis (16), a chronic cutane-ous and subcutaneous infection characterized by slowly ex-panding skin lesions, a granulomatous immune response, and the presence of meristematic melanized muriform fungal cells in tissue scrapings (4). The last characteristic is a crucial diag-nostic indicator that tends to be similar irrespective of the fungal pathogen. Chromoblastomycosis occurs worldwide in tropical and subtropical climates. Fonsecaea spp. are recover