Table 3.

Clinical forms and treatment recommendations.

Clinical Form	Treatment Recommendation
Pulmonary
Acute—Mild to moderate
Immunocompetent host
<4 weeks	Usually unnecessary
>4 weeks	Itraconazole for 6–12 weeks
Immunocompromised host
Regardless of duration	Itraconazole for 12 months
Acute—Moderately severe or severe
Immunocompetent host	Lipid Amphotericin B for 1–2 weeks followed by Itraconazole for 12 weeks
Immunocompromised host	Lipid Amphotericin B for 1–2 weeks followed by Itraconazole for at least 12
	months and negative or low antigen (<2 ng/mL)
	Methylprednisolone 0.5–1 mg/Kg during the first 1–2 weeks if the patient
	develops ARDS
Subacute	Itraconazole for 6–12 weeks
Nodular	None
Chronic cavitary	Itraconazole for at least 12 months
Mediastinal
Adenitis	As acute pulmonary
Granuloma
Asymptomatic	None
Symptomatic	Itraconazole for 6–12 weeks
Fibrosis	Symptomatic management (e.g., stents)
	Antifungal therapy not recommended
	Can consider Rituximab in certain cases
Progressive disseminated
Mild to moderate
Immunocompetent host	Itraconazole for 6–12 weeks
Immunocompromised host	Itraconazole for 12 months
Moderately severe or severe
Immunocompetent host	Lipid Amphotericin B for 1–2 weeks followed by Itraconazole for 12 weeks
Immunocompromised host	Lipid Amphotericin B for 1–2 weeks followed by Itraconazole for at least 12
	months and negative or low antigen (<2 ng/mL)
	Methylprednisolone 0.5–1 mg/Kg during the first 1–2 weeks if the patient
	develops ARDS