Pleural effusions in the yellow nail syndrome are thought to be secondary to dysfunction of pleural lymphatics. Once present, they tend to persist and may recur rapidly after therapeutic thoracentesis, making this an impractical option in many symptomatic patients. Chemical pleurodesis using quinacrine (Atabrine) and tetracycline has been successful in two patients. Nine patients have [...]

The triad of yellow nails, lymphedema and pleural effusion was first described by Emerson in 1966 and was labelled the yellow nail syndrome. Since then, more than 100 patients with the classic triad or variants thereof have been described. Pleural effusions in this syndrome range from small, unilateral and asymptomatic to large, bilateral and debilitating. [...]

Fluconazole is one of the new imidazoles undergoing clinical trials for the treatment of fungal infections. We used fluconazole at a dose of 50 or 100 mg/day for the treatment of patients with persistent or dissemi­nated coccidioidomycosis. Twelve of 14 patients had an initial favorable response, with definite improve­ment of clinical signs and symptoms of [...]

Subsequent Course Of the 12 who initially responded, only four re­mained free of coccidioidal disease. These patients have been followed for 10, 13, 15, and 18 months. One patient died of a myocardial infarction at the end of successful treatment of his fungal infection. Six of the 11 surviving responders had a relapse nine days [...]

Clinical response was favorable initially in 12 of 14 patients. The clinical scores of each patient at the beginning and end of treatment are listed in Table 1. The mean score before treatment for the 12 responders was 2.8 ±7; their mean score after treatment was 0.08 ±0.3. Resolution of visible lesions was relatively prompt. [...]

Patients were enrolled in this study at the University of California San Diego Medical Center and the VA Medical Center from July 1986 to March 1987. Participation in the study was offered to all known patients who had a diagnosis of coccidioidomycosis proven by culture or histology, and who had persistent pulmonary or disseminated infection. [...]

Treatment of chronic coccidioidomycosis can be difficult. There are only a few effective drugs. The best established drug, amphotericin B, must be administered parenterally and is highly toxic. Mico­nazole was the first imidazole to be tested against Coccidioides immitis. The use of miconazole is limited by the fact that it must be administered parenterally, the [...]