Patient selection: completion of an adequate course of antifungal therapy
Elements of apparent cure - all of the following:
(1) clinical cure
(2) mycologic cure
(3) radiologic cure
(4) serologic cure
Features of clinical cure:
(1) absence of signs and symptoms related to infection
(2) healing of all mucocutaneous lesions
(3) resolution of lymphadenopathy
(4) reversal of weight loss
Features of mycologic cure:
(1) negative studies after a complete evaluation
Features of serologic cure:
(1) negative serologic tests or a titer <= 1:2 for at least 2 years after stopping therapy (reversal of existing titers take 6-9 months)
Features of radiologic cure:
(1) gradual resolution of infectious nodules with shrinkage and scarring over time
(2) neither enlargement of existing lesions nor appearance of new lesions
It takes a year or two before a patient can be declared apparently cured. Ongoing monitoring is needed to determine if this is a correct assumption. This is because of the capacity of the fungus to lie dormant for long periods of time.
