Use of voriconazole to successfully treat disseminated Trichosporon asahii infection in a patient with acute myeloid leukaemia

Trichosporon spp. is an emerging fungal pathogen in immunocompromised hosts, and disseminated infection is often fatal in neutropenic patients. Reported here is a case of disseminated infection in a neutropenic patient with acute leukaemia. After failure of amphotericin B and fluconazole therapy, th...

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Bibliographic Details
Published in:European journal of clinical microbiology & infectious diseases 2002-12, Vol.21 (12), p.892-896
Main Authors: FOURNIER, S, PAVAGEAU, W, FEUILLHADE, M, DEPLUS, S, ZAGDANSKI, A.-M, VEROLA, O, DOMBRET, H, MOLINA, J. M
Format: Article
Language:English
Subjects:
Abscesses
Antibiotics. Antiinfectious agents. Antiparasitic agents
Antifungal agents
Antifungal Agents - administration & dosage
Antifungal Agents - adverse effects
Antifungal Agents - therapeutic use
Biological and medical sciences
Biopsy
Blood
Fever
Hematologic and hematopoietic diseases
Hospitals
Humans
Infections
Leukemia
Leukemia, Myeloid - complications
Leukemias. Malignant lymphomas. Malignant reticulosis. Myelofibrosis
Male
Medical sciences
Middle Aged
Mycoses - complications
Mycoses - drug therapy
Mycoses - microbiology
Mycoses - pathology
Neutropenia
Neutropenia - complications
Neutrophils
Pathogens
Patients
Pharmacology. Drug treatments
Pyrimidines - administration & dosage
Pyrimidines - adverse effects
Pyrimidines - therapeutic use
Risk Factors
Triazoles - administration & dosage
Triazoles - adverse effects
Triazoles - therapeutic use
Trichosporon
Trichosporon - drug effects
Trichosporon - physiology
Trichosporon asahii
Voriconazole
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Description
Summary:Trichosporon spp. is an emerging fungal pathogen in immunocompromised hosts, and disseminated infection is often fatal in neutropenic patients. Reported here is a case of disseminated infection in a neutropenic patient with acute leukaemia. After failure of amphotericin B and fluconazole therapy, the course of infection dramatically improved with voriconazole treatment. A literature search revealed 69 additional cases of disseminated Trichosporon spp. infections in neutropenic patients, and these are also reviewed. Clinical symptoms that suggest infection include fever, disseminated papulopustular cutaneous lesions and pulmonary involvement. Despite treatment with antifungal agents (amphotericin B, fluconazole), 78% of patients died. Voriconazole may represent a promising therapy for this life-threatening infection.
ISSN:0934-9723
1435-4373
DOI:10.1007/s10096-002-0841-y