A case of pulmonary aspergillosis with lack of response to caspofungin

Currently, susceptibility testing of Aspergillus isolates towards caspofungin is hampered by a lack of interpretative cut-off values. Nevertheless, caspofungin has been widely recommended for the treatment of invasive aspergillosis. This antifungal, however, could lead to therapy failure as demonstr...

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Bibliographic Details
Published in:Revista iberoamericana de micología 2006-06, Vol.23 (2), p.94
Main Authors: Rüchel, Reinhard, Perske, Christine, Glass, Bertram, Bäsecke, Jörg
Format: Article
Language:English
Subjects:
Acute Disease
Antifungal Agents - therapeutic use
Antineoplastic Combined Chemotherapy Protocols - adverse effects
Antineoplastic Combined Chemotherapy Protocols - therapeutic use
Aspergillosis - drug therapy
Aspergillosis - etiology
Bone Marrow Diseases - chemically induced
Bone Marrow Diseases - immunology
Candidiasis - complications
Candidiasis - drug therapy
Combined Modality Therapy
Contraindications
Echinocandins
Fatal Outcome
Female
Hematopoietic Stem Cell Transplantation
Hepatitis - complications
Hepatitis - microbiology
Humans
Immunocompromised Host
Immunosuppressive Agents - therapeutic use
Leukemia, Myeloid - complications
Leukemia, Myeloid - drug therapy
Leukemia, Myeloid - surgery
Lipopeptides
Lung Diseases, Fungal - drug therapy
Lung Diseases, Fungal - etiology
Middle Aged
Peptides, Cyclic - therapeutic use
Postoperative Complications - drug therapy
Postoperative Complications - etiology
Pyrimidines
Splenic Diseases - complications
Splenic Diseases - microbiology
Triazoles
Voriconazole
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Summary:Currently, susceptibility testing of Aspergillus isolates towards caspofungin is hampered by a lack of interpretative cut-off values. Nevertheless, caspofungin has been widely recommended for the treatment of invasive aspergillosis. This antifungal, however, could lead to therapy failure as demonstrated by the case in this report of a 55-year-old patient, who eight months after the diagnosis of leukemia and successful allogenic hematopoietic stem cell transplantation (HSCT), succumbed to a fatal pulmonary aspergillosis infection, which resisted treatment with caspofungin.
ISSN:1130-1406
DOI:10.1016/s1130-1406(06)70021-3