Open AccessSuccessful Rapid Desensitization to Micafungin in a Pediatric Patient
Author(s) -
Stephanie L. Ward,
Michelle C. Maciag,
Sarah Jones,
Joyce Lee,
John Lee,
Ana Dioun Broyles
Publication year - 2021
Publication title -
pediatric allergy, immunology, and pulmonology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.4
H-Index - 22
eISSN - 2151-3228
pISSN - 2151-321X
DOI - 10.1089/ped.2020.1204
Subject(s) - micafungin , echinocandin , medicine , desensitization (medicine) , antifungal , intensive care medicine , echinocandins , dermatology , caspofungin , amphotericin b , receptor , fluconazole
Introduction: Echinocandin antifungal medications including micafungin are being used more commonly in the treatment of invasive fungal infections in both pediatric and adult patients. Micafungin is also a first-line therapeutic option for candidemia and antifungal prophylaxis in a variety of clinical settings. Hypersensitivity reactions have not been well described; however, isolated cases have been reported. No cases of desensitization to echinocandins have been previously described. Case Presentation: In this report, we described a 14-year-old female with high-risk pre-B cell acute lymphoblastic leukemia diagnosed with pulmonary aspergillosis. She developed a hypersensitivity reaction to micafungin, which was deemed first-line therapy for the infection. A rapid intravenous desensitization protocol was successfully completed without reactions. The patient completed the remaining 2 months of therapy without reactions. Conclusion: This report outlines the first report of a successful desensitization to micafungin or any echinocandin. This is a safe method of completing antifungal therapy in a patient with echinocandin hypersensitivity and may be considered for other patients with micafungin hypersensitivities.