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Successful treatment of Scedosporium apiospermum soft tissue abscess with caspofungin and voriconazole in a severely immunocompromised patient with acute myeloid leukemia
Author(s) -
Beier F.,
Kittan N.,
Holzmann T.,
Schardt K.,
Andreesen R.,
Holler E.,
Hildebrandt G.C.
Publication year - 2010
Publication title -
transplant infectious disease
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.69
H-Index - 67
eISSN - 1399-3062
pISSN - 1398-2273
DOI - 10.1111/j.1399-3062.2010.00537.x
Subject(s) - voriconazole , caspofungin , scedosporium apiospermum , medicine , posaconazole , myeloid leukemia , amphotericin b , surgery , context (archaeology) , dermatology , antifungal , paleontology , biology
F. Beier, N. Kittan, T. Holzmann, K. Schardt, R. Andreesen, E. Holler, G.C. Hildebrandt. Successful treatment of Scedosporium apiospermum soft tissue abscess with caspofungin and voriconazole in a severely immunocompromised patient with acute myeloid leukaemia.
Transpl Infect Dis 2010: 12: 538–542. All rights reserved. Abstract: We report the case of a 53‐year‐old female patient with refractory acute myeloid leukemia developing a necrotic, soft tissue abscess on the right forearm caused by Scedosporium apiospermum during prolonged severe neutropenia (absolute white blood cell count <500/μL for 49 days). In the context of the severely immunocompromised state of the patient and her need for allogeneic hematopoietic stem cell transplantation (HSCT), surgical treatment options were not favored. Therefore, combined antifungal therapy with voriconazole and caspofungin was started, based on the results of the in vitro testing (minimum inhibitory concentrations of voriconazole, posaconazole, and amphotericin B: 1, 4, and >2 mg/L, respectively). The local site of infection slowly improved clinically and no spread of S. apiospermum infection to other sites was observed. After HSCT, the soft tissue abscess resolved completely and the patient has remained free of S. apiospermum infection since then. We successfully demonstrate that the use of combined antifungal therapy with voriconazole and casopfungin may further improve the clinical course and provides a promising therapeutic option to treat Scedosporium infections in such patients.