Successful treatment of invasive pulmonary aspergillosis in chronic granulomatous disease with orally administered itraconazole suspension.
A 3-yr-old boy with known chronic granulomatous disease presented with a left-sided chest wall mass. Extensive intrathoracic and extrathoracic aspergillosis was confirmed by CT scan-guided percutaneous biopsy. Initially, he was treated intravenously with liposomal amphotericin and subcutaneous gamma-interferon, but his clinical condition deteriorated over 7 wk of treatment. The amphotericin was therefore discontinued, and itraconazole in an oral suspension was begun. There was progressive clinical improvement after 3 months of this regime, and marked radiologic clearing was apparent after 8 months of treatment. A multicenter trial of this mode of therapy in patients with invasive aspergillosis is indicated.
Spencer
D A
DA
Birmingham Children's Hospital, United Kingdom.
John
P
P
Ferryman
S R
SR
Weller
P H
PH
Darbyshire
P
P
D000284:Administration, Oral; D000666:Amphotericin B / Q000494:pharmacology / Q000627:therapeutic use; D001229:Aspergillosis, Allergic Bronchopulmonary / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000209:etiology / Q000473:pathology; D001706:Biopsy; D002675:Child, Preschool; D004359:Drug Therapy, Combination; D006105:Granulomatous Disease, Chronic / Q000150:complications*; D006801:Humans; D007279:Injections, Subcutaneous; D007371:Interferon-gamma / Q000494:pharmacology / Q000627:therapeutic use; D017964:Itraconazole / Q000494:pharmacology / Q000627:therapeutic use*; D008297:Male; D013535:Suspensions; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
D013535:Suspensions; D017964:Itraconazole; D000666:Amphotericin B; D007371:Interferon-gamma