title: Successful control of disseminated Scedosporium prolificans infection with a combination of voriconazole and terbinafine.
abstract: Disseminated Scedosporium prolificans infections are almost uniformly fatal because of their resistance to antifungal agents. Recently, synergy between triazoles and terbinafine has been demonstrated against Scedosporium prolificans in vitro. Reported here is a patient who developed disseminated Scedosporium prolificans infection following bone marrow transplantation and who was successfully treated with a combination of voriconazole and terbinafine in addition to aggressive surgical debridement. Antifungal synergy testing and combination therapy should be considered in cases of disseminated infection with Scedosporium prolificans.
authors.affiliation: Department of Infectious Diseases, The Alfred Hospital, Commercial Road, Prahran, Melbourne, Victoria 3181, Australia. Benjamin.Howden@armc.org.au
authors.forename: B P
authors.initials: BP
authors.lastname: Howden
authors.forename: M A
authors.initials: MA
authors.lastname: Slavin
authors.forename: A P
authors.initials: AP
authors.lastname: Schwarer
authors.forename: A M
authors.initials: AM
authors.lastname: Mijch
mesh_terms: D000935:Antifungal Agents / Q000627:therapeutic use; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D016026:Bone Marrow Transplantation / Q000276:immunology; D004357:Drug Synergism; D004359:Drug Therapy, Combination; D005260:Female; D005500:Follow-Up Studies; D016469:Fungemia / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy*; D006801:Humans; D016867:Immunocompromised Host / Q000276:immunology; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D009101:Multiple Myeloma / Q000276:immunology / Q000628:therapy; D008271:Mycetoma / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy*; D009281:Naphthalenes / Q000008:administration & dosage*; D009894:Opportunistic Infections / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy*; D011743:Pyrimidines / Q000008:administration & dosage*; D018570:Risk Assessment; D021681:Scedosporium / Q000187:drug effects* / Q000302:isolation & purification; D000077291:Terbinafine; D016896:Treatment Outcome; D014230:Triazoles / Q000008:administration & dosage*; D065819:Voriconazole
chemical_list: D000935:Antifungal Agents; D009281:Naphthalenes; D011743:Pyrimidines; D014230:Triazoles; D000077291:Terbinafine; D065819:Voriconazole