title: Deep sinus aspergillosis in a liver transplant recipient successfully treated with a combination of caspofungin and voriconazole.
abstract: We describe the rare case of a diabetic patient who was successfully treated for cytomegalovirus viremia and leishmaniasis following liver transplantation for hepatitis C virus-related cirrhosis, but also developed invasive sinus Aspergillus infection, while still on liposomal amphotericin B (AmBisome). The patient refused radical surgery including eye enucleation, and received a combination of intravenous caspofungin and voriconazole, along with repeated, conservative, local surgical debridement. At follow-up, 15 months after the onset of sinusitis, the patient remains culture-negative, fully active, and without evidence of local recurrence.
authors.affiliation: Academic Department of Medicine, Hippokration General Hospital, 114 Vas. Sofias Avenue, Athens, Greece.
authors.forename: S
authors.initials: S
authors.lastname: Tsiodras
authors.forename: R
authors.initials: R
authors.lastname: Zafiropoulou
authors.forename: J
authors.initials: J
authors.lastname: Giotakis
authors.forename: G
authors.initials: G
authors.lastname: Imbrios
authors.forename: A
authors.initials: A
authors.lastname: Antoniades
authors.forename: E K
authors.initials: EK
authors.lastname: Manesis
mesh_terms: D000328:Adult; D000935:Antifungal Agents / Q000627:therapeutic use*; D001228:Aspergillosis / Q000188:drug therapy* / Q000382:microbiology; D000077336:Caspofungin; D054714:Echinocandins; D005260:Female; D006801:Humans; D055666:Lipopeptides; D016031:Liver Transplantation / Q000009:adverse effects*; D010455:Peptides / Q000627:therapeutic use*; D010456:Peptides, Cyclic; D011743:Pyrimidines / Q000627:therapeutic use*; D012852:Sinusitis / Q000188:drug therapy* / Q000382:microbiology; D016896:Treatment Outcome; D014230:Triazoles / Q000627:therapeutic use*; D065819:Voriconazole
chemical_list: D000935:Antifungal Agents; D054714:Echinocandins; D055666:Lipopeptides; D010455:Peptides; D010456:Peptides, Cyclic; D011743:Pyrimidines; D014230:Triazoles; D000077336:Caspofungin; D065819:Voriconazole