Successful treatment of brain aspergillosis with voriconazole.
Until recently, brain aspergillosis was almost always fatal, with a response rate to amphotericin B of < 10%. This study describes a retrospective analysis of eight consecutive cases of brain aspergillosis. All patients were immunosuppressed and five required mechanical ventilation. Antifungal treatment included amphotericin B (n = 7), itraconazole (n = 3), voriconazole (n = 2) and flucytosine (n = 1). Three (38%) patients survived following prolonged azole therapy after initial amphotericin B treatment, combined with a reduction in their immunosuppressive treatment. The prognosis of brain aspergillosis might be improved if immunosuppression could be reduced and prolonged oral azole therapy used.
Tattevin
P
P
Infectious Diseases and Intensive Care Unit, Pontchaillou Hospital, Rennes, France. pierre.tattevin@chu-rennes.fr
Bruneel
F
F
Lellouche
F
F
de Broucker
T
T
Chevret
S
S
Wolff
M
M
Régnier
B
B
D000328:Adult; D000368:Aged; D000666:Amphotericin B / Q000008:administration & dosage / Q000627:therapeutic use; D000935:Antifungal Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D001230:Aspergillus / Q000254:growth & development*; D001927:Brain Diseases / Q000188:drug therapy* / Q000382:microbiology; D003422:Critical Care; D005260:Female; D006801:Humans; D016867:Immunocompromised Host; D008297:Male; D008875:Middle Aged; D020953:Neuroaspergillosis / Q000188:drug therapy* / Q000382:microbiology; D011743:Pyrimidines / Q000008:administration & dosage / Q000627:therapeutic use*; D012189:Retrospective Studies; D014230:Triazoles / Q000008:administration & dosage / Q000627:therapeutic use*; D065819:Voriconazole
D000935:Antifungal Agents; D011743:Pyrimidines; D014230:Triazoles; D000666:Amphotericin B; D065819:Voriconazole