Scedosporium apiospermum soft tissue infection successfully treated with voriconazole: potential pitfalls in the transition from intravenous to oral therapy.
An immunocompromised patient with an invasive soft tissue infection due to Scedosporium apiospermum was successfully treated with voriconazole and surgical debridement. After transition from intravenous to oral therapy, successive adjustments of the oral dose were required to achieve complete resolution. For soft tissue infections due to molds characterized by thin, septate hyphae branching at acute angles, voriconazole should be considered a first-line antifungal agent. The potential usefulness of plasma voriconazole levels for guiding optimal therapy should be investigated.
Schaenman
Joanna M
JM
Department of Medicine, Stanford University School of Medicine, 300 Pasteur Dr., Rm. S-100, Stanford, CA 94305, USA. joannas@stanford.edu
DiGiulio
Daniel B
DB
Mirels
Laurence F
LF
McClenny
Nancy M
NM
Berry
Gerald J
GJ
Fothergill
Annette W
AW
Rinaldi
Michael G
MG
Montoya
Jose G
JG
D000284:Administration, Oral; D000935:Antifungal Agents / Q000008:administration & dosage* / Q000627:therapeutic use; D001132:Arm / Q000473:pathology; D005260:Female; D006225:Hand / Q000473:pathology; D006801:Humans; D007275:Injections, Intravenous; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D008271:Mycetoma / Q000188:drug therapy* / Q000382:microbiology / Q000473:pathology / Q000601:surgery; D011743:Pyrimidines / Q000008:administration & dosage* / Q000627:therapeutic use; D021681:Scedosporium / Q000187:drug effects*; D018461:Soft Tissue Infections / Q000188:drug therapy* / Q000473:pathology / Q000601:surgery; D016896:Treatment Outcome; D014230:Triazoles / Q000008:administration & dosage* / Q000627:therapeutic use; D065819:Voriconazole
D000935:Antifungal Agents; D011743:Pyrimidines; D014230:Triazoles; D065819:Voriconazole