title: Scedosporium apiospermum soft tissue infection successfully treated with voriconazole: potential pitfalls in the transition from intravenous to oral therapy.
abstract: 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.
authors.affiliation: Department of Medicine, Stanford University School of Medicine, 300 Pasteur Dr., Rm. S-100, Stanford, CA 94305, USA. joannas@stanford.edu
authors.forename: Joanna M
authors.initials: JM
authors.lastname: Schaenman
authors.forename: Daniel B
authors.initials: DB
authors.lastname: DiGiulio
authors.forename: Laurence F
authors.initials: LF
authors.lastname: Mirels
authors.forename: Nancy M
authors.initials: NM
authors.lastname: McClenny
authors.forename: Gerald J
authors.initials: GJ
authors.lastname: Berry
authors.forename: Annette W
authors.initials: AW
authors.lastname: Fothergill
authors.forename: Michael G
authors.initials: MG
authors.lastname: Rinaldi
authors.forename: Jose G
authors.initials: JG
authors.lastname: Montoya
mesh_terms: 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
chemical_list: D000935:Antifungal Agents; D011743:Pyrimidines; D014230:Triazoles; D065819:Voriconazole