title: [Combined effect of micafangin and itraconazole on severe aspergillosis of the bilateral pleural cavities in a patient with Wegener's granulomatosis].
abstract: Visceral fungal infections are difficult to manage in patients with collagen diseases and immunocompromised hosts. In particular aspergillosis can be a life-threatening complication in these patients. Here we report that combined use of two antifungal agents (micafangin and itraconazole) was effective against severe aspergillosis of the bilateral pleural cavities in a 48-year old male patient diagnosed with Wegener's granulomatosis. Immunosuppressive therapy with corticosteroids and cyclophosphamides improved his nasal and pulmonary symptoms, but inflammation of the bilateral pleural cavities caused bronchial fistulas. Aspergillus fumigatus then infected the bilateral pulmonary cavities through these fistulas. This patient was treated with combined therapy of ITCZ and MCFG was given to this patient because of the risk of renal dysfunction associated with AMPH-B. After 5 weeks of treatment his clinical findings had improved and the fungus was suppressed.
authors.affiliation: Kitasato University School of Medicine, Department of Internal Medicine, Sagamihara, Kanagawa, Japan.
authors.forename: Hirahito
authors.initials: H
authors.lastname: Endo
authors.forename: Hide
authors.initials: H
authors.lastname: Yoshida
authors.forename: Hirobumi
authors.initials: H
authors.lastname: Kondo
authors.forename: Hikaru
authors.initials: H
authors.lastname: Kume
authors.forename: Tomokiyo
authors.initials: T
authors.lastname: Nomura
mesh_terms: D000328:Adult; D000935:Antifungal Agents / Q000008:administration & dosage*; D001228:Aspergillosis / Q000188:drug therapy* / Q000209:etiology; D004334:Drug Administration Schedule; D004359:Drug Therapy, Combination; D054714:Echinocandins; D014890:Granulomatosis with Polyangiitis / Q000150:complications*; D006801:Humans; D017964:Itraconazole / Q000008:administration & dosage*; D055666:Lipopeptides; D008074:Lipoproteins / Q000008:administration & dosage*; D008172:Lung Diseases, Fungal / Q000188:drug therapy* / Q000209:etiology; D008297:Male; D000077551:Micafungin; D010456:Peptides, Cyclic / Q000008:administration & dosage*; D035422:Pleural Cavity / Q000382:microbiology
chemical_list: D000935:Antifungal Agents; D054714:Echinocandins; D055666:Lipopeptides; D008074:Lipoproteins; D010456:Peptides, Cyclic; D017964:Itraconazole; D000077551:Micafungin