title: Successful treatment of refractory chronic disseminated candidiasis after prolonged administration of caspofungin in a child with acute myeloid leukemia.
abstract: This report documents the clinical activity of caspofungin in a 13-year-old girl with acute myeloid leukemia (AML) and chronic disseminated candidiasis (CDC), refractory to amphotericin B and fluconazole. Caspofungin was started at 50 mg/d resulting in a temporary response. With no further clinical improvement and radiological progress after 2 months of therapy, the dose of caspofungin was increased to 100 mg/d, leading to a sustained clinical response. Therapy was given for a total of 12 months and had no attributable adverse effects. This approach resulted in successful treatment of refractory CDC with caspofungin.
authors.affiliation: Department of Pediatrics and Adolescent Medicine, Division of Pediatric Hematology and Oncology, University of Freiburg, Freiburg, Germany. kontny@kikli.ukl.uni-freiburg.de
authors.forename: Udo
authors.initials: U
authors.lastname: Kontny
authors.forename: Thomas J
authors.initials: TJ
authors.lastname: Walsh
authors.forename: Jochen
authors.initials: J
authors.lastname: Rossler
authors.forename: Markus
authors.initials: M
authors.lastname: Uhl
authors.forename: Charlotte M
authors.initials: CM
authors.lastname: Niemeyer
mesh_terms: D000293:Adolescent; D000935:Antifungal Agents / Q000627:therapeutic use*; D002177:Candidiasis / Q000188:drug therapy* / Q000473:pathology; D000077336:Caspofungin; D002908:Chronic Disease; D054714:Echinocandins; D005260:Female; D006801:Humans; D016867:Immunocompromised Host; D007951:Leukemia, Myeloid / Q000150:complications*; D055666:Lipopeptides; D008107:Liver Diseases / Q000188:drug therapy* / Q000382:microbiology / Q000473:pathology; D008279:Magnetic Resonance Imaging; D010456:Peptides, Cyclic / Q000627:therapeutic use*; D013158:Splenic Diseases / Q000188:drug therapy* / Q000382:microbiology / Q000473:pathology
chemical_list: D000935:Antifungal Agents; D054714:Echinocandins; D055666:Lipopeptides; D010456:Peptides, Cyclic; D000077336:Caspofungin