title: A case of pulmonary aspergillosis with lack of response to caspofungin.
abstract: Currently, susceptibility testing of Aspergillus isolates towards caspofungin is hampered by a lack of interpretative cut-off values. Nevertheless, caspofungin has been widely recommended for the treatment of invasive aspergillosis. This antifungal, however, could lead to therapy failure as demonstrated by the case in this report of a 55-year-old patient, who eight months after the diagnosis of leukemia and successful allogenic hematopoietic stem cell transplantation (HSCT), succumbed to a fatal pulmonary aspergillosis infection, which resisted treatment with caspofungin.
authors.affiliation: Department of Medical Microbiology, University Hospital of Göttingen, Göttingen, Germany. rrueche@gwdg.de
authors.forename: Reinhard
authors.initials: R
authors.lastname: Rüchel
authors.forename: Christine
authors.initials: C
authors.lastname: Perske
authors.forename: Bertram
authors.initials: B
authors.lastname: Glass
authors.forename: Jörg
authors.initials: J
authors.lastname: Bäsecke
mesh_terms: D000208:Acute Disease; D000935:Antifungal Agents / Q000627:therapeutic use*; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use; D001228:Aspergillosis / Q000188:drug therapy* / Q000209:etiology; D001855:Bone Marrow Diseases / Q000139:chemically induced / Q000276:immunology; D002177:Candidiasis / Q000150:complications / Q000188:drug therapy; D000077336:Caspofungin; D003131:Combined Modality Therapy; D000075202:Contraindications; D054714:Echinocandins; D017809:Fatal Outcome; D005260:Female; D018380:Hematopoietic Stem Cell Transplantation; D006505:Hepatitis / Q000150:complications / Q000382:microbiology; D006801:Humans; D016867:Immunocompromised Host; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D007951:Leukemia, Myeloid / Q000150:complications / Q000188:drug therapy / Q000601:surgery; D055666:Lipopeptides; D008172:Lung Diseases, Fungal / Q000188:drug therapy* / Q000209:etiology; D008875:Middle Aged; D010456:Peptides, Cyclic / Q000627:therapeutic use*; D011183:Postoperative Complications / Q000188:drug therapy* / Q000209:etiology; D011743:Pyrimidines; D013158:Splenic Diseases / Q000150:complications / Q000382:microbiology; D014230:Triazoles; D065819:Voriconazole
chemical_list: D000935:Antifungal Agents; D054714:Echinocandins; D007166:Immunosuppressive Agents; D055666:Lipopeptides; D010456:Peptides, Cyclic; D011743:Pyrimidines; D014230:Triazoles; D000077336:Caspofungin; D065819:Voriconazole