title: Voriconazole brain tissue levels in rhinocerebral aspergillosis in a successfully treated young woman.
abstract: Invasive aspergillosis of the central nervous system has a mortality rate exceeding 90%. We describe a 29-year-old woman with a medical history of chronic polyarthritis who developed a proven rhinocerebral Aspergillus fumigatus infection refractory to first-line treatment with liposomal amphotericin B. The patient responded successfully to salvage combination treatment with voriconazole and caspofungin. Furthermore, for the first time, voriconazole levels in an intracerebral abscess were measured in this patient undergoing voriconazole oral therapy.
authors.affiliation: 1st Department of Internal Medicine, University of Cologne, 50924 Cologne, Germany.
authors.forename: Thomas
authors.initials: T
authors.lastname: Elter
authors.forename: Michal
authors.initials: M
authors.lastname: Sieniawski
authors.forename: Axel
authors.initials: A
authors.lastname: Gossmann
authors.forename: Claudia
authors.initials: C
authors.lastname: Wickenhauser
authors.forename: Ursula
authors.initials: U
authors.lastname: Schröder
authors.forename: Harald
authors.initials: H
authors.lastname: Seifert
authors.forename: Johannes
authors.initials: J
authors.lastname: Kuchta
authors.forename: Jürgen
authors.initials: J
authors.lastname: Burhenne
authors.forename: Klaus-Dieter
authors.initials: KD
authors.lastname: Riedel
authors.forename: Gerd
authors.initials: G
authors.lastname: Fätkenheuer
authors.forename: Oliver A
authors.initials: OA
authors.lastname: Cornely
mesh_terms: D000328:Adult; D000666:Amphotericin B / Q000627:therapeutic use; D000935:Antifungal Agents / Q000493:pharmacokinetics / Q000627:therapeutic use*; D001168:Arthritis / Q000150:complications; D001232:Aspergillus fumigatus / Q000302:isolation & purification; D001921:Brain / Q000378:metabolism* / Q000382:microbiology; D001922:Brain Abscess / Q000188:drug therapy* / Q000378:metabolism / Q000382:microbiology; D000077336:Caspofungin; D002853:Chromatography, Liquid; D054714:Echinocandins; D005260:Female; D006801:Humans; D055666:Lipopeptides; D008279:Magnetic Resonance Imaging; D013058:Mass Spectrometry; D020953:Neuroaspergillosis / Q000188:drug therapy* / Q000378:metabolism / Q000382:microbiology; D010254:Paranasal Sinus Diseases / Q000188:drug therapy* / Q000378:metabolism / Q000382:microbiology; D010456:Peptides, Cyclic / Q000627:therapeutic use; D011743:Pyrimidines / Q000493:pharmacokinetics / Q000627:therapeutic use*; D013211:Staphylococcus aureus / Q000302:isolation & purification; D014230:Triazoles / Q000493:pharmacokinetics / Q000627:therapeutic use*; D065819:Voriconazole
chemical_list: D000935:Antifungal Agents; D054714:Echinocandins; D055666:Lipopeptides; D010456:Peptides, Cyclic; D011743:Pyrimidines; D014230:Triazoles; C068538:liposomal amphotericin B; D000666:Amphotericin B; D000077336:Caspofungin; D065819:Voriconazole