Quinupristin/dalfopristin and voriconazole controlled Staphylococcus epidermidis pneumonia and chronic necrotizing aspergillosis in a patient with severe lung degradation consequent to multiple treatments for Hodgkin's lymphoma.
We report here a 34-year-old woman with complicated severe opportunistic pulmonary infection, who was treated with the newly developed antibiotics quinupristin/dalfopristin (QPR/DPR) and voriconazole. She had received repeated chemotherapy, irradiation of the left lung, autologous and allogeneic bone marrow transplantation (BMT), and segmentectomy of the base of the left lung as treatments for Hodgkin's lymphoma. Although she had been in complete remission (CR), the structure of the left lung was severely degraded. Four years after achieving CR, she developed complicated life-threatening pulmonary infections with methicillin-resistant Staphylococcus epidermidis and Aspergillus niger during outpatient care. Chemotherapies with QPR/DPR for S. epidermidis pneumonia and voriconazole for chronic necrotizing pulmonary aspergillosis (CNPA) improved her symptoms rapidly without any major complications. QPR/DPR and voriconazole are considered effective for patients with life-threatening opportunistic pulmonary infections who have previously been treated with intensive regimens including radiotherapies to the lung.
Muto
Hideharu
H
Department of Clinical and Experimental Hematology, Doctoral Program in Advanced Biomedical Applications, Graduate School of Comprehensive Human Sciences, University of Tsukuba, 1-1-1, Tennodai, Tsukuba, Ibaraki 305-8575, Japan.
Kaneko
Shin
S
Machino
Takayuki
T
Okoshi
Yasushi
Y
Mukai
Harumi Y
HY
Suzukawa
Kazumi
K
Hasegawa
Yuichi
Y
Imagawa
Shigehiko
S
Kojima
Hiroshi
H
Ishii
Yukio
Y
Hitomi
Shigemi
S
Nagasawa
Toshiro
T
D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D000935:Antifungal Agents / Q000627:therapeutic use*; D001228:Aspergillosis / Q000150:complications / Q000188:drug therapy* / Q000473:pathology; D001234:Aspergillus niger / Q000187:drug effects* / Q000472:pathogenicity; D002908:Chronic Disease; D004359:Drug Therapy, Combination; D005260:Female; D006689:Hodgkin Disease / Q000628:therapy; D006801:Humans; D008172:Lung Diseases, Fungal / Q000150:complications / Q000000981:diagnostic imaging / Q000188:drug therapy*; D015182:Lymphatic Irradiation / Q000009:adverse effects; D009336:Necrosis; D018410:Pneumonia, Bacterial / Q000150:complications / Q000188:drug therapy* / Q000382:microbiology; D011743:Pyrimidines / Q000627:therapeutic use; D011832:Radiation Injuries / Q000150:complications; D011859:Radiography; D013203:Staphylococcal Infections / Q000188:drug therapy / Q000209:etiology; D013212:Staphylococcus epidermidis / Q000187:drug effects* / Q000472:pathogenicity; D014230:Triazoles / Q000627:therapeutic use; D014769:Virginiamycin / Q000031:analogs & derivatives / Q000627:therapeutic use; D065819:Voriconazole
D000900:Anti-Bacterial Agents; D000935:Antifungal Agents; D011743:Pyrimidines; D014230:Triazoles; D014769:Virginiamycin; C113825:quinupristin; D065819:Voriconazole; C113826:dalfopristin