Invasive pulmonary aspergillosis with hematological malignancy caused by Aspergillus terreus and in vitro susceptibility of A. terreus isolate to micafungin.
A 35-year-old man developed invasive pulmonary aspergillosis (IPA) with severe neutropenia after umbilical cord stem cell transplantation for chronic myelogenous leukemia. Filamentous fungus isolated from his sputum was identified as Aspergillus terreus. Despite systemic amphotericin B (AMPH) administration, IPA progressed. However, intravenous administration of micafungin (MCFG) and oral itraconazole improved clinical data and symptoms, although he later died of massive hemoptysis. Examination of the in vitro susceptibility of this A. terreus isolate to MCFG revealed a good minimum inhibitory concentration and good time-kill assay results compared to AMPH. Thus, MCFG might be useful for IPA caused by A. terreus.
Tokimatsu
Issei
I
Department of Infectious Diseases, Oita University Faculty of Medicine. issei@med.oita-u.ac.jp
Kushima
Hisako
H
Iwata
Atsuko
A
Hashinaga
Kazuhiko
K
Umeki
Kenji
K
Ohama
Minoru
M
Kohno
Kazuhiro
K
Ishii
Hiroshi
H
Kishi
Kenji
K
Ogata
Masao
M
Hiramatsu
Kazufumi
K
Saikawa
Tetsunori
T
Kadota
Jun-ichi
J
D000328:Adult; D000935:Antifungal Agents / Q000494:pharmacology* / Q000627:therapeutic use; D001228:Aspergillosis / Q000188:drug therapy / Q000209:etiology*; D001230:Aspergillus / Q000187:drug effects / Q000472:pathogenicity; D004359:Drug Therapy, Combination; D054714:Echinocandins; D006801:Humans; D017964:Itraconazole / Q000627:therapeutic use; D015464:Leukemia, Myelogenous, Chronic, BCR-ABL Positive / Q000150:complications / Q000628:therapy; D055666:Lipopeptides; D008074:Lipoproteins / Q000494:pharmacology* / Q000627:therapeutic use; D008172:Lung Diseases, Fungal / Q000188:drug therapy / Q000209:etiology*; D008297:Male; D000077551:Micafungin; D009503:Neutropenia / Q000150:complications; D009894:Opportunistic Infections / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology*; D010456:Peptides, Cyclic / Q000494:pharmacology* / Q000627:therapeutic use; D013183:Sputum / Q000382:microbiology; D033581:Stem Cell Transplantation / Q000009:adverse effects
D000935:Antifungal Agents; D054714:Echinocandins; D055666:Lipopeptides; D008074:Lipoproteins; D010456:Peptides, Cyclic; D017964:Itraconazole; D000077551:Micafungin