title: Disseminated invasive aspergillosis with cerebral involvement successfully treated with caspofungin and voriconazole.
abstract: We describe a case of cerebral aspergillosis which was successfully treated with a combination of caspofungin and voriconazole. The patient remains in remission 18 months after stopping antifungal treatment. We discuss primary and salvage therapy of invasive aspergillosis with focus on cerebral involvement. Since historical data showed a fatal outcome in most cases, amphotericin B does not cross the blood brain barrier while voriconazole does, we chose a combination of voriconazole plus caspofungin as primary therapy.
authors.affiliation: Dept. of Gastroenterology and Hepatology, University Hospital of Zurich, Zurich, Switzerland. christoph.gubler@spitaluster.ch
authors.forename: C
authors.initials: C
authors.lastname: Gubler
authors.forename: S M
authors.initials: SM
authors.lastname: Wildi
authors.forename: A
authors.initials: A
authors.lastname: Imhof
authors.forename: M
authors.initials: M
authors.lastname: Schneemann
authors.forename: B
authors.initials: B
authors.lastname: Müllhaupt
mesh_terms: D000328:Adult; D000935:Antifungal Agents / Q000627:therapeutic use*; D000077336:Caspofungin; D004359:Drug Therapy, Combination; D054714:Echinocandins / Q000627:therapeutic use*; D004660:Encephalitis / Q000188:drug therapy* / Q000382:microbiology*; D006801:Humans; D055666:Lipopeptides; D008297:Male; D020953:Neuroaspergillosis / Q000150:complications* / Q000188:drug therapy*; D011743:Pyrimidines / Q000627:therapeutic use*; D014230:Triazoles / Q000627:therapeutic use*; D065819:Voriconazole
chemical_list: D000935:Antifungal Agents; D054714:Echinocandins; D055666:Lipopeptides; D011743:Pyrimidines; D014230:Triazoles; D000077336:Caspofungin; D065819:Voriconazole