Successful treatment of invasive Aspergillus sinusitis with caspofungin and voriconazole.
Chronic invasive Aspergillus sinusitis is a rare and potentially devastating infection. Management typically requires extensive surgical debridement followed by long-term antifungal therapy, primarily with intravenous amphotericin B. We describe the case of an elderly woman who had been diagnosed with extensive Aspergillus sinusitis that had invaded critical structures. The extensiveness of the infection and the patients frailty and unwillingness to undergo a disfiguring procedure precluded surgery, and her medical condition was too fragile to withstandamphotericin B therapy Therefore, we decided to treat her with a combination ofcaspofungin and voriconazole, two relatively nontoxic antifungal agents that have different mechanisms of action. After administration of this novel regimen, the infection resolved rapidly.
Chirch
Lisa
L
Division of Infectious Diseases, Stony Brook University Medical Center, Stony Brook, NY 11794-8153, USA. lchirch@notes.cc.sunysb.edu
Roche
Patricia
P
Fuhrer
Jack
J
D000369:Aged, 80 and over; D000935:Antifungal Agents / Q000627:therapeutic use*; D001228:Aspergillosis / Q000188:drug therapy* / Q000382:microbiology; D000077336:Caspofungin; D004359:Drug Therapy, Combination; D054714:Echinocandins / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D055666:Lipopeptides; D011743:Pyrimidines / Q000627:therapeutic use*; D012852:Sinusitis / Q000188:drug therapy / Q000382:microbiology*; D016896:Treatment Outcome; D014230:Triazoles / Q000627:therapeutic use*; D065819:Voriconazole
D000935:Antifungal Agents; D054714:Echinocandins; D055666:Lipopeptides; D011743:Pyrimidines; D014230:Triazoles; D000077336:Caspofungin; D065819:Voriconazole