Invasive pulmonary aspergillosis after liver transplantation: rapid and complete response to combined and sequential antifungal therapy.
BACKGROUND
Invasive pulmonary aspergillosis is a rare, but severe and potentially fatal, complication after liver transplantation. There is no therapeutic regimen accepted worldwide for both initial and continuation therapy; nevertheless, several options have been proposed.


METHODS
Case report and review of the pertinent English-language literature.


RESULTS
In a patient with pulmonary aspergillosis after a liver transplant, combined and sequential therapy with caspofungin and voriconazole with termination of the immunosuppressive regimen and careful management were helpful to control the infection rapidly, possibly because of a positive drug interaction.


CONCLUSIONS
In cases of invasive aspergillosis that are refractory to monotherapy, this regimen may be used in an attempt to overcome the infection.
Can
Mehmet Fatih
MF
Department of Surgery, Gulhane School of Medicine, Ankara, Turkey. mfcan@gata.edu.tr
Yagci
Gokhan
G
Gorenek
Levent
L
Tozkoparan
Ergun
E
Ozerhan
Ismail
I
Cetiner
Sadettin
S
D000935:Antifungal Agents / Q000627:therapeutic use*; D001228:Aspergillosis / Q000188:drug therapy*; D000077336:Caspofungin; D004359:Drug Therapy, Combination; D054714:Echinocandins / Q000627:therapeutic use; D006801:Humans; D007165:Immunosuppression Therapy; D055666:Lipopeptides; D016031:Liver Transplantation; D008172:Lung Diseases, Fungal / Q000188:drug therapy* / Q000382:microbiology*; D008297:Male; D008875:Middle Aged; D011743:Pyrimidines / Q000627:therapeutic use; D013902:Radiography, Thoracic; D014055:Tomography, Emission-Computed; D014230:Triazoles / Q000627:therapeutic use; D065819:Voriconazole
D000935:Antifungal Agents; D054714:Echinocandins; D055666:Lipopeptides; D011743:Pyrimidines; D014230:Triazoles; D000077336:Caspofungin; D065819:Voriconazole