Pneumocystis jiroveci pneumonia in a patient with Wegener's granulomatosis treated efficiently with caspofungin.
A patient with Wegener's granulomatosis was on steroids (20 mg prednisolone per day) when he fell ill with an atypical pneumonia caused by Pneumocystis, which was diagnosed by detection of antigen in repeated bronchial lavage specimens. Because other treatment options were contraindicated, he received intravenous caspofungin starting with a loading dose of 70 mg and a maintenance dose of 50 mg daily over 3 weeks thereafter. The patient's complaints subsequently resolved within days after initiation of treatment. Tolerability of the drug was excellent. No relapse occurred during the ongoing 4 years, although immunosuppressive therapy continued.
Hof
Herbert
H
Institute for Microbiology and Hygiene, University Hospital Mannheim, Medical Faculty Mannheim of the University of Heidelberg, Germany. herbert.hof@imh.ma.uni-heidlelberg.de
Schnülle
Peter
P
D000935:Antifungal Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D018931:Antineoplastic Agents, Hormonal / Q000627:therapeutic use; D000077336:Caspofungin; D004334:Drug Administration Schedule; D054714:Echinocandins / Q000008:administration & dosage / Q000627:therapeutic use*; D014890:Granulomatosis with Polyangiitis / Q000150:complications* / Q000188:drug therapy; D006801:Humans; D007275:Injections, Intravenous; D055666:Lipopeptides; D008297:Male; D008875:Middle Aged; D016720:Pneumocystis Infections / Q000188:drug therapy* / Q000209:etiology*; D045363:Pneumocystis carinii / Q000302:isolation & purification; D011020:Pneumonia, Pneumocystis / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy*; D011239:Prednisolone / Q000627:therapeutic use; D016896:Treatment Outcome
D000935:Antifungal Agents; D018931:Antineoplastic Agents, Hormonal; D054714:Echinocandins; D055666:Lipopeptides; D011239:Prednisolone; D000077336:Caspofungin