title: Successful treatment of chronic disseminated candidiasis with high-dose fluconazole in a child with acute myelo-monocytic leukemia.
abstract: A 6-year-old boy with acute myelo-monocytic leukemia [French-American-British classification, M4 (Bennett et al., Br J Haematol 1976; 33: 451-458)] developed chronic disseminated candidiasis (CDC) in a phase of remission induction chemotherapy. The diagnosis was made based on the histological examination of the biopsy specimen of the liver that showed invasion of Candida. High-dose fluconazole (FCZ) therapy (up to 23.5 mg/kg/day) was given effectively and without significant side effect over a period of 15 months. Pharmacokinetic analysis revealed that FCZ showed one or two compartment model. Administration of 12 mg/kg/day of the drug showed that t (1 2 ) were 11.5 and 16.1 h, respectively. We would suggest that if lesser doses are ineffective in eradicating invasive fungal infection, dose escalation of FCZ was possible up to a single administration of 20 mg/kg daily in children.
authors.affiliation: Department of Pediatrics, Mie University School of Medicine, 2-174, Edobashi, Tsu-city, Mie, 514, Japan.
authors.forename: M
authors.initials: M
authors.lastname: Higashigawa
authors.forename: E
authors.initials: E
authors.lastname: Azuma
authors.forename: Y
authors.initials: Y
authors.lastname: Shimono
authors.forename: K
authors.initials: K
authors.lastname: Taniguchi
authors.forename: M
authors.initials: M
authors.lastname: Sakurai