[Combination antifungal therapy in hematopoietic stem cell transplantation patients].
Invasive fungal infections are a major cause of morbidity and mortality in hematopoietic stem cell transplantation patients. In recent years, new resistant fungal strains have emerged, requiring physicians to use new generation antifungal drugs or drug combinations. We report a case of invasive Fusarium infection involving the nasopharynx, skin and lungs, following haploidentical hematopoietic stem cell transplantation in an 8-year old patient with recurrent leukemia. The patient was treated with combination antifungal treatment of amphotericin B and voriconazole, as well as supportive care, with the improvement of his symptoms and home discharge. We reviewed the history of combination antifungal therapy. Combination antifungal treatment has been used since 1979, especially in immunocompromised patients. Although randomized controlled trials are lacking, reports favoring combination, especially for invasive mold infections, are increasingly published.
The Edmond and Lily Safra Children's Hospital, Chaim Sheba Medical Center, Tel Hashomer. jacobyelad@gmail.com
Elad
E
Jacoby
Nati
N
Keller
Galia
G
Barkai
D000666:Amphotericin B / Q000008:administration & dosage / Q000627:therapeutic use; D000935:Antifungal Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D002648:Child; D003881:Dermatomycoses / Q000188:drug therapy / Q000209:etiology / Q000382:microbiology; D004359:Drug Therapy, Combination; D060585:Fusariosis / Q000188:drug therapy* / Q000209:etiology; D018380:Hematopoietic Stem Cell Transplantation / Q000379:methods*; D006801:Humans; D016867:Immunocompromised Host; D007938:Leukemia / Q000628:therapy; D008172:Lung Diseases, Fungal / Q000188:drug therapy / Q000209:etiology / Q000382:microbiology; D008297:Male; D009302:Nasopharyngeal Diseases / Q000188:drug therapy / Q000209:etiology / Q000382:microbiology; D011743:Pyrimidines / Q000008:administration & dosage / Q000627:therapeutic use; D016896:Treatment Outcome; D014230:Triazoles / Q000008:administration & dosage / Q000627:therapeutic use; D065819:Voriconazole
D000935:Antifungal Agents; D011743:Pyrimidines; D014230:Triazoles; D000666:Amphotericin B; D065819:Voriconazole