title: Chronic invasive sinus and intracerebral aspergillosis controlled by combination therapy with micafungin and a daily dose of 400 mg itraconazole oral solution.
abstract: Chronic invasive aspergillosis of the sinus is frequently fatal in the absence of early surgical and chemotherapeutic intervention because of its invasion of vascular tissue. We attempted to control a case of inoperable invasive aspergillosis of the sinus with micafungin and itraconazole oral solution. We prescribed a daily oral dose of 400 mg of itraconazole, which is twice the usual dose, and monitored the serum concentration of the drug. Finally, we were able to control the spread of the lesion. This case indicates that combination therapy with micafungin and a daily dose of 400 mg itraconazole oral solution is an alternative treatment strategy for inoperable invasive aspergillosis of the sinus.
authors.affiliation: Center for Infectious Diseases, Nara Medical University, 840 Shijo-cho, Kashihara, Nara 634-8522, Japan. Electronic address: t_ogawa@naramed-u.ac.jp.
authors.forename: Taku
authors.initials: T
authors.lastname: Ogawa
authors.affiliation: Department of Clinical Pharmaceutics, Faculty of Pharmaceutical Sciences, Doshisha Women's College of Liberal Arts, Kodo, Kyotanabe, Kyoto, Japan.
authors.forename: Kana
authors.initials: K
authors.lastname: Matsumoto
authors.affiliation: Center for Infectious Diseases, Nara Medical University, 840 Shijo-cho, Kashihara, Nara 634-8522, Japan.
authors.forename: Kazunori
authors.initials: K
authors.lastname: Tsujimoto
authors.affiliation: Center for Infectious Diseases, Nara Medical University, 840 Shijo-cho, Kashihara, Nara 634-8522, Japan.
authors.forename: Naokuni
authors.initials: N
authors.lastname: Hishiya
authors.affiliation: Center for Infectious Diseases, Nara Medical University, 840 Shijo-cho, Kashihara, Nara 634-8522, Japan.
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Yamada
authors.affiliation: Center for Infectious Diseases, Nara Medical University, 840 Shijo-cho, Kashihara, Nara 634-8522, Japan.
authors.forename: Kenji
authors.initials: K
authors.lastname: Uno
authors.affiliation: Center for Infectious Diseases, Nara Medical University, 840 Shijo-cho, Kashihara, Nara 634-8522, Japan.
authors.forename: Kei
authors.initials: K
authors.lastname: Kasahara
authors.affiliation: Center for Infectious Diseases, Nara Medical University, 840 Shijo-cho, Kashihara, Nara 634-8522, Japan.
authors.forename: Koichi
authors.initials: K
authors.lastname: Maeda
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Nara Medical University, 840 Shijo-cho, Kashihara, Nara 634-8522, Japan.
authors.forename: Kazuhiko
authors.initials: K
authors.lastname: Nario
authors.affiliation: Center for Infectious Diseases, Nara Medical University, 840 Shijo-cho, Kashihara, Nara 634-8522, Japan.
authors.forename: Keiichi
authors.initials: K
authors.lastname: Mikasa
authors.affiliation: Department of Clinical Pharmaceutics, Faculty of Pharmaceutical Sciences, Doshisha Women's College of Liberal Arts, Kodo, Kyotanabe, Kyoto, Japan.
authors.forename: Kunihiko
authors.initials: K
authors.lastname: Morita
mesh_terms: D000368:Aged; D000935:Antifungal Agents / Q000008:administration & dosage*; D001228:Aspergillosis / Q000188:drug therapy* / Q000382:microbiology / Q000473:pathology; D020314:Central Nervous System Fungal Infections / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000382:microbiology / Q000473:pathology; D002908:Chronic Disease; D054714:Echinocandins / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D017964:Itraconazole / Q000008:administration & dosage*; D055666:Lipopeptides / Q000008:administration & dosage*; D000077551:Micafungin; D010254:Paranasal Sinus Diseases / Q000188:drug therapy* / Q000382:microbiology / Q000473:pathology; D011859:Radiography
chemical_list: D000935:Antifungal Agents; D054714:Echinocandins; D055666:Lipopeptides; D017964:Itraconazole; D000077551:Micafungin
keywords: Chronic invasive sinus aspergillus; Combination therapy; Itraconazole; Micafungin