title: Chronic Invasive Aspergillus Sinusitis and Otitis with Meningeal Extension Successfully Treated with Voriconazole.
abstract: Invasive aspergillosis (IA) is a severe disseminated fungal disease that occurs mostly in immunocompromised patients. However, central nervous system IA, combining meningitis and skull base involvement, does not occur only in groups with classic risk factors for IA; patients with chronic renal failure and diabetes mellitus are also at risk for more chronic forms. In both of our proven IA cases, voriconazole monotherapy was effective without surgery, and cerebrospinal fluid and serum 1,3-β-d-glucan test results were initially positive, in contrast to galactomannan antigen results.
authors.affiliation: Université Paris Descartes, Sorbonne Paris Cité, Hôpital Necker-Enfants Malades, Service des Maladies Infectieuses et Tropicales, Centre d'Infectiologie Necker-Pasteur, Institut Imagine, AP-HP, Paris, France.
authors.forename: Marjolaine
authors.initials: M
authors.lastname: Morgand
authors.affiliation: Université Paris Descartes, Sorbonne Paris Cité, Hôpital Necker-Enfants Malades, Service des Maladies Infectieuses et Tropicales, Centre d'Infectiologie Necker-Pasteur, Institut Imagine, AP-HP, Paris, France.
authors.forename: Blandine
authors.initials: B
authors.lastname: Rammaert
authors.affiliation: Université Paris Descartes, Sorbonne Paris Cité, Hôpital Necker-Enfants Malades, Service de Radiologie Adulte, AP-HP, Paris, France.
authors.forename: Sylvain
authors.initials: S
authors.lastname: Poirée
authors.affiliation: Université Paris Descartes, Sorbonne Paris Cité, Hôpital Necker-Enfants Malades, Service de Microbiologie, Unité de Parasitologie-Mycologie, AP-HP, Paris, France.
authors.forename: Marie-Elisabeth
authors.initials: ME
authors.lastname: Bougnoux
authors.affiliation: Service d'Oto-rhino-laryngologie, Hôpital Lariboisière, AP-HP, Paris, France.
authors.forename: Hugo
authors.initials: H
authors.lastname: Tran
authors.affiliation: Service d'Oto-rhino-laryngologie, Hôpital Lariboisière, AP-HP, Paris, France.
authors.forename: Romain
authors.initials: R
authors.lastname: Kania
authors.affiliation: Institut Pasteur, Unité d'Histopathologie Humaine et Modèles Animaux, Paris, France Université Paris Descartes, Sorbonne Paris Cité, Service de Neuropathologie, Centre Hospitalier Sainte Anne, AP-HP, Paris, France.
authors.forename: Fabrice
authors.initials: F
authors.lastname: Chrétien
authors.affiliation: Institut Pasteur, Unité d'Histopathologie Humaine et Modèles Animaux, Paris, France.
authors.forename: Gregory
authors.initials: G
authors.lastname: Jouvion
authors.affiliation: Université Paris Descartes, Sorbonne Paris Cité, Hôpital Necker-Enfants Malades, Service des Maladies Infectieuses et Tropicales, Centre d'Infectiologie Necker-Pasteur, Institut Imagine, AP-HP, Paris, France Institut Pasteur, Unité de Mycologie Moléculaire, CNRS URA3012, Paris, France olivier.lortholary@nck.aphp.fr.
authors.forename: Olivier
authors.initials: O
authors.lastname: Lortholary
mesh_terms: D000368:Aged; D000935:Antifungal Agents / Q000627:therapeutic use*; D001231:Aspergillus flavus / Q000187:drug effects / Q000254:growth & development / Q000472:pathogenicity; D001232:Aspergillus fumigatus / Q000187:drug effects / Q000254:growth & development / Q000472:pathogenicity; D002176:Candida albicans / Q000187:drug effects / Q000254:growth & development / Q000472:pathogenicity; D002908:Chronic Disease; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology; D005260:Female; D006801:Humans; D016921:Meningitis, Fungal / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy* / Q000382:microbiology; D020953:Neuroaspergillosis / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy* / Q000382:microbiology; D010031:Otitis / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy* / Q000382:microbiology; D051436:Renal Insufficiency, Chronic / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology; D012852:Sinusitis / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy* / Q000382:microbiology; D016896:Treatment Outcome; D065819:Voriconazole / Q000627:therapeutic use*; D047071:beta-Glucans / Q000097:blood / Q000134:cerebrospinal fluid
chemical_list: D000935:Antifungal Agents; D047071:beta-Glucans; C033363:beta-1,3-glucan; D065819:Voriconazole