1. Rapid improvement of disseminated aspergillosis with caspofungin/voriconazole combination in an adult leukemic patient.
- Author
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Damaj G, Ivanov V, Le Brigand B, D'incan E, Doglio MF, Bilger K, Faucher C, Vey N, and Gastaut JA
- Subjects
- Aspergillosis diagnostic imaging, Caspofungin, Drug Therapy, Combination, Echinocandins, Humans, Lipopeptides, Male, Middle Aged, Radiography, Treatment Outcome, Voriconazole, Antifungal Agents administration & dosage, Aspergillosis drug therapy, Leukemia, Myelomonocytic, Acute microbiology, Peptides administration & dosage, Peptides, Cyclic, Pyrimidines administration & dosage, Triazoles administration & dosage
- Abstract
A 57-year-old man with acute myeloid leukemia (AML) French-American-British (FAB) 4 developed disseminated invasive cerebral and pulmonary aspergillosis during postinduction aplasia. According to international consensus, infection was categorized as probable (two host factors: deep neutropenia for >10 days and refractory fever for >96 h; major clinical criteria of lower respiratory tract and CNS invasive fungal infection; positive results for galactomannan antigen in three blood samples). After the failure of standard amphotericin-based therapy, the spectacular regression of multifocal brain and lung lesions was rapidly achieved under a caspofungin acetate/voriconazole combination. Further permanent caspofungin maintenance with voriconazole added during aplasia periods permitted two consolidation courses and autograft-based intensification without any delay.
- Published
- 2004
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