Failure of voriconazole to cure disseminated zygomycosis in an immunocompromised child.

Détails

ID Serval
serval:BIB_E40FAD7E8B66
Type
Article: article d'un périodique ou d'un magazine.
Sous-type
Etude de cas (case report): rapporte une observation et la commente brièvement.
Collection
Publications
Institution
Titre
Failure of voriconazole to cure disseminated zygomycosis in an immunocompromised child.
Périodique
European Journal of Pediatrics
Auteur⸱e⸱s
Ritz N., Ammann R.A., Aebischer C.C., Gugger M., Jaton K., Schmid R.A., Aebi C.
ISSN
0340-6199 (Print)
ISSN-L
0340-6199
Statut éditorial
Publié
Date de publication
2005
Volume
164
Numéro
4
Pages
231-235
Langue
anglais
Notes
Publication types: Case Reports ; Journal Article
WOS Document Type: Article
Résumé
Voriconazole is increasingly used as a first-line agent for empirical antifungal therapy of prolonged febrile neutropenia in paediatric cancer patients. We describe the case of a 9-year-old patient with stage IV Burkitt lymphoma, who developed pulmonary and splenic zygomycosis while receiving voriconazole for persistent febrile neutropenia. The causative agent, Absidia corymbifera, was identified by broad-range fungal PCR in a lung biopsy sample. The patient was successfully treated with a combination of partial resection of the left upper lobe and antifungal therapy with high-dose liposomal amphotericin B followed by oral itraconazole as demonstrated by resolving pulmonary infiltrates on serial high resolution CT scans. CONCLUSION: This case emphasises that the lack of in vitro activity of voriconazole against zygomycetes is clinically relevant. Failure of voriconazole in suspected fungal infection should be investigated for the possibility of zygomycosis. Broad-range polymerase chain reaction may be able to identify the causative organism when cultures remain sterile.
Mots-clé
Absidia/drug effects, Absidia/isolation & purification, Antifungal Agents/therapeutic use, Child, Drug Resistance, Fungal, Female, Humans, Neutropenia/complications, Neutropenia/drug therapy, Positron-Emission Tomography, Pyrimidines/therapeutic use, Triazoles/therapeutic use, Zygomycosis/drug therapy, Zygomycosis/etiology
Pubmed
Web of science
Création de la notice
09/03/2011 11:39
Dernière modification de la notice
20/08/2019 16:07
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