A Case of Aspergillus Empyema Successfully Treated with Combination Therapy of Voriconazole and Micafungin: Excellent Penetration of Voriconazole and Micafungin into Pleural Fluid

Matsuda, Toshiaki; Koreeda, Yoshimizu; Mataki, Hiroko; Taira, Tetsuhiko; Noma, Satoshi; Higashimoto, Ikkou

doi:10.2169/internalmedicine.49.2860

Cited by 38 publications

(21 citation statements)

References 21 publications

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“…Candida species are a common cause of fungal empyemas (6). However, management of Candida empyema is not well defined (11), and there are limited data on the penetration of echinocandins into human pleural fluid (9). We therefore report the pharmacokinetics and penetration of anidulafungin into the pleural fluid of a patient with Candida tropicalis empyema.…”

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confidence: 96%

“…Disruption of loculations may enhance pleural drainage and allow better antifungal penetration. Unfortunately, there are only limited data on penetration of antifungal agents into pleural fluid of humans (7,9,10,(12)(13)(14). The range of percent penetration of antifungal agents into pleural fluid is reported to be 3% to 9.4% for liposomal amphotericin B and 45.2% to 94.7% for voriconazole (10,(12)(13)(14).…”

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confidence: 99%

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Pharmacokinetics of Anidulafungin in Pleural Fluid during the Treatment of a Patient with Candida Empyema

Moriyama

Ditullio

Wilson

et al. 2011

Antimicrob Agents Chemother

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Candida empyema is a serious complication of disseminated candidiasis. However, little is known about the intrapleural pharmacokinetics of echinocandins. We report the penetration of anidulafungin into the pleural fluid of a patient with Candida tropicalis empyema. The anidulafungin ratio for the area under the concentration-time curve from 0 h to the last measurement between pleural fluid and serum values was only 0.125 (12.5%), with pleural fluid concentrations ranging between 0.67 and 0.88 g/ml.

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confidence: 96%

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confidence: 99%

Pharmacokinetics of Anidulafungin in Pleural Fluid during the Treatment of a Patient with Candida Empyema

Moriyama

Ditullio

Wilson

et al. 2011

Antimicrob Agents Chemother

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“…In addition, many researchers have been trying to improve the results obtained with antifungal monotherapy. Although data from controlled clinical trials are scarce, many recent reports have claimed beneficial effects of antifungal combinations for the treatment of severe fungal infections (Johnson & Perfect 2010, Matsuda et al 2010.…”

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confidence: 99%

Cotrimoxazole enhances the in vitro susceptibility of Coccidioides posadasii to antifungals

Cordeiro

Astete-Medrano

Marques

et al. 2011

Mem. Inst. Oswaldo Cruz

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“…Aspergillus ampiyemlerine literatürde genel olarak tekli vaka bildirimleri olarak rastlanmaktadır [11][12][13][14]. En geniş seri Kearon ve ark.…”

Section: Discussionunclassified

“…Rezeksiyon sonrası uzamış hava kaçağı sıkça izlenir. Gö-ğüs tüpü ve plevral lavaj uygulama, debridman, açık pencere tüp torakostomi ile plevral boşluk temizliği gibi yöntemler uygulanabilir [10,11]. Hastalarımızın tümüne postoperatif dönemde göğüs tüpü ile plevral irrigasyona devam edildi.…”

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Isolated secondary fungal infections of pleural cavity

Ergin

Yeginsu²,

Zeybek³

et al. 2013

J Clin Exp Invest

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Objectives: Pleural fungal infections are rare, but the incidence has been increasing with immunosuppressant diseases and use of immunosuppressive medications. In this report, we present 6 patients with pleural effusions that have been determined fungal infection. Methods:The medical records of patients with followed and treated due to fungal infection of the pleural were retrospectively reviewed. Result:The 6 cases whom was 58 of the value median for age were treated as surgical and medical due to fungal infection of the pleural cavity. Dyspnea, cough and chest pain were the most common symptoms. Fever, night sweats and expectoration are relatively rare. In 4 patients, the infections of pleural cavity developed on the bases of rheumatoid arthritis, tuberculosis, pleural mesothelioma and esophagopleural fistula. In two patients had isolated fungal infections. Cultural positivity was seen in 5 patients. Fungal hyphae were determined by cytopathology in all of the patients.As a surgical procedure, all of the patients underwent decortication or pleural biopsy and pleural irrigation. In all patients, antifungal agents were added to surgical procedures. Full recovery of infection was seen in 5 patients. One patient died. Conclusion:In immunosuppressive patients, the incidence of pleural effusions due to or associated with fungal infections are more common. Addition to culture of pleural fluid, histopathological evaluation of pleura will aid diagnosis. J Clin Exp Invest 2013; 4 (4): 468-471Key words: Lung, fungal infection, pleural effusion ÖZET Amaç: Plevral mantar enfeksiyonları nadirdir. İmmünsup-resif hastalıkların ve immünsupresif tedavilerin artışı ile plevral mantar enfeksiyonlarının insidansı da artmaktadır. Bu klinik çalışmada, plevral mantar enfeksiyonuna bağlı plevral effüzyon izlenen hastalar literatür verileri eşliğinde gözden geçirildi.Yöntemler: Plevral mantar enfeksiyonu nedeniyle takip ve tedavi edilen hastalara ait medikal kayıtlar retrospektif olarak gözden geçirildi. Bulgular:Yaş median değeri 58 yıl olan 6 vaka plevral kavitenin mantar enfeksiyonu nedeni ile cerrahi ve medikal tedavi aldı. Radyolojik değerlendirmelerde tüm hastalarda değişik derecede plevral efüzyon izlendi. Hastalar sıklıkla dispne, öksürük ve göğüs ağrısı daha nadir ateş, gece terlemesi semptomlarına sahipti. Plevral mantar enfeksiyonu; 6 hastanın 4'ünde romatoid artrit, tüberküloz, mezotelyoma ve özefagoplevral fistüle sekonder geliş-mişti. İki hastada ise izole mantar enfeksiyonu saptandı. Hastaların tümünde plevral dokunun histopatolojik değer-lendirilmesi ile fungal hifler rapor edildi. Mikrobiyolojik olarak mantar kültür pozitifliği 5 hastada bildirildi. Hastalara cerrahi işlem olarak dekortikasyon, plevral biopsi, primer özefagial onarım ile yaklaşıldı. Tüm hastalara cerrahi iş-lemin yanı sıra antifungal ajanlar parenteral tedaviye eklendi. Beş hastada tam bir iyileşme izlenirken, bir hasta kaybedildi.Sonuç: İmmünsupresif veya genel durumu bozuk hastalarda, mantar enfeksiyonlarına bağlı radyolojik tetkiklerde sıklı...

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A Case of Aspergillus Empyema Successfully Treated with Combination Therapy of Voriconazole and Micafungin: Excellent Penetration of Voriconazole and Micafungin into Pleural Fluid

Abstract: A 62-year-old

Cited by 38 publications

References 21 publications

Pharmacokinetics of Anidulafungin in Pleural Fluid during the Treatment of a Patient with Candida Empyema

Pharmacokinetics of Anidulafungin in Pleural Fluid during the Treatment of a Patient with Candida Empyema

Cotrimoxazole enhances the in vitro susceptibility of Coccidioides posadasii to antifungals

Isolated secondary fungal infections of pleural cavity

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