Combination therapy of voriconazole and terbinafine for disseminated fusariosis: case report and literature review

Inano, Shojiro; Kimura, Masahiro; Iida, Joji; Arima, Nobuyoshi

doi:10.1007/s10156-013-0594-9

Cited by 31 publications

(19 citation statements)

References 36 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The drug combinations showing the highest percentage of positive interactions in vitro were (i) amphotericin B plus caspofungin or 5-flucytosine and (ii) voriconazole plus terbinafine (83)(84)(85). The clinical efficacy of these combinations is only supported by a few case reports, with an apparent publication bias (86). While terbinafine is usually not recommended for the treatment of invasive mycoses, its propensity for accumulation in skin and soft tissues might be interesting as adjuvant therapy for fusariosis because of the high frequency of primary or secondary skin lesions.…”

Section: Efficacy Of Antifungals In Vivomentioning

confidence: 99%

Therapeutic Challenges of Non- Aspergillus Invasive Mold Infections in Immunosuppressed Patients

Lamoth

Kontoyiannis

2019

Antimicrob Agents Chemother

View full text Add to dashboard Cite

While Aspergillus spp. remain the major cause of invasive mold infections in hematologic cancer patients and transplant recipients, other opportunistic molds, such as Mucorales, Fusarium, and Scedosporium spp. are increasingly encountered in an expanding population of patients with severe and prolonged immunosuppression. High potential for tissue invasion and dissemination, resistance to multiple antifungals and high mortality rates are hallmarks of these non-Aspergillus invasive mold infections (NAIMIs). Assessment of drug efficacy is particularly difficult in the complex treatment scenarios of NAIMIs. Specifically, correlation between in vitro susceptibility and in vivo responses to antifungals is hard to assess, in view of the multiple, frequently interrelated factors influencing outcomes, such as pharmacokinetic/pharmacodynamic parameters determining drug availability at the site of infection, the net state of immune suppression, delay in diagnosis, or surgical debulking of infectious foci. Our current therapeutic approach of NAIMIs should evolve toward a better integration of the dynamic interactions between the pathogen, the drug and the host. Innovative concepts of experimental research may consist in manipulating the host immune system to induce a specific antifungal response or targeted drug delivery. In this review, we discuss the challenges in the management of NAIMIs and provide an update about the latest advances in diagnostic and therapeutic approaches.

show abstract

Section: Efficacy Of Antifungals In Vivomentioning

confidence: 99%

Therapeutic Challenges of Non- Aspergillus Invasive Mold Infections in Immunosuppressed Patients

Lamoth

Kontoyiannis

2019

Antimicrob Agents Chemother

View full text Add to dashboard Cite

show abstract

“…346 Invasive disease or dissemination is exceptionally rare in immunocompetent hosts. 343,347 However, in patients with severe immune deficits, disseminated fusariosis can affect virtually any organ (e.g., lung, 331,335 sinuses, 348,349 bone, 350,351 joints, 352 endophthalmitis, 353 brain, 320 aorta, 354 and heart 339,[354][355][356] ). In disseminated fusariosis, lung involvement occurs in approximately 50%.…”

Section: Clinical Features Of Fusariosismentioning

confidence: 99%

“…Anecdotal successes have been cited with the combination of VCZ and terbinafine. 356 Despite excellent in vitro activity, breakthrough fungemias have also been described in patients on prophylaxis with POSA 359,360 or VCZ. 361…”

Section: Treatment Of Fusariosismentioning

confidence: 99%

Fungal Infections Complicating Lung Transplantation

Clark

Weigt

Fishbein³

et al. 2018

Semin Respir Crit Care Med

View full text Add to dashboard Cite

Lung transplantation is an increasingly utilized modality for treating advanced lung disease. However, lung transplant recipients (LTRs) experience high rates of infection-related mortality and, compared with other solid organ transplant recipients, are at increased risk of infectious complications given the intensity of immunosuppression employed, the presence of airway abnormalities after surgery and exposure of the allograft to the environment. Fungal infections, particularly mold infections, are problematic after transplantation as they are often associated with limited treatment options and poor outcomes. We describe the non- fungal infections occurring in LTRs, including their epidemiology, clinical features, and treatment.

show abstract

“…In these cases, prompt detection of fungal colonization and identification of the responsible organism are critical for initiating appropriate treatment. In fact, inappropriate therapy is associated with bloodstream dissemination and systemic disease [4]. …”

Section: Introductionmentioning

confidence: 99%

Colonization of a Central Venous Catheter by the Hyaline FungusFusarium solaniSpecies Complex: A Case Report and SEM Imaging

Colombo

Maccari

Congiu

et al. 2013

Case Reports in Medicine

View full text Add to dashboard Cite

The incidence of opportunistic infections by filamentous fungi is increasing partly due to the widespread use of central venous catheters (CVC), indwelling medical devices, and antineoplastic/immunosuppressive drugs. The case of a 13-year-old boy under treatment for acute lymphoblastic leukemia is presented. The boy was readmitted to the Pediatric Ward for intermittent fever of unknown origin. Results of blood cultures drawn from peripheral venous sites or through the CVC were compared. CVC-derived bottles (but not those from peripheral veins) yielded hyaline fungi that, based on morphology, were identified as belonging to the Fusarium solani species complex. Gene amplification and direct sequencing of the fungal ITS1 rRNA region and the EF-1alpha gene confirmed the isolate as belonging to the Fusarium solani species complex. Portions of the CVC were analyzed by scanning electron microscopy. Fungi mycelia with long protruding hyphae were seen into the lumen. The firm adhesion of the fungal formation to the inner surface of the catheter was evident. In the absence of systemic infection, catheter removal and prophylactic voriconazole therapy were followed by disappearance of febrile events and recovery. Thus, indwelling catheters are prone to contamination by environmental fungi.

show abstract

Combination therapy of voriconazole and terbinafine for disseminated fusariosis: case report and literature review

Cited by 31 publications

References 36 publications

Therapeutic Challenges of Non- Aspergillus Invasive Mold Infections in Immunosuppressed Patients

Therapeutic Challenges of Non- Aspergillus Invasive Mold Infections in Immunosuppressed Patients

Fungal Infections Complicating Lung Transplantation

Colonization of a Central Venous Catheter by the Hyaline FungusFusarium solaniSpecies Complex: A Case Report and SEM Imaging

Contact Info

Product

Resources

About