Voriconazole in the Treatment of Fungal Osteomyelitis of the Orbit in the Immunocompromised Host

O'Doherty, M; Hannan, Margaret M.; Fulcher, Timothy

doi:10.1080/01676830500187696

Cited by 18 publications

(12 citation statements)

References 23 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Voriconazole has been used in children with Scedosporium osteomyelitis [2,7] but as its pharmacokinetics in children appear to be linear, drug level monitoring may be warranted in adjusting voriconazole dosing. In our case voriconazole was administered at a dose of 8 mg/kg/d with favourable response; though the current dose of voriconazole in children is 7 mg/kg twice daily [13].…”

Section: Discussionmentioning

confidence: 99%

“…Empirical antifungal therapy with amphotericin B (1mg/kg/d) was initiated, while antibacterial treatment was discontinued. Following identification of the isolate, as Scedosporium sp., voriconazole IV 8mg/kg/d at a dose recommended for children at that time [1], replaced the amphotericin B regimen, due to the reported good response of Scedosporium infections to voriconazole [2,3]. Marked improvement in clinical symptoms was noted 20 days after voriconazole IV therapy when it was discontinued and she was administered 4 mg/kg every 12 h oral voriconazole, for a total of six months.…”

Section: Case Reportmentioning

confidence: 92%

See 1 more Smart Citation

Scedosporium apiospermumskeletal infection in an immunocompetent child

et al. 2009

View full text Add to dashboard Cite

This is a case of Scedosporium apiospermum skeletal infection in a 10-year-old immunocompetent girl whose chief complaint was left knee swelling and pain. The child had a history of a bicycle accident two months before with a resultant deep penetrating trauma. Systematic administration of broad-spectrum antibiotics for 10 days was used, with no clinical improvement. Magnetic Resonance Imaging and arthrotomy of the affected joint revealed findings suggestive of osteomyelitis. Empirical intravenous antimicrobial therapy was instituted for a total of two months but one month after completion of antibacterial therapy the child returned to the hospital because of persistent knee swelling and pain. Following a new arthrotomy, Scedosporium apiospermum was isolated. The patient was cured with intravenous administration of voriconazole without any side effects and has no evidence of relapse after four years of follow-up.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Case Reportmentioning

confidence: 92%

Scedosporium apiospermumskeletal infection in an immunocompetent child

et al. 2009

View full text Add to dashboard Cite

show abstract

“…[ 59 60 ] Recently, oral voriconazole, which is also highly active against Aspergillus spp., has gained favor in the management of invasive aspergillosis. [ 61 62 63 ]…”

Section: Fungal Infectionsmentioning

confidence: 99%

Rare orbital infections ~ State of the art ~ Part II

Hamed-Azzam

AlHashash

Briscoe

et al. 2018

J Ophthalmic Vis Res

View full text Add to dashboard Cite

Infections of the orbit and periorbita are relatively frequent. Identifying unusual organisms is crucial because they can cause severe local and systemic morbidity, despite their rarity. Opportunistic infections of the orbit should be considered mainly in debilitated or immunocompromised patients. The key to successful management includes a high index of suspicion, prompt diagnosis, and addressing the underlying systemic disease. This review summarizes unusual infectious processes of the orbit, including mycobacterial, fungal, and parasitic infections, as well as their pathophysiology, symptoms, signs, and treatment.

show abstract

“…Treatment recommendations are based on case reports. [165][166][167][168] CNS and eye infections due to S. apiospermum should be treated with voriconazole while combination therapy (voriconazole plus terbinafine) is recommended for CNS/ eye infections due to S. prolificans (grade D recommendation). Posaconazole is an alternative agent but has only been studied as salvage therapy.…”

Section: Cns Disease and Endophthalmitismentioning

confidence: 99%

“…CNS disease and endophthalmitis A solitary mass or multiple brain abscesses are the most frequent CNS manifestations of Scedosporium infections. Treatment recommendations are based on case reports 165–168 …”

mentioning

confidence: 99%

Recommendations for the treatment of established fungal infections

Thursky

Playford

Seymour

et al. 2008

Internal Medicine Journal

View full text Add to dashboard Cite

Evidence-based guidelines for the treatment of established fungal infections in the adult haematology/oncology setting were developed by a national consensus working group representing clinicians, pharmacists and microbiologists. These updated guidelines replace the previous guidelines published in the Internal Medicine Journal by Slavin et al. in 2004. The guidelines are pathogen-specific and cover the treatment of the most common fungal infections including candidiasis, aspergillosis, cryptococcosis, zygomycosis, fusariosis, scedosporiosis, and dermatophytosis. Recommendations are provided for management of refractory disease or salvage therapies, and special sites of infections such as the cerebral nervous system and the eye. Because of the widespread use newer broad-spectrum triazoles in prophylaxis and empiric therapy, these guidelines should be implemented in concert with the updated prophylaxis and empiric therapy guidelines published by this group. This section of the guidelines is dedicated to the management of established invasive antifungal infections (IFI) in the adult haematology/oncology setting. Our recommendations are based on the antifungal agents licensed for use in Australia at the time of writing, and are organized according to pathogen.Where there is a radiological abnormality on computed tomography (CT)/high resolution computed tomography (HRCT) without early microbiological confirmation, clinicians should consider the most common clinical scenario. Microbiological confirmation with histology and/or culture should be pursued in all cases where the patient's clinical status permits additional investigations, such as bronchoscopy and/or biopsy. Newer diagnostic modalities such as polymerase chain reaction (PCR), galactomannan (GM) testing and molecular sequencing, are becoming increasingly available, particularly at specialist centres, and will play an increasing role in identifying probable and proven fungal infections. They are discussed in detail in the previous section of the guidelines by Morrissey et al.When considering the possibility of mould infections, Aspergillus is still the most likely organism within the Australasian setting.

show abstract

Voriconazole in the Treatment of Fungal Osteomyelitis of the Orbit in the Immunocompromised Host

Cited by 18 publications

References 23 publications

Scedosporium apiospermumskeletal infection in an immunocompetent child

Scedosporium apiospermumskeletal infection in an immunocompetent child

Rare orbital infections ~ State of the art ~ Part II

Recommendations for the treatment of established fungal infections

Contact Info

Product

Resources

About