Refractory invasive aspergillosis controlled with posaconazole and pulmonary surgery in a patient with chronic granulomatous disease: case report

KEPENEKLİ KADAYİFCİ E., Soysal A., Kuzdan C., ERMERAK N. O., YÜKSEL M., Bakir M.

ITALIAN JOURNAL OF PEDIATRICS, cilt.40, 2014 (SCI-Expanded) identifier identifier identifier

  • Yayın Türü: Makale / Tam Makale
  • Cilt numarası: 40
  • Basım Tarihi: 2014
  • Doi Numarası: 10.1186/1824-7288-40-2
  • Dergi Adı: ITALIAN JOURNAL OF PEDIATRICS
  • Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus
  • Anahtar Kelimeler: Chronic granulomatous disease, Invasive pulmonary aspergillosis, Posaconazole, HEMATOPOIETIC ALLOGRAFT, CLINICAL-FEATURES, FUNGAL-INFECTION, THERAPY, ITRACONAZOLE, PATHOGENESIS, MULTICENTER, MANAGEMENT
  • Marmara Üniversitesi Adresli: Evet

Özet

Invasive aspergillosis is an important cause of morbidity and mortality in immunocompromised patients. Among primary immunodefiencies, chronic granulomatous disease (CGD) has the highest prevalence of invasive fungal diseases. Voriconazole is recommended for the primary treatment of invasive aspergillosis in most patients. In patients whose aspergillosis is refractory to voriconazole, therapeutic options include changing class of antifungal, for example using an amphotericin B formulation, an echinocandin, combination therapy, or further use of azoles. Posaconazole is a triazole derivative which is effective in Aspergillosis prophylaxis and treatment. Rarely, surgical therapy may be needed in some patients. Lesions those are contiguous with the great vessels or the pericardium, single cavitary lesion that cause hemoptysis, lesions invading the chest wall, aspergillosis that involves the skin and the bone are the indications for surgical therapy.