Treatment of cavitary pulmonary zygomycosis with surgical resection and posaconazole

Ann Thorac Surg. 2006 Jul;82(1):338-40. doi: 10.1016/j.athoracsur.2005.09.043.

Abstract

We describe a 57-year-old woman with acute lymphoblastic leukemia who had a cavitary lesion develop in the right upper lobe caused by Cunninghamella bertholletiae, a zygomycete. The infection was resistant to both high-dose liposomal amphotericin B and voriconazole. The current report demonstrates successful treatment, even in the setting of subsequent bone marrow transplantation and immunosuppression, using a combination of surgical resection and posaconazole therapy.

Publication types

  • Case Reports

MeSH terms

  • Amphotericin B / therapeutic use
  • Antifungal Agents / therapeutic use*
  • Antineoplastic Combined Chemotherapy Protocols / adverse effects
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use
  • Asparaginase / administration & dosage
  • Asparaginase / adverse effects
  • Benzamides
  • Bone Marrow Transplantation
  • Cefepime
  • Cephalosporins / therapeutic use
  • Combined Modality Therapy
  • Cunninghamella / isolation & purification*
  • Daunorubicin / administration & dosage
  • Daunorubicin / adverse effects
  • Drug Resistance, Multiple, Fungal
  • Female
  • Humans
  • Imatinib Mesylate
  • Immunocompromised Host
  • Lung Diseases, Fungal / drug therapy
  • Lung Diseases, Fungal / microbiology
  • Lung Diseases, Fungal / surgery*
  • Middle Aged
  • Neutropenia / chemically induced
  • Piperazines / administration & dosage
  • Piperazines / adverse effects
  • Pneumonectomy*
  • Precursor Cell Lymphoblastic Leukemia-Lymphoma / complications
  • Precursor Cell Lymphoblastic Leukemia-Lymphoma / drug therapy
  • Precursor Cell Lymphoblastic Leukemia-Lymphoma / surgery
  • Prednisone / administration & dosage
  • Prednisone / adverse effects
  • Pyrimidines / administration & dosage
  • Pyrimidines / adverse effects
  • Pyrimidines / therapeutic use
  • Transplantation Conditioning / adverse effects
  • Triazoles / therapeutic use*
  • Vancomycin / therapeutic use
  • Vincristine / administration & dosage
  • Vincristine / adverse effects
  • Voriconazole
  • Zygomycosis / drug therapy
  • Zygomycosis / microbiology
  • Zygomycosis / surgery*

Substances

  • Antifungal Agents
  • Benzamides
  • Cephalosporins
  • Piperazines
  • Pyrimidines
  • Triazoles
  • liposomal amphotericin B
  • Vincristine
  • Vancomycin
  • posaconazole
  • Amphotericin B
  • Cefepime
  • Imatinib Mesylate
  • Asparaginase
  • Voriconazole
  • Prednisone
  • Daunorubicin