Long-term treatment of invasive sinus, tracheobroncheal, pulmonary and intracerebral aspergillosis in acute lymphoblastic leukaemia

Infection. 2012 Feb;40(1):81-5. doi: 10.1007/s15010-011-0158-9. Epub 2011 Jul 21.

Abstract

A 59-year-old male with acute lymphoblastic leukemia developed sinus, tracheobroncheal, pulmonary, and intracerebral aspergillosis. All lesions except the intracerebral aspergillosis healed after combination antifungal treatment. Long-term voriconazole--but not posaconazole--therapy induced partial regression of the cerebral manifestations. At the time of writing, 3.5 years after the initial diagnosis, the patient is working half-time and suffers from a possible voriconazole-induced polyneuropathy.

Publication types

  • Case Reports

MeSH terms

  • Amphotericin B / administration & dosage
  • Amphotericin B / therapeutic use
  • Antifungal Agents / administration & dosage
  • Antifungal Agents / therapeutic use*
  • Aspergillus fumigatus / drug effects
  • Aspergillus fumigatus / isolation & purification
  • Brain / diagnostic imaging
  • Brain / microbiology
  • Brain / pathology
  • Caspofungin
  • Cerebrum / diagnostic imaging
  • Cerebrum / microbiology
  • Cerebrum / pathology
  • Echinocandins / administration & dosage
  • Echinocandins / therapeutic use
  • Humans
  • Larynx / diagnostic imaging
  • Larynx / microbiology
  • Larynx / pathology
  • Lipopeptides
  • Lung / diagnostic imaging
  • Lung / microbiology
  • Lung / pathology
  • Magnetic Resonance Imaging
  • Male
  • Middle Aged
  • Neuroaspergillosis / drug therapy*
  • Neuroaspergillosis / microbiology*
  • Paranasal Sinuses / diagnostic imaging
  • Paranasal Sinuses / microbiology
  • Paranasal Sinuses / pathology
  • Peripheral Nervous System Diseases / microbiology
  • Peripheral Nervous System Diseases / physiopathology
  • Precursor Cell Lymphoblastic Leukemia-Lymphoma / complications*
  • Precursor Cell Lymphoblastic Leukemia-Lymphoma / microbiology
  • Pulmonary Aspergillosis / drug therapy*
  • Pulmonary Aspergillosis / microbiology*
  • Pyrimidines / administration & dosage
  • Pyrimidines / therapeutic use
  • Sweden
  • Tomography, X-Ray Computed
  • Triazoles / administration & dosage
  • Triazoles / therapeutic use
  • Voriconazole

Substances

  • Antifungal Agents
  • Echinocandins
  • Lipopeptides
  • Pyrimidines
  • Triazoles
  • posaconazole
  • Amphotericin B
  • Caspofungin
  • Voriconazole