Case Report: Immune Checkpoint Blockade Plus Interferon-Γ Add-On Antifungal Therapy in the Treatment of Refractory Covid-Associated Pulmonary Aspergillosis and Cerebral Mucormycosis

Alexandra Serris; Amani Ouedrani; Fabrice Uhel; Marianne Gazzano; Vincent Bedarida; Claire Rouzaud; Marie-Elisabeth Bougnoux; Jean-Herlé Raphalen; Sylvain Poirée; Olivier Lambotte; Guillaume Martin-Blondel; Fanny Lanternier

doi:10.3389/fimmu.2022.900522

Case Report: Immune Checkpoint Blockade Plus Interferon-Γ Add-On Antifungal Therapy in the Treatment of Refractory Covid-Associated Pulmonary Aspergillosis and Cerebral Mucormycosis

Front Immunol. 2022 Jun 1:13:900522. doi: 10.3389/fimmu.2022.900522. eCollection 2022.

Authors

Alexandra Serris¹, Amani Ouedrani^{2

3}, Fabrice Uhel⁴, Marianne Gazzano⁵, Vincent Bedarida⁶, Claire Rouzaud¹, Marie-Elisabeth Bougnoux⁷, Jean-Herlé Raphalen⁸, Sylvain Poirée⁹, Olivier Lambotte^{10

11}, Guillaume Martin-Blondel^{12

13}, Fanny Lanternier^{1

14}

Affiliations

¹ Centre for Infectious Diseases and Tropical Medicine, Hôpital Universitaire Necker-Enfants Malades, Assistance Publique -Hôpitaux de Paris, Université de Paris, Paris, France.
² Immunology Laboratory, Hôpital Universitaire Necker-Enfants Malades, Assistance Publique -Hôpitaux de Paris, Université de Paris, Paris, France.
³ Immunoregulation and Immunopathology, Département Immunologie UMR_S1151 UMR8253 Institut Necker Enfants Malades, Université de Paris, Paris, France.
⁴ Intensive Care Medicine, Hôpital Louis Mourier, Assistance Publique -Hôpitaux de Paris, Colombes, France.
⁵ Department of Immunologie, Hôpitaux universitaires Pitié Salpêtrière-Charles Foix, Assistance Publique -Hôpitaux de Paris, Paris, France.
⁶ Otolaryngology-Head and Neck Surgery Department, Hôpital Lariboisière, Assistance Publique-Hôpitaux de Paris, Paris, France.
⁷ Parasitology-Mycology Laboratory, Hôpital Universitaire Necker-Enfants Malades, Assistance Publique -Hôpitaux de Paris, Paris, France.
⁸ Intensive Care Medicine, Hôpital Universitaire Necker-Enfants Malades, Assistance Publique -Hôpitaux de Paris, Université de Paris, Paris, France.
⁹ Department of Adult radiology, Hôpital Universitaire Necker-Enfants Malades, Assistance Publique -Hôpitaux de Paris, Paris, France.
¹⁰ Service de Médecine Interne Immunologie Clinique, Hôpital Bicêtre, Assistance Publique-Hôpitaux de Paris, Université Paris-Saclay, Le Kremlin Bicêtre, France.
¹¹ Center for Immunology of Viral, Auto-immune, Hematological and Bacterial diseases (IDMIT/IMVA-HB), UMR1184, Université Paris-Saclay, Inserm, CEA, Le Kremlin Bicêtre, France.
¹² Service des Maladies Infectieuses et Tropicales, CHU de Toulouse, Université Toulouse III, Toulouse, France.
¹³ Institut Toulousain des Maladies Infectieuses et Inflammatoires (Infinity) INSERM UMR1291 - CNRS UMR5051 - Université Toulouse III, Toulouse, France.
¹⁴ Molecular Mycology Unit, National Reference Centre for Invasive Mycoses and Antifungals, UMR 2000, Institut Pasteur, CNRS, Université de Paris, Paris, France.

Abstract

Invasive fungal diseases (IFD) still cause substantial morbidity and mortality, and new therapeutic approaches are urgently needed. Recent data suggest a benefit of checkpoint inhibitors (ICI). We report the case of a diabetic patient with refractory IFD following a SARSCoV-2 infection treated by ICI and interferon-gamma associated with antifungal treatment.

Keywords: anti-PD 1; cerebral mucormycosis; covid-associated pulmonary aspergillosis; immunotherapy; invasive fungal disease.

Publication types

Case Reports

MeSH terms

Antifungal Agents / therapeutic use
COVID-19 Drug Treatment*
COVID-19* / complications
Humans
Immune Checkpoint Inhibitors / therapeutic use
Interferon-gamma / therapeutic use
Mucormycosis* / complications
Mucormycosis* / drug therapy
Pulmonary Aspergillosis*

Substances

Antifungal Agents
Immune Checkpoint Inhibitors
Interferon-gamma