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Breakthrough Disseminated Scedosporium prolificans Infection in a Patient with Relapsed Leukaemia on Prolonged Voriconazole Followed by Posaconazole Prophylaxis

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Abstract

A man with acute lymphoblastic leukaemia developed disseminated Scedosporium prolificans infection following chemotherapy for disease relapse while on posaconazole prophylaxis. Scedosporium prolificans infection during posaconazole prophylaxis has not been reported previously. This report is timely as the uptake of posaconazole, the broadest spectrum azole clinically available, is likely to grow with recent evidence supporting its role as prophylaxis against invasive fungal infections in high-risk haematology patients.

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References

  1. Cornely OA, et al. Posaconazole vs. fluconazole or itraconazole prophylaxis in patients with neutropenia. N Engl J Med. 2007;356:348–59. doi:10.1056/NEJMoa061094.

    Article  PubMed  CAS  Google Scholar 

  2. Ullmann AJ, et al. Posaconazole or fluconazole for prophylaxis in severe graft-versus-host disease. N Engl J Med. 2007;356:335–47. doi:10.1056/NEJMoa061098.

    Article  PubMed  CAS  Google Scholar 

  3. Imhof A, et al. Breakthrough fungal infections in stem cell transplant recipients receiving voriconazole. Clin Infect Dis. 2004;39:743–6. doi:10.1086/423274.

    Article  PubMed  Google Scholar 

  4. Kantarjian HM, et al. Results of treatment with hyper-CVAD, a dose-intensive regimen, in adult acute lymphocytic leukemia. J Clin Oncol. 2000;18:547–61.

    PubMed  CAS  Google Scholar 

  5. Husain S, et al. Infections due to Scedosporium apiospermum and Scedosporium prolificans in transplant recipients: clinical characteristics and impact of antifungal agent therapy on outcome. Clin Infect Dis. 2005;40:89–99. doi:10.1086/426445.

    Article  PubMed  Google Scholar 

  6. Lamaris GA, et al. Scedosporium infection in a tertiary care cancer center: a review of 25 cases from 1989–2006. Clin Infect Dis 2006;43:1580–4. doi:10.1086/509579.

    Article  PubMed  Google Scholar 

  7. Cooley L, et al. Infection with Scedosporium apiospermum and S. prolificans, Australia. Emerg Infect Dis. 2007;13:1170–7.

    PubMed  Google Scholar 

  8. Lionakis MS, et al. The significance of blood cultures positive for emerging saprophytic moulds in cancer patients. Clin Microbiol Infect. 2004;10:922–5. doi:10.1111/j.1469–0691.2004.00933.x.

    Article  PubMed  CAS  Google Scholar 

  9. Howden BP, et al. Successful control of disseminated Scedosporium prolificans infection with a combination of voriconazole and terbinafine. Eur J Clin Microbiol Infect Dis. 2003;22:111–3.

    PubMed  CAS  Google Scholar 

  10. Li JY, et al. Successful control of Scedosporium prolificans septic arthritis and probable osteomyelitis in a long-term renal transplant recipient. Transpl Infect Dis. 2008;10:63–5.

    Article  PubMed  CAS  Google Scholar 

  11. Steinbach WJ, et al. Scedosporium prolificans osteomyelitis in an immunocompetent child treated with voriconazole and caspofungin, as well as locally applied polyhexamethylene biguanide. J Clin Microbiol. 2003;41:3981–5. doi:10.1128/JCM.41.8.3981-3985.2003.

    Article  PubMed  Google Scholar 

  12. Singh N, et al. Combination of voriconazole and caspofungin as primary therapy for invasive aspergillosis in solid organ transplant recipients: a prospective, multicenter, observational study. Transplantation. 2006;81:320–6. doi:10.1097/01.tp.0000202421.94822.f7.

    Article  PubMed  CAS  Google Scholar 

  13. Carrillo AJ, et al. In vitro activities of four novel triazoles against Scedosporium spp. Antimicrob Agents Chemother. 2001;45:2151–3. doi:10.1128/AAC.45.7.2151-2153.2001.

    Article  PubMed  CAS  Google Scholar 

  14. Cuenca-Estrella M, et al. Head-to-head comparison of the activities of currently available antifungal agents against 3,378 Spanish clinical isolates of yeasts and filamentous fungi. Antimicrob Agents Chemother. 2006;50:917–21. doi:10.1128/AAC.50.3.917-921.2006.

    Article  PubMed  CAS  Google Scholar 

  15. Siwek GT, et al. Invasive zygomycosis in hematopoietic stem cell transplant recipients receiving voriconazole prophylaxis. Clin Infect Dis. 2004;39:584–7. doi:10.1086/422723.

    Article  PubMed  Google Scholar 

  16. Kontoyiannis DP, et al. Zygomycosis in a tertiary-care cancer center in the era of Aspergillus-active antifungal therapy: a case-control observational study of 27 recent cases. J Infect Dis. 2005;191:1350–60. doi:10.1086/428780.

    Article  PubMed  Google Scholar 

  17. Maertens J, et al. Mucormycosis in allogeneic bone marrow transplant recipients: report of five cases and review of the role of iron overload in the pathogenesis. Bone Marrow Transplant. 1999;24:307–12. doi:10.1038/sj.bmt.1701885.

    Article  PubMed  CAS  Google Scholar 

  18. Walsh TJ, et al. Treatment of invasive aspergillosis with posaconazole in patients who are refractory to or intolerant of conventional therapy: an externally controlled trial. Clin Infect Dis. 2007;44:2–12. doi:10.1086/508774.

    Article  PubMed  CAS  Google Scholar 

  19. Krishna G, Martinho M, Chandrasekar P, Ullmann AJ, Patino H. Pharmacokinetics of oral posaconazole in allogeneic hematopoietic stem cell transplant recipients with graft-versus-host disease. Pharmacotherapy. 2007;27:1627–36. doi:10.1592/phco.27.12.1627.

    Article  PubMed  CAS  Google Scholar 

  20. Ullmann A, et al. Pharmacokinetics, safety, and efficacy of posaconazole in patients with persistent febrile neutropenia or refractory invasive fungal infection. Antimicrob Agents Chemother. 2006;50:658–66. doi:10.1128/AAC.50.2.658-666.2006.

    Article  PubMed  CAS  Google Scholar 

  21. Mullane K, et al. Posaconazole salvage therapy allows successful allogeneic hematopoietic stem cell transplantation in patients with refractory invasive mold infections. Transpl Infect Dis. 2007;9:89–96. doi:10.1111/j.1399-3062.2007.00208.x.

    Article  PubMed  CAS  Google Scholar 

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Correspondence to M. R. Ananda-Rajah.

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MAR: No conflicts

AG: Has served on an advisory board for Schering Plough.

MAS: Has served as a consultant for, received grant support and honoraria from and has given lectures for Gilead Sciences, Pfizer, Merck Sharp and Dohme, Bristol-Myers Squibb and Schering Plough.

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Ananda-Rajah, M.R., Grigg, A. & Slavin, M.A. Breakthrough Disseminated Scedosporium prolificans Infection in a Patient with Relapsed Leukaemia on Prolonged Voriconazole Followed by Posaconazole Prophylaxis. Mycopathologia 166, 83–86 (2008). https://doi.org/10.1007/s11046-008-9131-2

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  • DOI: https://doi.org/10.1007/s11046-008-9131-2

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