Document Detail


Scedosporium apiospermum mycetoma with bone involvement successfully treated with voriconazole.
MedLine Citation:
PMID:  16714039     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Treatment of Scedosporium apiospermum mycetoma usually requires limb amputation. A 49-year-old woman, from Ivory Coast, was diagnosed with Madura foot in 1995. She failed to respond to several treatments including itraconazole, fluconazole and co-trimoxazole, and refused limb amputation. In December 2002 she was admitted to hospital in France with a painful, swollen right leg and foot. She had no fever and C-reactive protein was 120 mg/l. Magnetic resonance imaging (MRI) confirmed the destruction of tarsus bones with a tibia extension. Voriconazole (400 mg/day) treatment was initiated in March 2003; a significant clinical improvement was observed within 4 months as confirmed by C-reactive protein (16 mg/l) and MRI. Voriconazole was maintained for 18 months with good tolerance. Cholestasis appeared after the first month and remained stable. In October 2004 voriconazole was discontinued due to side effects on the liver (alanine aminotransferase 17 times the normal level); MRI showed impressive regression of bone lesions. As of July 2005, the patient remains clinically well. Voriconazole appears to be a promising drug for the treatment of S. apiospermum mycetomas.
Authors:
L Porte; S Khatibi; L El Hajj; S Cassaing; A Berry; P Massip; M D Linas; J F Magnaval; N Sans; B Marchou
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Publication Detail:
Type:  Case Reports; Journal Article     Date:  2006-05-22
Journal Detail:
Title:  Transactions of the Royal Society of Tropical Medicine and Hygiene     Volume:  100     ISSN:  0035-9203     ISO Abbreviation:  Trans. R. Soc. Trop. Med. Hyg.     Publication Date:  2006 Sep 
Date Detail:
Created Date:  2006-07-10     Completed Date:  2006-12-11     Revised Date:  2008-11-21    
Medline Journal Info:
Nlm Unique ID:  7506129     Medline TA:  Trans R Soc Trop Med Hyg     Country:  England    
Other Details:
Languages:  eng     Pagination:  891-4     Citation Subset:  IM    
Affiliation:
Department of Infectious and Tropical Diseases, Purpan University Hospital, 31059 Toulouse Cedex, France. porte.l@chu-toulouse.fr
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MeSH Terms
Descriptor/Qualifier:
Antifungal Agents / therapeutic use*
Bone Diseases, Infectious / drug therapy*,  microbiology,  pathology
Female
Humans
Middle Aged
Mycetoma / drug therapy*,  pathology
Pyrimidines / therapeutic use*
Scedosporium*
Tarsal Bones / microbiology,  pathology
Tibia / microbiology,  pathology
Treatment Outcome
Triazoles / therapeutic use*
Chemical
Reg. No./Substance:
0/Antifungal Agents; 0/Pyrimidines; 0/Triazoles; 0/voriconazole

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