Document Detail

Successful treatment of refractory chronic necrotizing pulmonary aspergillosis with micafungin.
MedLine Citation:
PMID:  17721689     Owner:  NLM     Status:  MEDLINE    
A 63-year-old man was admitted to our hospital because he complained of fever and productive cough; this was associated with cavitary infiltrates on his chest X-ray. Although several antibiotics were given, his symptoms did not improve. Bronchofiberscope investigation yielded Aspergillus fumigatus; thus, he was diagnosed with chronic necrotizing pulmonary aspergillosis. Itraconazole, 200 mg/day, was given, and his symptoms and infiltrates on chest X-ray gradually improved. After 2 months of treatment, new infiltrates appeared on a chest X-ray. Antibacterial agents had also shown no effect, and voriconazole was substituted for itraconazole. However, the infiltrates progressed in spite of the voriconazole administration. We added micafungin to the voriconazole treatment. Both his symptoms and the infiltrates on chest X-rays improved. Because voriconazole is thought to be the most effective agent against Aspergillus spp., it is difficult to treat cases that are refractory to voriconazole. The treatment of this case provides invaluable information on how to treat pulmonary aspergillosis related to diseases other than hematologic malignancies.
Hiroshi Ouchi; Masaki Fujita; Satoshi Ikegame; Ichiro Inoshima; Eiji Harada; Yoichi Nakanishi
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Publication Detail:
Type:  Case Reports; Journal Article     Date:  2007-08-27
Journal Detail:
Title:  Journal of infection and chemotherapy : official journal of the Japan Society of Chemotherapy     Volume:  13     ISSN:  1341-321X     ISO Abbreviation:  J. Infect. Chemother.     Publication Date:  2007 Aug 
Date Detail:
Created Date:  2007-08-27     Completed Date:  2007-12-03     Revised Date:  2008-11-21    
Medline Journal Info:
Nlm Unique ID:  9608375     Medline TA:  J Infect Chemother     Country:  Japan    
Other Details:
Languages:  eng     Pagination:  258-62     Citation Subset:  IM    
Research Institute for Diseases of the Chest, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashiku, Fukuoka 812-8582, Japan.
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MeSH Terms
Antifungal Agents / therapeutic use*
Aspergillosis / drug therapy*,  pathology,  radiography
Aspergillus fumigatus / drug effects*
Chronic Disease
Drug Resistance, Multiple, Fungal / drug effects
Echinocandins / therapeutic use*
Lipoproteins / therapeutic use*
Lung Diseases, Fungal / drug therapy*,  pathology,  radiography
Middle Aged
Pyrimidines / therapeutic use
Triazoles / therapeutic use
Reg. No./Substance:
0/Antifungal Agents; 0/Echinocandins; 0/Lipopeptides; 0/Lipoproteins; 0/Pyrimidines; 0/Triazoles; 0/micafungin; 0/voriconazole

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