Vol.64 No.5 September 2016

Disseminated invasive aspergillosis successfully treated with combination antifungal therapy

Tomoharu Matsui^1,2), Naohi Sahara^1,2), Nami Sakamoto¹⁾, Hironobu Yasuyama¹⁾, Tomoki Fujii^1,2), Seiji Irie¹⁾ and Toshimasa Uekusa³⁾

¹⁾Department of Hematology, Japan Labour Health and Welfare Organization, 1-1 Kizukisumiyoshi-cho, Nakahara-ku, Kawasaki, Kanagawa, Japan
²⁾Department of Oncology, Japan Labour Health and Welfare Organization
³⁾Department of Pathology, Japan Labour Health and Welfare Organization

Abstract

We report herein on a 76-year-old male with disseminated aspergillosis treated with concurrent voriconazole (VRCZ) and caspofungin (CPFG). All lesions diminished in response to this treatment. The patient had been treated with imatinib and prednisolone for chronic eosinophilic leukemia diagnosed in April. In early August, he presented with a high fever and was diagnosed as having invasive pulmonary aspergillosis. The fever pattern, the inflammatory response, and the diagnostic imaging findings improved with oral VRCZ. At the end of September, high fever recurred. Multiple nodular lesions were detected with computed tomography systemically throughout the organs, and additionally in the subcutaneous tissues. Disseminated aspergillosis was diagnosed based on subcutaneous nodule biopsy. The combination of VRCZ and CPFG diminished the systemically disseminated lesions in the organs and maintained the lesion status in the long term.

Key word

voriconazole, caspofungin, disseminated aspergillosis

Received

October 28, 2015

Accepted

May 6, 2016

Jpn. J. Chemother. 64 (5): 750-754, 2016