TY - JOUR
T1 - Fatal Rhizopus Pneumonia in Allogeneic Stem Cell Transplant Patients Despite Posaconazole Prophylaxis
T2 - Two Cases and Review of the Literature
AU - Lekakis, Lazaros J.
AU - Lawson, Amber
AU - Prante, Jeanette
AU - Ribes, Julie
AU - Davis, Gregory J.
AU - Monohan, Gregory
AU - Baraboutis, Ioannis G.
AU - Skoutelis, Athanasios T.
AU - Howard, Dianna S.
PY - 2009/8
Y1 - 2009/8
N2 - Posaconazole is a triazole with broad spectrum of activity against multiple fungi including members of the fungal order Mucorales. This activity has been shown both in clinical and in vitro studies, which are critically reviewed here. It has become very popular in prophylaxis in acute myelogenous leukemia (AML) induction and in the graft-versus-host disease (GVHD) settings after 2 recent prospective trials that showed advantage of posaconazole prophylaxis compared to fluconazole or itraconazole. In this report, 2 patients are presented, in whom, despite posaconazole prophylaxis, invasive and ultimately fatal Rhizopus pulmonary infections developed. These cases are similar to a previously reported case of Rhizopus infection in a stem cell transplant recipient who also received posaconazole, indicating a potential newly recognized pattern of breakthrough infections in patients receiving posaconazole prophylaxis.
AB - Posaconazole is a triazole with broad spectrum of activity against multiple fungi including members of the fungal order Mucorales. This activity has been shown both in clinical and in vitro studies, which are critically reviewed here. It has become very popular in prophylaxis in acute myelogenous leukemia (AML) induction and in the graft-versus-host disease (GVHD) settings after 2 recent prospective trials that showed advantage of posaconazole prophylaxis compared to fluconazole or itraconazole. In this report, 2 patients are presented, in whom, despite posaconazole prophylaxis, invasive and ultimately fatal Rhizopus pulmonary infections developed. These cases are similar to a previously reported case of Rhizopus infection in a stem cell transplant recipient who also received posaconazole, indicating a potential newly recognized pattern of breakthrough infections in patients receiving posaconazole prophylaxis.
KW - BMT
KW - GVHD
KW - Mucorales
KW - Posaconazole
KW - Rhizopus
UR - http://www.scopus.com/inward/record.url?scp=67649604583&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=67649604583&partnerID=8YFLogxK
U2 - 10.1016/j.bbmt.2009.04.007
DO - 10.1016/j.bbmt.2009.04.007
M3 - Article
C2 - 19589489
AN - SCOPUS:67649604583
SN - 1083-8791
VL - 15
SP - 991
EP - 995
JO - Biology of Blood and Marrow Transplantation
JF - Biology of Blood and Marrow Transplantation
IS - 8
ER -