Successful treatment of Scedosporium apiospermum soft tissue abscess with caspofungin and voriconazole in a severely immunocompromised patient with acute myeloid leukemia

F. Beier, N. Kittan, T. Holzmann, K. Schardt, R. Andreesen, E. Holler, G. C. Hildebrandt

Research output: Contribution to journalArticlepeer-review

14 Scopus citations

Abstract

We report the case of a 53-year-old female patient with refractory acute myeloid leukemia developing a necrotic, soft tissue abscess on the right forearm caused by Scedosporium apiospermum during prolonged severe neutropenia (absolute white blood cell count <500/μL for 49 days). In the context of the severely immunocompromised state of the patient and her need for allogeneic hematopoietic stem cell transplantation (HSCT), surgical treatment options were not favored. Therefore, combined antifungal therapy with voriconazole and caspofungin was started, based on the results of the in vitro testing (minimum inhibitory concentrations of voriconazole, posaconazole, and amphotericin B: 1, 4, and >2 mg/L, respectively). The local site of infection slowly improved clinically and no spread of S. apiospermum infection to other sites was observed. After HSCT, the soft tissue abscess resolved completely and the patient has remained free of S. apiospermum infection since then. We successfully demonstrate that the use of combined antifungal therapy with voriconazole and casopfungin may further improve the clinical course and provides a promising therapeutic option to treat Scedosporium infections in such patients.

Original languageEnglish
Pages (from-to)538-542
Number of pages5
JournalTransplant Infectious Disease
Volume12
Issue number6
DOIs
StatePublished - Dec 2010

Keywords

  • Allogeneic stem cell transplantation
  • Caspofungin
  • Combination therapy
  • Pseudallescheria boydii
  • Scedosporium apiospermum
  • Soft tissue abscess
  • Voriconazole

ASJC Scopus subject areas

  • Infectious Diseases
  • Transplantation

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