Skip to main content
Top
Published in: Infection 6/2020

01-12-2020 | Voriconazole | Case Report

Duration of posaconazole therapy for Aspergillus fumigatus osteomyelitis dictated by serial monitoring of 1,3-beta-D glucan

Authors: James B. Doub, Poonam Mathur

Published in: Infection | Issue 6/2020

Login to get access

Abstract

Here, we present a case of an immunocompetent 37-year old male who developed Aspergillus fumigatus osteomyelitis 16 years after extensive chest wall reconstructive surgery for Ewing sarcoma. His treatment course was complicated by a severe adverse drug reaction to voriconazole, requiring the use of oral posaconazole therapy. Serum 1,3-beta-D glucan assay was utilized to dictate the duration of posaconazole therapy. The patient successfully completed 9 months of oral posaconazole therapy and has not had clinical recurrence for 9 months off antifungal therapy.
Literature
1.
go back to reference Fang W, et al. Microbe profile: aspergillus fumigatus: a saprotrophic and opportunistic fungal pathogen. Microbiology. 2018;164:1009–111.CrossRef Fang W, et al. Microbe profile: aspergillus fumigatus: a saprotrophic and opportunistic fungal pathogen. Microbiology. 2018;164:1009–111.CrossRef
2.
go back to reference Vinas F, et al. Spinal aspergillus osteomyelitis. Clin Infect Dis. 1999;28:1223–9.CrossRef Vinas F, et al. Spinal aspergillus osteomyelitis. Clin Infect Dis. 1999;28:1223–9.CrossRef
3.
go back to reference Gamaletsou M, et al. Aspergillus osteomyelitis: epidemiology, clinical manifestations, management, and outcome. J Infect. 2014;68:478–93.CrossRef Gamaletsou M, et al. Aspergillus osteomyelitis: epidemiology, clinical manifestations, management, and outcome. J Infect. 2014;68:478–93.CrossRef
4.
go back to reference Patterson T, et al. Practice guidelines for the diagnosis and management of aspergillosis: 2016 Update by the infectious diseases society of America. Clin Infect Dis. 2016;63:e1–e60.CrossRef Patterson T, et al. Practice guidelines for the diagnosis and management of aspergillosis: 2016 Update by the infectious diseases society of America. Clin Infect Dis. 2016;63:e1–e60.CrossRef
5.
go back to reference Nicholson S, et al. Aspergillus osteomyelitis of the skull. J Craniofacial Surg. 2016;27:e504–e506506.CrossRef Nicholson S, et al. Aspergillus osteomyelitis of the skull. J Craniofacial Surg. 2016;27:e504–e506506.CrossRef
6.
go back to reference Noxafil package insert. Merck & Co, Inc. NJ: Whitehouse Station; 2014. Noxafil package insert. Merck & Co, Inc. NJ: Whitehouse Station; 2014.
7.
go back to reference Lodge B, et al. Aspergillus fumigatus empyema, arthritis, and calcaneal osteomyelitis in a lung transplant patient successfully treated with posaconazole. J Clin Microbiol. 2004;42:1376–8.CrossRef Lodge B, et al. Aspergillus fumigatus empyema, arthritis, and calcaneal osteomyelitis in a lung transplant patient successfully treated with posaconazole. J Clin Microbiol. 2004;42:1376–8.CrossRef
8.
go back to reference Hodiamont C, et al. Multiple-azole-resistant Aspergillus fumigatus osteomyelitis in a patient with chronic granulomatous disease successfully treated with long-term oral posaconazole and surgery. Med Mycol. 2009;47:217–20.CrossRef Hodiamont C, et al. Multiple-azole-resistant Aspergillus fumigatus osteomyelitis in a patient with chronic granulomatous disease successfully treated with long-term oral posaconazole and surgery. Med Mycol. 2009;47:217–20.CrossRef
9.
go back to reference Mandell G, et al. Principles and practice of infectious diseases. 7th ed. Philadelphia: Elsevier inc; 2010. Mandell G, et al. Principles and practice of infectious diseases. 7th ed. Philadelphia: Elsevier inc; 2010.
10.
go back to reference Lash B, et al. Cross-reactivity between voriconazole, fluconazole and itraconazole. J Clin Pharm Ther. 2016;41:566–7.CrossRef Lash B, et al. Cross-reactivity between voriconazole, fluconazole and itraconazole. J Clin Pharm Ther. 2016;41:566–7.CrossRef
12.
go back to reference Slomaka M, et al. A rare case of Blastomyces dermatitidis brain abscess in an immunocompetent host. Med Mycology Case Rep. 2020;28:8–11.CrossRef Slomaka M, et al. A rare case of Blastomyces dermatitidis brain abscess in an immunocompetent host. Med Mycology Case Rep. 2020;28:8–11.CrossRef
13.
go back to reference Lamoth F, et al. β-Glucan antigenemia assay for the diagnosis of invasive fungal infections in patients with hematological malignancies: a systematic review and meta-analysis of cohort studies from the Third European Conference on Infections in Leukemia (ECIL-3). Clin Infect Dis. 2012;54:633–43.CrossRef Lamoth F, et al. β-Glucan antigenemia assay for the diagnosis of invasive fungal infections in patients with hematological malignancies: a systematic review and meta-analysis of cohort studies from the Third European Conference on Infections in Leukemia (ECIL-3). Clin Infect Dis. 2012;54:633–43.CrossRef
14.
go back to reference Singh S, et al. Evaluation of biomarkers: Galactomannan and 1,3-beta-D-glucan assay for the diagnosis of invasive fungal infections in immunocompromised patients from a tertiary care centre. Indian J Med Microbiol. 2018;36:557–63.CrossRef Singh S, et al. Evaluation of biomarkers: Galactomannan and 1,3-beta-D-glucan assay for the diagnosis of invasive fungal infections in immunocompromised patients from a tertiary care centre. Indian J Med Microbiol. 2018;36:557–63.CrossRef
15.
go back to reference Ellis M, et al. Assessment of the clinical utility of serial beta-D-glucan concentrations in patients with persistent neutropenic fever. J Med Microbiol. 2008;57:287–95.CrossRef Ellis M, et al. Assessment of the clinical utility of serial beta-D-glucan concentrations in patients with persistent neutropenic fever. J Med Microbiol. 2008;57:287–95.CrossRef
16.
go back to reference Desoubeaux G, et al. Combination of β-(1, 3)-D-glucan testing in serum and qPCR in nasopharyngeal aspirate for facilitated diagnosis of Pneumocystis jirovecii pneumonia. Mycoses. 2019;62:1015–22.CrossRef Desoubeaux G, et al. Combination of β-(1, 3)-D-glucan testing in serum and qPCR in nasopharyngeal aspirate for facilitated diagnosis of Pneumocystis jirovecii pneumonia. Mycoses. 2019;62:1015–22.CrossRef
17.
go back to reference Pini P, et al. Prognostic potential of the panfungal marker (1 → 3)-β-D-Glucan in invasive mycoses patients. Mycopathologia. 2019;184:147–50.CrossRef Pini P, et al. Prognostic potential of the panfungal marker (1 → 3)-β-D-Glucan in invasive mycoses patients. Mycopathologia. 2019;184:147–50.CrossRef
18.
go back to reference Martson A, et al. Posaconazole therapeutic drug monitoring in clinical practice and longitudinal analysis of the effect of routine laboratory measurements on posaconazole concentrations. Mycoses. 2019;62:698–705.CrossRef Martson A, et al. Posaconazole therapeutic drug monitoring in clinical practice and longitudinal analysis of the effect of routine laboratory measurements on posaconazole concentrations. Mycoses. 2019;62:698–705.CrossRef
Metadata
Title
Duration of posaconazole therapy for Aspergillus fumigatus osteomyelitis dictated by serial monitoring of 1,3-beta-D glucan
Authors
James B. Doub
Poonam Mathur
Publication date
01-12-2020
Publisher
Springer Berlin Heidelberg
Published in
Infection / Issue 6/2020
Print ISSN: 0300-8126
Electronic ISSN: 1439-0973
DOI
https://doi.org/10.1007/s15010-020-01489-2

Other articles of this Issue 6/2020

Infection 6/2020 Go to the issue
Obesity Clinical Trial Summary

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.

Developed by: Springer Medicine

Highlights from the ACC 2024 Congress

Year in Review: Pediatric cardiology

Watch Dr. Anne Marie Valente present the last year's highlights in pediatric and congenital heart disease in the official ACC.24 Year in Review session.

Year in Review: Pulmonary vascular disease

The last year's highlights in pulmonary vascular disease are presented by Dr. Jane Leopold in this official video from ACC.24.

Year in Review: Valvular heart disease

Watch Prof. William Zoghbi present the last year's highlights in valvular heart disease from the official ACC.24 Year in Review session.

Year in Review: Heart failure and cardiomyopathies

Watch this official video from ACC.24. Dr. Biykem Bozkurt discusses last year's major advances in heart failure and cardiomyopathies.