Zygomycosis over-infection during voriconazole therapy for aspergillosis in a heart transplant patient, successfully treated with liposomal amphotericin and posaconazole

Transpl Infect Dis. 2012 Oct;14(5):E56-9. doi: 10.1111/j.1399-3062.2012.00772.x. Epub 2012 Jul 31.

Abstract

Aspergillosis and zygomycosis are life-threatening fungal infections in immunocompromised patients. We report a heart transplant recipient with an early pulmonary invasive aspergillosis successfully treated with association of voriconazole and caspofungin. Zygomycosis sinusitis, which was diagnosed while he still was on voriconazole therapy, was successfully treated with the use of combination antifungal therapy including liposomal amphotericin plus posaconazole and conservative surgical debridement.

MeSH terms

  • Amphotericin B / therapeutic use*
  • Antifungal Agents / therapeutic use*
  • Debridement
  • Drug Therapy, Combination
  • Heart Transplantation / adverse effects*
  • Humans
  • Immunocompromised Host
  • Invasive Pulmonary Aspergillosis / complications*
  • Invasive Pulmonary Aspergillosis / drug therapy
  • Invasive Pulmonary Aspergillosis / microbiology
  • Male
  • Middle Aged
  • Pyrimidines
  • Sinusitis / diagnosis
  • Sinusitis / drug therapy*
  • Sinusitis / microbiology
  • Sinusitis / surgery
  • Treatment Outcome
  • Triazoles / therapeutic use*
  • Voriconazole
  • Zygomycosis / diagnosis
  • Zygomycosis / drug therapy*
  • Zygomycosis / microbiology
  • Zygomycosis / surgery

Substances

  • Antifungal Agents
  • Pyrimidines
  • Triazoles
  • liposomal amphotericin B
  • posaconazole
  • Amphotericin B
  • Voriconazole