Safety and clinical response of intraventricular caspofungin for Scedosporium apiospermum complex central nervous system infection

John R Williams; Mark W Tenforde; Jeannie D Chan; Andrew Ko; Susan M Graham

doi:10.1016/j.mmcr.2016.07.003

Safety and clinical response of intraventricular caspofungin for Scedosporium apiospermum complex central nervous system infection

Med Mycol Case Rep. 2016 Jul 9:13:1-4. doi: 10.1016/j.mmcr.2016.07.003. eCollection 2016 Sep.

Authors

John R Williams¹, Mark W Tenforde², Jeannie D Chan³, Andrew Ko¹, Susan M Graham⁴

Affiliations

¹ Department of Neurological Surgery, University of Washington School of Medicine, Seattle, WA, USA.
² Department of Medicine, University of Washington School of Medicine, Seattle, WA, USA.
³ Department of Pharmacy, Harborview Medical Center, Seattle, WA, USA.
⁴ Department of Medicine, University of Washington School of Medicine, Seattle, WA, USA; Department of Global Health, University of Washington School of Medicine, Seattle, WA, USA; Department of Epidemiology, University of Washington School of Public Health, Seattle, WA, USA.

Abstract

We present a 71-year old woman treated with 14 days of 5 mg intraventricular caspofungin for Scedosporium apiospermum complex meningoencephalitis diagnosed after spinal fusion and instrumentation. Cerebrospinal fluid studies improved during therapy and intraventricular administration was well tolerated. Within weeks of discontinuation, the patient experienced clinical deterioration with disease progression. There are sparse data on the efficacy and safety of administering intraventricular caspofungin. While apparently safe, intraventricular caspofungin was insufficient for disease control in this case.

Keywords: Caspofungin; Intraventricular; Scedosporium apiospermum; Scedosporium apiospermum complex.

Grants and funding

T32 AI007044/AI/NIAID NIH HHS/United States