Combination antifungal therapy and surgery for the treatment of invasive pulmonary aspergillosis after hematopoietic stem cell transplantation

Autor: Tiziana Toffolutti, Rita Alaggio, Piergiorgio Gamba, Anna Pegoraro, Chiara Messina, Chiara Mainardi, Silvia Bergamo, Elisabetta Calore, Marta Pillon, Simone Cesaro
Jazyk: angličtina
Rok vydání: 2011
Předmět:
Zdroj: Pediatric Reports, Vol 3, Iss 3, Pp e18-e18 (2011)
Druh dokumentu: article
ISSN: 2036-749X
2036-7503
DOI: 10.4081/pr.2011.e18
Popis: An 8-year old boy, affected by severe aplastic anemia, developed a probable pulmonary invasive aspergillosis (IA) early after a second unrelated allogeneic hematopoietic stem cell transplant (HSCT). He was treated promptly with the combination of liposomal amphotericin B and caspofungin. Despite the initial stabilization, the patient deteriorated and the antifungal therapy was switched to voriconazole and caspofungin. The patient gradually improved and was discharged home on day +29 post-HSCT on oral voriconazole. On day +119, a sudden episode of hemoptysis occurred and a right superior lobectomy was decided to remove the residual aspergilloma. The patient is now alive and well more than 24 months from HSCT. This case demonstrated that antifungal combination therapy and surgery are valid options to cure pulmonary IA even in patients at high-risk and severely immunosuppressed.
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