Failure of Voriconazole to Cure Disseminated Zygomycosis in an Immunocompromised Child

Overview

Journal Eur J Pediatr

Specialty Pediatrics

Date 2005 Jan 6

PMID 15633048

Citations 8

Authors

Nicole Ritz

Roland A Ammann

Carmen Casaulta Aebischer

Mathias Gugger

Katia Jaton

Ralph A Schmid

Christoph Aebi

Affiliations

Soon will be listed here.

Abstract

Unlabelled: Voriconazole is increasingly used as a first-line agent for empirical antifungal therapy of prolonged febrile neutropenia in paediatric cancer patients. We describe the case of a 9-year-old patient with stage IV Burkitt lymphoma, who developed pulmonary and splenic zygomycosis while receiving voriconazole for persistent febrile neutropenia. The causative agent, Absidia corymbifera, was identified by broad-range fungal PCR in a lung biopsy sample. The patient was successfully treated with a combination of partial resection of the left upper lobe and antifungal therapy with high-dose liposomal amphotericin B followed by oral itraconazole as demonstrated by resolving pulmonary infiltrates on serial high resolution CT scans.

Conclusion: This case emphasises that the lack of in vitro activity of voriconazole against zygomycetes is clinically relevant. Failure of voriconazole in suspected fungal infection should be investigated for the possibility of zygomycosis. Broad-range polymerase chain reaction may be able to identify the causative organism when cultures remain sterile.

Citing Articles

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