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Annals of Hematology

, Volume 93, Issue 3, pp 493–498 | Cite as

Breakthrough invasive fungal diseases during echinocandin treatment in high-risk hospitalized hematologic patients

  • Thomas S. Y. Chan
  • Harinder Gill
  • Yu-Yan Hwang
  • Joycelyn Sim
  • Alan C. T. Tse
  • Florence Loong
  • Pek-Lan Khong
  • Eric Tse
  • Anskar Y. H. Leung
  • Chor-Sang Chim
  • Albert K. W. Lie
  • Yok-Lam Kwong
Original Article

Abstract

The frequency of breakthrough invasive fungal diseases (IFDs) during echinocandin therapy is unclear. We retrospectively analyzed 534 hematologic patients treated with echinocandin (caspofungin, N = 55; micafungin, N = 306; anidulafungin, N = 173). Four proven IFDs were found, caused by Candida parapsilosis (N = 2), C. parapsilosis and Candida glabrata (N = 1), and Fusarium species (N = 1). Four cases of possible IFDs were observed, all showing pulmonary infection. One case showed features suggestive of hepatosplenic candidiasis. Six of these eight cases had previously received the purine analog clofarabine. Breakthrough IFD during echinocandin treatment occurred infrequently (1.5 %), caused predominantly by Candida species. Clofarabine usage was an important risk factor.

Keywords

Echinocandin Breakthrough invasive fungal infections 

Notes

Conflict of interest

The authors have no conflict of interest to declare.

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Copyright information

© Springer-Verlag Berlin Heidelberg 2013

Authors and Affiliations

  • Thomas S. Y. Chan
    • 1
  • Harinder Gill
    • 1
  • Yu-Yan Hwang
    • 1
  • Joycelyn Sim
    • 1
  • Alan C. T. Tse
    • 1
  • Florence Loong
    • 2
  • Pek-Lan Khong
    • 3
  • Eric Tse
    • 1
  • Anskar Y. H. Leung
    • 1
  • Chor-Sang Chim
    • 1
  • Albert K. W. Lie
    • 1
  • Yok-Lam Kwong
    • 1
  1. 1.Department of MedicineQueen Mary HospitalHong KongChina
  2. 2.Department of PathologyQueen Mary HospitalHong KongChina
  3. 3.Department of Diagnostic RadiologyQueen Mary HospitalHong KongChina

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