Abstract.
A severely neutropenic patient with chronic lymphocytic leukemia developed a diffuse bilateral pulmonary infection while receiving a therapeutic daily dosage of intravenous amphotericin B for Candida glabrata esophagitis. Computed tomography of the chest showed numerous lung nodules, ground glass areas and a pleural effusion. Biopsy of one nodule demonstrated hyaline septate hyphae. Multiple sputum cultures grew Acremonium strictum. Increasing the dose of amphotericin B and the addition of itraconazole did not resolve the infection. Change of treatment to posaconazole given orally at 200 mg four times/d resulted in progressive improvement leading finally to cure after 24 weeks of therapy. Treatment with posaconazole was clinically and biologically well tolerated.
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Herbrecht, .R., Letscher-Bru, .V., Fohrer, .C. et al. Acremonium strictum Pulmonary Infection in a Leukemic Patient Successfully Treated with Posaconazole After Failure of Amphotericin B. Eur J Clin Microbiol Infect Dis 21, 814–817 (2002). https://doi.org/10.1007/s10096-002-0828-8
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DOI: https://doi.org/10.1007/s10096-002-0828-8