We present a 10-year-old male patient with a diagnosis of relapsed acute myeloid leukemia (AML), presenting with high-risk febrile neutropenia (HRFN), after a cycle of intensive chemotherapy, evolving with an invasive fungal infection demonstrated by histopathology. Treatment with intravenous voriconazole was started, with erratic plasmatic levels, which require successive dose adjustments which also occurred with oral administration. Finally, he had a favorable response to treatment, despite of the dosing difficulties to reach therapeutic levels. Active search as well as preemptive antifungal therapy, together with plasmatic level monitorization of voriconazole allowed a prompt recovery and improved the patient prognosis.
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http://dx.doi.org/10.4067/S0716-10182022000200203 | DOI Listing |
Med Mycol Case Rep
March 2025
Department of Rheumatology and Clinical Immunology, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
A 59-year-old female with anti-MDA5 antibody-positive dermatomyositis was treated with prednisolone, tacrolimus, cyclophosphamide, tofacitinib, and plasma exchange. Five months post-treatment, elevated β-D-glucan levels and a pulmonary shadow on CT were noted. was identified, leading to voriconazole initiation.
View Article and Find Full Text PDFBMJ Case Rep
January 2025
Internal Medicine, East Suffolk and North Essex NHS Foundation Trust Ipswich Hospital, Ipswich, UK.
This case report presents a complex medical scenario involving early 60s female patient with a history of chronic lymphocytic leukaemia (CLL) complicated by Evans syndrome, characterised by autoimmune haemolytic anaemia and immune thrombocytopenia. The patient had received various treatments, including steroids, rituximab, cyclosporine and acalabrutinib. The patient's neurological symptoms began around 3 years prior to presentation, with shaking of her right leg, followed by shaking of both hands, particularly the left hand.
View Article and Find Full Text PDFEmerg Microbes Infect
January 2025
Department of Dermatology and Venerology, Peking University First Hospital, Beijing, China.
species, the leading cause of dermatophytosis globally, are increasingly resistant to antifungal treatments, concerns about effective management strategies. In light of the absence of established resistance criteria for terbinafine and azoles, coupled with a dearth of research on resistance mechanisms in , antifungal susceptibility and drug resistance gene diversity were analyzed across 64 , 65 , and 2 isolates collected in China between 2001 and 2024 and 101 published strains. Analyses of the minimum inhibitory concentrations (MICs) of terbinafine, itraconazole, voriconazole, posaconazole, and isavuconazole revealed a concerning increase in with terbinafine resistance, including two novel isolates from China.
View Article and Find Full Text PDFExpert Opin Drug Saf
January 2025
Department of Pharmacy, West China Hospital, Sichuan University, Chengdu, China.
Background: The aim of this study was to explore the risk of severe cutaneous adverse reactions (SCARs) caused by different antifungal drugs in the real world.
Methods: We extracted the data from the FDA Adverse Event Reporting System (FAERS) from January 2004 to December 2022 and performed disproportionality analyses to characterize the signal differences of antifungal agents-related SCARs.
Results: A total of 952 antifungals-related SCARs were identified.
Front Pharmacol
December 2024
Department of Pharmacy, Quanzhou First Hospital Affiliated to Fujian Medical University, Quanzhou, Fujian Province, China.
Objectives: Exploring adjustments to the voriconazole dosing program based on therapeutic drug monitoring results to implement individualized therapy.
Methods: PubMed and Embase were systematically searched to obtain study about voriconazole dose adjustment program guided by therapeutic drug monitoring. Quality evaluation and summarization of the obtained studies were performed to obtain program adjustments for voriconazole under therapeutic drug monitoring.
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