Successful Treatment of Brain Aspergillosis With Voriconazole

Clin Microbiol Infect. 2004 Oct;10(10):928-31. doi: 10.1111/j.1469-0691.2004.00981.x.

Abstract

Until recently, brain aspergillosis was almost always fatal, with a response rate to amphotericin B of < 10%. This study describes a retrospective analysis of eight consecutive cases of brain aspergillosis. All patients were immunosuppressed and five required mechanical ventilation. Antifungal treatment included amphotericin B (n = 7), itraconazole (n = 3), voriconazole (n = 2) and flucytosine (n = 1). Three (38%) patients survived following prolonged azole therapy after initial amphotericin B treatment, combined with a reduction in their immunosuppressive treatment. The prognosis of brain aspergillosis might be improved if immunosuppression could be reduced and prolonged oral azole therapy used.

MeSH terms

  • Adult
  • Aged
  • Amphotericin B / administration & dosage
  • Amphotericin B / therapeutic use
  • Antifungal Agents / administration & dosage
  • Antifungal Agents / therapeutic use*
  • Aspergillus / growth & development*
  • Brain Diseases / drug therapy*
  • Brain Diseases / microbiology
  • Critical Care
  • Female
  • Humans
  • Immunocompromised Host
  • Male
  • Middle Aged
  • Neuroaspergillosis / drug therapy*
  • Neuroaspergillosis / microbiology
  • Pyrimidines / administration & dosage
  • Pyrimidines / therapeutic use*
  • Retrospective Studies
  • Triazoles / administration & dosage
  • Triazoles / therapeutic use*
  • Voriconazole

Substances

  • Antifungal Agents
  • Pyrimidines
  • Triazoles
  • Amphotericin B
  • Voriconazole