Isavuconazole Diffusion in Infected Human Brain

Antimicrob Agents Chemother. 2019 Sep 23;63(10):e02474-18. doi: 10.1128/AAC.02474-18. Print 2019 Oct.

Abstract

We report the cases of a 39-year-old woman with chronic lymphocytic leukemia and a 21-year-old man with chronic granulomatous disease treated for cerebral aspergillosis. The patients required radical surgery for infection progression despite adequate isavuconazole plasma concentration or neurological complication. We thus decided to measure the brain isavuconazole concentration. These results suggest that the concentrations of isavuconazole obtained in the infected brain tissue clearly differ from those obtained in the normal brain tissue and the cerebrospinal fluid.

Keywords: cerebral aspergillosis; isavuconazole; pharmacokinetic; therapeutic drug monitoring.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Aspergillosis / drug therapy
  • Aspergillosis / microbiology
  • Aspergillus fumigatus / drug effects
  • Aspergillus fumigatus / pathogenicity
  • Brain / microbiology*
  • Cerebrospinal Fluid
  • Female
  • Granulomatous Disease, Chronic / drug therapy*
  • Granulomatous Disease, Chronic / microbiology
  • Humans
  • Magnetic Resonance Imaging
  • Nitriles / therapeutic use*
  • Pyridines / therapeutic use*
  • Triazoles / therapeutic use*
  • Young Adult

Substances

  • Nitriles
  • Pyridines
  • Triazoles
  • isavuconazole