Invasive Fungal Disease, Isavuconazole Treatment Failure, and Death in Acute Myeloid Leukemia Patients

Emerg Infect Dis. 2019 Sep;25(9):1778-1779. doi: 10.3201/eid2509.190598.


We present 2 fatal cases of invasive fungal disease with isavuconazole treatment failure in immunocompromised patients: one with a TR34-L98H azole-resistant Aspergillus fumigatus isolate and the other a Rhizomucor-A. fumigatus co-infection. Such patients probably require surveillance by galactomannan antigen detection and quantitative PCRs for A. fumigatus and Mucorales fungi.

Keywords: Aspergillus fumigatus; CT; France; Rhizomucor; acute myeloid leukemia; antimicrobial resistance; aspergillosis; computed tomography; death; fungal co-infection; fungi; galactomannan antigen; graft-versus-host disease; hematopoietic stem-cell transplantation; immunocompromised patients; invasive fungal disease; isavuconazole; mucormycosis; qPCR; quantitative PCR; treatment failure.

Publication types

  • Case Reports
  • Letter

MeSH terms

  • Antifungal Agents / therapeutic use
  • Aspergillus fumigatus / isolation & purification*
  • Diagnosis, Differential
  • Fatal Outcome
  • Humans
  • Immunocompromised Host*
  • Leukemia, Myeloid, Acute*
  • Male
  • Middle Aged
  • Nitriles / therapeutic use
  • Pulmonary Aspergillosis / diagnosis*
  • Pulmonary Aspergillosis / drug therapy
  • Pulmonary Aspergillosis / microbiology
  • Pyridines / therapeutic use
  • Treatment Failure
  • Triazoles / therapeutic use


  • Antifungal Agents
  • Nitriles
  • Pyridines
  • Triazoles
  • isavuconazole