Duration of posaconazole therapy for Aspergillus fumigatus osteomyelitis dictated by serial monitoring of 1,3-beta-D glucan

Infection. 2020 Dec;48(6):959-963. doi: 10.1007/s15010-020-01489-2. Epub 2020 Jul 27.


Here, we present a case of an immunocompetent 37-year old male who developed Aspergillus fumigatus osteomyelitis 16 years after extensive chest wall reconstructive surgery for Ewing sarcoma. His treatment course was complicated by a severe adverse drug reaction to voriconazole, requiring the use of oral posaconazole therapy. Serum 1,3-beta-D glucan assay was utilized to dictate the duration of posaconazole therapy. The patient successfully completed 9 months of oral posaconazole therapy and has not had clinical recurrence for 9 months off antifungal therapy.

Keywords: 1,3-beta-D-glucan; Aspergillus fumigatus; Osteomyelitis; Posaconazole; Voriconazole adverse drug reaction.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Antifungal Agents / therapeutic use*
  • Aspergillosis / complications
  • Aspergillosis / drug therapy*
  • Aspergillus fumigatus / physiology*
  • Baltimore
  • Humans
  • Male
  • Osteomyelitis / drug therapy*
  • Osteomyelitis / microbiology
  • Treatment Outcome
  • Triazoles / therapeutic use*
  • beta-Glucans / blood*


  • Antifungal Agents
  • Triazoles
  • beta-Glucans
  • posaconazole