Successful treatment of combination of invasive candidiasis (C.krusei) and aspergillosis (A.flavus) in haematological patient

Ref ID: 19412

Author:

E. Shagdileeva,1 S. N. Khostelidy,1 E. R. Raush,1 E. N. Shaidaeva,2
I. Samorodova,2 A. V. Klimovich,2 N. Kotova,2 J. M. Melehina,1
T. S. Bogomolova,1 I. V. Vybornova1 and N. N. Klimko1

Author address:

1North-Western State Medical University named after I.I.
Mechnicov, Saint-Petersburg, Russian Federation and 2City
hospital 31, Saint-Petersburg, Russian Federation

Full conference title:

6th Trends in Medical Mycology 2013

Date: 11 October 2014

Abstract:

Objectives Invasive candidiasis (IA) and aspergillosis (IA) are lead-
ing causes of morbidity and mortality in haematological patients.
Publications about combination of iC and IA in haematological
patients are limited.
Methods EORTS/MSG criteria (2008) of diagnosis of IFD and treat-
ment response were used.
Results 58 years old male was hospitalized in the City hospital ’31,
Saint-Petersburg, at 06.08.2012 with non-Hodgkin’s lymphoma,
IVB. He received cytostatic chemotherapy R-DA-EPOCH. The refrac-
tory to antibacterials febrile neutropenia started after a week of che-
motherapy. C krusei was identified in cultures of peripheral blood and
central venous catheter (CVC) samples. Treatment with amphotericin
B 50 mg/day was started, CVC was replaced. At the same time the
necrotic changes of nasal soft tissues developed. On computerized
tomography (CT) scans there were symptoms of rhinosinusitis and
pulmonary infiltrates in the upper lobes of the lungs. Necrosectomy
of nasal soft tissues was performed. In microscopy of tissue specific
hyphae were seen. A.flavus was revealed in culture of this tissue and
bronchoalveolar lavage fluid. The treatment was changed to caspo-
fungin 50 mg/day and voriconazole 400 mg/day.
A complete effect of the treatment of invasive candidosis (C.krusei)
and invasive aspergillosis (A. flavus) was achieved. Duration of anti-
fungal therapy was 98 days. There were no side effects of caspofun-
gin and voriconazole.
Conclusion Combination therapy with caspofungin and voriconaz-
ole can be successful in the treatment of combination of invasive
candidiasis and aspergillosis in haematological patients.

Abstract Number: p171

Conference Year: 2013

Link to conference website: NULL

New link: NULL

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