Date: 26 November 2013
Secondary metabolites, structure diagram: Trivial name – territrem C
Copyright: n/a
Notes:
Species: A. terreusSystematic name: 4H,11H-Naphtho(2,1-b)pyrano(3,4-e)pyran-1,11(5H)-dione, 4a,6,6a,12,12a,12b-hexahydro-4a,12a-dihydroxy-9-(4-hydroxy-3,5-dimethoxyphenyl)-4,4,6a,12b-tetramethyl-, (4aR-(4a-alpha,6a-beta,12a-alpha,12b-beta))-Molecular formulae: C28H32O9Molecular weight: 512.548Chemical abstracts number: 89020-33-7Selected references: Ling KH, Yang CK, Peng FT. Territrems, tremorgenic mycotoxins of Aspergillus terreus. Appl Environ Microbiol. 1979 Mar;37(3):355-7. Ling KH, Liou HH, Yang CM, Yang CK. Related Articles, Links Isolation, chemical structure, acute toxicity, and some physicochemical properties of territrem C from Aspergillus terreus. Appl Environ Microbiol. 1984 Jan;47(1):98-100. Chen JW, Ling KH. Territrems: Naturally Occurring Specific Irreversible Inhibitors of Acetylcholinesterase. J Biomed Sci. 1996 Jan;3(1):54-58.Toxicity: mouse LD50 intraperitoneal 6280ug/kg (6.28mg/kg) Applied and Environmental Microbiology. Vol. 47, Pg. 98, 1984.
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After 3 weeks of posaconazole given for chronic pulmonary aspergillosis, patient NC had a remarkable exacerbation of psoriasis. He had had psoriasis for years, with little trouble and almost no treatment. After taking posaconazole 400mg twice daily, he developed psoriatic plaques on his hands for the first time ever. The plaques on his lower legs became confluent. This occurred in association with worsening chest symptoms, notably increased coughing, more breathlessness and increasing oxygen requirement.
Posaconazole was stopped after 3 weeks, and 2 weeks later he was still very symptomatic with his chest. This responded to a 2 week course of corticosteroids, and his psoriasis also improved.
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Patient PC: An example of localised caspofungin rash and phlebitis related to caspofungin infusion.
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This 55 year old man with asthma, ABPA, severe bronchiectasis and lung fibrosis was treated with voriconazole, starting in June 2010. He had developed increasing dyspnoea on itraconazole for over 7 years, and his total IgE remained at 1100 KIU/L. He had marked photopsia (visual hallucinations) and facial erythema in the first 3 weeks of therapy. His trough voriconazole concentration was 1.17 mg/L. Over 3 months, he had minor improvement in his breathlessness but continued facial erythema, despite factor 50 sunblock. After 5 months of therapy his facial rash has altered to show acneiform lesions with localised crusting and background severe erythema. His face effectively crusted over, and he stopped therapy.
Over the next 3 weeks his facial appearance slowly improved .
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