RRC ID 46950
Author Ogata R, Hagiwara E, Shiihara J, Ogura T, Takahashi H, Kamei K.
Title [A case of lung scedosporiosis successfully treated with monitoring of plasma voriconazole concentration level].
Journal Nihon Kokyuki Gakkai Zasshi
Abstract A 71-year-old man was referred because of fever and productive cough. His chest radiograph showed a large cavitary mass with an intracavitary mycetoma-like lesion in the left middle lung field. We undertook bronchoscopy and CT-guided biopsy, and both bronchial lavage fluid culture and CT-guided biopsy culture revealed Scedosporium apiospermum. On a diagnosis of lung scedosporiosis, he was treated with 200 mg/day voriconazole for 2 months, but his symptoms did not improve. Measurement of the plasma voriconazole level showed low plasma concentration levels (peak level: 2.15 microg/ml, trough level: 0.72 microg/ml). We then increased the voriconazole dosage from 200 mg/day to 400 mg/day. After that, his symptoms and chest radiograph findings improved immediately, accompanied by an elevated plasma voriconazole level (peak level: 5.13 microg/ml, trough level: 3.13 microg/ml). We believe that measurement of plasma voriconazole levels is useful to determine its dosage in lung scedosporiosis.
Volume 49(5)
Pages 388-92
Published 2011-5
PMID 21688649
MeSH Aged Antifungal Agents / administration & dosage* Antifungal Agents / blood* Humans Lung Diseases, Fungal / drug therapy* Male Pyrimidines / administration & dosage* Pyrimidines / blood* Scedosporium* Triazoles / administration & dosage* Triazoles / blood* Voriconazole
Pathogenic microorganisms ?