Treatment of cerebral Aspergillosis with itraconazole: do high doses improve the prognosis?

Abstract

We describe a 72-year-old woman with chronic asthma who presented with cerebral abscesses due to Aspergillus fumigatus after she received treatment with corticosteroids. Therapy with high-dose itraconazole (800 mg/d for 5 months, followed by 400 mg/d for an additional 4.5 months) resulted in complete resolution of all lesions. Serum concentrations of the drug ranged from 2 micrograms/mL to 30 micrograms/mL. Review of 20 cases of cerebral aspergillosis that were treated with itraconazole revealed that three of the four patients who received high doses (800 mg/d in the adults) of the drug responded favorably, while only two of the 16 patients who received a dose of 400 mg/d were cured. The use of high-dose itraconazole appears to be justified for high-risk patients with cerebral aspergillosis for whom conventional therapy has failed.

• Authors: C Sánchez, E Mauri, D Dalmau, S Quintana, A Aparicio, J Garau
• Journal: Clinical infectious diseases : an official publication of the Infectious Diseases Society of America (Clin Infect Dis) Vol. 21 Issue 6 Pg. 1485-7 (Dec 1995) ISSN: 1058-4838 [Print] United States
• PMID: 8749640 (Publication Type: Case Reports, Journal Article, Review)

Chemical References

• Antifungal Agents
• Itraconazole

Topics

• Aged
• Antifungal Agents (metabolism, therapeutic use)
• Aspergillosis (drug therapy, pathology)
• Aspergillus fumigatus (drug effects, isolation & purification)
• Brain Abscess (drug therapy, microbiology)
• Dose-Response Relationship, Drug
• Female
• Follow-Up Studies
• Humans
• Itraconazole (metabolism, therapeutic use)
• Prognosis
• Tomography, X-Ray Computed