Invasive pulmonary aspergillosis with hematological malignancy caused by Aspergillus terreus and in vitro susceptibility of A. terreus isolate to micafungin.

Abstract	A 35-year-old man developed invasive pulmonary aspergillosis (IPA) with severe neutropenia after umbilical cord stem cell transplantation for chronic myelogenous leukemia. Filamentous fungus isolated from his sputum was identified as Aspergillus terreus. Despite systemic amphotericin B (AMPH) administration, IPA progressed. However, intravenous administration of micafungin (MCFG) and oral itraconazole improved clinical data and symptoms, although he later died of massive hemoptysis. Examination of the in vitro susceptibility of this A. terreus isolate to MCFG revealed a good minimum inhibitory concentration and good time-kill assay results compared to AMPH. Thus, MCFG might be useful for IPA caused by A. terreus.
Authors	Issei Tokimatsu, Hisako Kushima, Atsuko Iwata, Kazuhiko Hashinaga, Kenji Umeki, Minoru Ohama, Kazuhiro Kohno, Hiroshi Ishii, Kenji Kishi, Masao Ogata, Kazufumi Hiramatsu, Tetsunori Saikawa, Jun-ichi Kadota
Journal	Internal medicine (Tokyo, Japan) (Intern Med) Vol. 46 Issue 11 Pg. 775-9 ( 2007) ISSN: 1349-7235 [Electronic] Japan
PMID	17541234 (Publication Type: Case Reports, Journal Article)
Chemical References	Antifungal Agents Echinocandins Lipopeptides Lipoproteins Peptides, Cyclic Itraconazole Micafungin
Topics	Adult Antifungal Agents (pharmacology, therapeutic use) Aspergillosis (drug therapy, etiology) Aspergillus (drug effects, pathogenicity) Drug Therapy, Combination Echinocandins Humans Itraconazole (therapeutic use) Leukemia, Myelogenous, Chronic, BCR-ABL Positive (complications, therapy) Lipopeptides Lipoproteins (pharmacology, therapeutic use) Lung Diseases, Fungal (drug therapy, etiology) Male Micafungin Neutropenia (complications) Opportunistic Infections (diagnosis, drug therapy, etiology) Peptides, Cyclic (pharmacology, therapeutic use) Sputum (microbiology) Stem Cell Transplantation (adverse effects)

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