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

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.
AuthorsC Sánchez, E Mauri, D Dalmau, S Quintana, A Aparicio, J Garau
JournalClinical 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
PMID8749640 (Publication Type: Case Reports, Journal Article, Review)
Chemical References
  • Antifungal Agents
  • Itraconazole
  • 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

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