Osteoarticular Cryptococcosis Successfully Treated with High-Dose Liposomal Amphotericin B Followed by Oral Fluconazole.

Cryptococcus neoformans fluconazole desensitization immunocompetent liposomal amphotericin B osteoarticular cryptococcosis

Journal

Infection and drug resistance
ISSN: 1178-6973
Titre abrégé: Infect Drug Resist
Pays: New Zealand
ID NLM: 101550216

Informations de publication

Date de publication:
2021
Historique:
received: 26 11 2020
accepted: 19 01 2021
entrez: 4 3 2021
pubmed: 5 3 2021
medline: 5 3 2021
Statut: epublish

Résumé

Skeletal involvement of We herein report a case of bone and soft tissue cryptococcal infection in a 42-year-old male from Pakistan with well-controlled diabetes without other associated immunodeficiencies treated with antifungal therapy without surgical debridement. Furthermore, the patient developed toxidermia due to fluconazole use, so a fluconazole desensitization was performed. Therapeutic management also included the performance of therapeutic drug monitoring of fluconazole plasma concentrations. To our knowledge, this is the first case of osteoarticular cryptococcosis treated with this treatment regimen. This strategy may be of interest to try to reduce hospital stay and associated complications.

Sections du résumé

BACKGROUND BACKGROUND
Skeletal involvement of
CASE PRESENTATION METHODS
We herein report a case of bone and soft tissue cryptococcal infection in a 42-year-old male from Pakistan with well-controlled diabetes without other associated immunodeficiencies treated with antifungal therapy without surgical debridement. Furthermore, the patient developed toxidermia due to fluconazole use, so a fluconazole desensitization was performed. Therapeutic management also included the performance of therapeutic drug monitoring of fluconazole plasma concentrations.
CONCLUSION CONCLUSIONS
To our knowledge, this is the first case of osteoarticular cryptococcosis treated with this treatment regimen. This strategy may be of interest to try to reduce hospital stay and associated complications.

Identifiants

pubmed: 33658808
doi: 10.2147/IDR.S294299
pii: 294299
pmc: PMC7917311
doi:

Types de publication

Case Reports

Langues

eng

Pagination

719-722

Informations de copyright

© 2021 Deus et al.

Déclaration de conflit d'intérêts

Juan Pablo Horcajada reports being a speaker with honoraria advisory boards for MSD, Pfizer, and Menarini. The authors report no conflicts of interest in this work.

Références

Front Microbiol. 2015 Jan 14;5:740
pubmed: 25642211
Medicine (Baltimore). 2016 Feb;95(5):e2613
pubmed: 26844472
Clin Infect Dis. 2019 Jan 18;68(3):393-401
pubmed: 29945252
Clin Infect Dis. 2010 Feb 1;50(3):291-322
pubmed: 20047480
J Am Podiatr Med Assoc. 2017 May;107(3):248-252
pubmed: 28650761
PLoS Negl Trop Dis. 2018 Mar 29;12(3):e0006206
pubmed: 29596420
Open Forum Infect Dis. 2019 Oct 1;6(10):
pubmed: 31420668
Mycoses. 2016 Jun;59(6):334-42
pubmed: 26968335
Infect Dis Clin North Am. 2006 Sep;20(3):507-44, v-vi
pubmed: 16984867
Ann Allergy Asthma Immunol. 2008 Jun;100(6):616-7
pubmed: 18592829
N Engl J Med. 2018 Mar 15;378(11):1004-1017
pubmed: 29539274
Can J Infect Dis. 1996 Mar;7(2):125-32
pubmed: 22514429

Auteurs

Guillem Deus (G)

Infectious Diseases Service, Hospital del Mar, Infectious Pathology and Antimicrobials Research Group (IPAR), Institut Hospital del Mar d'Investigacions Mèdiques (IMIM), Universitat Autònoma de Barcelona (UAB), CEXS-Universitat Pompeu Fabra, Barcelona, Spain.

Silvia Gómez-Zorrilla (S)

Infectious Diseases Service, Hospital del Mar, Infectious Pathology and Antimicrobials Research Group (IPAR), Institut Hospital del Mar d'Investigacions Mèdiques (IMIM), Universitat Autònoma de Barcelona (UAB), CEXS-Universitat Pompeu Fabra, Barcelona, Spain.

Daniel Echeverria-Esnal (D)

Pharmacy Service, Hospital del Mar, Infectious Pathology and Antimicrobials Research Group (IPAR), Institut Hospital del Mar d'Investigacions Mèdiques (IMIM), Universitat Autònoma de Barcelona (UAB), Barcelona, Spain.

Ana Siverio (A)

Microbiology Service, Laboratori de Referència de Catalunya, Hospital del Mar, Barcelona, Spain.

Robert Güerri-Fernandez (R)

Infectious Diseases Service, Hospital del Mar, Infectious Pathology and Antimicrobials Research Group (IPAR), Institut Hospital del Mar d'Investigacions Mèdiques (IMIM), Universitat Autònoma de Barcelona (UAB), CEXS-Universitat Pompeu Fabra, Barcelona, Spain.

Jesús Ares (J)

Department of Radiology, Hospital del Mar, Universitat Autònoma de Barcelona (UAB), Barcelona, Spain.

Nuria Campillo (N)

Pharmacy Service, Hospital del Mar, Infectious Pathology and Antimicrobials Research Group (IPAR), Institut Hospital del Mar d'Investigacions Mèdiques (IMIM), Universitat Autònoma de Barcelona (UAB), Barcelona, Spain.

Emili Letang (E)

Infectious Diseases Service, Hospital del Mar, Infectious Pathology and Antimicrobials Research Group (IPAR), Institut Hospital del Mar d'Investigacions Mèdiques (IMIM), Universitat Autònoma de Barcelona (UAB), CEXS-Universitat Pompeu Fabra, Barcelona, Spain.
ISGlobal, Barcelona Institute for Global, Universitat de BarcelonaHealth, Barcelona, Spain.

Hernando Knobel (H)

Infectious Diseases Service, Hospital del Mar, Infectious Pathology and Antimicrobials Research Group (IPAR), Institut Hospital del Mar d'Investigacions Mèdiques (IMIM), Universitat Autònoma de Barcelona (UAB), CEXS-Universitat Pompeu Fabra, Barcelona, Spain.

Santiago Grau (S)

Pharmacy Service, Hospital del Mar, Infectious Pathology and Antimicrobials Research Group (IPAR), Institut Hospital del Mar d'Investigacions Mèdiques (IMIM), Universitat Autònoma de Barcelona (UAB), Barcelona, Spain.

Juan Pablo Horcajada (JP)

Infectious Diseases Service, Hospital del Mar, Infectious Pathology and Antimicrobials Research Group (IPAR), Institut Hospital del Mar d'Investigacions Mèdiques (IMIM), Universitat Autònoma de Barcelona (UAB), CEXS-Universitat Pompeu Fabra, Barcelona, Spain.

Classifications MeSH