Cunninghamella bertholletiae infection in a bone marrow transplant patient: amphotericin lung penetration, MIC determinations, and review of the literature.
Pharmacotherapy
; 21(7): 855-60, 2001 Jul.
Article
em En
| MEDLINE
| ID: mdl-11444582
ABSTRACT
Infections caused by Cunninghamella bertholletiae, an opportunistic fungal organism, have an extremely high mortality rate. A fatal case of C. bertholletiae fungal pneumonia occurred in a man who had received an allogeneic bone marrow transplant. Aggressive debridement and high-dose liposomal amphotericin B failed to eradicate the infection. Right lung tissue samples obtained during lobectomy were assayed for amphotericin B concentrations by high-performance liquid chromatography, and minimum inhibitory concentration (MIC) determinations of amphotericin B against C. bertholletiae were determined by the macrobroth dilution method. The MIC for the isolate of C. bertholletiae was 4 microg/ml. Amphotericin B lung concentrations averaged 9.5 microg/ml (range 3.7-13.8 microg/ml), with a corresponding serum trough concentration of 0.9 microg/ml. To our knowledge, this is the first reported case of amphotericin B concentrations measured at the site of infection in a patient with a pulmonary Cunninghamella infection, together with a corresponding MIC of the organism. The patient's death, which occurred despite aggressive debridement and high amphotericin B lung concentrations, highlights the need for novel strategies to treat infections caused by invasive molds such as C. bertholletiae.
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Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Anfotericina B
/
Transplante de Medula Óssea
/
Cunninghamella
/
Pneumopatias Fúngicas
/
Mucormicose
/
Antifúngicos
Limite:
Humans
/
Male
/
Middle aged
Idioma:
En
Revista:
Pharmacotherapy
Ano de publicação:
2001
Tipo de documento:
Article
País de afiliação:
Estados Unidos