Clinical resolution of Scedosporium prolificans pneumonia associated with treatment with liposomal amphotericin B in a patient with acute leukemia.

Scedosporium prolificans is a filamentous fungus which has been recently identified as the aetiologic agent of severe infections in patients with haematological malignancies. Due to the resistance of S. prolificans to all known antifungals there are very few patients recovering from invasive infections. We describe the case of a patient with acute leukaemia who developed a S. prolificans pneumonia successfully treated with liposomal amphotericin B and who underwent autologous peripheral blood stem cells transplantation. The patient is in good health and has shown no evidence of reactivation of S. prolificans infection over one year after the transplant. Liposomal amphotericin B may be an effective treatment of pneumonia caused by S. prolificans in haematological patients.

[Invasive bronchopulmonary aspergillosis treated with itraconazole in a patient with acute leukemia]. / Aspergilosis broncopulmonar invasiva tratada con itraconazol en una paciente con leucemia aguda.

A case of invasive broncopulmonar aspergillosis caused by Aspergillus terreus successfully treated with itraconazole is reported in a patient undergoing autologous bone marrow transplantation for acute lymphoblastic leukaemia. Although the patient was on prophylaxis with fluconazole and she did not respond to amphotericin B, there was an excellent response to itraconazole which allowed the transplant without any Aspergillus infection during both the transplant and the post-transplant periods. Due to its oral administration, good tolerance and low toxicity, itraconazole is a promising drug for the treatment of invasive broncopulmonar aspergillosis.