Successful treatment of Fusarium proliferatum pneumonia with posaconazole in a lung transplant recipient

Herbrecht, Raoul; Kessler, Romain; Kravanja, Christine; Meyer, Marie-Hélène; Waller, Jocelyn; Letscher-Bru, Valérie

doi:10.1016/j.healun.2003.09.033

« Previous Next »The Journal of Heart and Lung Transplantation
Volume 23, Issue 12 , Pages 1451-1454, December 2004

Successful treatment of Fusarium proliferatum pneumonia with posaconazole in a lung transplant recipient

Raoul Herbrecht, MD
- Department of Hematology and Oncology, Hôpital de Hautepierre, Hôpitaux Universitaires de Strasbourg, 67098 Strasbourg, France
- Reprint requests: Raoul Herbrecht, MD, Département d’Hématologie et d’Oncologie, Hôpital de Hautepierre, Hôpitaux Universitaires de Strasbourg, 67098 Strasbourg, France. Telephone: +33-388-12-76-88. Fax: +33-388-12-76-81.
Romain Kessler, MD
- Department of Pulmonology, Hôpital de Hautepierre, Hôpitaux Universitaires de Strasbourg, 67098 Strasbourg, France
Christine Kravanja, PharmD
- Department of Hematology and Oncology, Hôpital de Hautepierre, Hôpitaux Universitaires de Strasbourg, 67098 Strasbourg, France
Marie-Hélène Meyer, PharmD
- Department of Hematology and Oncology, Hôpital de Hautepierre, Hôpitaux Universitaires de Strasbourg, 67098 Strasbourg, France
Jocelyn Waller, MD
- Institute of Parasitology and Tropical Pathology, Strasbourg, France
Valérie Letscher-Bru, PharmD
- Institute of Parasitology and Tropical Pathology, Strasbourg, France

Received 30 June 2003; received in revised form 1 September 2003; accepted 29 September 2003.

Abstract

A 62-year-old lung transplant recipient had Fusarium proliferatum pneumonia during itraconazole prophylaxis. Severe dyspnea and emphysema ensued, requiring supplemental oxygen therapy. Therapeutic options for this patient were limited; renal insufficiency and cyclosporine use precluded amphotericin B therapy, and susceptibility testing indicated that itraconazole and fluconazole had poor activity against F proliferatum. Treatment with posaconazole, a new triazole in clinical development for the prophylaxis and treatment of fungal infection, resulted in rapid clinical improvement and successful eradication of F proliferatum. Posaconazole may provide effective treatment for difficult-to-treat Fusarium infections.