Cure of orthopaedic infection with Scedosporium prolificans, using voriconazole plus terbinafine, without the need for radical surgery

被引：62

作者：

Gosbell, IB

Toumasatos, V

Yong, J

Kuo, RS

Ellis, DH

Perrie, RC

机构：

[1] S Western Area Pathol Serv, Dept Microbiol & Infect Dis, Liverpool, NSW, Australia

[2] S Western Area Pathol Serv, Dept Anat Pathol, Liverpool, NSW, Australia

[3] Univ New S Wales, Fac Med, Sch Med Sci, Dept Pathol, Kensington, NSW 2033, Australia

[4] Liverpool Hosp, Dept Orthopaed, Liverpool, NSW, Australia

[5] Womens & Childrens Hosp, Mycol Unit, Adelaide, SA, Australia

来源：

MYCOSES | 2003年 / 46卷 / 5-6期

关键词：

Scedosporium prolificans; antimycotic chemotherapy; voriconazole; terbinafine; synergy;

D O I：

10.1046/j.1439-0507.2003.00878.x

中图分类号：

R75 [皮肤病学与性病学];

学科分类号：

100206 ;

摘要：

Scedosporium prolificans infections of normal hosts usually require extensive debridement and sometimes amputation to effect cure, due to the intrinsic resistance of this species to available antifungal agents. Newer agents have not tested favourably. Variable results are obtained with voriconazole, and 100% resistance is described with echinocandins. Itraconazole and terbinafine has offered synergy against various moulds including S. prolificans. In vivo success is reported with the azole/terbinafine combination in S. apiospermum pulmonary infection and Pythium insidiosum periorbital cellulitis. We report a case of orthopaedic infection in a non-immunocompromised host with S. prolificans, in which the combinations of itraconazole/terbinafine and voriconazole/terbinafine showed synergy in vitro, and success was achieved without radical surgery, using voriconazole and terbinafine.

引用

页码：233 / 236

页数：4

共 18 条

[1] Comparative in-vitro activity of voriconazole (UK-109,496) and six other antifungal agents against clinical isolates of Scedosporium prolificans and Scedosporium apiospermum [J].