Successful Control of Disseminated Scedosporium prolificans Infection with a Combination of Voriconazole and Terbinafine

  title={Successful Control of Disseminated Scedosporium prolificans Infection with a Combination of Voriconazole and Terbinafine},
  author={Benjamin P. Howden and Monica A. Slavin and Anthony P. Schwarer and Anne M. Mijch},
  journal={European Journal of Clinical Microbiology and Infectious Diseases},
  • B. Howden, M. Slavin, +1 author A. Mijch
  • Published 14 February 2003
  • Medicine
  • European Journal of Clinical Microbiology and Infectious Diseases
Disseminated Scedosporium prolificans infections are almost uniformly fatal because of their resistance to antifungal agents. Recently, synergy between triazoles and terbinafine has been demonstrated against Scedosporium prolificans in vitro. Reported here is a patient who developed disseminated Scedosporium prolificans infection following bone marrow transplantation and who was successfully treated with a combination of voriconazole and terbinafine in addition to aggressive surgical… 
Breakthrough Disseminated Scedosporium prolificans Infection in a Patient with Relapsed Leukaemia on Prolonged Voriconazole Followed by Posaconazole Prophylaxis
This report is timely as the uptake of posaconazole, the broadest spectrum azole clinically available, is likely to grow with recent evidence supporting its role as prophylaxis against invasive fungal infections in high-risk haematology patients.
Scedosporium prolificans brain abscess in a patient with chronic granulomatous disease: Successful combination therapy with voriconazole and terbinafine
This is the first reported cure of a CNS S. prolificans infection in an immunocompromised host thanks to a synergistic effect of terbinafine and voriconazole.
Disseminated Scedosporium prolificans infection in a Labrador retriever with immune mediated haemolytic anaemia
This is the first report of disseminated scedosporiosis due to Scedosporium prolificans in a Labrador retriever dog that was receiving immunosuppressive drug therapy for treatment of immune-mediated haemolytic anaemia.
Disseminated Scedosporium prolificans infection in an ‘extensive metaboliser’: navigating the minefield of drug interactions and pharmacogenomics
We report a case of non‐fatal disseminated Scedosporium prolificans infection, including central nervous system disease and endophthalmitis, in a relapsed acute myeloid leukaemia patient with
Successful control of Scedosporium prolificans septic arthritis and probable osteomyelitis without radical surgery in a long‐term renal transplant recipient
A long‐term renal transplant recipient who developed isolated S. prolificans septic monoarthritis and probable osteomyelitis is reported here and the infection was successfully treated with a combination of voriconazole and terbinafine in addition to joint washout but did not require radical surgery.
Scedosporium apiospermum infections and the role of combination antifungal therapy and GM-CSF: A case report and review of the literature
An immunocompromised patient with a cutaneous S. apiospermum infection that disseminated despite treatment with voriconazole is presented, indicating a potential synergistic role of dual-antifungal and immunotherapeutic agents.
Disseminated Scedosporium apiospermum infection in a Patient with Chronic Granulomatous Disease
We report a case of disseminated Scedosporium apiospermum in a young man with chronic granulomatous disease who was successfully treated with surgery, combined antifungal therapy, and granulocyte
Breakthrough lung Scedosporium prolificans infection with multiple cavity lesions in a patient receiving voriconazole for probable invasive aspergillosis associated with monoclonal gammopathy of undetermined significance (MGUS).
A case of lung Scedosporium prolificans infection with multiple cavities in a 58-year-old man with monoclonal gammopathy of undetermined significance during voriconazole treatment for probable invasive aspergillosis is reported.
Disseminated Scedosporium prolificans infection and survival of a child with acute lymphoblastic leukemia.
This report reports on a pediatric patient who developed overwhelming S. prolificans sepsis after induction chemotherapy for acute lymphoblastic leukemia and continues to receive chemotherapy for leukemia, which remains in remission.
Combination Antifungal Therapy in the Treatment of Scedosporium apiospermum Central Nervous System Infections
Two cases of the successful treatment of S. apiospermum CNS infections with the combination of voriconazole and terbinafine are presented.


Disseminated infection and colonization by Scedosporium prolificans: a review of 18 cases, 1990-1999.
Scedosporium prolificans infection was analyzed in 18 patients from whom the fungus was isolated during the period 1990-1999, and 4 patients with leukemia died, 1 patient with breast cancer who underwent autologous bone marrow transplantation survived, and1 patient with advanced acquired immunodeficiency syndrome died, although the fungal infection did not seem to affect his clinical symptoms.
Disseminated infection by Scedosporium Prolificans: an emerging fatality among haematology patients. Case report and review
A case of proven disseminated infection by Scedosporium prolificans in a profoundly neutropenic patient and reversal of the underlying deficient immune status appears of great importance is described.
In Vitro Interaction of Terbinafine with Itraconazole against Clinical Isolates of Scedosporium prolificans
ABSTRACT In order to develop new approaches for the chemotherapy of invasive infections caused by Scedosporium prolificans, the in vitro interaction between itraconazole and terbinafine against 20
Airborne outbreak of nosocomial Scedosporium prolificans infection
It is concluded that fatal multidrug-resistant S prolificans epidemics can be aerially transmitted and can be prevented with implementation of appropriate infection-control measures.
Disseminated phaeohyphomycosis: review of an emerging mycosis.
Disseminated phaeohyphomycosis is an uncommon infection caused by dematiaceous fungi, although the number of case reports has been increasing in recent years.
Comparative in-vitro activity of voriconazole (UK-109,496) and six other antifungal agents against clinical isolates of Scedosporium prolificans and Scedosporium apiospermum.
Voriconazole was much more active than fluconazole and flucytosine, moreactive than amphotericin B, itraconazole, ketoconazoles and ketoconzole and was as active as miconazoles against S. apiospermum isolates.
Synergistic interaction of terbinafine with triazoles or amphotericin B against Aspergillus species.
The results suggest potential clinical application of terbinafine in aspergillosis, either alone or in combination with amphotericin or triazoles, or with itraconazole or voriconazole.
In Vitro Activities of New and Conventional Antifungal Agents against Clinical Scedosporium Isolates
Low growth-inhibitory antifungal activities were found in vitro for most of the drugs tested against S. prolificans isolates, with the MICs at which 90% of isolates are inhibited (MIC90s) being >8 μg/ml; the MIC90s of voriconazole and UR-9825, however, were 4 μg/ ml.
In Vitro Fungicidal Activities of Voriconazole, Itraconazole, and Amphotericin B against Opportunistic Moniliaceous and Dematiaceous Fungi
The role of the MFC as a predictor of clinical outcome needs to be established in clinical trials by following standardized testing conditions for determination of these in vitro values.
National Committee for Clinical Laboratory Standards.
Many members of the Academy of Pediatrics seem to be generally unaware of the fact that your Academy has participated for ten years in a very interesting and valuable organization, the National