Isavuconazole Treatment of Spinal Cord Invasive Aspergillosis Guided by Cerebrospinal Fluid (1,3)-β-d-Glucan Levels in a Patient with Low Interferon-Gamma and Ulcerative Colitis

This case highlights the use of (1,3)-beta-d glucan to direct treatment of a cervical spinal cord Aspergillus fumigatus infection in a 22-year-old woman immunocompromised due to steroid and anti-TNF therapy in the context of ulcerative colitis and interferon gamma deficiency. A 4-year treatment cour...

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Autores principales: O’Regan, Siobhan, O’Kelly, Brendan, Reidy, Paul, O’Toole, Aoibhlinn, Caird, John, McNally, Cora, McConkey, Samuel, de Barra, Eoghan
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Case Report
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9224947/
https://www.ncbi.nlm.nih.gov/pubmed/35736040
http://dx.doi.org/10.3390/jof8060557
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author O’Regan, Siobhan
O’Kelly, Brendan
Reidy, Paul
O’Toole, Aoibhlinn
Caird, John
McNally, Cora
McConkey, Samuel
de Barra, Eoghan
author_facet O’Regan, Siobhan
O’Kelly, Brendan
Reidy, Paul
O’Toole, Aoibhlinn
Caird, John
McNally, Cora
McConkey, Samuel
de Barra, Eoghan
author_sort O’Regan, Siobhan
collection PubMed
description This case highlights the use of (1,3)-beta-d glucan to direct treatment of a cervical spinal cord Aspergillus fumigatus infection in a 22-year-old woman immunocompromised due to steroid and anti-TNF therapy in the context of ulcerative colitis and interferon gamma deficiency. A 4-year treatment course requiring neurosurgical intervention on four occasions and prolonged antifungal therapy, including isavuconazole, resulted in clinical cure with a corresponding decrease in CSF beta-d-glucan to <30 pg/mL. Serum and CSF galactomannan levels were not elevated at any point during the clinical course.
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spelling pubmed-92249472022-06-24 Isavuconazole Treatment of Spinal Cord Invasive Aspergillosis Guided by Cerebrospinal Fluid (1,3)-β-d-Glucan Levels in a Patient with Low Interferon-Gamma and Ulcerative Colitis O’Regan, Siobhan O’Kelly, Brendan Reidy, Paul O’Toole, Aoibhlinn Caird, John McNally, Cora McConkey, Samuel de Barra, Eoghan J Fungi (Basel) Case Report This case highlights the use of (1,3)-beta-d glucan to direct treatment of a cervical spinal cord Aspergillus fumigatus infection in a 22-year-old woman immunocompromised due to steroid and anti-TNF therapy in the context of ulcerative colitis and interferon gamma deficiency. A 4-year treatment course requiring neurosurgical intervention on four occasions and prolonged antifungal therapy, including isavuconazole, resulted in clinical cure with a corresponding decrease in CSF beta-d-glucan to <30 pg/mL. Serum and CSF galactomannan levels were not elevated at any point during the clinical course. MDPI 2022-05-25 /pmc/articles/PMC9224947/ /pubmed/35736040 http://dx.doi.org/10.3390/jof8060557 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Case Report
O’Regan, Siobhan
O’Kelly, Brendan
Reidy, Paul
O’Toole, Aoibhlinn
Caird, John
McNally, Cora
McConkey, Samuel
de Barra, Eoghan
Isavuconazole Treatment of Spinal Cord Invasive Aspergillosis Guided by Cerebrospinal Fluid (1,3)-β-d-Glucan Levels in a Patient with Low Interferon-Gamma and Ulcerative Colitis
title Isavuconazole Treatment of Spinal Cord Invasive Aspergillosis Guided by Cerebrospinal Fluid (1,3)-β-d-Glucan Levels in a Patient with Low Interferon-Gamma and Ulcerative Colitis
title_full Isavuconazole Treatment of Spinal Cord Invasive Aspergillosis Guided by Cerebrospinal Fluid (1,3)-β-d-Glucan Levels in a Patient with Low Interferon-Gamma and Ulcerative Colitis
title_fullStr Isavuconazole Treatment of Spinal Cord Invasive Aspergillosis Guided by Cerebrospinal Fluid (1,3)-β-d-Glucan Levels in a Patient with Low Interferon-Gamma and Ulcerative Colitis
title_full_unstemmed Isavuconazole Treatment of Spinal Cord Invasive Aspergillosis Guided by Cerebrospinal Fluid (1,3)-β-d-Glucan Levels in a Patient with Low Interferon-Gamma and Ulcerative Colitis
title_short Isavuconazole Treatment of Spinal Cord Invasive Aspergillosis Guided by Cerebrospinal Fluid (1,3)-β-d-Glucan Levels in a Patient with Low Interferon-Gamma and Ulcerative Colitis
title_sort isavuconazole treatment of spinal cord invasive aspergillosis guided by cerebrospinal fluid (1,3)-β-d-glucan levels in a patient with low interferon-gamma and ulcerative colitis
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9224947/
https://www.ncbi.nlm.nih.gov/pubmed/35736040
http://dx.doi.org/10.3390/jof8060557
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