Okugawa Shu, Ota Yasuo, Tatsuno Keita, Tsukada Kunihisa, Kishino Satoshi, Koike Kazuhiko
Department of Infectious Disease, the University of Tokyo, Graduate School of Medicine, Tokyo, Japan.
Scand J Infect Dis. 2007;39(4):344-6. doi: 10.1080/00365540600951333.
Invasive aspergillosis has an extremely high mortality rate. In Japan, micafungin, an echinocandin drug that has a new mechanism of action as an antifungal agent and has a clinical effect against Aspergillus species, became available in 2002. However, little is known about its penetration into the central nervous system (CNS), or its efficacy for the treatment of invasive CNS aspergillosis. We report a 65-y-old female with diabetes mellitus and CNS aspergillosis who was treated with micafungin. During treatment, micafungin concentrations were measured in the cerebrospinal fluid and plasma. On a dose of 300 mg/d, the ratio of the micafungin concentration in the cerebrospinal fluid to that in plasma was extremely low (0.2%-0.05%); nevertheless, the patient did not have a relapse of invasive CNS aspergillosis after micafungin treatment.
侵袭性曲霉病的死亡率极高。在日本，米卡芬净是一种棘白菌素类药物，作为抗真菌剂具有新的作用机制，对曲霉菌种有临床疗效，于2002年上市。然而，关于其在中枢神经系统（CNS）中的渗透情况，或其治疗侵袭性中枢神经系统曲霉病的疗效，人们知之甚少。我们报告了一名65岁患有糖尿病和中枢神经系统曲霉病的女性，她接受了米卡芬净治疗。治疗期间，测量了脑脊液和血浆中的米卡芬净浓度。在每日300毫克的剂量下，脑脊液中米卡芬净浓度与血浆中米卡芬净浓度的比值极低（0.2%-0.05%）；尽管如此，该患者在接受米卡芬净治疗后，侵袭性中枢神经系统曲霉病并未复发。
