Department of Internal Medicine, McMaster University;
Can J Infect Dis Med Microbiol. 2012 Summer;23(2):e44-7. doi: 10.1155/2012/272197.
Fungi are an important and common cause of cutaneous infections affecting solid organ transplant recipients. These infections can represent a primary site of infection with the potential for dissemination, or a manifestation of metastatic infection. The high morbidity and mortality associated with these infections necessitates urgent therapy with antifungal drugs; however, the interaction between these drugs and immunosuppressive therapies can be a major limitation because of drug toxicity. A case of soft tissue infection of the toe caused by Fusarium chlamydosporum and Candida guilliermondii in a liver transplant patient on sirolimus, who was successfully treated with the new antifungal agent posaconazole, is described. The pharmacokinetic interactions of sirolimus and the new triazoles, and their impact on treatment choices are briefly discussed.
真菌是导致影响实体器官移植受者的皮肤感染的重要且常见的原因。这些感染可能代表感染的主要部位，并有可能传播，或者表现为转移性感染。这些感染相关的高发病率和死亡率需要用抗真菌药物进行紧急治疗；然而，由于药物毒性，这些药物与免疫抑制治疗之间的相互作用可能是一个主要的限制因素。描述了一例在使用西罗莫司的肝移植患者中，由枝顶孢霉和季也蒙毕赤酵母引起的脚趾软组织感染，该患者成功地用新型抗真菌药物泊沙康唑进行了治疗。简要讨论了西罗莫司与新型三唑类药物的药代动力学相互作用及其对治疗选择的影响。
