Kang Seung Hun, Kim Hyun Seon, Bae Myoung Nam, Kim Jihye, Yoo Ji Yeon, Lee Kwan Yong, Lee Dong-Gun, Kim Hee-Je
Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea.
Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea. ; Catholic Blood and Marrow Transplantation Center, College of Medicine, The Catholic University of Korea, Seoul, Korea.
Infect Chemother. 2015 Mar;47(1):49-54. doi: 10.3947/ic.2015.47.1.49. Epub 2015 Mar 30.
Posaconazole is a new oral triazole with broad-spectrum antifungal activity. Posaconazole has also shown a significant advantage of preventing invasive fungal infection compared to fluconazole or itraconazole in patients with prolonged neutropenia. Indeed, posaconazole has been commonly used for antifungal prophylaxis in patients undergoing remission induction chemotherapy for acute myelogenous leukemia or myelodysplastic syndrome. We experienced a case of fatal mucormycosis despite posaconazole prophylaxis. To our knowledge, this is the first reported case of fatal breakthrough mucormycosis in a patient receiving posaconazole prophylaxis during remission induction chemotherapy in Korea. This case demonstrated that breakthrough fungal infection can occurs in patients receiving posaconazole prophylaxis because of its limited activity against some mucorales.
泊沙康唑是一种新型口服三唑类药物，具有广谱抗真菌活性。与氟康唑或伊曲康唑相比，泊沙康唑在长期中性粒细胞减少的患者中预防侵袭性真菌感染方面也显示出显著优势。实际上，泊沙康唑已普遍用于急性髓性白血病或骨髓增生异常综合征缓解诱导化疗患者的抗真菌预防。尽管进行了泊沙康唑预防，我们仍经历了一例致命的毛霉菌病病例。据我们所知，这是韩国首例在缓解诱导化疗期间接受泊沙康唑预防的患者发生致命突破性毛霉菌病的报告病例。该病例表明，接受泊沙康唑预防的患者可能会发生突破性真菌感染，因为其对某些毛霉目真菌的活性有限。
