Sternberg Candice A, Martinez Andres, Olayiwola Ayoola, Almonte Maria Morel, Vu Christine A, Quiroz Tanya, Montreuil Nadine, Ayoade Folusakin
University of Miami, Miller School of Medicine, FL, USA.
Jackson Health System, Miami, FL, USA.
J Investig Med High Impact Case Rep. 2025 Jan-Dec;13:23247096251329684. doi: 10.1177/23247096251329684. Epub 2025 Mar 26.
Co-infection with and in an immunocompetent host is rare but can occur. In this case, we present a patient with central nervous system tuberculosis (TB) and biopsy-proven spinal co-infections with TB and Aspergillosis. We highlight the complexities of treating a TB-Aspergillosis co-infection given drug-drug interactions between standard therapy for both conditions. Using susceptibilities for the and carefully monitoring drug levels of the antifungal agents, we were able to optimally treat the co-infection. This patient was ultimately discharged on isoniazid 1200 mg (15 mg/kg) daily, levofloxacin 750 mg daily, rifabutin 450 mg daily, and posaconazole 300 mg twice daily with a tentative plan to treat for at least 1 year with close outpatient follow-up. This case can serve as a guide for other providers who need to treat cases of TB and Aspergillosis co-infection by learning from our experience and paying attention to potential pitfalls.
在免疫功能正常的宿主中，与[未提及具体病原体]共同感染的情况很少见，但也可能发生。在本病例中，我们报告了一名患有中枢神经系统结核病（TB）且经活检证实脊柱存在结核与曲霉病共同感染的患者。鉴于两种疾病标准治疗之间的药物相互作用，我们强调了治疗结核 - 曲霉病共同感染的复杂性。通过利用[未提及具体病原体]的药敏结果并仔细监测抗真菌药物的血药浓度，我们得以对共同感染进行了最佳治疗。该患者最终出院时，每日服用异烟肼1200毫克（15毫克/千克）、左氧氟沙星750毫克、利福布汀450毫克以及泊沙康唑300毫克，每日两次，初步计划进行至少1年的治疗，并在门诊密切随访。该病例可为其他需要治疗结核与曲霉病共同感染病例的医疗人员提供指导，通过借鉴我们的经验并注意潜在的陷阱。
