Fatal Breakthrough Mucormycosis in an Acute Myelogenous Leukemia Patient while on Posaconazole Prophylaxis
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초록
Posaconazole is a new oral triazole with broad-spectrum antifungal activity. Posaconazole has also shown a significant advantageof 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 chemotherapyfor acute myelogenous leukemia or myelodysplastic syndrome. We experienced a case of fatal mucormycosis despiteposaconazole prophylaxis. To our knowledge, this is the first reported case of fatal breakthrough mucormycosis in a patientreceiving posaconazole prophylaxis during remission induction chemotherapy in Korea. This case demonstrated that breakthroughfungal infection can occurs in patients receiving posaconazole prophylaxis because of its limited activity against somemucorales.
Abstract
Posaconazole is a new oral triazole with broad-spectrum antifungal activity. Posaconazole has also shown a significant advantageof 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 chemotherapyfor acute myelogenous leukemia or myelodysplastic syndrome. We experienced a case of fatal mucormycosis despiteposaconazole prophylaxis. To our knowledge, this is the first reported case of fatal breakthrough mucormycosis in a patientreceiving posaconazole prophylaxis during remission induction chemotherapy in Korea. This case demonstrated that breakthroughfungal infection can occurs in patients receiving posaconazole prophylaxis because of its limited activity against somemucorales.
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