Fatal Rhizopus Pneumonia in Allogeneic Stem Cell Transplant Patients Despite Posaconazole Prophylaxis: Two Cases and Review of the Literature

Lazaros Lekakis, Amber Lawson, Jeanette Prante, Julie Ribes, Gregory J. Davis, Gregory Monohan, Ioannis G. Baraboutis, Athanasios T. Skoutelis, Dianna S. Howard

Research output: Contribution to journalArticle

37 Citations (Scopus)

Abstract

Posaconazole is a triazole with broad spectrum of activity against multiple fungi including members of the fungal order Mucorales. This activity has been shown both in clinical and in vitro studies, which are critically reviewed here. It has become very popular in prophylaxis in acute myelogenous leukemia (AML) induction and in the graft-versus-host disease (GVHD) settings after 2 recent prospective trials that showed advantage of posaconazole prophylaxis compared to fluconazole or itraconazole. In this report, 2 patients are presented, in whom, despite posaconazole prophylaxis, invasive and ultimately fatal Rhizopus pulmonary infections developed. These cases are similar to a previously reported case of Rhizopus infection in a stem cell transplant recipient who also received posaconazole, indicating a potential newly recognized pattern of breakthrough infections in patients receiving posaconazole prophylaxis.

Original languageEnglish
Pages (from-to)991-995
Number of pages5
JournalBiology of Blood and Marrow Transplantation
Volume15
Issue number8
DOIs
StatePublished - Aug 1 2009
Externally publishedYes

Fingerprint

Rhizopus
Pneumonia
Stem Cells
Transplants
Mucorales
Infection
Triazoles
Itraconazole
Fluconazole
Graft vs Host Disease
Acute Myeloid Leukemia
Fungi
posaconazole
Lung

Keywords

  • BMT
  • GVHD
  • Mucorales
  • Posaconazole
  • Rhizopus

ASJC Scopus subject areas

  • Transplantation
  • Hematology

Cite this

Fatal Rhizopus Pneumonia in Allogeneic Stem Cell Transplant Patients Despite Posaconazole Prophylaxis : Two Cases and Review of the Literature. / Lekakis, Lazaros; Lawson, Amber; Prante, Jeanette; Ribes, Julie; Davis, Gregory J.; Monohan, Gregory; Baraboutis, Ioannis G.; Skoutelis, Athanasios T.; Howard, Dianna S.

In: Biology of Blood and Marrow Transplantation, Vol. 15, No. 8, 01.08.2009, p. 991-995.

Research output: Contribution to journalArticle

Lekakis, Lazaros ; Lawson, Amber ; Prante, Jeanette ; Ribes, Julie ; Davis, Gregory J. ; Monohan, Gregory ; Baraboutis, Ioannis G. ; Skoutelis, Athanasios T. ; Howard, Dianna S. / Fatal Rhizopus Pneumonia in Allogeneic Stem Cell Transplant Patients Despite Posaconazole Prophylaxis : Two Cases and Review of the Literature. In: Biology of Blood and Marrow Transplantation. 2009 ; Vol. 15, No. 8. pp. 991-995.
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