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

Lazaros J. 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

38 Scopus citations

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 (US)
Pages (from-to)991-995
Number of pages5
JournalBiology of Blood and Marrow Transplantation
Volume15
Issue number8
DOIs
StatePublished - Aug 2009

Keywords

  • BMT
  • GVHD
  • Mucorales
  • Posaconazole
  • Rhizopus

ASJC Scopus subject areas

  • Transplantation
  • Hematology

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