Cure of orthopaedic infection with Scedosporium prolificans, using voriconazole plus terbinafine, without the need for radical surgery
- 1 June 2003
- Vol. 46 (5-6) , 233-236
- https://doi.org/10.1046/j.1439-0507.2003.00878.x
Abstract
© 2003 Blackwell Publishing LtdScedosporium prolificans infections of normal hosts usually require extensive debridement and sometimes amputation to effect cure, due to the intrinsic resistance of this species to available antifungal agents. Newer agents have not tested favourably. Variable results are obtained with voriconazole, and 100% resistance is described with echinocandins. Itraconazole and terbinafine has offered synergy against various moulds including S. prolificans. In vivo success is reported with the azole/terbinafine combination in S. apiospermum pulmonary infection and Pythium insidiosum periorbital cellulitis. We report a case of orthopaedic infection in a non-immunocompromised host with S. prolificans, in which the combinations of itraconazole/terbinafine and voriconazole/terbinafine showed synergy in vitro, and success was achieved without radical surgery, using voriconazole and terbinafine.I. B. Gosbell, V. Toumasatos, J. Yong, R. S. Kuo, D. H. Ellis and R. C. PerriKeywords
This publication has 15 references indexed in Scilit:
- In Vitro Interaction of Terbinafine with Itraconazole against Clinical Isolates of Scedosporium prolificansAntimicrobial Agents and Chemotherapy, 2000
- Clinical, pathologic and epidemiologic features of infection with Scedosporium prolificans: four cases and reviewClinical Microbiology & Infection, 1999
- Antifungal Agents: Mode of Action, Mechanisms of Resistance, and Correlation of These Mechanisms with Bacterial ResistanceClinical Microbiology Reviews, 1999
- Successful Medical Therapy for Deeply Invasive Facial Infection Due toPythium insidiosumin a ChildClinical Infectious Diseases, 1998
- Activities of amphotericin B and antifungal azoles alone and in combination against Pseudallescheria boydiiAntimicrobial Agents and Chemotherapy, 1995
- Clinical Features of Human Infection with Scedosporium inflatumClinical Infectious Diseases, 1992
- Endocarditis and Hip Arthritis Associated With Scedosporium inflatumSouthern Medical Journal, 1990
- Scedosporium inflatum: Clinical Spectrum of a Newly Recognized PathogenThe Journal of Infectious Diseases, 1990
- Potted plants in hospitals as reservoirs of pathogenic fungiMycopathologia, 1989