TITLE:
Utility of Miconazole Therapy for Trichosporon Fungemia in Patients with Acute Leukemia
AUTHORS:
Kazunori Nakase, Kei Suzuki, Taiichi Kyo, Yumiko Sugawara, Shinichi Kageyama, Naoyuki Katayama
KEYWORDS:
Miconazole; Trichosporon; Fungemia; Acute Leukemia
JOURNAL NAME:
Advances in Microbiology,
Vol.3 No.8A,
December
26,
2013
ABSTRACT: Invasive trichosporonosis is an
extremely rare mycosis, but Trichosporon fungemia (TF) in patients
with hematologic malignancies has been increasingly recognized to be a
fulminant and highly lethal infection. Although the utility of azole therapy
has been demonstrated in several observations, little is known about the
efficacy of one of azoles, miconazole (MCZ). To assess its therapeutic role, we
retrospectively investigated 6 cases of TF in patients with acute leukemia
receiving MCZ containing regimens. Successful outcome was obtained in 4
patients [MCZ + amphotericin B (AmB) in 2, MCZ only and MCZ + fluconazole
(FLCZ) + AmB in one each], but not in 2 (MCZ + FLCZ + AmB and
MCZ + FLCZ in one each). Although MCZ and AmB exhibited good in vitro activities against isolates
from all patients, FLCZ had such finding from only one patient. Considering the
reportedly limited utility of AmB, MCZ seemed to play a critical role
even in the
combination therapies for TF. Despite the release of newer
azoles and other classes of antifungals, the use of MCZ remains a potential
therapeutic approach for TF in patients with acute leukemia.