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Utility of Miconazole Therapy for Trichosporon Fungemia in Patients with Acute Leukemia

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DOI: 10.4236/aim.2013.38A008    2,530 Downloads   3,641 Views   Citations

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.

Conflicts of Interest

The authors declare no conflicts of interest.

Cite this paper

K. Nakase, K. Suzuki, T. Kyo, Y. Sugawara, S. Kageyama and N. Katayama, "Utility of Miconazole Therapy for Trichosporon Fungemia in Patients with Acute Leukemia," Advances in Microbiology, Vol. 3 No. 8A, 2013, pp. 47-51. doi: 10.4236/aim.2013.38A008.

References

[1] T. J. Walsh, “Trichosporonosis,” Infectious Disease Clinics of North America, Vol. 3, No. 1, 1989, pp. 43-52.
[2] K. Shimazu, M. Ando, T. Sakata, K. Yoshida and S. Araki, “Hypersensitivity Pneumonitis Induced by Trichosporon cutaneum,” American Review of Respiratory Disease, Vol. 130, No. 3, 1984, pp. 409-411.
[3] S. Kataoka-Nishimura, H. Akiyama, K. Saku, M. Kashiwa, S. Mori, S. Tanikawa, H. Sakamaki and Y. Onozawa, “Invasive Infection Due to Trichosporon cutaneum in Patients with Hematologic Malignancies,” Cancer, Vol. 82, No. 3, 1998, pp. 484-487.
http://dx.doi.org/10.1002/(SICI)1097-0142(19980201)82:3<484::AID-CNCR9>3.0.CO;2-P
[4] V. Kremery Jr., F. Mateicka, A. Kunova, S. Spanik, J. Gyarfas, Z. Sycova and J. Trupl, “Hematogenous Trichosporonosis in Cancer Patients: Report of 12 Cases Including 5 during Prophylaxis with Itraconazole,” Support Care Cancer, Vol. 7, No. 1, 1999, pp. 39-43.
http://dx.doi.org/10.1007/s005200050221
[5] D. P. Kontoyiannis, H. A. Torres, M. Chagua, R. Hachem, J. J. Tarrand, G. P. Bodey and I. I. Raad, “Trichosporonosis in a Tertiary Care Cancer Center: Risk Factors, Changing Spectrum and Determinants of Outcome,” Scandinavian Journal of Infectious Disease, Vol. 36, No. 8, 2004, pp. 564-569.
[6] C. Girmenia, L. Pagano, B. Martino, D. D’Antonio, R. Fanci, G. Specchia, L. Melillo, M. Buelli, G. Pizzarelli, M. Venditti and P. Martino, “Invasive Infections Caused by Trichosporon Species and Geotrichum capitatum in Patients with Hematological Malignancies: A Retrospective Multicenter Study from Italy and Review of the Literature,” Journal of Clinical Microbiology, Vol. 43, No. 4, 2005, pp. 1818-1828.
http://dx.doi.org/10.1128/JCM.43.4.1818-1828.2005
[7] K. Suzuki, K. Nakase, T. Kyo, T. Kohara, Y. Sugawara, T. Shibazaki, K. Oka, T. Tsukada and N. Katayama, “Fatal Trichosporon Fungemia in Patients with Hematological Malignancies,” European Journal of Haematology, Vol. 84, No. 5, 2010, pp. 441-447.
http://dx.doi.org/10.1111/j.1600-0609.2010.01410.x
[8] E. Anaissie, A. Gokaslan, R. Hachem, R. Rubin, G. Griffin, R. Robinson, J. Sobel and G. Bodey, “Azole Therapy for Trichosporonosis: Clinical Evaluation of Eight Patients, Experimental Therapy for Murine Infection, and Review,” Clinical Infectious Disease, Vol. 15, No. 5, 1992, pp. 781-787.
http://dx.doi.org/10.1093/clind/15.5.781
[9] S. Fournier, W. Pavageau, M. Feuillhade, S. Deplus, A. M. Zagdanski, O. Verola, H. Dombret and J. M. Molina, “Use of Voriconazole to Successfully Treat Disseminated Trichosporon asahii Infection in a Patient with Acute Myeloid Leukemia,” European Journal of Clinical Microbiology & Infectious Disease, Vol. 21, No. 12, 2002, pp. 892-896.
[10] R. Falk, D. G. Wolf, M. Shaprio and I. Polacheck, “Multidrug Resistant Trichosporon asahii Isolates Are Susceptible to Voriconazole,” Journal of Clinical Microbiology, Vol. 41, No. 2, 2003, p. 911.
http://dx.doi.org/10.1128/JCM.41.2.911.2003
[11] I. J. Sud and D. S. Feingold, “Heterogeneity of Action Mechanisms among Antimycotic Imidazoles,” Antimicrobial Agents and Chemotherapy, Vol. 20, No. 1, 1981, pp. 171-174.
http://dx.doi.org/10.1128/AAC.20.1.71
[12] D. Kobayashi, K. Kondo, N. Uehara, S. Otokozawa, N. Tsuji, A. Yagihashi and N. Watanabe, “Endogenous Reactive Oxygen Species Is an Important Mediator of Miconazole Antifungal Effect,” Antimicrobial Agents and Chemotherapy, Vol. 46, No. 10, 2002, pp. 3113-3117.
http://dx.doi.org/10.1128/AAC.46.10.3113-3117.2002
[13] National Committee for Clinical Laboratory Standards, “Reference Method for Broth Dilution Antifungal Susceptibility Testing of Yeast; Approved Standard,” NCCLS document M27-A, National Committee for Clinical Laboratory Standards, Wayne, 1997.
[14] K. Perparim, H. Nagai, A. Hashimoto, Y. Goto, T. Tashiro and M. Nasu, “In Vitro Susceptibility of Trichosporon beigelii to Antifungal Agents,” Journal of Chemotherapy, Vol. 8, No. 6, 1996, pp. 445-448.
[15] K. Marr, “Combination Antifungal Therapy: Where Are We Now, and Where Are We Going?” Oncology (Williston Park), Vol. 18, No. 13, 2004, pp. 24-29.
[16] H. Senati, C. F. Ramos, A. S. Bayer and M. A. Ghannoum, “Combination Therapy with Amphotericin B and Fluconazole against Invasive Candidiasis in NeutropenicMouse and Infective-Endocarditis Rabbit Models,” Antimicrobial Agents and Chemotherapy, Vol. 41, No. 6, 1997, pp. 1345-1348.
[17] A. I. Popp, M. H. White, T. Quadri, L. Walshe and D. Armastrong, “Amphotericin B with and without Itraconazole for Invasive Aspergillosis: A Three-Year Retrospective Study,” International Journal of Infectious Disease, Vol. 3, No. 3, 1999, pp. 157-160.
http://dx.doi.org/10.1016/S1201-9712(99)90038-3
[18] T. J. Walsh, G. P. Melcher, M. G. Rinaldi, J. Lecciones, D. A. McGough, P. Kelly, J. Lee, D. Callender, M. Rubin and P. A. Pizzo, “Trichosporon beigeli, an Emerging Pathogen Resistant to Amphotericin B,” Journal of Clinical Microbiology, Vol. 28, No. 7, 1990, pp. 1616-1622.
[19] A. L. Colombo, A. C. B. Padovan and G. M. Chaves, “Current Knowledge of Trichosporon spp. and Trichosporonosis,” Clinical Microbiology Reviews, Vol. 24, No. 4, 2011, pp. 682-700.
http://dx.doi.org/10.1128/CMR.00003-11

  
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