Combination therapy of disseminated coccidioidomycosis with caspofungin and fluconazole

Dae Won Park, Jang Wook Sohn, Hee Jin Cheong, Woo Joo Kim, Min Ja Kim, Je Hyeong Kim, Chol Shin

Research output: Contribution to journalArticlepeer-review

26 Citations (Scopus)

Abstract

Background: The current recommended therapy for diffuse coccidioidal pneumonia involves initial treatment with amphotericin B deoxycholate or high-dose fluconazole, followed by an azole after clinical improvement. Amphotericin B is more frequently used as initial therapy if the patient's deterioration is rapid. Case presentation: A 31-year-old Korean male with coccidioidomycosis presented to the hospital with miliary infiltrates on chest X-ray (CXR) and skin rash on the face and trunk. Initially, the patient did not respond to amphotericin B deoxycholate therapy. However, following caspofungin and fluconazole combination therapy, the patient showed favourable radiological, serological, and clinical response. Conclusion: This appears to be the first case of diffuse coccidioidal pneumonia with skin involvement in an immunocompetent patient who was treated successfully with caspofungin and fluconazole. Combination therapy with caspofungin and fluconazole may, therefore, be an alternative treatment for diffuse coccidioidal pneumonia that does not respond to amphotericin B deoxycholate therapy.

Original languageEnglish
Article number26
JournalBMC infectious diseases
Volume6
DOIs
Publication statusPublished - 2006 Feb 15

ASJC Scopus subject areas

  • Infectious Diseases

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