dalfopristin and Necrosis

We report here a 34-year-old woman with complicated severe opportunistic pulmonary infection, who was treated with the newly developed antibiotics quinupristin/dalfopristin (QPR/DPR) and voriconazole. She had received repeated chemotherapy, irradiation of the left lung, autologous and allogeneic bone marrow transplantation (BMT), and segmentectomy of the base of the left lung as treatments for Hodgkin's lymphoma. Although she had been in complete remission (CR), the structure of the left lung was severely degraded. Four years after achieving CR, she developed complicated life-threatening pulmonary infections with methicillin-resistant Staphylococcus epidermidis and Aspergillus niger during outpatient care. Chemotherapies with QPR/DPR for S. epidermidis pneumonia and voriconazole for chronic necrotizing pulmonary aspergillosis (CNPA) improved her symptoms rapidly without any major complications. QPR/DPR and voriconazole are considered effective for patients with life-threatening opportunistic pulmonary infections who have previously been treated with intensive regimens including radiotherapies to the lung.

Topics: Adult; Anti-Bacterial Agents; Antifungal Agents; Aspergillosis; Aspergillus niger; Chronic Disease; Drug Therapy, Combination; Female; Hodgkin Disease; Humans; Lung Diseases, Fungal; Lymphatic Irradiation; Necrosis; Pneumonia, Bacterial; Pyrimidines; Radiation Injuries; Radiography; Staphylococcal Infections; Staphylococcus epidermidis; Triazoles; Virginiamycin; Voriconazole