micafungin and Renal-Insufficiency

Echinocandins are not active against basidiomycetous yeasts, such as Cryptococcus neoformans, Trichosporon, and Rhodotorula species, and zygomycosis. We present a patient with renal failure and candidemia, who developed a breakthrough fungal infection with cryptococcemia and cryptococcuria while receiving micafungin therapy.

Topics: Aged; Antifungal Agents; Candidiasis; Cryptococcosis; Cryptococcus neoformans; Echinocandins; Fungemia; Humans; Lipopeptides; Male; Micafungin; Renal Insufficiency

Topics: Antifungal Agents; Aspergillosis; Aspergillus fumigatus; Debridement; DNA, Fungal; Drug Therapy, Combination; Echinocandins; Hematopoietic Stem Cell Transplantation; Humans; Immunocompromised Host; Itraconazole; Lipopeptides; Lipoproteins; Lymphoma, Non-Hodgkin; Male; Maxillary Diseases; Maxillary Sinus; Micafungin; Middle Aged; Opportunistic Infections; Peptides, Cyclic; Renal Insufficiency; Sinusitis; Treatment Outcome

Invasive aspergillosis is an important factor in the morbidity and mortality of patients suffering from hematologic disorders treated with chemotherapy. Treatment with amphotericin B is often limited because of toxicity, particularly nephrotoxicity. We describe a case of invasive pulmonary Aspergillus fumigatus infection in acute myeloid leukemia with renal failure due to amphotericin B therapy, which responded to treatment with a new antifungal agent, micafungin. Micafungin appears to be an effective and safe therapy for Aspergillus infections with renal failure due to amphotericin B.

Topics: Amphotericin B; Aspergillosis; Echinocandins; Humans; Leukemia, Monocytic, Acute; Lipopeptides; Lipoproteins; Lung Diseases, Fungal; Male; Micafungin; Middle Aged; Peptides, Cyclic; Renal Insufficiency; Treatment Outcome