Chronic Invasive Aspergillus Sinusitis and Otitis with Meningeal Extension Successfully Treated with Voriconazole

Morgand, Marjolaine; Rammaert, Blandine; Poirée, S.; Bougnoux, Marie‐Elisabeth; Tran, H.; Kania, Romain; Chrétien, Fabrice; Jouvion, Grégory; Lortholary, Olivier

doi:10.1128/aac.01506-15

Cited by 18 publications

(9 citation statements)

References 24 publications

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“…The morbidity of medical management via intravenous (IV) amphotericin B was just as substantial, with severe side effects such as nephrotoxicity, encephalopathy and seizures . Only in the last decade have some case reports described utilization of voriconazole in management of invasive forms of fungal disease …”

mentioning

confidence: 99%

Chronic invasive fungal sinusitis: characterization and shift in management of a rare disease

D’Anza

Stokken

Greene

et al. 2016

Int Forum Allergy Rhinol

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mentioning

confidence: 99%

Chronic invasive fungal sinusitis: characterization and shift in management of a rare disease

D’Anza

Stokken

Greene

et al. 2016

Int Forum Allergy Rhinol

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“…Morgand and colleagues reported two cases of CNS infection due to Aspergillus spp. (n ϭ 1 each of Aspergillus fumigatus and Aspergillus flavus), in which serum and CSF Aspergillus galactomannan antigen testing were negative, serum BDG was negative, and CSF BDG was positive (31). The previously noted paper by Myint and colleagues also reported two cases of Aspergillus meningitis, each with CSF BDG levels of Ͼ500 pg/ml (24).…”

Section: Resultsmentioning

confidence: 92%

Efficacy of Cerebrospinal Fluid Beta- d -Glucan Diagnostic Testing for Fungal Meningitis: a Systematic Review

Davis

Wheat²,

Myint

et al. 2020

J Clin Microbiol

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Several case reports and cohort studies have examined the use of (1,3)-beta-d-glucan measurement with cerebrospinal fluid to diagnose fungal meningitis. This systematic review aims to characterize the evidence regarding cerebrospinal fluid (1,3)-beta-d-glucan measurement to detect fungal meningitis. We searched PubMed for (1,3)-beta-d-glucan and each of several distinct fungi, cerebrospinal fluid, and meningitis. Summary data including diagnostic performance (where applicable) were recorded. A total of 939 records were examined via a PubMed search. One hundred eighteen records remained after duplicates were removed, and 104 records were excluded, as they did not examine cerebrospinal fluid, included animals, or focused on nonfungal infections. Fourteen studies were included in this systematic review. A variety of fungi, including species of Candida, Aspergillus, Exserohilum, Cryptococcus, Histoplasma, and Coccidioides, were studied, although most were case reports. Diagnostic accuracy was examined in 5 studies. Cerebrospinal fluid (CSF) (1,3)-beta-d-glucan measurement showed >95% sensitivity in the corticosteroid injection-related outbreak of Exserohilum rostratum. One study in Histoplasma meningitis found 53% (53/87) sensitivity and 87% (133/153) specificity, while another study of Cryptococcus meningitis found 89% (69/78) sensitivity and 85% (33/39) specificity. CSF (1,3)-beta-d-glucan testing may be useful, primarily as a nonspecific marker of fungal meningitis. Although the FDA black box warning states that Cryptococcus spp. do not make (1,3)-beta-d-glucan, the current evidence shows that (1,3)-beta-d-glucan is detectable in cryptococcal meningitis. Organism-specific testing should be used in conjunction with (1,3)-beta-d-glucan measurement.

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“…The BDG assay have been approved by the United State Food and Drug Administration (FDA) for serological diagnosis of invasive fungal disease, but BDG testing is not approved for cerebrospinal fluid (CSF), and the appropriate cutoff value remains controversial [ 9 , 66 , 67 , 68 ]. Recent data suggest that the BDG assay may be useful for the early identification of some invasive mycoses and for monitoring antifungal therapy efficacy [ 69 ].…”

Section: Bdg In Cerebrospinal Fluid (Csf)mentioning

confidence: 99%

Translational Development and Application of (1→3)-β-d-Glucan for Diagnosis and Therapeutic Monitoring of Invasive Mycoses

McCarthy

Petraitienė

Walsh

2017

IJMS

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Early diagnosis and prompt initiation of appropriate antimicrobial therapy are crucial steps in the management of patients with invasive fungal infections. However, the diagnosis of invasive mycoses remains a major challenge in clinical practice, because presenting symptoms may be subtle and non-invasive diagnostic assays often lack sensitivity and specificity. Diagnosis is often expressed on a scale of probability (proven, probable and possible) based on a constellation of imaging findings, microbiological tools and histopathology, as there is no stand-alone assay for diagnosis. Recent data suggest that the carbohydrate biomarker (1→3)-β-d-glucan may be useful in both the diagnosis and therapeutic monitoring of invasive fungal infections due to some yeasts, molds, and dimorphic fungi. In this paper, we review recent advances in the use of (1→3)-β-d-glucan to monitor clinical response to antifungal therapy and explore how this assay may be used in the future.

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Chronic Invasive Aspergillus Sinusitis and Otitis with Meningeal Extension Successfully Treated with Voriconazole

Cited by 18 publications

References 24 publications

Chronic invasive fungal sinusitis: characterization and shift in management of a rare disease

Chronic invasive fungal sinusitis: characterization and shift in management of a rare disease

Efficacy of Cerebrospinal Fluid Beta- d -Glucan Diagnostic Testing for Fungal Meningitis: a Systematic Review

Translational Development and Application of (1→3)-β-d-Glucan for Diagnosis and Therapeutic Monitoring of Invasive Mycoses

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