Successful treatment of pulmonary candidiasis and aspergillosis in patient with refractory Hodgkin lymphoma using micafungin – case study and brief literature review

Barańska M, Kroll-Balcerzak R, Gil L, Rupa-Matysek J, Komarnicki M. Successful treatment of pulmonary candidiasis and aspergillosis in patient with refractory Hodgkin lymphoma using micafungin – case study and brief literature review. Central European Journal of Immunology. 2017;42(1):111-115. doi:10.5114/ceji.2016.65893.

APA

Barańska, M., Kroll-Balcerzak, R., Gil, L., Rupa-Matysek, J.,  & Komarnicki, M. (2017). Successful treatment of pulmonary candidiasis and aspergillosis in patient with refractory Hodgkin lymphoma using micafungin – case study and brief literature review. Central European Journal of Immunology, 42(1), 111-115. https://doi.org/10.5114/ceji.2016.65893

Chicago

Barańska, Marta, Renata Kroll-Balcerzak, Lidia Gil, Joanna Rupa-Matysek,  and Mieczysław Komarnicki. 2017. "Successful treatment of pulmonary candidiasis and aspergillosis in patient with refractory Hodgkin lymphoma using micafungin – case study and brief literature review". Central European Journal of Immunology 42 (1): 111-115. doi:10.5114/ceji.2016.65893.

Harvard

Barańska, M., Kroll-Balcerzak, R., Gil, L., Rupa-Matysek, J.,  and Komarnicki, M. (2017). Successful treatment of pulmonary candidiasis and aspergillosis in patient with refractory Hodgkin lymphoma using micafungin – case study and brief literature review. Central European Journal of Immunology, 42(1), pp.111-115. https://doi.org/10.5114/ceji.2016.65893

MLA

Barańska, Marta et al. "Successful treatment of pulmonary candidiasis and aspergillosis in patient with refractory Hodgkin lymphoma using micafungin – case study and brief literature review." Central European Journal of Immunology, vol. 42, no. 1, 2017, pp. 111-115. doi:10.5114/ceji.2016.65893.

Vancouver

Barańska M, Kroll-Balcerzak R, Gil L, Rupa-Matysek J, Komarnicki M. Successful treatment of pulmonary candidiasis and aspergillosis in patient with refractory Hodgkin lymphoma using micafungin – case study and brief literature review. Central European Journal of Immunology. 2017;42(1):111-115. doi:10.5114/ceji.2016.65893.

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The number of patients with hematological malignancies who develop invasive fungal disease (IFD) has increased dramatically in recent decades. This increase is attributed to impairment of the host immune system due to intensive cytotoxic chemotherapies, use of corticosteroids and profound immunosuppression after hematopoietic stem cell transplantation (HSCT). Additionally, the increasing prevalence of fungal infections caused by emerging and rare pathogens, IFD of mixed etiology or of atypical localization is observed. There are also much more patients with IFD who do not belong to a well-described risk group, like patient with lymphoproliferative disorders. Within this heterogeneous group of patients, IFD epidemiology is not well defined and antifungal prophylaxis practices vary.

The aim of this paper is to present the case of a 58-year-old patient with refractory Hodgkin disease, focusing on infectious complication after subsequent lines of chemotherapy. During deep and prolonged neutropaenia the patient developed symptoms of pneumonia. Despite antifungal prophylaxis with fluconazole, IFD of mixed etiology with the presence of Candida glabrata and Aspergillus fumigatus was diagnosed. The infection showed a poor response to monotherapy with liposomal amphotericin B, but was successfully treated with therapy involving micafungin. Analysis of the presented case demonstrated the necessity of new approaches to the prevention of IFD in patients with lymphoproliferative disorders heavily pretreated with numerous chemotherapy protocols. Prolonged neutropenia and high corticosteroid exposure put these patients in high risk of IFD like patients with acute myeloid leukemia/myelodysplastic syndrome or after allogeneic HSCT.

keywords:

Successful treatment of pulmonary candidiasis and aspergillosis in patient with refractory Hodgkin lymphoma using micafungin – case study and brief literature review

Marta Barańska , Renata Kroll-Balcerzak , Lidia Gil , Joanna Rupa-Matysek , Mieczysław Komarnicki

Candidiasis, aspergillosis, invasive fungal disease, micafungin

Marta Barańska

,

Renata Kroll-Balcerzak

,

Lidia Gil

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Joanna Rupa-Matysek

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Mieczysław Komarnicki