Successful Long-Term Use of Isavuconazole in a Tacrolimus-Treated Japanese Kidney Transplant Recipient With Disseminated Cryptococcosis and Probable Invasive Aspergillosis
Abstract
Disseminated cryptococcosis, particularly cryptococcal meningitis, remains a severe fungal infection with high mortality in immunocompromised patients and usually requires prolonged azole therapy. In kidney transplant recipients receiving tacrolimus (TAC), careful management of drug-drug interactions via CYP3A is essential to maintain stable blood concentrations. We report the case of a 44-year-old man with a history of focal segmental glomerulosclerosis who had undergone a living-donor kidney transplant three years earlier. He was receiving immunosuppressive therapy with TAC, mycophenolate mofetil, and methylprednisolone. The patient developed cryptococcal meningitis and skin and soft tissue infection due to Cryptococcus neoformans, together with probable invasive aspergillosis of the paranasal sinuses. He received induction therapy with liposomal amphotericin B and flucytosine for approximately 10 weeks, but persistent intracranial hypertension required placement of a ventriculoperitoneal shunt. Consolidation and maintenance therapy with isavuconazole (ISCZ) was then initiated and has been continued successfully for more than 12 months, without adverse events and with stable TAC concentrations. At the time of writing, the treatment duration has exceeded 365 days, and he remains under outpatient management with no signs of recurrence. To our knowledge, reports describing more than 12 months of ISCZ therapy for cryptococcal infection are limited. This case highlights its…
How strong is the evidence?
Evidence Hub reads this as a case report, done in people. Its evidence level is 5 of 5 (Very low · case / narrative / animal / in vitro / in silico). Case reports, narrative reviews, and animal, cell or computer-model studies give the weakest evidence for human health.
Read the paper
Related studies
- Penicillins for Treatment of Pneumococcal Pneumonia: Does In Vitro Resistance Really Matter?
- Thiophenes—Naturally Occurring Plant Metabolites: Biological Activities and In Silico Evaluation of Their Potential as Cathepsin D Inhibitors
- Inhalable Mannosylated Rifampicin–Curcumin Co-Loaded Nanomicelles with Enhanced In Vitro Antimicrobial Efficacy for an Optimized Pulmonary Tuberculosis Therapy
- Development and validation of microbial bioassay for quantification of Levofloxacin in pharmaceutical preparations
- GC-MS Analysis and Biomedical Therapy of Oil from n-Hexane Fraction of Scutellaria edelbergii Rech. f.: In Vitro, In Vivo, and In Silico Approach
- Propranolol, chlorpromazine and diclofenac restore susceptibility of extensively drug-resistant (XDR)-Acinetobacter baumannii to fluoroquinolones
Go deeper in Evidence Hub
Evidence Hub adds a study data sheet (design, sample size, evidence level, key numbers), an AI summary and a chat grounded in the paper's text.