Case |
Fungus |
Antifungal Treatment
(Weeks) |
Weaned Off Prednisone |
Response |
1 |
C parapsilosis & others |
2 V&A |
yes |
Resolution cough and sputum by 2 wk, recurrence 5
wk later, then death 3 wk later related to mucous plugging |
2 |
C albicans, C glabrata |
6 V |
- |
Resolution of rhonchi and congested cough by 3 wk,
recurrence at 6 mo |
3 |
C albicans & others |
8 V&A |
yes |
Improved sputum by 3 wk, with recurrence at 4 mo |
4 |
C krusei |
16 V |
prednisone for GVHD |
Resolution of rhonchi and congested cough by 3 wk,
continued until death from multiorgan failure |
5 |
C tropicalis |
1 V&A |
prednisone for rheumatoid arthritis |
Resolution of cough and sputum by 2 wk, with
recurrence at 5 mo |
6 |
C albicans, Aspergillus |
2 V |
yes |
Significant improvement by 2 wk, then recurrence 2
wk later |
7 |
C albicans & others |
not treated |
stayed on prednisone |
Continued sputum and high prednisone over next
year |
8 |
C albicans |
1 F&A, then 4 F |
- |
Improved cough and sputum by 2 wk, trauma then
death 3 mo later |
9 |
C Krusei |
3 F&A, then 3 V&A |
yes |
Near resolution of cough, sputum, and hemoptysis
after 3 wk of V&A, died months later |
10 |
C albicans, C glabrata, Aspergillus |
1 V&A |
- |
Improved sputum over a week, then comfort measures
and death |
11 |
C albicans & others |
1.5 V |
- |
Near resolution of cough, sputum by 12 days, with
recurrence after 4 mo |
wk – weeks, mo – months.Antifungal treatments include A - nebulized amphotericin, F - fluconazole, V – voriconazole. Voriconazole was generally 200 mg twice daily orally; nebulized amphotericin B 10
mg in 3 cc sterile water daily or twice daily.