Date: 26 November 2013
Pt FT. Autopsy appearance of the trachea, after the adherent pseudomembrane had been removed, revealing confluent ulceration superiorly with small green plaques of Aspergillus growth on the trachea inferiorly.
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Notes:
This patient had an acute onset of neutropenia, of undetermined origin, which was treated with prednisolone, before developing rapidly progressive and ultimately fatal pseudomembranous Aspergillus tracheobronchitis. His case was reported because he developed a unilateral monophonic wheeze, which prompted a diagnostic bronchoscopy.Tait RC, O’Driscoll BR, Denning DW. Unilateral wheeze due to pseudomembranous Aspergillus tracheobronchitis in the immunocompromised patient. Thorax 1993; 48: 1285-1287. Disseminated aspergillosis was found at autopsy and cultures from each organ were found to be clonal (Birch M, Nolard N, Shankland G, Denning DW. DNA typing of epidemiologically-related isolates of Aspergillus fumigatus. Infect Epidemiol 1995; 114: 161-168.)
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Patient with chronic productive cough, chest pain and ABPA, unable to take itraconazole or nebulised amphotericin B. Smokes at least 40 roll up cigarettes a day.
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Laryngeal aspergillosis, probably related to inhaled corticosteroids.
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VL-2397 (formerly known as ASP2397) is a novel antifungal drug initially developed by our partner, Astellas Pharma. This drug was isolated from a leaf litter fungus Acremonium species collected in a Malaysian national park. Astellas presented two posters at the 2014 ICAAC meeting which described the in vitro and the in vivo antifungal activities of this drug. The differentiating attributes from the preclinical data of VL-2397 include:
- A novel mechanism of action, with a potential to be complementary or synergistic with the existing classes of antifungals.
- Rapid fungal cell kill activity demonstrated in preclinical models, which was faster than marketed antifungals.
- Activity against azole-resistant fungal species.
- Low propensity for P450 drug-drug interactions.
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SCY-078, new orally available beta-1,3-d-glucan synthase inhibitor, Formely MK-3118.
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Pt DSM Community acquired primary Aspergillus pneumonia. Two x-rays taken on 02/02/2010 then 05/03/2010
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