Aspergillus spp
[CID 2016]
Clinical
New Topic-1 Risk factors:
- prosthetic valve
- central venous catheters
- broad spectrum antibiotic use
- malignancy
- injection drug use
- Consult Infectious Diseases.
- Valve replacement almost always necessary
Diagnosis
Blood culture - < 5% positive
Serum galactomannan
Tissue culture of surgical material
| Therapy | Dose | Duration |
|---|---|---|
| Voriconazole | 6mg/kg IV/PO x 2 doses then 4mg/kg IV/PO bid | Minimum 6 weeks after valve replacement |
Alternative
| Therapy | Dose | Duration |
|---|---|---|
| Amphotericin B, lipid formulation | 5mg/kg IV daily | Minimum 6 weeks after valve replacement |
| Therapy | Dose | Duration |
|---|---|---|
| Combination therapy can be considered in patients unresponsive to initial monotherapy. | Consider long term suppressive therapy with oral voriconazole. |