Lomentosporosis
[Lancet Infect Dis 2021;21:e246-57]
Usual Pathogen
Lomentospora (Scedosporium) prolificans
- Resistant to amphotericin B, flucytosine, fluconazole, itraconazole, and isavuconazole.
- Infectious Diseases consult recommended.
| Empiric Therapy | Duration | |
|---|---|---|
| Voriconazole |
6mg/kg IV/PO bid x 2 doses, then 4mg/kg IV/PO bid |
Treat until all signs and symptoms of the infection have resolved, radiographic abnormalities have stabilized, and significant immune reconstitution has occurred. |
| + |
|
|
| Terbinafine | 500mg PO daily |
|
| Alternative | ||
| Posaconazole |
300mg IV/DR tab PO bid x 2 doses, then 300mg IV/DR PO daily |
Treat until all signs and symptoms of the infection have resolved, radiographic abnormalities have stabilized, and significant immune reconstitution has occurred. |
| + |
|
|
| Terbinafine | 500mg PO daily |