Successful treatment of azole-resistant invasive aspergillosis in a bottlenose dolphin with high-dose posaconazole

Publication date: June 2017
Source:Medical Mycology Case Reports, Volume 16
Author(s): Paulien E. Bunskoek, Seyedmojtaba Seyedmousavi, Steven J.M. Gans, Peter B.J. van Vierzen, Willem J.G. Melchers, Cornelis E. van Elk, Johan W. Mouton, Paul E. Verweij
Invasive aspergillosis due to azole-resistant Aspergillus fumigatus is difficult to manage. We describe a case of azole-resistant invasive aspergillosis in a female bottlenose dolphin, who failed to respond to voriconazole and posaconazole therapy. As intravenous therapy was precluded, high dose posaconazole was initiated aimed at achieving trough levels exceeding 3mg/l. Posaconazole serum levels of 3–9.5mg/l were achieved without significant side-effects. Follow-up bronchoscopy and computed tomography showed complete resolution of the lesions.



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