Statements in which the resource exists as a subject.
PredicateObject
rdf:type
lifeskim:mentions
pubmed:issue
8
pubmed:dateCreated
2005-10-5
pubmed:abstractText
The mortality of central nervous system (CNS) aspergillosis approaches 100%, requiring improved therapies. Voriconazole gives superior efficacy and survival in invasive aspergillosis, compared with amphotericin B. Also, in contrast to other antifungal drugs, voriconazole penetrates well into the CNS. We evaluated, retrospectively, the outcome and survival of 81 patients who were treated with voriconazole for definite (n = 48) or probable (n = 33) CNS aspergillosis. Complete and partial responses were recorded in 35% of patients and varied by the underlying disease group: hematologic malignancies (54%), other underlying conditions (50%), chronic immunosuppression (45%), solid organ transplantation (36%), and hematopoietic stem cell transplantation (16%). Thirty-one percent of patients survived CNS aspergillosis for a median observation time of 390 days. There were 31 patients who underwent neurosurgical procedures, including craniotomy/abscess resection (n = 14), abscess drainage (n = 12), ventricular shunt (n = 4), and Ommaya-reservoir (n = 1). Multifactorial analysis revealed that neurosurgery was associated with improved survival (P = .02). Patients who underwent hematopoietic stem cell transplantation had a poorer survival (P = .02), but 7 (22%) of 32 survived for a median of 203 days. We conclude from this large cohort of patients that voriconazole treatment together with neurosurgical management, whenever feasible, is currently the best approach to treat patients with CNS aspergillosis.
pubmed:commentsCorrections
pubmed:language
eng
pubmed:journal
pubmed:citationSubset
AIM
pubmed:chemical
pubmed:status
MEDLINE
pubmed:month
Oct
pubmed:issn
0006-4971
pubmed:author
pubmed:issnType
Print
pubmed:day
15
pubmed:volume
106
pubmed:owner
NLM
pubmed:authorsComplete
Y
pubmed:pagination
2641-5
pubmed:dateRevised
2006-11-15
pubmed:meshHeading
pubmed-meshheading:15998833-Adult, pubmed-meshheading:15998833-Aged, pubmed-meshheading:15998833-Aged, 80 and over, pubmed-meshheading:15998833-Antifungal Agents, pubmed-meshheading:15998833-Aspergillosis, pubmed-meshheading:15998833-Central Nervous System Fungal Infections, pubmed-meshheading:15998833-Child, pubmed-meshheading:15998833-Child, Preschool, pubmed-meshheading:15998833-Female, pubmed-meshheading:15998833-Humans, pubmed-meshheading:15998833-Infant, pubmed-meshheading:15998833-Magnetic Resonance Imaging, pubmed-meshheading:15998833-Male, pubmed-meshheading:15998833-Middle Aged, pubmed-meshheading:15998833-Pyrimidines, pubmed-meshheading:15998833-Retrospective Studies, pubmed-meshheading:15998833-Risk Factors, pubmed-meshheading:15998833-Survival Rate, pubmed-meshheading:15998833-Treatment Outcome, pubmed-meshheading:15998833-Triazoles
pubmed:year
2005
pubmed:articleTitle
Improved outcome in central nervous system aspergillosis, using voriconazole treatment.
pubmed:affiliation
Medizinische Klinik III, Hämatologie, Onkologie und Transfusionsmedizin, Charité--Universitätsmedizin Berlin, Campus Benjamin Franklin, Hindenburgdamm 30, 12200 Berlin, Germany. stefan.schwartz@charite.de
pubmed:publicationType
Journal Article, Research Support, Non-U.S. Gov't