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Case Reports
. 2019 Oct 22;63(11):e01184-19.
doi: 10.1128/AAC.01184-19. Print 2019 Nov.

Low Central Nervous System Posaconazole Concentrations during Cerebral Phaeohyphomycosis

François Barde  1 , Eliane Billaud  2 , Lauriane Goldwirt  3 , Catherine Horodyckid  4 , Vincent Jullien  2 , Fanny Lanternier  1   5 , Philippe Lesprit  6 , Lucie Limousin  7 , Jérémie F Cohen  1 , Olivier Lortholary  8   5
Affiliations
Case Reports

Low Central Nervous System Posaconazole Concentrations during Cerebral Phaeohyphomycosis

François Barde et al. Antimicrob Agents Chemother. .

Abstract

Posaconazole diffusion has been documented in various organs, which contrasts with the scarce data available for the human central nervous system (CNS). We analyzed posaconazole concentrations in plasma and multiple CNS specimens taken from a patient who received posaconazole because of cerebral phaeohyphomycosis. Low posaconazole concentrations were obtained in CNS specimens, with sample-to-plasma ratios between 5% and 22%. This case highlights the role of neurosurgery during cerebral phaeohyphomycoses, even those caused by posaconazole-susceptible black fungi.

Keywords: Rhinocladiella mackenziei; antifungal therapy; cerebral phaeohyphomycosis; invasive fungal infections; plasma drug levels; therapeutic drug monitoring.

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Figures

FIG 1
FIG 1
Postcontrast axial T1-weighted MRI images. (A) Rim-enhancing left temporal lesion with central hypointensity (baseline). (B) Postsurgical cavity with decreased perilesional edema (3 months after surgery).
See this image and copyright information in PMC

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