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Successful Long-Term Use of Isavuconazole in a Tacrolimus-Treated Japanese Kidney Transplant Recipient With Disseminated Cryptococcosis and Probable Invasive Aspergillosis - PubMed

7 hours ago
  • #Kidney Transplant
  • #Cryptococcosis
  • #Isavuconazole
  • Successful long-term use of isavuconazole (ISCZ) in a tacrolimus (TAC)-treated Japanese kidney transplant recipient with disseminated cryptococcosis and probable invasive aspergillosis.
  • Patient history: 44-year-old man with focal segmental glomerulosclerosis, post-living-donor kidney transplant, on immunosuppressive therapy (TAC, mycophenolate mofetil, methylprednisolone).
  • Developed cryptococcal meningitis, skin/soft tissue infection (Cryptococcus neoformans), and probable invasive aspergillosis of paranasal sinuses.
  • Initial treatment: liposomal amphotericin B and flucytosine for ~10 weeks; required ventriculoperitoneal shunt due to persistent intracranial hypertension.
  • Consolidation/maintenance therapy with ISCZ continued successfully for >12 months, no adverse events, stable TAC concentrations.
  • Case highlights ISCZ as a viable maintenance option in transplant recipients, especially when fluconazole/voriconazole are unsuitable due to TAC interactions.
  • Limited reports exist on ISCZ therapy exceeding 12 months for cryptococcal infections.