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Aspergillomas develop from progressive layers of mycelial growth on the walls of pulmonary cavities over months. Aspergillomas are characteristic of chronic pulmonary aspergillosis and are a risk factor for azole resistance. We investigated genotypic and phenotypic alterations in Aspergillus fumigatus recovered from aspergillomas. Aspergillomas were removed from three patients (two at surgery, one...
Micafungin is an echinocandin with broad spectrum activity against Candida spp. and Aspergillus spp. This agent is extensively used to treat these opportunistic fungal pathogens in immunocompromised hosts. This review summarises the clinical pharmacology of micafungin, including pharmacokinetics, pharmacodynamics and use in special populations.
Azole resistance in Aspergillus spp. is unusual. We report a patient who received long-term treatment with itraconazole and voriconazole for bilateral chronic cavitary aspergillosis with aspergillomas whose isolates of Aspergillus fumigatus developed simultaneous resistance to itraconazole and voriconazole. A novel mutation (G138C) in the target gene (cyp51A) encoding 14α-demethylase was detected...
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