학술논문
Successful Rapid Desensitization to Micafungin in a Pediatric Patient.
Document Type
Academic Journal
Author
Ward SL; Division of Allergy and Immunology, Department of Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA.; The University of Cincinnati College of Medicine, Cincinnati, Ohio, USA.; Maciag MC; Division of Allergy and Immunology, Boston Children's Hospital, Boston, Massachusetts, USA.; Department of Pediatrics, Harvard Medical School, Boston, Massachusetts, USA.; Jones S; Department of Pharmacy, Boston Children's Hospital, Boston, Massachusetts, USA.; Lee J; Department of Pharmacy, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA.; Lee J; Division of Allergy and Immunology, Boston Children's Hospital, Boston, Massachusetts, USA.; Department of Pediatrics, Harvard Medical School, Boston, Massachusetts, USA.; Broyles AD; Division of Allergy and Immunology, Boston Children's Hospital, Boston, Massachusetts, USA.; Department of Pediatrics, Harvard Medical School, Boston, Massachusetts, USA.
Source
Publisher: Mary Ann Liebert, Inc Country of Publication: United States NLM ID: 101549629 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 2151-3228 (Electronic) Linking ISSN: 2151321X NLM ISO Abbreviation: Pediatr Allergy Immunol Pulmonol Subsets: MEDLINE
Subject
Language
English
Abstract
Introduction: Echinocandin antifungal medications including micafungin are being used more commonly in the treatment of invasive fungal infections in both pediatric and adult patients. Micafungin is also a first-line therapeutic option for candidemia and antifungal prophylaxis in a variety of clinical settings. Hypersensitivity reactions have not been well described; however, isolated cases have been reported. No cases of desensitization to echinocandins have been previously described. Case Presentation: In this report, we described a 14-year-old female with high-risk pre-B cell acute lymphoblastic leukemia diagnosed with pulmonary aspergillosis. She developed a hypersensitivity reaction to micafungin, which was deemed first-line therapy for the infection. A rapid intravenous desensitization protocol was successfully completed without reactions. The patient completed the remaining 2 months of therapy without reactions. Conclusion: This report outlines the first report of a successful desensitization to micafungin or any echinocandin. This is a safe method of completing antifungal therapy in a patient with echinocandin hypersensitivity and may be considered for other patients with micafungin hypersensitivities.