Miltefosine-based regimen as salvage therapy in Lomentospora prolificans bone and joint infection

L. Quaesaet (1) , E. Stindel (1) , F. Lanternier (2, 3, 4, 5, 6) , T. Williams (1) , S. Jaffuel (1) , E. Moalic (1) , D. Garcia Hermoso (4, 5, 3) , O. Lortholary (7, 8, 3) , S. Ansart (1)

1 CHRU Brest - Centre Hospitalier Régional Universitaire de Brest
2 Hôpital Necker - Enfants Malades [AP-HP]
3 UPD5 - Université Paris Descartes - Paris 5
4 CNRMA - Centre National de Référence Mycoses Invasives et Antifongiques - National Reference Center Invasive Mycoses & Antifungals
5 Mycologie moléculaire
6 Imagine - U1163 - Imagine - Institut des maladies génétiques (IHU)
7 Centre d'infectiologie Necker-Pasteur [CHU Necker]
8 IP - Institut Pasteur [Paris]

1. Introduction We report the second case of miltefosine, terbinafine, and voriconazole-based regimen as salvage therapy in a Lomentospora prolificans bone and joint infection. A favorable outcome was observed when combined with aggressive surgery. A poor prior evolution was observed following three surgical procedures of debridement combined with terbinafine and voriconazole. This report of a safe and successful use of miltefosine highlights the need for an interdisciplinary expertise for appropriate surgical and medical treatment.

Mots clés: Bone and joint infection; Infection ostéoarticulaire; Lomentospora prolificans; Miltéfosine

Domaines: Mycologie

L. Quaesaet, E. Stindel, F. Lanternier, T. Williams, S. Jaffuel, et al.. Miltefosine-based regimen as salvage therapy in Lomentospora prolificans bone and joint infection. Médecine et Maladies Infectieuses, 2018, 48 (1), pp.63-65. ⟨10.1016/j.medmal.2017.10.005⟩. ⟨pasteur-02193093⟩