{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,14]],"date-time":"2026-02-14T03:13:05Z","timestamp":1771038785942,"version":"3.50.1"},"reference-count":28,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2017,11,22]],"date-time":"2017-11-22T00:00:00Z","timestamp":1511308800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"Basilea Pharmaceutica International Ltd, Basel, Switzerland"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Mycoses"],"published-print":{"date-parts":[[2018,3]]},"abstract":"<jats:title>Summary<\/jats:title><jats:p>Recent years have seen important advances in the diagnosis of invasive pulmonary aspergillosis (<jats:styled-content style=\"fixed-case\">IPA<\/jats:styled-content>), complemented by the introduction of new therapies. Despite this, <jats:styled-content style=\"fixed-case\">IPA<\/jats:styled-content> remains a major cause of infection\u2010related mortality in patients with haematological diseases. There are two main reasons for this. First, diagnosis of <jats:styled-content style=\"fixed-case\">IPA<\/jats:styled-content> remains a challenge, since risk factors and the clinical, radiological and mycological presentations vary not only by fungal disease stage, but also by patient group (eg neutropenic vs non\u2010neutropenic patients). Diagnosis is particularly challenging in patients receiving mould\u2010active prophylactic or empirical treatment, which reduces the sensitivity of all diagnostic tests for <jats:styled-content style=\"fixed-case\">IPA<\/jats:styled-content>. Second, treatment of <jats:styled-content style=\"fixed-case\">IPA<\/jats:styled-content> is complex due to unpredictable pharmacokinetic profiles of antifungal agents, small therapeutic window in terms of exposure and adverse events, and multiple drug\u2010drug interactions through the <jats:styled-content style=\"fixed-case\">CYP<\/jats:styled-content>450 system. Here we report a case of a 23\u2010year\u2010old male with severe aplastic anaemia and subpleural nodules. Diagnostic tests for <jats:styled-content style=\"fixed-case\">IPA<\/jats:styled-content> obtained during ongoing mould\u2010active empirical treatment were negative. Intravenous voriconazole was stopped after visual disturbances and hallucinations. The patient then had an anaphylactic reaction to liposomal amphotericin B and was switched to intravenous posaconazole, which had to be discontinued due to a significant increase in transaminase levels. He was treated with oral isavuconazole with reduced dosage, triggered by increasing transaminases under the standard dosage. Even under reduced dosage, blood concentrations of isavuconazole were high and treatment was successful. The case illustrates real\u2010world challenges and unmet needs in the diagnosis and treatment of <jats:styled-content style=\"fixed-case\">IPA<\/jats:styled-content> in patients with haematological diseases.<\/jats:p>","DOI":"10.1111\/myc.12727","type":"journal-article","created":{"date-parts":[[2017,11,7]],"date-time":"2017-11-07T13:36:35Z","timestamp":1510061795000},"page":"201-205","source":"Crossref","is-referenced-by-count":29,"title":["Real\u2010world challenges and unmet needs in the diagnosis and treatment of suspected invasive pulmonary aspergillosis in patients with haematological diseases: An illustrative case study"],"prefix":"10.1111","volume":"61","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1653-2824","authenticated-orcid":false,"given":"Martin","family":"Hoenigl","sequence":"first","affiliation":[{"name":"Section of Infectious Diseases and Tropical Medicine Department of Internal Medicine Medical University Graz  Graz Austria"},{"name":"Division of Pulmonology Department of Internal Medicine Medical University of Graz  Graz Austria"},{"name":"CBmed \u2010 Center for Biomarker Research in Medicine  Graz Austria"},{"name":"Division of Infectious Diseases Department of Medicine University of California\u2013San Diego  San Diego CA USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Juergen","family":"Prattes","sequence":"additional","affiliation":[{"name":"Section of Infectious Diseases and Tropical Medicine Department of Internal Medicine Medical University Graz  Graz Austria"},{"name":"CBmed \u2010 Center for Biomarker Research in Medicine  Graz Austria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Peter","family":"Neumeister","sequence":"additional","affiliation":[{"name":"Division of Haematology Department of Internal Medicine Medical University of Graz  Graz Austria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Albert","family":"W\u00f6lfler","sequence":"additional","affiliation":[{"name":"Division of Haematology Department of Internal Medicine Medical University of Graz  Graz Austria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Robert","family":"Krause","sequence":"additional","affiliation":[{"name":"Section of Infectious Diseases and Tropical Medicine Department of Internal Medicine Medical University Graz  Graz Austria"},{"name":"CBmed \u2010 Center for Biomarker Research in Medicine  Graz Austria"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2017,11,22]]},"reference":[{"key":"e_1_2_5_2_1","article-title":"Levels of interleukin (IL)\u20106 and IL\u20108 are\u00a0elevated in serum and bronchoalveolar lavage fluid of haematological patients with invasive pulmonary aspergillosis","author":"Heldt S","year":"2017","journal-title":"Mycoses"},{"key":"e_1_2_5_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/myc.12628"},{"key":"e_1_2_5_4_1","doi-asserted-by":"crossref","first-page":"1813","DOI":"10.1086\/588660","article-title":"European Organization for Research and Treatment of Cancer\/InvasiveFungal Infections Cooperative Group. Revised definitions of invasive fungal disease from the European Organization for Research and Treatment of Cancer\/Invasive Fungal Infections Cooperative Group and the National Institute of Allergy and Infectious Diseases Mycoses Study Group (EORTC\/MSG) Consensus Group. National Institute of Allergy and Infectious Diseases Mycoses Study Group (EORTC\/MSG) Consensus Group","volume":"46","author":"De Pauw B","year":"2008","journal-title":"Clin Infect Dis"},{"key":"e_1_2_5_5_1","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.201111-1978OC"},{"key":"e_1_2_5_6_1","doi-asserted-by":"crossref","first-page":"248","DOI":"10.1164\/rccm.201407-1227ED","article-title":"As galactomannan disappoints, our quest for a feasible diagnostic standard for invasive aspergillosis continues","volume":"190","author":"Vehreschild JJ","year":"2014","journal-title":"Am J Respir Crit Care Med"},{"key":"e_1_2_5_7_1","doi-asserted-by":"publisher","DOI":"10.1093\/jac\/dks155"},{"key":"e_1_2_5_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(15)01159-9"},{"key":"e_1_2_5_9_1","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.00467-14"},{"key":"e_1_2_5_10_1","doi-asserted-by":"publisher","DOI":"10.1097\/TP.0000000000000153"},{"key":"e_1_2_5_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-0609.2012.01806.x"},{"key":"e_1_2_5_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijantimicag.2015.05.017"},{"key":"e_1_2_5_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cmi.2015.09.009"},{"key":"e_1_2_5_14_1","doi-asserted-by":"publisher","DOI":"10.1093\/jac\/dks208"},{"key":"e_1_2_5_15_1","first-page":"528","article-title":"Galactomannan testing and Aspergillus PCR in same\u2010day brochoalveolar lavage and blood samples for diagnosis of invasive aspergillosis","volume":"55","author":"Eigl S","year":"2017","journal-title":"Med Mycol"},{"key":"e_1_2_5_16_1","article-title":"Clinical evaluation of the newly formatted lateral\u2010flow device for invasive pulmonary aspergillosis","author":"Hoenigl M","year":"2017","journal-title":"Mycoses"},{"key":"e_1_2_5_17_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12281-015-0224-3"},{"key":"e_1_2_5_18_1","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.00251-13"},{"key":"e_1_2_5_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijantimicag.2014.03.013"},{"key":"e_1_2_5_20_1","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.00389-16"},{"key":"e_1_2_5_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ccm.2016.12.006"},{"key":"e_1_2_5_22_1","doi-asserted-by":"publisher","DOI":"10.1111\/myc.12343"},{"key":"e_1_2_5_23_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jinf.2017.05.014"},{"key":"e_1_2_5_24_1","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciw326"},{"key":"e_1_2_5_25_1","volume-title":"Exposure\u2010response analysis of isavuconazole in patients with disease caused by Aspergillus species or other filamentous fungi","author":"Desai AV","year":"2015"},{"key":"e_1_2_5_26_1","doi-asserted-by":"crossref","first-page":"582","DOI":"10.5414\/CP202434","article-title":"Isavuconazole absorption following oral administration in healthy subjects is comparable to intravenous dosing, and is not affected by food, or drugs that alter stomach pH","volume":"54","author":"Schmitt\u2010Hoffmann A","year":"2016","journal-title":"Int J Clin Pharmacol Ther"},{"key":"e_1_2_5_27_1","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.00863-13"},{"key":"e_1_2_5_28_1","doi-asserted-by":"publisher","DOI":"10.1002\/cpdd.284"},{"key":"e_1_2_5_29_1","doi-asserted-by":"publisher","DOI":"10.1592\/phco.26.12.1730"}],"container-title":["Mycoses"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fmyc.12727","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/myc.12727","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,25]],"date-time":"2023-09-25T15:19:17Z","timestamp":1695655157000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/myc.12727"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2017,11,22]]},"references-count":28,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2018,3]]}},"alternative-id":["10.1111\/myc.12727"],"URL":"https:\/\/doi.org\/10.1111\/myc.12727","archive":["Portico"],"relation":{},"ISSN":["0933-7407","1439-0507"],"issn-type":[{"value":"0933-7407","type":"print"},{"value":"1439-0507","type":"electronic"}],"subject":[],"published":{"date-parts":[[2017,11,22]]}}}