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ORIGINAL RESEARCH article
Front. Med.
Sec. Pulmonary Medicine
Volume 12 - 2025 | doi: 10.3389/fmed.2025.1565071
Isavuconazole as an optimal treatment option for multiple pathogens induced severe pneumonia in immunocompromised hosts: a case series report
Provisionally accepted
Xinyin Wang 1,2
Yanjing You 2
Shuyang Chen 3
Peiyu Wang 1 Shengyuan Zeng 1,2 Liying Zhuang 1,2 Meng Wang 4 Guoxiang Lai 2,4,5 Zongyang Yu 2,4,5 Guoqing Yu 2,4,5* Wen Wen 2,4,5*- 1 Fujian Medical University, Fuzhou, China
- 2 Department of Respiratory and Critical Care Medicine, Fuzong Clinical Medical College of Fujian Medical University, Fujian, China
- 3 Zhongshan Hospital, Fudan University, Shanghai, Shanghai Municipality, China
- 4 Dongfang Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, Fujian Province, China
- 5 The 900th Hospital of Chinese PLA Logistic Support Forces, Fuzhou, Fujian Province, China
Background: Treating severe pneumonia caused by multiple pathogens in immunocompromised hosts (ICHs) presents significant challenges. Isavuconazole (ISA), a next-generation triazole antifungal agent, has shown promise in managing fungal infections. However, clinical evidence regarding its efficacy in cases of complex infections involving multiple pathogens in ICHs remains limited.Case presentation: This study describes a case series of three ICHs diagnosed with severe pneumonia, including invasive aspergillosis (IA). All three patients received ISA-based personalized antimicrobial regimens. Alleviation of symptoms was observed in all patients following antimicrobial treatment, with notable absorption of pulmonary lesions and no significant hepatorenal toxic side effects, with no recurrence observed. Conclusion: ICHs are highly susceptible to fungal infections, and the severity of their condition can escalate dramatically, with a significant risk of mortality, when severe pneumonia caused by multiple pathogens occurs concurrently. A stepwise treatment strategy, which balance the use between immunosuppressant and effective antimicrobial treatment, is crucial. The selection of appropriate drugs should account for potential adverse drug reactions (ADRs). In this case series, ISA exhibited robust efficacy in treating IA with minimal ADRs. Therefore, ISA represents a valuable option for managing severe pneumonia in ICHs, particularly in the context of IA and co-infections caused by multiple pathogens.
Keywords: Complex Infections, Immunocompromised hosts, invasive aspergillosis, Isavuconazole, Severe pneumonia
Received: 22 Jan 2025; Accepted: 03 Apr 2025.
Copyright: © 2025 Wang, You, Chen, Wang, Zeng, Zhuang, Wang, Lai, Yu, Yu and Wen. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Guoqing Yu, Department of Respiratory and Critical Care Medicine, Fuzong Clinical Medical College of Fujian Medical University, Fujian, China
Wen Wen, Dongfang Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, Fujian Province, China
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