Invasive Pulmonary Aspergillosis after Liver Transplantation: Rapid and Complete Response to Combined and Sequential Antifungal Therapy

ABSTRACT Background: Invasive pulmonary aspergillosis is a rare, but severe and potentially fatal, complication after liver transplantation. There is no therapeutic regimen accepted worldwide for both initial and continuation therapy; nevertheless, several options have been proposed. Methods: Case report and review of the pertinent English-language literature. Results: In a patient with pulmonary aspergillosis after a liver transplant, combined and sequential therapy with caspofungin and voriconazole with termination of the immunosuppressive regimen and careful management were helpful to control the infection rapidly, possibly because of a positive drug interaction. Conclusion: In cases of invasive aspergillosis that are refractory to monotherapy, this regimen may be used in an attempt to overcome the infection.