Control of invasive pulmonary aspergillosis with oral itraconazole in a bone marrow transplant patient

Pulmonary aspergillosis following bone marrow transplantation carries a mortality of 94%, irrespective of current treatment. We treated a patient who had acquired aspergillosis some 80 days after allogeneic bone marrow transplantation, with oral itraconazole, 600 mg daily. After initial deterioration, clinical and radiographic resolution occurred during 3 months of therapy despite severe graft-vs.-host and cytomegalovirus disease. Itraconazole should be considered for therapy of pulmonary aspergillosis in this and other immunocompromised settings.