SUCCESSFUL TREATMENT OF INVASIVE PULMONARY ASPERGILLOSIS IN CHRONIC GRANULOMATOUS-DISEASE WITH ORALLY-ADMINISTERED ITRACONAZOLE SUSPENSION

A 3-yr-old boy with known chronic granulomatous disease presented with a left-sided chest wall mass. Extensive intrathoracic and extrathorac ic aspergillosis was confirmed by CT scan-guided percutaneous biopsy. Initially, he was treated intravenously with liposomal amphotericin an d subcutaneous gamma-interferon, but his clinical condition deteriorat ed over 7 wk of treatment. The amphotericin was therefore discontinued , and itraconazole in an oral suspension was begun. There was progress ive clinical improvement after 3 months of this regime, and marked rad iologic clearing was apparent after 8 months of treatment. A multicent er trial of this mode of therapy in patients with invasive aspergillos is is indicated.