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Table 1 Timeline of events

From: Successful outcome of disseminated mucormycosis in a 3-year-old child suffering from acute leukaemia: the role of isavuconazole? A case report

  Clinical features Biology results Antimicrobial therapy
D-19 Start of chemotherapy Neutropenia   
D0 Febrile neutropenia High level of CRP and PCT Antibiotherapy introduction Ceftriaxone 100 mg/kg/d
D3 Persistence of fever Rising of CRP and PCT rates Antibiotherapy switch Tazobactam Piperacillin 400 mg/kg/d
Amikacine
D6 Persistence of fever   Adding antifungal therapy Caspofungin 70 mg/m2 day 1, then 50 mg/m2/d
D10 Abnormal chest CT scan and abdominal ultra-sound   Antifungal combined therapy Adding voriconazole 9 mg/kg bid day 1, then 8 mg/kg bid IV
D16   Negative BAL Withdrawal Antibiotherapy and caspofungin  
D21   Positive Fundoscopy Voriconazole intravitreal injection 50 μg/ml  
D24 Abnormal brain MRI
Initiation of TDM on D27
  Switch antifungal therapy Isavuconazole 70 mg every 8 h for 48 h, then 70 mg/d IV
D31     Isavuconazole 90 mg/d IV
D37    Antifungal combined therapy Isavuconazole 90 mg bid IV
L-AmB 10 mg/kg/d
D39 Fever resolution    
D58     Isavuconazole 100 mg bid p.o
D63 TPL steady state    
M6 Regression of lesions on imagery    
M8 Leukaemia relapse   Withdrawal isavuconazole L-AmB 7 mg/kg/d
M12 Complete remission   Switch antifungal therapy Isavuconazole 50 mg bid p.o
M16 Regression of lesions on imagery    
  1. BAL bronchoalveolar lavage, bid, twice a day, CRP C-Reactive protein, d day, IV intra-venous, L-AmB liposomal amphotericin B, PCT procalcitonin, p.o per os, TDM therapeutic drug monitoring, TPL trough plasma level