Invasive aspergillosis due to azole-resistant Aspergillus fumigatus is difficult to manage. We describe a case of azole-resistant invasive aspergillosis in a female bottlenose dolphin, who failed to respond to voriconazole and posaconazole therapy. As intravenous therapy was precluded, high dose posaconazole was initiated aimed at achieving trough levels exceeding 3 mg/l. Posaconazole serum levels of 3–9.5 mg/l were achieved without significant side-effects. Follow-up bronchoscopy and computed tomography showed complete resolution of the lesions.

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doi.org/10.1016/j.mmcr.2017.03.005, hdl.handle.net/1765/99050
Medical Mycology Case Reports
Department of Medical Microbiology and Infectious Diseases

Bunskoek, P., Seyedmousavi, S., Gans, S., van Vierzen, P.B.J. (Peter B.J.), Melchers, W., van Elk, N., … Verweij, P. (2017). Successful treatment of azole-resistant invasive aspergillosis in a bottlenose dolphin with high-dose posaconazole. Medical Mycology Case Reports, 16, 16–19. doi:10.1016/j.mmcr.2017.03.005