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Table 1. Summary of Recommendations for the Treatment
of Aspergillosis (cont'd)
Condition Therapy
Invasive
syndromes of
Aspergillus Primary Alternative Comments
Aspergillus
infections
of the heart
(endocarditis,
pericarditis, and
myocarditis)
Similar to IPA Similar to IPA • Endocardial
lesions caused by
Aspergillus species
require surgical
resection.
• Aspergillus
pericarditis
usually requires
pericardiectomy.
Aspergillus
osteomyelitis
and septic
arthritis
Similar to IPA Similar to IPA Surgical resection
of devitalized
bone and cartilage
is important for
curative intent.
Aspergillus
infections
of the eye
(endophthalmitis
and keratitis)
Systemic IV or oral
voriconazole plus
intravitreal AmB
or voriconazole
indicated with
partial vitrectomy
• Similar to invasive
pulmonary
aspergillosis
• Limited data with
echinocandins
and poor ocular
penetration by
this class
• Systemic therapy
may be beneficial
in management
of aspergillus
endophthalmitis.
Ophthalmologic
intervention and
management is
recommended for
all forms of ocular
infection.
• Topical therapy
for keratitis is
indicated.
Cutaneous
aspergillosis
Similar to IPA Similar to IPA Surgical resection
is indicated where
feasible.
Aspergillus
peritonitis
Similar to IPA Similar to IPA Removal of
peritoneal dialysis
catheter is essential.
