Contemporary Treatment and Outcomes of Zygomycosis in a Non-oncologic Tertiary Care Center

Background Zygomycosis is an emerging mycosis of increasing relevance. Limited data exist for outcomes with contemporary therapies. Methods A 6-year retrospective chart review was performed in a non-oncological tertiary care center for patients with zygomycosis. Results Sixteen episodes of proven (E...

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Bibliographic Details
Published in:Archives of medical research 2007, Vol.38 (1), p.90-93
Main Authors: Sims, Charles R, Ostrosky-Zeichner, Luis
Format: Article
Language:English
Subjects:
Adult
Aged
Antifungal Agents - therapeutic use
Combined Modality Therapy
Female
Hospitals, Special
Humans
Internal Medicine
Male
Middle Aged
Mucor - isolation & purification
Mucormycosis - drug therapy
Mucormycosis - mortality
Mucormycosis - therapy
Non-oncologic patients
Rhizopus - isolation & purification
Treatment
Treatment Outcome
Zygomycosis
Zygomycosis - therapy
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Summary:Background Zygomycosis is an emerging mycosis of increasing relevance. Limited data exist for outcomes with contemporary therapies. Methods A 6-year retrospective chart review was performed in a non-oncological tertiary care center for patients with zygomycosis. Results Sixteen episodes of proven (EORTC/MSG criteria) zygomycosis were identified. The average age was 49.2 years. Sites of infection were surgical/traumatic wound [5], rhinocerebral [4], disseminated [2], pulmonary [2], peritoneal [2], and localized skin [1]. Associated conditions included diabetes [7], ketoacidosis [2], end-stage renal disease [4], surgery/trauma [4], steroids [3], solid organ transplant [2], neutropenia [1], and intravenous drug use [1]. Twelve patients had surgical debridement. Medical therapy included liposomal amphotericin B, conventional amphotericin B (CAB), and amphotericin B lipid complex. Overall mortality was 4/16 (25%), occurring in a patient each with rhinocerebral, pulmonary, surgical wound infection, and disseminated disease. Mortality with surgical treatment was 2/12 (17%) vs. 2/4 (50%) without surgery. Mortality for patients treated with CAB was 1/3 vs. 3/12 for those treated with any lipid preparation. Serious morbidity occurred in 7/12 survivors. Conclusions In this limited study of contemporary therapies, patients with zygomycosis from a non-oncological tertiary care center have lower mortality than classically described. This disease and its treatments are still associated with severe morbidity, disfigurement, and disability.
ISSN:0188-4409
1873-5487
DOI:10.1016/j.arcmed.2006.06.009