[Non-fatal disseminated mucormycosis in a solid organ transplant].

Abstract

BACKGROUND:

Mucormycosis is a rare fungal infection occurring most frequently in immunocompromised patients. The pathogens are filamentous fungi, order of Mucorales. Disseminated mucormycosis is a severe, life treating disease. Early diagnosis is a major determinant for prognosis, however, it remains difficult. The management consists in an early antifungal therapy using lipid formulation of amphotericin B associated with an extensive surgical debridement. Despite this therapeutic of choice, the mortality of disseminated mucormycosis remains high.

OBSERVATION:

We report the case of disseminated mucormycosis in a 25 years old woman 9 months after a pulmonary transplantation. The clinical presentation included pulmonary and thyroid localization and the pathogen was Absidia corymbifera. The patient survived thanks to a large surgical debridement, and an early antifungal bitherapy by lipid formulation of amphotericin B and posaconazole.

CONCLUSION:

The re-emergence and the high mortality of mucormycosis in solid organ transplant receiver show the necessity to find new therapeutic approaches. Posaconazole associated with liposomal amphotericin B could be an interesting option to treat disseminated mucormycosis and improve their outcome.

• Authors: C Minet, A Bonadona, A Tabah, A Karkas, L Mescam, C Schwebel, R Hamidfar, C Pison, C Saint-Raymond, O Faure, D Salameire, J-F Timsit
• Journal: Revue des maladies respiratoires (Rev Mal Respir) Vol. 26 Issue 9 Pg. 998-1002 (Nov 2009) ISSN: 1776-2588 [Electronic] France
• Vernacular Title: Mucormycose disséminée d'évolution favorable chez une greffée pulmonaire.
• PMID: 19953048 (Publication Type: Case Reports, English Abstract, Journal Article)

Chemical References

• Antifungal Agents
• Triazoles
• posaconazole
• Amphotericin B

Topics

• Absidia
• Adult
• Amphotericin B (administration & dosage)
• Antifungal Agents (administration & dosage)
• Combined Modality Therapy
• Debridement
• Female
• Humans
• Lung Diseases, Fungal (diagnosis, surgery)
• Lung Transplantation
• Mucormycosis (diagnosis, drug therapy, surgery)
• Opportunistic Infections (diagnosis, drug therapy, surgery)
• Thyroid Diseases (diagnosis, surgery)
• Triazoles (administration & dosage)