| Zygomycosis in Immunocompromised non-Haematological Patients. | |
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MedLine Citation:
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PMID: 21625316 Owner: NLM Status: PubMed-not-MEDLINE |
Abstract/OtherAbstract:
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Zygomycoses caused by fungi of the mucorales order (mucormycoses) are emerging fungal diseases with a high fatality rate. The most important risk factors include neutropenia or functional neutropenia, diabetic ketoacidosis, iron overload, major trauma, prolonged use of corticosteroids, illicit intravenous drug (ID) use, neonatal prematurity, malnourishment, and maybe a previous exposure to antifungal agents with no activity against zygomycetes, such as voriconazole and echinocandins.A high index of suspicion is crucial for the diagnosis, as prompt and appropriate management can considerably reduce morbidity and mortality. Suspicion index can be increased through recognition of the differential patterns of clinical presentation. In the non- haematological immunocompromised patients, mucormycosis can manifest in various clinical forms, depending on the underlying condition: mostly as rhino-orbital or rhino-cerebral in diabetes patients, pulmonary infection in patients with malignancy or solid organ transplantation, disseminated infection in iron overloaded or deferoxamine treated patients, cerebral - with no sinus involvement - in ID users, gastrointestinal in premature infants or malnourishment, and cutaneous after direct inoculation in immunocompetent individuals with trauma or burns.Treating a patient's underlying medical condition and reducing immunosuppression are essential to therapy. Rapid correction of metabolic abnormalities is mandatory in cases such as uncontrolled diabetes, and corticosteroids or other immunosuppressive drugs should be discontinued where feasible. AmphotericinB or its newer and less toxic lipid formulations are the drugs of choice regarding antifungal chemotherapy, while extensive surgical debridement is essential to reduce infected and necrotic tissue. A high number of cases could be prevented through measures including diabetes control programmes and proper pre- and post-surgical hygiene. |
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Authors:
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George Petrikkos; Miranda Drogari-Apiranthitou |
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Publication Detail:
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Type: Journal Article Date: 2011-03-15 |
Journal Detail:
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Title: Mediterranean journal of hematology and infectious diseases Volume: 3 ISSN: 2035-3006 ISO Abbreviation: Mediterr J Hematol Infect Dis Publication Date: 2011 |
Date Detail:
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Created Date: 2011-05-31 Completed Date: 2011-07-14 Revised Date: 2011-07-28 |
Medline Journal Info:
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Nlm Unique ID: 101530512 Medline TA: Mediterr J Hematol Infect Dis Country: Italy |
Other Details:
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Languages: eng Pagination: e2011012 Citation Subset: - |
Affiliation:
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4st Dept. of Internal Medicine, School of Medicine, National and Kapodistrian University of Athens, "ATTIKON" Hospital, RIMINI 1 - Haidari, Athens - 12464. Greece. |
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