Forty-one recent cases of invasive zygomycosis from a global clinical registry

Abstract

Pathogen distribution and, consequently, drug susceptibility seem to vary across different geographic regions. Furthermore, protection from invasive zygomycosis for patients on posaconazole prophylaxis is not absolute. Our findings indicate that the use of liposomal amphotericin B as first-line treatment for patients diagnosed with zygomycoses merits further investigation, preferably in the form of a clinical trial.

Combined antifungal approach for the treatment of invasive mucormycosis in patients with hematologic diseases: a report from the SEIFEM and FUNGISCOPE registries

“…In 56% of our cases, a favorable clinical response was achieved (>70% if stable disease was included into the definition). This rate compares favorably with recent case series, in which response rates ranged from 32% to 59%, [1][2][3] and with the response rates reported from a compassionate use trial that evaluated posaconazole as salvage therapy. In the latter trial, 6 of 13 patients (46%) receiving Lip-AmB+POS displayed a favorable response; all were partial responses.…”

“…Livio Pagano, 1 Oliver A. Cornely, 2,3 Alessandro Busca, 4 Morena Caira, 1 Simone Cesaro, 5 Cristiana Gasbarrino, 6 Corrado Girmenia, 7 Werner J. Heinz, 8 Raoul Herbrecht, 9 Cornelia Lass-Flörl, 10 Annamaria Nosari, 11 Leonardo Potenza, 12 Zdenek Racil, 13 1-2011-2012).…”

“…[1][2][3] Among the available antifungals, amphotericin B (AmB) formulations and posaconazole demonstrate the most promising in vitro activities against Mucorales, 4,5 and their combination displays synergistic in vitro activity. 6,7 However, pre-clinical studies in neutropenic and diabetic ketoacidotic mice with IM reported no improvement in survival under a combination of posaconazole and liposomal amphotericin B (LAmB), compared to L-AmB monotherapy.…”

Aspects cliniques et radiologiques des mucormycoses

“…L'atteinte est préférentiellement rhino-orbito-cérébrale chez les diabétiques (Figure 1). Actuellement, face à l'augmentation constante du nombre de patients sévèrement immunodéprimés, le diabète n'est plus la cause prédo-minante des infections mucormycosiques [5,6,18,19]. La présence d'une neutropénie profonde, et surtout prolongée, est actuellement le facteur de risque le plus commun.…”

“…Enfin, l'inoculation intraveineuse directe de Mucorales présentes dans des drogues contaminées peut aboutir à des infections profondes primitives, volontiers cérébrales, chez des toxicomanes [16]. 1 [1][2][3][4][5][6]. Malgré une expression clinique bruyante, le diagnostic de certitude est toujours difficile et donc très souvent tardif.…”