Primary cutaneous mucormycosis in an immunocompetent host

Wani, Tehmeena; Hussain, Wajahat; Zargar, Haroon Rashid; Sheikh, Abdul Rashid; Iqbal, Shabir

doi:10.1007/s11046-007-9041-8

Cited by 27 publications

(15 citation statements)

References 6 publications

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“…in 2 cases we did not identify any of these stated risk factors, however. Usually this event, according to the current literature, is more frequently observed in Asia, probably due to the favorable climatic conditions [18][19][20] .…”

Section: Statistical Resultsmentioning

confidence: 89%

Zygomycosis in Italy: A Survey of FIMUA-ECMM (Federazione Italiana Di Micopatologia Umana ed Animale and European Confederation of Medical Mycology)

Pagano¹,

Valentini²,

Posteraro³

et al. 2009

Journal of Chemotherapy

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The aims of the study were to analyze the clinical and epidemiological characteristics and treatments for patients who developed zygomycosis enrolled in Italy during the European Confederation of Medical Mycology of medical mycology survey. This prospective multicenter study was performed between 2004 and 2007 at 49 italian Departments. 60 cases of zygomycosis were enrolled: the median age was 59.5 years (range 1-87), with a prevalence of males (70%). The majority of cases were immunocompromised patients (42 cases, 70%), mainly hematological malignancies (37). Among non-immunocompromised (18 cases, 30%), the main category was represented by patients with penetrating trauma (7/18, 39%). The most common sites of infection were sinus (35%) with/without CNS involvement, lung alone (25%), skin (20%), but in 11 cases (18%) dissemination was observed. According to EORTC criteria, the diagnosis of zygomycosis was proven in 46 patients (77%) and in most of them it was made in vivo (40/46 patients, 87%); in the remaining 14 cases (23%) the diagnosis was probable. 51 patients received antifungal therapy and in 30 of them surgical debridement was also performed. The most commonly used antifungal drug was liposomal amphotericin B (L-AmB), administered in 44 patients: 36 of these patients (82%) responded to therapy. Altogether an attributable mortality rate of 32% (19/60) was registered, which was reduced to 18% in patients treated with L-AmB (8/44). Zygomycosis is a rare and aggressive filamentous fungal infection, still associated with a high mortality rate. This study indicates an inversion of this trend, with a better prognosis and significantly lower mortality than that reported in the literature. It is possible that new extensive, aggressive diagnostic and therapeutic procedures, such as the use of L-AmB and surgery, have improved the prognosis of these patients.

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Section: Statistical Resultsmentioning

confidence: 89%

Zygomycosis in Italy: A Survey of FIMUA-ECMM (Federazione Italiana Di Micopatologia Umana ed Animale and European Confederation of Medical Mycology)

Pagano¹,

Valentini²,

Posteraro³

et al. 2009

Journal of Chemotherapy

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“…14 In all other cases, trauma ranged from large crush injuries with major soil inoculation 12 to minor intramuscular injections. 13 A literature review using PubMed was performed, specifically looking for cases of upper extremity mucormycosis in immunocompetent patients using the following terms: mucormycosis upper extremity, mucormycosis hand, zygomycosis upper extremity, zygomycosis hand, cutaneous mucormycosis immunocompetent, cutaneous zygomycosis immunocompetent. In total, 8 similar reports were found with the term "limb salvage," indicating no amputation was required ( Table 1).…”

Section: Discussionmentioning

confidence: 99%

Cutaneous Mucormycosis of the Upper Extremity in an Immunocompetent Host: Case Report

Lineberry

Boettcher²,

Blount³

et al. 2012

The Journal of Hand Surgery

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“…The mortality rate of mucormycosis associated with Cunninghamella is 81 % (Gomes et al, 2011). Mucormycosis in an immunocompetent patient has good prognosis (Sridhara et al, 2005;Zhao et al, 2009;Lechevalier et al, 2008;Tehmeena et al, 2007;Jayasuriya et al, 2006;Radner et al, 1995). Therefore, a case of mucormycosis in an immunocompetent patient who died, without autopsy, was suspected to have involved a coexisting malignancy or other disease that immunocompromised the patient (Baradkar et al, 2008;Shiva Prasad et al, 2008).…”

Section: Discussionmentioning

confidence: 99%

Diagnosis of pulmonary mucormycosis aiding the diagnosis of small cell lung cancer

Uchida

Tsukino

Shigemori

et al. 2012

Journal of Medical Microbiology

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Mucormycosis is a rare complication in immunocompromised patients. Antemortem diagnosis of mucormycosis is difficult and often incorrect. We report a case of pulmonary mucormycosis caused by Cunninghamella bertholletiae in an elderly man with interstitial pneumonia. The diagnosis of mucormycosis was established by bronchoalveolar lavage. A coexisting immune deficiency condition was considered. Lung cancer was suspected because of an elevated progastrin-releasing peptide level and bilateral hilar and mediastinal lymphadenopathy; it was diagnosed after performing endoscopic ultrasound-guided fine-needle aspiration. Treatment by intravenous liposomal amphotericin B was effective, but relapse occurred because of bone marrow suppression caused by chemotherapy for lung cancer. Treatment for mucormycosis was resumed, but the patient died of carcinomatous lymphangiosis. Autopsy confirmed the diagnosis of pulmonary mucormycosis and revealed refractory anaemia with small cell lung cancer. Mucormycosis often occurs in immunocompromised patients, but this case is rare because the mucormycosis was diagnosed before the diagnosis of malignancy. Because prognosis is often poor, the possibility of coexisting malignancies should always be investigated in patients with mucormycosis infections. IntroductionMucormycosis is a rare but opportunistic fungal infection that occurs in immunocompromised patients. Its antemortem diagnosis is especially difficult. Mucormycosis often carries a poor prognosis, which is particularly poor when the disease is caused by Cunninghamella species (Roden et al., 2005). We report a case of pulmonary Cunninghamella infection with lung cancer and refractory anaemia. Lung cancer was diagnosed after the diagnosis of pulmonary mucormycosis, and refractory anaemia was revealed by autopsy. This is a rare case because mucormycosis was diagnosed before diagnosing the malignancy. The possibility of coexisting malignancies should be investigated without fail in patients with mucormycosis infections. Case reportA 74-year-old Japanese man with interstitial pneumonia (IP) and pulmonary emphysema, for which no medication had been administered, was admitted with fever, cough and exertional dyspnoea. His haemoglobin A1c levels had recently increased to 6.5 % National Glycohemoglobin Standardization Program (NGSP) derived units [47.2 mmol mol 21, International Federation of Clinical Chemists' (IFCC) units], but he was not treated for diabetes mellitus. His medical history was significant for previous myocardial infarction, angina pectoris and chronic heart failure. He was a 60-pack-year ex-smoker living in a 70-year-old wooden house and managed a metal-recycling company; thus, he was exposed to fine metal particles. On admission, his vital signs were stable, with ambient oxygen saturation of 94 %. Auscultation revealed a few fine crackles bilaterally in the lower lung fields and coarse crackles in the right upper lung field. The complete blood count was normal. His C-reactive protein level was 3.4 mg dl 21 and his KL-6 w...

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Primary cutaneous mucormycosis in an immunocompetent host

Abstract: Mucormycosis in immunocompetent hosts is rare, and is often related to trauma. We report a case of primary cutaneous mucormycosis in a 26 year old immunocompetent female due to Mucor species. A combination of Amphotericin B and surgical debridement completely eradicated the infection.

Cited by 27 publications

References 6 publications

Zygomycosis in Italy: A Survey of FIMUA-ECMM (Federazione Italiana Di Micopatologia Umana ed Animale and European Confederation of Medical Mycology)

Zygomycosis in Italy: A Survey of FIMUA-ECMM (Federazione Italiana Di Micopatologia Umana ed Animale and European Confederation of Medical Mycology)

Cutaneous Mucormycosis of the Upper Extremity in an Immunocompetent Host: Case Report

Diagnosis of pulmonary mucormycosis aiding the diagnosis of small cell lung cancer

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