The successful use of amphotericin B followed by oral posaconazole in a rare case of invasive fungal sinusitis caused by co-infection with mucormycosis and aspergillus

Mahomed, Saajida; Basanth, Sujith; Mlisana, Koleka

doi:10.1016/j.idcr.2015.10.001

Cited by 12 publications

(10 citation statements)

References 8 publications

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“…Therefore, it might reasonably be expected that this would be reflected in worse treatment outcomes in patients with IFD caused by multiple fungal species. Consistent with this expectation, fatal outcomes were reported in more than half of the case reports we found in a search of the literature for patients with IFD involving multiple fungal species . This figure may be underestimated because case reports tend to favour positive outcomes.…”

Section: Discussionsupporting

confidence: 80%

“…1 Antifungal treatment options for most IFDs include amphotericin B formulations, echinocandins, and triazole antifungal agents, although each may be associated with limitations that include pathogen susceptibility and patient tolerability. 2 Despite that IFDs in clinical practice usually involve a single fungal pathogen, concurrent infections with more than one fungal species have been reported in case studies [3][4][5][6][7][8][9][10][11][12][13][14][15][16][17] and retrospective analyses. [18][19][20] A multiple-species IFD may pose a unique clinical challenge because of the potential for increased virulence and different susceptibility profiles of the pathogens.…”

Section: Introductionmentioning

confidence: 99%

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Isavuconazole for treatment of invasive fungal diseases caused by more than one fungal species

Marty

Cornely

Mullane

et al. 2018

Mycoses

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The optimal approach to treat invasive fungal disease (IFD) caused by more than one fungal species is unknown. We documented the efficacy and safety of isavuconazole for treatment of IFDs caused by more than one fungal species. VITAL was a single-arm, international, open-label study evaluating the efficacy and safety of isavuconazole (200 mg orally or intravenously every 8 hours for 48 hours, then once daily) for treatment of rare IFDs. The primary outcome was the overall response at Day 42; key secondary outcomes were overall responses at Day 84 and end of treatment (EOT), mortality at Days 42 and 84, and safety. This analysis includes patients with IFD caused by multiple fungal species. Fifteen patients were included in this analysis (including Aspergillus spp., n = 11; without Aspergillus spp., n = 4); median treatment duration was 97 days [range, 6-544] days). Overall treatment success was observed in 2/15 patients (13.3%) at Days 42 and 84, and 2/14 (14.3%) at EOT. All-cause mortality was 2/15 (13.3%) at Day 42 and 4/15 (26.7%) at Day 84. All patients had ≥1 treatment-emergent adverse event (TEAE); 12 patients (80.0%) had serious TEAEs; TEAEs led to discontinuation of isavuconazole in two patients (13.3%). Isavuconazole may be useful to treat some IFDs caused by multiple fungal species.

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Section: Discussionsupporting

confidence: 80%

Section: Introductionmentioning

confidence: 99%

Isavuconazole for treatment of invasive fungal diseases caused by more than one fungal species

Marty

Cornely

Mullane

et al. 2018

Mycoses

View full text Add to dashboard Cite

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“…We cannot rule out the implication of Cunninghamella in the inaugural epilepsy: Cerebral embolism through hematogenous dissemination has recently been reported, as well as isolated cerebral mucormycosis whose diagnosis was made only after surgical exploration . In retrospect, the pulmonary lesions that were attributed to Aspergillus fumigatus are not incompatible with Cunninghamella infection, as co‐infections with Mucorales and Aspergillus have been demonstrated …”

Section: Discussionmentioning

confidence: 97%

Early necrotic skin lesions after a ABO‐incompatible kidney transplantation: The threat of Cunninghamella Spp.

Béllière

Rolland

Tournier

et al. 2019

Transplant Infectious Dis

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A 49-year-old man underwent ABO-incompatible kidney transplantation with a living donor. At day 33 post-transplantation, he presented with undiagnosed epilepsy with generalized tonic-clonic seizures. At day 44 post-transplantation, he developed left-sided pneumonia attributed to Aspergillus fumigatus and treatment with liposomal amphotericin B was initiated. At day 51 post-transplantation, necrotic skin lesions appeared. DNA sequencing in a fresh cutaneous biopsy finally identified Cunninghamella Spp., a member of the order Mucorales. Unfortunately, the necrotic lesions spread, and the patient died at day 60 post-transplantation. This case report highlights the infectious risk related to ABO-incompatible kidney transplantation and suggests a requirement for rapid identification of every skin lesion, even in the early phases of immunosuppression. K E Y W O R D S ABO-incompatible kidney transplantation, Cunninghamella, mucormycosis, necrotic skin lesions

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“…Another case was reported from South Africa in 2015, where a case of oro-rhinocerebral disease caused by mucormycosis and aspergillus co-infection was found in a 54-year-old insulin-dependent diabetic patient. Although the patient was successfully treated with parenteral amphotericin B followed by oral posaconazole, she was left with irreversible blindness of the right eye and multiple cranial nerve palsies [ 13 ].…”

Section: Discussionmentioning

confidence: 99%

A treated case of rhinocerebral zygomycosis with aspergillosis: a case report from India

Malhothra

Mandal

Meena

et al. 2020

Access Microbiology

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Zygomycosis and aspergillosis are two serious fungal infections that are commonly seen in immunocompromised patients. Since both of these infections involve fungi that invade vessels of the arterial system, an early and rapid diagnosis by direct examination of KOH mounts of the relevant clinical sample can clinch the diagnosis. Here, we present a case of a 60-year-old diabetic patient who presented with swelling and pain over the nose and left eye for 7 days with loss of vision in the left eye. After investigation, the patient was diagnosed as having rhinocerebral mucormycosis and aspergillosis, and was initially treated with amphotericin B (1 mg kg−1 day−1 intravenously), followed by endoscopic debridement under general anaesthesia. The patient gradually improved after surgery, and treatment with intravenous amphotericin B was continued along with the addition of 200 mg oral voriconazole twice daily (for the aspergillosis). With prompt diagnosis and treatment, the patient survived these fatal fungal co-infections and finally was discharged.

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The successful use of amphotericin B followed by oral posaconazole in a rare case of invasive fungal sinusitis caused by co-infection with mucormycosis and aspergillus

Cited by 12 publications

References 8 publications

Isavuconazole for treatment of invasive fungal diseases caused by more than one fungal species

Isavuconazole for treatment of invasive fungal diseases caused by more than one fungal species

Early necrotic skin lesions after a ABO‐incompatible kidney transplantation: The threat of Cunninghamella Spp.

A treated case of rhinocerebral zygomycosis with aspergillosis: a case report from India

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