Rhinocerebral Mucormycosis Treated with Amphotericin B Colloidal Dispersion in Three Patients
| Autor: | Josef Elidan, Masha Brickman, Galia Rahav, Allon E. Moses, Yechezkel Barenholz, Itzhack Polacheck, Mervyn Shapiro, Shmuel Gillis, Badri Azaz |
|---|---|
| Rok vydání: | 1998 |
| Předmět: |
Adult
Male Microbiology (medical) medicine.medical_specialty Antifungal Agents medicine.medical_treatment Opportunistic Infections Nephrotoxicity Amphotericin B Diabetes mellitus Paranasal Sinus Diseases medicine Humans Mucormycosis Mycosis Aged Chemotherapy ABCD² score business.industry Middle Aged medicine.disease Surgery Infectious Diseases Creatinine Female Zygomycosis business medicine.drug |
| Zdroj: | Clinical Infectious Diseases. 26:1430-1433 |
| ISSN: | 1537-6591 1058-4838 |
| DOI: | 10.1086/516349 |
| Popis: | Rhinocerebral mucormycosis (zygomycosis) primarily affects diabetic or immunosuppressed patients and typically progresses rapidly, necessitating surgical excision and antifungal therapy with amphotericin B. Large doses of amphotericin B are required for cure, causing significant renal toxicity. Amphotericin B colloidal dispersion (ABCD; Amphocil, Sequus Pharmaceuticals, Menlo Park, CA) is a 1:1 complex of cholesteryl sulfate and amphotericin B, which results in significant reduction of toxicity, especially nephrotoxicity. We describe three patients with life-threatening rhinocerebral mucormycosis treated with ABCD. All patients had high serum creatinine levels due to prior treatment with amphotericin B; these levels reverted to normal during treatment with ABCD. Two patients with diabetes mellitus were cured after receiving a combination of surgery and ABCD therapy. The third patient, who had myelodysplastic syndrome, had an initial good response, with cure of the fungal infection; however, he eventually died of his primary illness. To the best of our knowledge, this is the first detailed clinical description of the treatment of mucormycosis with ABCD. |
| Databáze: | OpenAIRE |
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