Therapeutic Challenges of Hepatic Mucormycosis in Hematologic Malignancy: A Case Report and Review of the Literature
| Autor: | Maricar Malinis, Ananta Gurung, Raffaele Bernardo, Dhanpat Jain |
|---|---|
| Rok vydání: | 2016 |
| Předmět: |
0301 basic medicine
medicine.medical_specialty Posaconazole Abdominal pain Antifungal Agents Liver Abscess 030106 microbiology Malignancy Gastroenterology Immunocompromised Host 03 medical and health sciences Fatal Outcome 0302 clinical medicine Risk Factors Amphotericin B Internal medicine medicine Humans Mucormycosis Treatment Failure 030212 general & internal medicine business.industry Liver Diseases Induction chemotherapy Articles General Medicine Middle Aged Triazoles medicine.disease Surgery Leukemia Myeloid Acute Leukemia Treatment Outcome Chemotherapy Adjuvant Mucorales Female medicine.symptom business Liver abscess medicine.drug |
| Zdroj: | The American Journal of Case Reports |
| ISSN: | 1941-5923 |
| Popis: | Patient: Female, 58 Final Diagnosis: Hepatic mucormycosis Symptoms: Abdominal pain • fever Medication: Amphotericin • posaconazole Clinical Procedure: IR-guided aspiration Specialty: Infectious Diseases Objective: Rare disease Background: The clinical presentation of mucormycosis can vary widely based on various host factors. Among malignancy-and bone marrow transplant-associated infections, the lungs are the most common site of infection. Involvement of the gastrointestinal tract is less frequently encountered. The clinical presentation is often nonspecific, and cultures typically yield no growth, making the diagnosis challenging. Case Report: We present a case of isolated hepatic mucormycosis in the setting of neutropenic fever and abdominal pain following induction chemotherapy for the treatment of acute myeloid leukemia. The patient was treated with combination antifungal therapy with amphotericin and posaconazole without surgical resection, given the presence of multiple liver lesions. After a prolonged course of dual antifungal therapy, the size of her liver lesions improved. Unfortunately, her lymphoproliferative disorder proved fatal, following approximately 13 months of antifungal therapy. Conclusions: Among patient with mucormycosis, mortality remains high, especially in the setting of gastrointestinal involvement. Although surgical resection along with dual antifungal therapy can improve outcomes, the high mortality rate necessitates further investigation into improved diagnostic and treatment strategies including optimal antifungal therapy. |
| Databáze: | OpenAIRE |
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