Rhinofacial conidiobolomycosis: Clinical and microbiological characterisation and shift in the management of a rare disease
| Autor: | George M. Varghese, Susanne Pulimood, Lisa Mary Cherian, Joy Sarojini Michael, Vedantam Rupa, Rani Diana Sahni, Meera Thomas, Divya Dayanand, Abi Manesh, Regi Kurien, Lalee Varghese, Dincy Peter |
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| Rok vydání: | 2021 |
| Předmět: |
0301 basic medicine
Adult Male medicine.medical_specialty Antifungal Agents Itraconazole 030106 microbiology Dermatology Microbial Sensitivity Tests Tertiary Care Centers 030207 dermatology & venereal diseases 03 medical and health sciences Minimum inhibitory concentration Young Adult 0302 clinical medicine Rare Diseases Zygomycosis Internal medicine Amphotericin B Nose Diseases medicine Humans Rhinofacial conidiobolomycosis Retrospective Studies Conidiobolus business.industry Disease Management General Medicine Middle Aged medicine.disease Regimen Infectious Diseases Conidiobolomycosis Face Histopathology Female business medicine.drug Rare disease |
| Zdroj: | MycosesREFERENCES. 64(8) |
| ISSN: | 1439-0507 |
| Popis: | BACKGROUND Conidiobolomycosis is a rare tropical rhinofacial fungal infection which has not been well characterised. The available evidence in its management is sparse due to lack of clinical studies and the limited data on antifungal susceptibility patterns. OBJECTIVE To analyse the clinical manifestations, antifungal treatment and outcomes of patients with conidiobolomycosis and to determine antifungal susceptibility profiles of the isolates. PATIENTS/METHODS Retrospective analysis of data of all patients with a diagnosis of conidiobolomycosis confirmed by histopathology and culture at a tertiary care hospital from 2012 to 2019 was done. RESULTS There were 22 patients, 21 males and one female, with a mean age of 37.1 years. Most common presenting symptom was nasal obstruction, found in 20 (90.90%) patients. Patients who presented within 12 months had a better cure rate (85%) compared to those who presented late (67%). Among the 19 patients who had a follow-up, good outcome was seen in 15 of the 17 (88.24%) patients who were on itraconazole or potassium iodide containing regimen. Of the six patients who received additional trimethoprim-sulphamethoxazole (co-trimoxazole), 67% showed good outcome with two patients showing complete cure and two patients still on treatment with significant improvement. High minimum inhibitory concentration (MIC) values were noted for azoles and amphotericin B, whereas co-trimoxazole showed lowest MIC ranges. CONCLUSION Itraconazole and potassium iodide are reasonable first-line options for the treatment of conidiobolomycosis. Good clinical response to KI and comparatively lower MIC of co-trimoxazole are promising. Further studies are required for developing clinical breakpoints that can predict therapeutic outcomes. |
| Databáze: | OpenAIRE |
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