1. [Non-fatal disseminated mucormycosis in a solid organ transplant]
- Author
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Minet, Clémence, Bonadona, Agnès, Tabah, Alexis, Karkas, Alexandre, Mescam, L., Schwebel, Carole, Hamidfar, Rebecca, Pison, Christophe, Saint-Raymond, Christel, Faure, Odile, Salameire, Dimitri, Timsit, Jean-François, Unité de pneumologie, CHU Grenoble, Unité de Réanimation médicale, Unité d'Oto-rhinolaryngologie, Département d'anatomie et cythologie pathologique, CHU Grenoble-Hôpital Michallon, Clinique de réanimation médicale, Université Joseph Fourier - Grenoble 1 (UJF)-CHU Grenoble-Hôpital Michallon, Unité de Parasitologie-mycologie, Laboratoire de parasitologie et mycologie, Université Joseph Fourier - Grenoble 1 (UJF)-CHU Grenoble, INSERM U823, équipe 11 (Epidémiologie des cancers et des affections graves), Institut d'oncologie/développement Albert Bonniot de Grenoble (INSERM U823), Université Joseph Fourier - Grenoble 1 (UJF)-CHU Grenoble-EFS-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Joseph Fourier - Grenoble 1 (UJF)-CHU Grenoble-EFS-Institut National de la Santé et de la Recherche Médicale (INSERM)-Unité de Réanimation médicale, and Vesin, Aurélien
- Subjects
Adult ,Antifungal Agents ,Lung Diseases, Fungal ,Opportunistic Infections ,Triazoles ,Combined Modality Therapy ,Thyroid Diseases ,Debridement ,[SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie ,Amphotericin B ,Humans ,Mucormycosis ,Female ,[SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie ,Absidia ,Lung Transplantation - Abstract
International audience; BACKGROUND: Mucormycosis is a rare fungal infection occurring most frequently in immunocompromised patients. The pathogens are filamentous fungi, order of Mucorales. Disseminated mucormycosis is a severe, life treating disease. Early diagnosis is a major determinant for prognosis, however, it remains difficult. The management consists in an early antifungal therapy using lipid formulation of amphotericin B associated with an extensive surgical debridement. Despite this therapeutic of choice, the mortality of disseminated mucormycosis remains high. OBSERVATION: We report the case of disseminated mucormycosis in a 25 years old woman 9 months after a pulmonary transplantation. The clinical presentation included pulmonary and thyroid localization and the pathogen was Absidia corymbifera. The patient survived thanks to a large surgical debridement, and an early antifungal bitherapy by lipid formulation of amphotericin B and posaconazole. CONCLUSION: The re-emergence and the high mortality of mucormycosis in solid organ transplant receiver show the necessity to find new therapeutic approaches. Posaconazole associated with liposomal amphotericin B could be an interesting option to treat disseminated mucormycosis and improve their outcome.
- Published
- 2009