Subject(s)
Melanosis/pathology , Severity of Illness Index , Academic Medical Centers , Adult , Analysis of Variance , Cohort Studies , Confidence Intervals , Female , Humans , Male , Retrospective Studies , TexasABSTRACT
Mucormycosis (MCM) is a life-threatening infection that carries high mortality rates despite recent advances in its diagnosis and treatment. The objective was to report 14 cases of mucormycosis infection and review the relevant literature. We retrospectively analyzed the demographic and clinical data of 14 consecutive patients that presented with MCM in a tertiary-care teaching hospital in northern Mexico. The mean age of the patients was 39.9 (range 5-65). Nine of the patients were male. Ten patients had diabetes mellitus as the underlying disease, and 6 patients had a hematological malignancy (acute leukemia). Of the diabetic patients, 3 had chronic renal failure and 4 presented with diabetic ketoacidosis. All patients had rhinocerebral involvement. In-hospital mortality was 50%. All patients received medical therapy with polyene antifungals and 11 patients underwent surgical therapy. Survivors were significantly younger and less likely to have diabetes than nonsurvivors, and had higher levels of serum albumin on admission. The clinical outcome of patients with MCM is poor. Uncontrolled diabetes and age are negative prognostic factors.
ABSTRACT
Melanoma has shown a greater increase in frequency as compared to other neoplasms, demonstrated by a 619% incidence increase in the USA from 1950 to the year 2000. Its treatment has always been a challenge, and once it has metastasized, there are no available curative regimens. In recent years considerable progress in the understanding of its pathophysiology and progression has been achieved; with the description of the genetic, molecular, and immunologic changes, new and specific drugs have been developed, with better response rates than conventional chemotherapy. Currently, a broad scope of therapeutic choices is available, although only eight are approved by the FDA. In the following literature review we present some of the better-known systemic treatment options for melanoma, from conventional chemotherapy, molecular (MAPK inhibitors) and immunomodulatory (interleukin-2, tumor necrosis factor alpha, cytotoxic T lymphocyte antigen-4 and programmed death-1 inhibitors) therapies, to miscellaneous options, among which are angiogenesis inhibitors, apoptosis modulators, vaccines, and radiotherapy.
