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Rev Mal Respir ; 26(9): 998-1002, 2009 Nov.
Article in French | MEDLINE | ID: mdl-19953048

ABSTRACT

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.


Subject(s)
Absidia , Lung Diseases, Fungal/diagnosis , Lung Transplantation , Mucormycosis/diagnosis , Opportunistic Infections/diagnosis , Thyroid Diseases/diagnosis , Adult , Amphotericin B/administration & dosage , Antifungal Agents/administration & dosage , Combined Modality Therapy , Debridement , Female , Humans , Lung Diseases, Fungal/surgery , Mucormycosis/drug therapy , Mucormycosis/surgery , Opportunistic Infections/drug therapy , Opportunistic Infections/surgery , Thyroid Diseases/surgery , Triazoles/administration & dosage
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