Zygomycosis: An emerging fungal infection with new options for management
Zygomycosis occurs primarily in immunosuppressed patients and those with diabetes mellitus. Diabetes remains the most common risk factor; however, zygomycosis has increased among transplant recipients and patients with hematologic malignancy. Treatment or prophylaxis with voriconazole seems to be associated with the development of zygomycosis among severely immunosuppressed patients in these latter risk groups. Rhino-orbital-cerebral zygomycosis is the most common manifestation in patients with diabetes mellitus, but transplant recipients and patients with hematologic malignancy are more likely to develop pulmonary infection. Zygomycosis remains difficult to treat and requires a multifaceted approach involving elimination of predisposing factors, surgical debridement, and antifungal therapy. Lipid formulations of amphotericin B are the treatments of choice. The use of posaconazole has been successful in salvage trials but should not be used as first-line therapy until an effective intravenous formulation is available.
Unable to display preview. Download preview PDF.
- 5.Torres-Narbona M, Guiniea J, Martinez-Alarcon J, et al.: In vitro activities of amphotericin B, caspofungin, itraconazole, posaconazole, and voriconazole against 45 clinical isolates of zygomycetes: comparison of CLSI M38-A, Sensititre Yeast One, and the E test. Antimicrob Agents Chemother 2007, 51:1126–1129.PubMedCrossRefGoogle Scholar
- 26.Adams RD, Hunter G, DiTomasso J, Comerci G: Mucormycosis: emerging prominence of cutaneous infections. Clin Infect Dis 1994, 19:67–76.Google Scholar
- 27.Agha FP, Lee HH, Boland CR, Bradley SF: Mucormycoma of the colon: early diagnosis and successful management. Am J Roentgenol 1985, 145:739–741.Google Scholar
- 29.Rinaldi MG: Zygomycosis. Infect Dis Clin N Am 1989, 3:19–41.Google Scholar
- 30.Kontoyiannis DP, Chamilos G, Lewis RE, Tarrand JJ: Increased culture recovery of zygomycetes under physiologic temperatuire conditions [abstract #279]. Presented at the 43rd Annual Meeting of the Infectious Diseases Society of America. San Francisco, CA; October 6–9, 2005.Google Scholar