Management of Pulmonary Mucormycosis After Orthotopic Heart Transplant: A Case Series

Hill, Michael C.; Belkin, Mark N.; McMullen, Phillip; Pillarella, J.; Macaluso, G; Treitman, Adam; Pappas, Patroklos; Tatooles, Antone; Cotts, William; Andrade, Ambar; Kim, Gene; Narang, Nikhil

doi:10.1016/j.transproceed.2021.09.034

Cited by 4 publications

(1 citation statement)

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“…In this situation, combination therapies and other adjunctive therapies may be significant. It is notable that seven patients treated with nebulized AmB obtained a favorable prognosis [ 22 , 23 , 24 , 25 , 26 , 27 , 28 ]. Among them, one case reported the successful treatment of PM through the intravenous inhalation and local airway perfusion of AmB [ 28 ].…”

Section: Discussionmentioning

confidence: 99%

Oral Isavuconazole Combined with Nebulized Inhalation and Bronchoscopic Administration of Amphotericin B for the Treatment of Pulmonary Mucormycosis: A Case Report and Literature Review

Leng,

Zhou,

et al. 2024

JoF

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Pulmonary mucormycosis (PM) is an invasive and potentially fatal fungal infection, with Rhizopus microsporus (R. microsporus) being the most common pathogen. The routine therapy for this infection includes surgery and antifungal agents. However, the therapeutic effects of single agents are unsatisfactory due to the rapid progression of mucormycosis, while not all patients can tolerate surgery. Innovative treatment methods like combination therapy await validations of their clinical efficacy. We report a case of PM that was diagnosed via metagenomics next-generation sequencing (mNGS) of black drainage fluid from the patient’s lung. The patient eventually recovered and was discharged after a combination therapy of oral isavuconazole, inhaled amphotericin B, and local perfusion of amphotericin B through bronchoscopy, which may be a promising strategy for the treatment of PM, especially for cases where surgery is not possible. A retrospective study of 297 cases in a literature review highlights the different treatment methods used in clinical practice.

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