Mucormycosis in haematological patients: case report and results of prospective study in Saint Petersburg, Russia

Abstract

SummaryWe prospectively observed 36 haematological patients with mucormycosis from nine hospitals of St. Petersburg during 2004-2013. The most frequent underlying diseases were acute leukaemia (64%), and main risk factors were prolonged neutropenia (92%) and lymphocytopenia (86%). In 50% of the patients, mucormycosis was diagnosed 1-65 days after invasive aspergillosis. Main clinical form of mucormycosis was pulmonary (64%), while two or more organ involvement was noted in 50% of the cases. The most frequent aetiological agents of mucormycosis were Rhizopus spp. (48%). Twelve-week survival rate was 50%. Combination therapy (echinocandins + amphotericin B forms) and recovery from the underlying disease significantly improved the survival rate.

Rhinocerebral mucormycosis, risk factors and the type of oral manifestations in patients referred to a University Hospital in Tabriz, Iran 2007‐2017

“…In the present study, the mortality rate was estimated at 42.5% in 40 patients over a period of >10 years, which is comparable to global statistics (Table ). The mortality rate of mucormycosis depends on the clinical manifestations, background factors, surgery and the extension of infection . Ambrosioni et al in a retrospective study of 55 patients of invasive mucormycosis reported a mortality rate of 75% for cases that were treated only with antifungal agents and 14% for cases treated with a combination of surgery and antifungal agents .…”

Role of <I>FKS</I> Gene in the Susceptibility of Pathogenic Fungi to Echinocandins

“…For treatment of blastomycosis 100) , coccidioidomycosis 101) , and Pneumocystis pneumonia 79, 80) (type 3), though not approved nor recommended, it has been reported that echinocandins, alone or in combination, was effective. For therapy of mucormycosis (type 4), combination of lipid formulations of amphotericin B and echinocandins, though its mechanism is unknown, has often been used [102][103][104] and recommended as first-line or salvage therapy in some guidelines 97,105) . echinocandins by other mechanisms than point mutations of Fks 63,64) .…”

MUCORMYCOSIS IN ONCOHEMATOLOGY PATIENTS (results of the prospective study)

“…В настоящем исследовании применение комбини-рованной терапии, наряду с ремиссией фонового забо-левания, было статистически достоверным прогности-ческим фактором, что совпадает с ранее полученными результатами [22]. Поэтому лечение мукормикоза у онкогематологических больных надо начинать с при-менения липидного комплекса АмВ в сочетании с каспофунгином, а после стабилизации состояния пациента использовать позаконазол.…”