Zygomycosis (Mucormycosis) and HIV Infection: Report of Three Cases and Review

Nagy-Agren, Stephanie; Chu, Patrick; Smith, Greg T.; Waskin, Hetty; Altice, Frederick L.

doi:10.1097/00042560-199512000-00007

Cited by 73 publications

(32 citation statements)

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“…Other unusual forms of infection include superior vena cava syndrome (51) and external otitis (110). Although mucormycosis is not commonly seen in AIDS patients, there have been a number of case reports of this infection in this patient population (41,105,134).…”

Section: Epidemiology and Disease Manifestationsmentioning

confidence: 99%

Novel Perspectives on Mucormycosis: Pathophysiology, Presentation, and Management

2005

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Mucormycosis is a life-threatening fungal infection that occurs in immunocompromised patients. These infections are becoming increasingly common, yet survival remains very poor. A greater understanding of the pathogenesis of the disease may lead to future therapies. For example, it is now clear that iron metabolism plays a central role in regulating mucormycosis infections and that deferoxamine predisposes patients to mucormycosis by inappropriately supplying the fungus with iron. These findings raise the possibility that iron chelator therapy may be useful to treat the infection as long as the chelator does not inappropriately supply the fungus with iron. Recent data support the concept that high-dose liposomal amphotericin is the preferred monotherapy for mucormycosis. However, several novel therapeutic strategies are available. These options include combination therapy using lipid-based amphotericin with an echinocandin or with an azole (largely itraconazole or posaconazole) or with all three. The underlying principles of therapy for this disease remain rapid diagnosis, reversal of underlying predisposition, and urgent surgical debridement

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Section: Epidemiology and Disease Manifestationsmentioning

confidence: 99%

Novel Perspectives on Mucormycosis: Pathophysiology, Presentation, and Management

2005

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“…Menos frecuentemente se ha reportado en pacientes diabéticos, sometidos a trasplante renal, infectados por VIH, e incluso en huéspedes inmunocompetentes 2,[29][30][31][32][33][34] . La zigomicosis pulmonar puede ocurrir también como parte de una infección diseminada y raras veces después de una enfermedad rinocerebral 1,34 .…”

Section: Mucormicosis Pulmonarunclassified

Mucormicosis en Pediatría

P¹,

2004

Rev. chil. infectol.

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IntroducciónTambién llamada phycomicosis o zigomicosis, (aunque este segundo término es más amplio y engloba además a infecciones causadas por Entomophtorales), es una afección causada por hongos saprófítos aeróbicos, generalmente no pató-genos para el hospedero inmunocompetente 1,2 . El desarrollo de enfermedad depende del estado inmune del huésped; los macrófagos y neutrófilos parecen ser el componente primario de la respuesta inmune contra estos microorganismos, previniendo la germinación de las esporas inhaladas 3 . El sello de la mucormicosis es la invasión vascular por hifas que conduce a la trombosis arterial, infarto secundario, trombosis venosa y hemorragia consecuente. Las razones de la afinidad del hongo por el tejido vascular son desconocidas y materia de especulación 2,5 . Los hongos del Orden Mucorales son microorganismos no fastidiosos que crecen en un rango de temperatura de 25 a 55° C, aeróbicos y demoran 2 a 5 días en formar colonias visibles a ojo desnudo. Las colonias tienen aspecto lanudo, a menudo parecen tenues puntos negros. Las especies de estos géneros desarrollan estolones, rizoides (en Rhizopus, Absidia y Rhizomucor) y el esporangio contiene en su extremo miriadas de esporangiosporas de 3-6 mm de diámetro cada una, que sirven como la forma de diseminación al medioambiente. La observación directa del tejido extraído, tratado con KOH al 10%, permite apreciar formas irregulares, hifas características largas y con ancho de 10 a 30 mµ, no septadas, que adoptan a menudo formas curvas o de cintas ramificadas en ángulo recto ( Etiología Mucormycosis in PediatricsMucormycosis is an infrequent infection caused by opportunistic fungi belonging to the Mucorales order; Mucoraceae family, whose characteristics are vascular invasion by hyphae, which determine thrombosis and tissue infarction. In generally affects patients with underlying diseases and produces serious invasive and often fulminant infections. Some of the risk factors leading to mucormycosis are diabetic ketoacidosis, immunosuppressive therapy, leukemia and lymphomas with prolonged neutropenia. Various clinical presentations are described, relating to anatomical site involved, being the rhinocerebral site, the most frequent one, specially in diabetic patients. Although this infection has a high morbidity and mortality, its prognosis has improved the last years, relating to therapeutic measures like correction of predisposing conditions, use of amphotericin B and early aggressive surgery. It is very important to suspect this infection in patients with predisposing conditions so an early diagnosis can be made.

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“…They have minimal intrinsic pathogenicity but are known to initiate an aggressive and often fatal infection in certain conditions such as diabetic ketoacidosis, lymphoproliferative disorders, renal failure and viral hepatitis [3][4][5] . The list of predisposing conditions continues to grow, the latest additions being desferrioxamine therapy for iron/ aluminum overload in dialysis patients [6] and intravenous drug abuse particularly in those with HIV infection [15][16][17][18] . The four main presentations of zygomycosis described in man are the rhinocerebral, pulmonary, gastrointestinal and disseminated forms [5] .…”

Section: Discussionmentioning

confidence: 99%

Isolated Renal Zygomycosis: Novel Diagnostic and Prognostic Criteria with Experience of a Tertiary Care Center

Chipde¹,

Ranjan²,

Lal³

et al. 2012

Urol Int

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Background: Isolated renal zygomycosis is a life-threatening infection and difficult to diagnose ante mortem due to varied presentations. Most reports in the literature are case reports. We are presenting our experience of 10 patients. Materials and Methods: Retrospective data of 10 consecutive patients with primary renal zygomycosis, including 2 post-transplant patients, in our tertiary care center was analyzed. Epidemiological characteristics, predisposing conditions, clinical presentation, diagnostic findings and treatment outcomes were recorded. Characteristic radiological findings were recorded. Localized disease was managed by supportive treatment or percutaneous drainage and extensive disease with unilateral or bilateral nephrectomy. Renal involvement was confirmed in all patients by histopathology. Results: The mean age of presentation was 35 years. Five patients who had bilateral renal involvement presented with oliguric acute renal failure, hematuria and abdominal pain. Three had unilateral renal disease and presented with flank pain and fever. The two post-transplant patients presented with fever and graft dysfunction. Even after aggressive treatment 5 patients died, accounting for a mortality rate of 50%. Conclusion: Isolated renal zygomycosis can be diagnosed with typical radiological findings, combined with clinical, laboratory and histopathological features. This study describes the newer ante mortem radiological diagnostic criteria and prognostic predictors of the disease.

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Zygomycosis (Mucormycosis) and HIV Infection: Report of Three Cases and Review

Cited by 73 publications

References 0 publications

Novel Perspectives on Mucormycosis: Pathophysiology, Presentation, and Management

Novel Perspectives on Mucormycosis: Pathophysiology, Presentation, and Management

Mucormicosis en Pediatría

Isolated Renal Zygomycosis: Novel Diagnostic and Prognostic Criteria with Experience of a Tertiary Care Center

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