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Titolo:
SUCCESSFUL MEDICAL AND ANTIFUNGAL THERAPY OF RHIZOPUS-ORYZAE RHINO-CEREBRAL MUCORMYCOSIS WITHOUT SURGICAL-TREATMENT
Autore:
NEVEZ G; MASSIP P; LINAS MD; LELLOUCHE B; TUBERY M; CARME B; PESSEY JJ; DUFFAUT M; SEGUELA JP;
Indirizzi:
CHU,HOP SUD,SERV PARASITOL MYCOL F-80054 AMIENS FRANCE CHU RANGUEIL,SERV MALAD INFECT F-31054 TOULOUSE FRANCE
Titolo Testata:
Journal de mycologie medicale
fascicolo: 4, volume: 5, anno: 1995,
pagine: 254 - 258
SICI:
1156-5233(1995)5:4<254:SMAATO>2.0.ZU;2-6
Fonte:
ISI
Lingua:
FRE
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Science Citation Index Expanded
Science Citation Index Expanded
Citazioni:
7
Recensione:
Indirizzi per estratti:
Citazione:
G. Nevez et al., "SUCCESSFUL MEDICAL AND ANTIFUNGAL THERAPY OF RHIZOPUS-ORYZAE RHINO-CEREBRAL MUCORMYCOSIS WITHOUT SURGICAL-TREATMENT", Journal de mycologie medicale, 5(4), 1995, pp. 254-258

Abstract

Precise modalities of rhinocerebral mucormycosis therapy remain unknown and evolution of these mycosis is often fatal. We report the results of a successful therapy of a mycosis with very extensive involvementin a 75-year-old diabetic man. The patient was followed during 3 years. Surgical incision was discussed and not used because it was impossible to remove all necrosed tissue. However, diabetic ketoacidosis correction and iv administration of amphotericin B permitted a rapid and an unexpected amelioration. Eight months later, alternative per os therapy was decided and in vitro susceptibility tests were used to determine which antifungal to administer. The evolution of tissular lesion was checked over with serial computed tomography and resonance imaging scans and the therapy was associated with iterative tests of drug serumconcentration. It was surprising that susceptibility tests showed in vitro resistance to amphotericin B in spite of favorable clinical results; the fungus was also resistant to itraconazole and sensitive to ketoconazole. Dosages of this agent of 400 mg. daily was used. Although antifungal serum concentrations revealed lower level than necessary, the same regimen was undergone for fourteen months and recovery obtained without relaps. In this case-report, it should be possible that underlying diseases treatment (diabetes and ketoacidosis) was the main factor of successful therapy, then, the use of ketoconazole for treatmentof mucormycosis wouldn't have been evaluated. The decision to differ surgical excision probably contribued to the complete cure without neurologic after-effect, although surgical incision is considered as the most important option of treatment in order to ensure the mortality rate due to mucormycosis.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 25/11/20 alle ore 04:22:32