Abstract
Zygomycosis are invasive mould infections, rarely diagnosed in hematologic patients. Most of the cases published are in patients with prolonged neutropenia, along with other risk factors such as the use of prior broad-spectrum antibiotics (including new antifungal agents, such as voriconazole), diabetes mellitus (with or without ketoacidosis), malnutrition, iron overload (with or without the use of deferoxamine). These infections have poor prognosis due to the involvement of vital anatomic structures and late diagnosis. Until recent years, the treatment was based on high doses of amphotericin B plus surgical debridement. Here we present two patients with hematologic diseases (one with leukemia, the second with aplastic anemia) with an impaired immune system and the diagnosis of zygomycosis. The survival of one of them was mainly due to early diagnosis and surgical debridement; unfortunately the second was misdiagnosed as an extensive ecchymosis due to thrombocytopenia and died with CNS involvement.
References
Jul 1, 1999·Archives of Internal Medicine·F Y LeeK A Adal
Jun 14, 2000·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·D P KontoyiannisK V Rolston
Oct 4, 2000·Nature Medicine·D Dickson
Apr 17, 2001·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·J W BaddleyP G Pappas
Sep 11, 2002·The Lancet Infectious Diseases·Mar Masiá Canuto, Félix Gutiérrez Rodero
Jan 7, 2003·Infectious Disease Clinics of North America·Corina E GonzalezAlan M Sugar
Apr 8, 2003·The Lancet Infectious Diseases·David W DenningUNKNOWN British Society for Medical Mycology
Apr 15, 2003·Neurologic Clinics·Amy A Pruitt
May 20, 2003·Infectious Disease Clinics of North America·Emmanuel RoilidesStephen Chanock
Mar 19, 2005·The Journal of Infectious Diseases·Dimitrios P KontoyiannisIssam I Raad
May 2, 2006·Biophysical Journal·Yougang Mao, Yong Ba
Sep 21, 2006·Infectious Disease Clinics of North America·Dimitrios P Kontoyiannis, Russell E Lewis
Apr 20, 2007·International Journal of Dermatology·Mahreen AmeenRogelio Zacarias
Apr 26, 2008·Otolaryngologic Clinics of North America·Victoria A Epstein, Robert C Kern