Successful treatment of rhinocerebral zygomycosis with a combination of caspofungin and liposomal amphotericin B.
Genera of the order Mucorales (Rhizopus, Mucor, Rhizomucor, Absidia, Apophysomyces, Cunninghamella, and Saksenaea) cause an angioinvasive infection called zygomycosis. Mortality rates can approach 100% depending on the patient's underlying disease and form of zygomycosis. We report here on the unusual case of a patient with acute myelogenous leukemia and zygomycosis unresponsive to monotherapy with liposomal amphotericin B, who responded favorably following the addition of the echinocandin caspofungin acetate.
Vazquez
L
L
Servicio de Hematologia, Hospital Universitario, Salamanca, Spain. lvazlo@usal.es
Mateos
J J
JJ
Sanz-Rodriguez
C
C
Perez
E
E
Caballero
D
D
San Miguel
J F
JF
D000666:Amphotericin B / Q000008:administration & dosage / Q000627:therapeutic use*; D000935:Antifungal Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use; D000077336:Caspofungin; D003131:Combined Modality Therapy; D003561:Cytarabine / Q000008:administration & dosage / Q000009:adverse effects; D003646:Debridement; D004172:Diplopia / Q000209:etiology; D004359:Drug Therapy, Combination; D054714:Echinocandins; D006801:Humans; D015255:Idarubicin / Q000008:administration & dosage / Q000009:adverse effects; D016867:Immunocompromised Host; D015470:Leukemia, Myeloid, Acute / Q000150:complications / Q000188:drug therapy; D055666:Lipopeptides; D008297:Male; D008875:Middle Aged; D008942:Mitoxantrone / Q000008:administration & dosage / Q000009:adverse effects; D009894:Opportunistic Infections / Q000188:drug therapy* / Q000209:etiology; D009916:Orbital Diseases / Q000188:drug therapy* / Q000209:etiology / Q000382:microbiology / Q000601:surgery; D010456:Peptides, Cyclic / Q000008:administration & dosage / Q000627:therapeutic use*; D012852:Sinusitis / Q000188:drug therapy* / Q000209:etiology / Q000382:microbiology / Q000601:surgery; D020096:Zygomycosis / Q000188:drug therapy* / Q000209:etiology / Q000601:surgery
D000935:Antifungal Agents; D054714:Echinocandins; D055666:Lipopeptides; D010456:Peptides, Cyclic; C068538:liposomal amphotericin B; D003561:Cytarabine; D000666:Amphotericin B; D008942:Mitoxantrone; D000077336:Caspofungin; D015255:Idarubicin