Contemporary treatment and outcomes of zygomycosis in a non-oncologic tertiary care center.
BACKGROUND
Zygomycosis is an emerging mycosis of increasing relevance. Limited data exist for outcomes with contemporary therapies.


METHODS
A 6-year retrospective chart review was performed in a non-oncological tertiary care center for patients with zygomycosis.


RESULTS
Sixteen episodes of proven (EORTC/MSG criteria) zygomycosis were identified. The average age was 49.2 years. Sites of infection were surgical/traumatic wound [5], rhinocerebral [4], disseminated [2], pulmonary [2], peritoneal [2], and localized skin [1]. Associated conditions included diabetes [7], ketoacidosis [2], end-stage renal disease [4], surgery/trauma [4], steroids [3], solid organ transplant [2], neutropenia [1], and intravenous drug use [1]. Twelve patients had surgical debridement. Medical therapy included liposomal amphotericin B, conventional amphotericin B (CAB), and amphotericin B lipid complex. Overall mortality was 4/16 (25%), occurring in a patient each with rhinocerebral, pulmonary, surgical wound infection, and disseminated disease. Mortality with surgical treatment was 2/12 (17%) vs. 2/4 (50%) without surgery. Mortality for patients treated with CAB was 1/3 vs. 3/12 for those treated with any lipid preparation. Serious morbidity occurred in 7/12 survivors.


CONCLUSIONS
In this limited study of contemporary therapies, patients with zygomycosis from a non-oncological tertiary care center have lower mortality than classically described. This disease and its treatments are still associated with severe morbidity, disfigurement, and disability.
Sims
Charles R
CR
Laboratory of Mycology Research, Division of Infectious Diseases, University of Texas-Houston Medical School, Houston, Texas 77030, USA. Charles.R.Sims@uth.tmc.edu
Ostrosky-Zeichner
Luis
L
D000328:Adult; D000368:Aged; D000935:Antifungal Agents / Q000627:therapeutic use; D003131:Combined Modality Therapy; D005260:Female; D006782:Hospitals, Special; D006801:Humans; D008297:Male; D008875:Middle Aged; D009089:Mucor / Q000302:isolation & purification*; D009091:Mucormycosis / Q000188:drug therapy / Q000401:mortality* / Q000628:therapy*; D012233:Rhizopus / Q000302:isolation & purification*; D016896:Treatment Outcome; D020096:Zygomycosis / Q000628:therapy
D000935:Antifungal Agents