title: Palatal zygomycosis: experience of 21 cases.
abstract: OBJECTIVE
  To present a clinical report of palatal zygomycosis, its epidemiological, mycological features, and our treatment experience.
  
  
  METHODS
  Retrospective report.
  
  
  METHODS
  This is a 25-year long retrospective trial of clinically and mycologically proven cases of zygomycosis. Some patients underwent a biopsy of the palatal lesion and autopsy. This study reports the treatment experience with amphotericin B alone and in combination with itraconazole and fluconazole.
  
  
  RESULTS
  Twenty-one cases (18.75%) of zygomycosis with palatal involvement were included in the study, from a total of 112 cases screened. Mean age was 36.5 years, with 18 adults and three children. The associated pre-disposing factors were: ketoacidotic diabetes (five type-1 and 15 type-2), and acute leukaemia in one patient. The clinical varieties were as follows: 19 cases of rhinocerebral (RC) involvement and two disseminated cases. Palatal ulcers occurred in 3/21 early cases (14.3%) and in 16/21 cases after the nasal involvement. All patients received amphotericin B; in four patients, it was combined with itraconazole and four with fluconazole. Clinical and mycological cure was achieved in 4/21 patients (19.04%).
  
  
  CONCLUSIONS
  Zygomycosis with palatal involvement occurs in around 18% of cases, usually associated with RC modalities; it has an acute and generally lethal course.
authors.affiliation: Department of Mycology, Hospital General de México OD, Mexico GF. a_bonifaz@yahoo.com.mx
authors.forename: A
authors.initials: A
authors.lastname: Bonifaz
authors.forename: B
authors.initials: B
authors.lastname: Macias
authors.forename: F
authors.initials: F
authors.lastname: Paredes-Farrera
authors.forename: P
authors.initials: P
authors.lastname: Arias
authors.forename: R M
authors.initials: RM
authors.lastname: Ponce
authors.forename: J
authors.initials: J
authors.lastname: Araiza
mesh_terms: D020095:Absidia / Q000302:isolation & purification; D000293:Adolescent; D000328:Adult; D000368:Aged; D000666:Amphotericin B / Q000008:administration & dosage / Q000627:therapeutic use; D000935:Antifungal Agents / Q000008:administration & dosage / Q000627:therapeutic use; D001927:Brain Diseases / Q000382:microbiology; D002648:Child; D016883:Diabetic Ketoacidosis / Q000150:complications; D004338:Drug Combinations; D005260:Female; D015725:Fluconazole / Q000008:administration & dosage / Q000627:therapeutic use; D006801:Humans; D017964:Itraconazole / Q000008:administration & dosage / Q000627:therapeutic use; D008297:Male; D009059:Mouth Diseases / Q000188:drug therapy / Q000382:microbiology*; D009091:Mucormycosis / Q000175:diagnosis / Q000188:drug therapy; D009668:Nose Diseases / Q000382:microbiology; D009894:Opportunistic Infections / Q000175:diagnosis; D019226:Oral Ulcer / Q000382:microbiology; D010159:Palate / Q000382:microbiology*; D054218:Precursor T-Cell Lymphoblastic Leukemia-Lymphoma / Q000150:complications; D012189:Retrospective Studies; D012233:Rhizopus / Q000302:isolation & purification; D016896:Treatment Outcome; D020096:Zygomycosis / Q000175:diagnosis* / Q000188:drug therapy
chemical_list: D000935:Antifungal Agents; D004338:Drug Combinations; D017964:Itraconazole; D000666:Amphotericin B; D015725:Fluconazole