Rhino-cerebral zygomycosis resistant to antimycotic treatment: a case report.
We report a fatal case of a rhino-cerebral zygomycosis, caused by Rhizopus arrhizus (oryzae). The patient was suffering from idiopathic thrombopenic purpura, diagnosed 1 year earlier. He was already treated with methylprednisolone 5 months prior to his admission to the hospital for a loss of vision and pain in the left eye as well as left orbital cellulitis. After an initial empirical treatment with broad spectrum antibiotics and voriconazole (infection of unknown origin), the patient was treated with liposomal amphotericin as soon as a positive fungal culture revealed a zygomycete. Unfortunately, the mould was resistant to amphotericin B (MIC: 16 microg ml(-1)) and probably to posaconazole (MIC: 4 microg ml(-1)), which was co-administrated a few days later.
Vyzantiadis
Timoleon-Achilleas
TA
Kioumi
Anna
A
Papadakis
Emmanouil
E
Braimi
Margarita
M
Dermitzakis
Emmanouil
E
Tsitouridis
Ioannis
I
Antoniadis
Antonios
A
D000368:Aged; D000666:Amphotericin B / Q000494:pharmacology / Q000627:therapeutic use; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D000935:Antifungal Agents / Q000627:therapeutic use; D002493:Central Nervous System Diseases / Q000188:drug therapy / Q000382:microbiology*; D025141:Drug Resistance, Fungal; D017809:Fatal Outcome; D006801:Humans; D008297:Male; D008775:Methylprednisolone / Q000627:therapeutic use; D016553:Purpura, Thrombocytopenic, Idiopathic / Q000150:complications; D011743:Pyrimidines / Q000627:therapeutic use; D012220:Rhinitis / Q000188:drug therapy / Q000382:microbiology*; D012233:Rhizopus / Q000302:isolation & purification*; D014230:Triazoles / Q000494:pharmacology / Q000627:therapeutic use; D065819:Voriconazole; D020096:Zygomycosis / Q000175:diagnosis* / Q000188:drug therapy
D000893:Anti-Inflammatory Agents; D000935:Antifungal Agents; D011743:Pyrimidines; D014230:Triazoles; C101425:posaconazole; D000666:Amphotericin B; D065819:Voriconazole; D008775:Methylprednisolone