[Case of a diabetic man cured of rhinocerebral zygomycosis].
Zygomycosis (mucormycosis) is a rare, highly aggressive opportunistic fungal disease caused by saprophytic fungi, belonging to the division Zygomycota, class Zygomycetes. Patients with immunodeficiency, neutropenia, iron overload, hematological malignancies, as well as diabetics with ketoacidosis are typically affected.


METHODS
Authors describe the case of an eighteen-year old man with poor compliance suffering from diabetes since the age of nine. He was admitted with ketoacidotic somnolence in severe general condition with unilateral periorbital erythematous edema. Though from nasal exudates gained by the fibero-endoscopic sinus surgery Methicillin-resistant Staphylococcus aureus and Pseudomas aeruginosa was cultured, amphotericin-B was administered as the medical history, clinical picture suggested presence of zygomycosis. An invasive infection caused by Rhizopus oryzae was confirmed by histology and microbiology.


CONCLUSIONS
The combination of antifungal therapy, repeated surgical interventions and granulocyte colony-stimulating factor resulted in good clinical response. Four month after discharge he is alive and doing well.
Lakatos
Botond
B
Egyesített Szent István és Szent László Kórház Neuroinfektológiai Osztály Budapest Gyáli út 5-7. 1097. botond.lakatos@istvankorhaz.hu
Nikolova
Radka
R
Ocskay
László
L
Csomor
Judit
J
Prinz
Gyula
G
D000293:Adolescent; D000666:Amphotericin B / Q000627:therapeutic use*; D000935:Antifungal Agents / Q000627:therapeutic use*; D048909:Diabetes Complications / Q000188:drug therapy* / Q000382:microbiology*; D003922:Diabetes Mellitus, Type 1 / Q000150:complications*; D003926:Diabetic Coma / Q000150:complications; D016179:Granulocyte Colony-Stimulating Factor / Q000627:therapeutic use; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D055624:Methicillin-Resistant Staphylococcus aureus / Q000302:isolation & purification; D011552:Pseudomonas Infections / Q000188:drug therapy; D011550:Pseudomonas aeruginosa / Q000302:isolation & purification; D013203:Staphylococcal Infections / Q000188:drug therapy / Q000382:microbiology; D020096:Zygomycosis / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy*
D000935:Antifungal Agents; D016179:Granulocyte Colony-Stimulating Factor; D000666:Amphotericin B