title: Mortality risk factors in patients with zygomycosis: a retrospective and multicentre study of 25 cases.
abstract: OBJECTIVE
  To investigate mortality risk factors in patients with zygomycosis.
  
  
  METHODS
  Retrospective case history review of patients diagnosed with proven zygomicosis in 17 centres in Spain. We compared demographics and risk factors in patients who survived, and in those who died.
  
  
  RESULTS
  We identified twenty-five patients with proven zygomycosis. The primary site of infection was rhino-orbito-cerebral (28%) and disseminated (20%) or cutaneous/soft infections (20%) of the patients. Eleven patients (44%) received preemptive or empirical antifungal treatment; of these patients, 4 received liposomal amphotericin B, 1 received amphotericin B lipid complex, and 6 received other antifungals. The overall mortality rate was 72%. In the univariate analysis factors associated with an increased risk of death were the presence of a haematological malignancy (P=.03), neutropenia (P=.03) and monocytopenia (P=.008).
  
  
  CONCLUSIONS
  Our study supports previous research that has documented a high mortality rate among patients with invasive zygomycosis, especially among those with an underlying haematological malignancy, and the need for a rapid initiation of an effective antifungal treatment.
authors.affiliation: Servicio de Hematología, Hospital Joan XXIII, IISPV, Tarragona, Spain. allorente.hj23.ics@gencat.cat
authors.forename: Andreu
authors.initials: A
authors.lastname: Llorente
authors.forename: Ignacio
authors.initials: I
authors.lastname: Perez-Valero
authors.forename: E
authors.initials: E
authors.lastname: García
authors.forename: I
authors.initials: I
authors.lastname: Heras
authors.forename: V
authors.initials: V
authors.lastname: Fraile
authors.forename: P
authors.initials: P
authors.lastname: García
authors.forename: J
authors.initials: J
authors.lastname: López
authors.forename: M
authors.initials: M
authors.lastname: Salavert
authors.forename: F
authors.initials: F
authors.lastname: Bobillo
mesh_terms: D000328:Adult; D000368:Aged; D000935:Antifungal Agents / Q000627:therapeutic use; D020314:Central Nervous System Fungal Infections / Q000188:drug therapy / Q000401:mortality; D003131:Combined Modality Therapy; D048909:Diabetes Complications / Q000401:mortality; D005260:Female; D016469:Fungemia / Q000188:drug therapy / Q000401:mortality; D019337:Hematologic Neoplasms / Q000150:complications / Q000453:epidemiology; D006801:Humans; D016867:Immunocompromised Host; D007970:Leukopenia / Q000150:complications / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009503:Neutropenia / Q000150:complications / Q000453:epidemiology; D009894:Opportunistic Infections / Q000188:drug therapy / Q000382:microbiology / Q000401:mortality / Q000601:surgery; D012189:Retrospective Studies; D012307:Risk Factors; D018461:Soft Tissue Infections / Q000188:drug therapy / Q000401:mortality; D013030:Spain / Q000453:epidemiology; D055815:Young Adult; D020096:Zygomycosis / Q000188:drug therapy / Q000401:mortality* / Q000601:surgery
chemical_list: D000935:Antifungal Agents