title: Renal mucormycosis complicating extracorporeal membrane oxygenation.
abstract: Zygomycosis can manifest as severe infections, particularly in immunocompromised patients, which can be nosocomial in nature resulting from complications of invasive procedures. We report the case of a 65-year-old woman with a medical history of unclassified inflammatory rheumatism who underwent arteriovenous extracorporeal membrane oxygenation because of a myocardial failure following the drainage of a tuberculous tamponade. This procedure was complicated by a superinfection of the scarpa which revealed a disseminated zygomycosis with renal involvement. A favorable outcome was achieved after 15 months of antifungal therapy involving the use of liposomal amphotericin B followed with posaconazole which involved the close monitoring of the concentrations of this antifungal. Extracorporeal membrane oxygenation is a frequent procedure which could be complicated with severe fungal nosocomial infections such as zygomycosis. The outcome of such complication can be favorable with the utilization of new antifungal therapies.
authors.affiliation: Hôpital Foch, Service de Médecine Interne, Suresnes, France. pierredecristal@hotmail.com
authors.forename: Pierre
authors.initials: P
authors.lastname: Charles
authors.forename: Jean-Emmanuel
authors.initials: JE
authors.lastname: Kahn
authors.forename: Felix
authors.initials: F
authors.lastname: Ackermann
authors.forename: Patrick
authors.initials: P
authors.lastname: Honderlick
authors.forename: Olivier
authors.initials: O
authors.lastname: Lortholary
mesh_terms: D058186:Acute Kidney Injury / Q000188:drug therapy / Q000382:microbiology*; D000368:Aged; D000666:Amphotericin B / Q000008:administration & dosage; D000935:Antifungal Agents / Q000008:administration & dosage*; D003428:Cross Infection / Q000188:drug therapy* / Q000382:microbiology; D015199:Extracorporeal Membrane Oxygenation / Q000009:adverse effects*; D005260:Female; D005602:France; D006333:Heart Failure / Q000628:therapy; D006801:Humans; D016867:Immunocompromised Host; D007668:Kidney / Q000382:microbiology; D009091:Mucormycosis / Q000188:drug therapy* / Q000382:microbiology; D012213:Rheumatic Fever / Q000150:complications; D012233:Rhizopus / Q000187:drug effects* / Q000302:isolation & purification; D016896:Treatment Outcome; D014230:Triazoles / Q000008:administration & dosage; D014397:Tuberculosis, Pulmonary / Q000150:complications / Q000628:therapy
chemical_list: D000935:Antifungal Agents; D014230:Triazoles; C068538:liposomal amphotericin B; C101425:posaconazole; D000666:Amphotericin B