Universität zu Köln

Tacke, Daniela, Koehler, Philipp ORCID: 0000-0002-7386-7495, Markiefka, Birgid and Cornely, Oliver A. (2014). Our 2014 approach to mucormycosis. Mycoses, 57 (9). S. 519 - 525. HOBOKEN: WILEY. ISSN 1439-0507

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Abstract

Mucormycosis, previously termed as zygomycosis, is caused by fungi belonging to the order Mucorales and is a very severe disease in immunocompromised patients with an often unfavourable outcome. Given the high morbidity and mortality of mucormycosis, establishing a timely diagnosis followed by immediate treatment is of major importance. As randomised clinical trials are lacking, we present our current diagnostic and treatment pathways for mucormycosis in the immunocompromised host. Due to the difficulty to distinguish mucormycosis from other filamentous fungi, mucormycosis always has to be considered as differential diagnosis in predisposed patients. Diagnostic procedures comprise imaging, microscopy, culture and histopathology and need to be rigorously used. In patients with a high suspicion of mucormycosis, e. g. reversed halo sign on computed tomography scanning, our approach combines liposomal amphotericin B (LAmB) with surgical debridement. In light of the rapid deterioration and poor prognosis of these patients, we prefer a daily dose of LAmB of at least 5 mg kg(-1) despite nephrotoxicity. In patients with stable disease we switch to posaconazole 200 mg four times per day. In case of progression antifungal combination is an option.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Tacke, Daniela UNSPECIFIED UNSPECIFIED UNSPECIFIED Koehler, Philipp UNSPECIFIED orcid.org/0000-0002-7386-7495 UNSPECIFIED Markiefka, Birgid UNSPECIFIED UNSPECIFIED UNSPECIFIED Cornely, Oliver A. UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-430939
DOI:	10.1111/myc.12203
Journal or Publication Title:	Mycoses
Volume:	57
Number:	9
Page Range:	S. 519 - 525
Date:	2014
Publisher:	WILEY
Place of Publication:	HOBOKEN
ISSN:	1439-0507
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language REVERSED HALO SIGN; B LIPID COMPLEX; AMPHOTERICIN-B; INVASIVE PULMONARY; SALVAGE THERAPY; ZYGOMYCOSIS; POSACONAZOLE; CASPOFUNGIN; SUSCEPTIBILITY; EPIDEMIOLOGY Multiple languages Dermatology; Mycology Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/43093