Universität zu Köln

Cornely, O. A., Arikan-Akdagli, S., Dannaoui, E., Groll, A. H., Lagrou, K., Chakrabarti, A., Lanternier, F., Pagano, L., Skiada, A., Akova, M., Arendrup, M. C., Boekhout, T., Chowdhary, A., Cuenca-Estrella, M., Freiberger, T., Guinea, J., Guarro, J., de Hoog, S., Hope, W., Johnson, E., Kathuria, S., Lackner, M., Lass-Floerl, C., Lortholary, O., Meis, J. F., Meletiadis, J., Munoz, P., Richardson, M., Roilides, E., Tortorano, A. M., Ullmann, A. J., van Diepeningen, A., Verweij, P. and Petrikkos, G. (2014). ESCMID dagger and ECMM double dagger joint clinical guidelines for the diagnosis and management of mucormycosis 2013. Clin. Microbiol. Infect., 20. S. 5 - 27. OXFORD: ELSEVIER SCI LTD. ISSN 1469-0691

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Abstract

These European Society for Clinical Microbiology and Infectious Diseases and European Confederation of Medical Mycology Joint Clinical Guidelines focus on the diagnosis and management of mucormycosis. Only a few of the numerous recommendations can be summarized here. To diagnose mucormycosis, direct microscopy preferably using optical brighteners, histopathology and culture are strongly recommended. Pathogen identification to species level by molecular methods and susceptibility testing are strongly recommended to establish epidemiological knowledge. The recommendation for guiding treatment based on MICs is supported only marginally. Imaging is strongly recommended to determine the extent of disease. To differentiate mucormycosis from aspergillosis in haematological malignancy and stem cell transplantation recipients, identification of the reverse halo sign on computed tomography is advised with moderate strength. For adults and children we strongly recommend surgical debridement in addition to immediate first-line antifungal treatment with liposomal or lipid-complex amphotericin B with a minimum dose of 5mg/kg/day. Amphotericin B deoxycholate is better avoided because of severe adverse effects. For salvage treatment we strongly recommend posaconazole 4x200mg/day. Reversal of predisposing conditions is strongly recommended, i.e. using granulocyte colony-stimulating factor in haematological patients with ongoing neutropenia, controlling hyperglycaemia and ketoacidosis in diabetic patients, and limiting glucocorticosteroids to the minimum dose required. We recommend against using deferasirox in haematological patients outside clinical trials, and marginally support a recommendation for deferasirox in diabetic patients. Hyperbaric oxygen is supported with marginal strength only. Finally, we strongly recommend continuing treatment until complete response demonstrated on imaging and permanent reversal of predisposing factors.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Cornely, O. A. UNSPECIFIED UNSPECIFIED UNSPECIFIED Arikan-Akdagli, S. UNSPECIFIED UNSPECIFIED UNSPECIFIED Dannaoui, E. UNSPECIFIED UNSPECIFIED UNSPECIFIED Groll, A. H. UNSPECIFIED UNSPECIFIED UNSPECIFIED Lagrou, K. UNSPECIFIED UNSPECIFIED UNSPECIFIED Chakrabarti, A. UNSPECIFIED UNSPECIFIED UNSPECIFIED Lanternier, F. UNSPECIFIED UNSPECIFIED UNSPECIFIED Pagano, L. UNSPECIFIED UNSPECIFIED UNSPECIFIED Skiada, A. UNSPECIFIED UNSPECIFIED UNSPECIFIED Akova, M. UNSPECIFIED UNSPECIFIED UNSPECIFIED Arendrup, M. C. UNSPECIFIED UNSPECIFIED UNSPECIFIED Boekhout, T. UNSPECIFIED UNSPECIFIED UNSPECIFIED Chowdhary, A. UNSPECIFIED UNSPECIFIED UNSPECIFIED Cuenca-Estrella, M. UNSPECIFIED UNSPECIFIED UNSPECIFIED Freiberger, T. UNSPECIFIED UNSPECIFIED UNSPECIFIED Guinea, J. UNSPECIFIED UNSPECIFIED UNSPECIFIED Guarro, J. UNSPECIFIED UNSPECIFIED UNSPECIFIED de Hoog, S. UNSPECIFIED UNSPECIFIED UNSPECIFIED Hope, W. UNSPECIFIED UNSPECIFIED UNSPECIFIED Johnson, E. UNSPECIFIED UNSPECIFIED UNSPECIFIED Kathuria, S. UNSPECIFIED UNSPECIFIED UNSPECIFIED Lackner, M. UNSPECIFIED UNSPECIFIED UNSPECIFIED Lass-Floerl, C. UNSPECIFIED UNSPECIFIED UNSPECIFIED Lortholary, O. UNSPECIFIED UNSPECIFIED UNSPECIFIED Meis, J. F. UNSPECIFIED UNSPECIFIED UNSPECIFIED Meletiadis, J. UNSPECIFIED UNSPECIFIED UNSPECIFIED Munoz, P. UNSPECIFIED UNSPECIFIED UNSPECIFIED Richardson, M. UNSPECIFIED UNSPECIFIED UNSPECIFIED Roilides, E. UNSPECIFIED UNSPECIFIED UNSPECIFIED Tortorano, A. M. UNSPECIFIED UNSPECIFIED UNSPECIFIED Ullmann, A. J. UNSPECIFIED UNSPECIFIED UNSPECIFIED van Diepeningen, A. UNSPECIFIED UNSPECIFIED UNSPECIFIED Verweij, P. UNSPECIFIED UNSPECIFIED UNSPECIFIED Petrikkos, G. UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-442073
DOI:	10.1111/1469-0691.12371
Journal or Publication Title:	Clin. Microbiol. Infect.
Volume:	20
Page Range:	S. 5 - 27
Date:	2014
Publisher:	ELSEVIER SCI LTD
Place of Publication:	OXFORD
ISSN:	1469-0691
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language LIPOSOMAL AMPHOTERICIN-B; IN-VITRO SUSCEPTIBILITIES; ORBITAL-CEREBRAL MUCORMYCOSIS; HEMATOLOGY-ONCOLOGY PATIENTS; ORGAN TRANSPLANT RECIPIENTS; DESORPTION IONIZATION-TIME; INVASIVE FUNGAL-INFECTIONS; MYCOSES STUDY-GROUP; REVERSED HALO SIGN; LIPID COMPLEX Multiple languages Infectious Diseases; Microbiology Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/44207