RESUMO
Aspergillosis and zygomycosis are life-threatening fungal infections in immunocompromised patients. We report a heart transplant recipient with an early pulmonary invasive aspergillosis successfully treated with association of voriconazole and caspofungin. Zygomycosis sinusitis, which was diagnosed while he still was on voriconazole therapy, was successfully treated with the use of combination antifungal therapy including liposomal amphotericin plus posaconazole and conservative surgical debridement.
Assuntos
Anfotericina B/uso terapêutico , Antifúngicos/uso terapêutico , Transplante de Coração/efeitos adversos , Aspergilose Pulmonar Invasiva/complicações , Sinusite/tratamento farmacológico , Triazóis/uso terapêutico , Zigomicose/tratamento farmacológico , Desbridamento , Quimioterapia Combinada , Humanos , Hospedeiro Imunocomprometido , Aspergilose Pulmonar Invasiva/tratamento farmacológico , Aspergilose Pulmonar Invasiva/microbiologia , Masculino , Pessoa de Meia-Idade , Pirimidinas , Sinusite/diagnóstico , Sinusite/microbiologia , Sinusite/cirurgia , Resultado do Tratamento , Voriconazol , Zigomicose/diagnóstico , Zigomicose/microbiologia , Zigomicose/cirurgiaRESUMO
Cutaneous zygomycosis is a fungal infection caused by zygomycetes that affects the skin. It occurs in uncontrolled diabetic patients and immunosuppressed individuals. It has 2 clinical forms: primary cutaneous zygomycosis and secondary cutaneous zygomycosis. The first is characterized by necrotic lesions and the fungus is usually inoculated by trauma. If diagnosed early, it generally has a good prognosis. Secondary zygomycosis is usually a complication and extension of the rhinocerebral variety that starts as a palpebral fistula and progresses to a necrotic lesion with a poor prognosis. The diagnosis is made by identification of the fungus by direct KOH examination, culture, and biopsy. Treatment for the primary disease is surgical debridement plus amphotericin B. The secondary type is treated with amphotericin B and/or posaconazole.
Assuntos
Anfotericina B/uso terapêutico , Antifúngicos/uso terapêutico , Desbridamento/métodos , Dermatomicoses/tratamento farmacológico , Triazóis/uso terapêutico , Zigomicose/tratamento farmacológico , Dermatomicoses/patologia , Dermatomicoses/cirurgia , Quimioterapia Combinada , Humanos , Zigomicose/patologia , Zigomicose/cirurgiaAssuntos
Abscesso Abdominal/diagnóstico , Dor Abdominal/diagnóstico , Entomophthorales/isolamento & purificação , Febre/diagnóstico , Zigomicose/diagnóstico , Abscesso Abdominal/tratamento farmacológico , Abscesso Abdominal/etiologia , Abscesso Abdominal/cirurgia , Dor Abdominal/tratamento farmacológico , Dor Abdominal/etiologia , Dor Abdominal/cirurgia , Adulto , Antifúngicos/uso terapêutico , Febre/tratamento farmacológico , Febre/etiologia , Febre/cirurgia , Humanos , Cetoconazol/uso terapêutico , Masculino , Resultado do Tratamento , Índias Ocidentais , Zigomicose/complicações , Zigomicose/tratamento farmacológico , Zigomicose/cirurgiaRESUMO
We report three cases of traumatic cutaneous zygomycosis related to soil-contaminated skin lesions occurring after automobile accidents in individuals with no underlying disorders, which showed delayed development and diagnosis in comparison with typical zygomycosis cutaneous lesions.