Utility of Itraconazole in Combination with Liposomal Amphotericin B in Rhizopus oryzae Associated Mucormycosis-An Exploratory Study.

IF 3.6 3区生物学 Q2 MYCOLOGY

Mycopathologia Pub Date : 2024-06-12 DOI:10.1007/s11046-024-00859-w

Himanshu Dandu, Naveen Kumar, Neeraj Kumar, Hardeep Singh Malhotra, Vikas Prabhu, Vipin Raj Bharti, Prashant Gupta, Geeta Yadav, Veerendra Verma

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引用次数: 0

Abstract

Background: During the COVID-19 pandemic-associated mucor epidemic, acute antifungal drug shortage necessitated the exploration of other antifungals based on culture sensitivity. Itraconazole is a cheap, safe, and effective antifungal in sensitive cases.

Methodology: We enrolled itraconazole-sensitive COVID-19-associated mucormycosis during the mucormycosis pandemic. After the intensive phase course of liposomal amphotericin B, Itraconazole was offered in susceptible cases during the maintenance phase along with standard of care. These patients were clinically and radiologically followed for 6 months.

Results: We enrolled 14 patients (Male: Female-11:3) of Rhino-orbito-cerebral mucormycosis (ROCM) which included 12 diabetics. All patients had facial swelling, orbital swelling, visual impairment, and headache. MRI showed involvement of bilateral sinus (10/14), orbital extension (13/14), cavernous sinus (5/14), cerebral part of the internal carotid artery (3/14), and brain infarcts (4/14). All 14 patients showed sensitivity to Itraconazole with 12 having minimum inhibitory concentration (MIC) ≤ 1 μg/ml and 2 having MIC ≤ 2 μg/ml. Follow-up at 6 months showed clinical improvement in the majority (11/14) and radiological improvement in six out of seven scanned patients.

Conclusion: Our study shows the potential therapeutic role of oral Itraconazole in ROCM.

Abstract Image

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伊曲康唑与两性霉素 B 脂质体联合治疗根霉菌性粘液瘤病的效用--一项探索性研究

背景：在COVID-19大流行病相关的粘孢子菌流行期间，由于抗真菌药物严重短缺，必须根据培养敏感性探索其他抗真菌药物。伊曲康唑是一种廉价、安全且对敏感病例有效的抗真菌药物：在粘孢子菌病大流行期间，我们收治了对伊曲康唑敏感的 COVID-19 相关粘孢子菌病患者。在脂质体两性霉素 B 强化阶段疗程后，伊曲康唑与标准护理一起用于易感病例的维持阶段。我们对这些患者进行了为期 6 个月的临床和影像学随访：我们共收治了 14 名鼻-眼-脑粘液瘤病 (ROCM) 患者（男：女：11:3），其中包括 12 名糖尿病患者。所有患者均有面部肿胀、眼眶肿胀、视力障碍和头痛。磁共振成像显示双侧鼻窦（10/14）、眼眶扩展（13/14）、海绵窦（5/14）、颈内动脉大脑部分（3/14）和脑梗塞（4/14）受累。所有 14 名患者均对伊曲康唑敏感，其中 12 人的最低抑菌浓度 (MIC) ≤ 1 μg/ml，2 人的最低抑菌浓度 (MIC) ≤ 2 μg/ml。6 个月的随访显示，大多数患者（11/14）的临床症状有所改善，7 名扫描患者中有 6 名的放射学症状有所改善：我们的研究显示了口服伊曲康唑对 ROCM 的潜在治疗作用。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Mycopathologia 生物-真菌学

CiteScore

6.80

自引率

3.60%

发文量

审稿时长

3 months

期刊介绍： Mycopathologia is an official journal of the International Union of Microbiological Societies (IUMS). Mycopathologia was founded in 1938 with the mission to ‘diffuse the understanding of fungal diseases in man and animals among mycologists’. Many of the milestones discoveries in the field of medical mycology have been communicated through the pages of this journal. Mycopathologia covers a diverse, interdisciplinary range of topics that is unique in breadth and depth. The journal publishes peer-reviewed, original articles highlighting important developments concerning medically important fungi and fungal diseases. The journal highlights important developments in fungal systematics and taxonomy, laboratory diagnosis of fungal infections, antifungal drugs, clinical presentation and treatment, and epidemiology of fungal diseases globally. Timely opinion articles, mini-reviews, and other communications are usually invited at the discretion of the editorial board. Unique case reports highlighting unprecedented progress in the diagnosis and treatment of fungal infections, are published in every issue of the journal. MycopathologiaIMAGE is another regular feature for a brief clinical report of potential interest to a mixed audience of physicians and laboratory scientists. MycopathologiaGENOME is designed for the rapid publication of new genomes of human and animal pathogenic fungi using a checklist-based, standardized format.