Cutaneous Mucormycosis: Mycological, Clinical, and Therapeutic Aspects

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• 作者：Alexandro Bonifaz ; Andrés Tirado-Sánchez ; Luz Calderón…
• 关键词：Mucormycosis ; Mucorales ; Zygomycosis ; Rhizopus sp. ; Apophysomyces complex ; Amphotericin B ; Posaconazole ; Caspofungin ; Surgical debridement
• 刊名：Current Fungal Infection Reports
• 出版年：2015
• 出版时间：December 2015
• 年：2015
• 卷：9
• 期：4
• 页码：229-237
• 全文大小：3,709 KB
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• 作者单位：Alexandro Bonifaz (1)
  Andrés Tirado-Sánchez (1)
  Luz Calderón (1)
  Rosa María Ponce (1)
  
  1. Dermatology Service & Mycology Department, Hospital General de México “Dr. Eduardo Liceaga- Dr. Balmis 148, col., 06720, Doctores, DF, Mexico
  
• 刊物主题：Infectious Diseases; Internal Medicine; Tropical Medicine; Occupational Medicine/Industrial Medicine; Pneumology/Respiratory System;
• 出版者：Springer US
• ISSN：1936-377X

文摘

Cutaneous mucormycosis (CM) is caused by ubiquitous filamentous fungi belonging to the order Mucorales. It is a rare, emerging mycosis, with increasing incidence since the last two decades, only surpassed by rhinocerebral and pulmonary mucormycosis. CM can be further classified in primary and secondary clinical forms. Primary cases can be seen on immunocompetent patients, frequently due to traumatic injuries, while in immunocompromised patients (those with diabetes mellitus or hematologic malignancies), lesions can arise at catheter insertion sites or after the use of contaminated adhesive tapes. Clinical features of primary cutaneous mucormycosis (PCM) are necrosis, followed by ulceration, generally associated to good prognosis. Secondary cutaneous mucormycosis (SCM) is related to rhinocerebral and/or disseminated forms. SCM usually starts as a palpebral fistula, as an erythematous area that rapidly evolves to necrosis and ulceration, related to worse prognosis. Direct examination, cultures, skin biopsies, and molecular tests are performed to diagnose both clinical forms. Liposomal amphotericin B (LAmB) in combination with surgical debridement constitutes the treatment of choice; however, for SCM, the addition of posaconazole or caspofungin is recommended. Keywords Mucormycosis Mucorales Zygomycosis Rhizopus sp. Apophysomyces complex Amphotericin B Posaconazole Caspofungin Surgical debridement