Mucormycosis-A clinicoepidemiological review of cases over 10 years.
Adult
Age Distribution
Aged
Aged, 80 and over
Antifungal Agents
/ therapeutic use
Child
Debridement
Drug Therapy, Combination
/ methods
Female
Hematologic Neoplasms
/ complications
Humans
India
/ epidemiology
Male
Middle Aged
Mucorales
/ classification
Mucormycosis
/ epidemiology
Sex Distribution
Survival Analysis
Tertiary Care Centers
Treatment Outcome
Wound Infection
/ epidemiology
Wounds and Injuries
/ complications
ROCM
epidemiology
haematological conditions
mucormycosis
outcomes
Journal
Mycoses
ISSN: 1439-0507
Titre abrégé: Mycoses
Pays: Germany
ID NLM: 8805008
Informations de publication
Date de publication:
Apr 2019
Apr 2019
Historique:
received:
29
06
2018
revised:
17
11
2018
accepted:
18
01
2019
pubmed:
28
1
2019
medline:
30
4
2019
entrez:
28
1
2019
Statut:
ppublish
Résumé
Limited data exist for epidemiology and outcomes of various agents causing mucormycosis in various clinical settings from developing countries like India. To study the epidemiology and outcomes of various agents causing mucormycosis in different clinical settings in a tertiary care hospital from South India. We reviewed details of 184 consecutive patients with culture-proven mucormycosis with consistent clinical syndrome and supporting features from September 2005 to September 2015. The mean age of patients was 50.42 years; 70.97% were male. Unlike developed countries, R microsporus (29/184; 15.7%) and Apophysomyces elegans (20/184; 10.8%) also evolved as important pathogens in addition to R arrhizus in our setting. Paranasal sinuses (136/184; 73.9%) followed by musculoskeletal system (28/184; 15.2%) were the common areas of involvement. Apophysomyces elegans typically produced skin and musculoskeletal disease in immune-competent individuals with trauma (12/20; 60%) and caused significantly lower mortality (P = 0.03). R microsporus was more common in patients with haematological conditions (25% vs 15.7%) and was less frequently a cause for sinusitis than R arrhizus (27.58% vs 10.9%). The overall mortality was 30.97%. Combination therapy with surgery and antifungals offered the best chance for cure. Agents causing mucormycosis may have unique clinical and epidemiological characteristics.
Sections du résumé
BACKGROUND
BACKGROUND
Limited data exist for epidemiology and outcomes of various agents causing mucormycosis in various clinical settings from developing countries like India.
OBJECTIVES
OBJECTIVE
To study the epidemiology and outcomes of various agents causing mucormycosis in different clinical settings in a tertiary care hospital from South India.
PATIENTS AND METHODS
METHODS
We reviewed details of 184 consecutive patients with culture-proven mucormycosis with consistent clinical syndrome and supporting features from September 2005 to September 2015.
RESULTS
RESULTS
The mean age of patients was 50.42 years; 70.97% were male. Unlike developed countries, R microsporus (29/184; 15.7%) and Apophysomyces elegans (20/184; 10.8%) also evolved as important pathogens in addition to R arrhizus in our setting. Paranasal sinuses (136/184; 73.9%) followed by musculoskeletal system (28/184; 15.2%) were the common areas of involvement. Apophysomyces elegans typically produced skin and musculoskeletal disease in immune-competent individuals with trauma (12/20; 60%) and caused significantly lower mortality (P = 0.03). R microsporus was more common in patients with haematological conditions (25% vs 15.7%) and was less frequently a cause for sinusitis than R arrhizus (27.58% vs 10.9%). The overall mortality was 30.97%. Combination therapy with surgery and antifungals offered the best chance for cure.
CONCLUSIONS
CONCLUSIONS
Agents causing mucormycosis may have unique clinical and epidemiological characteristics.
Substances chimiques
Antifungal Agents
0
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
391-398Informations de copyright
© 2019 Blackwell Verlag GmbH.