Global guideline for the diagnosis and management of mucormycosis: an initiative of the European Confederation of Medical Mycology in cooperation with the Mycoses Study Group Education and Research Consortium.
Journal
The Lancet. Infectious diseases
ISSN: 1474-4457
Titre abrégé: Lancet Infect Dis
Pays: United States
ID NLM: 101130150
Informations de publication
Date de publication:
12 2019
12 2019
Historique:
received:
11
01
2019
revised:
10
04
2019
accepted:
05
06
2019
pubmed:
9
11
2019
medline:
17
6
2020
entrez:
9
11
2019
Statut:
ppublish
Résumé
Mucormycosis is a difficult to diagnose rare disease with high morbidity and mortality. Diagnosis is often delayed, and disease tends to progress rapidly. Urgent surgical and medical intervention is lifesaving. Guidance on the complex multidisciplinary management has potential to improve prognosis, but approaches differ between health-care settings. From January, 2018, authors from 33 countries in all United Nations regions analysed the published evidence on mucormycosis management and provided consensus recommendations addressing differences between the regions of the world as part of the "One World One Guideline" initiative of the European Confederation of Medical Mycology (ECMM). Diagnostic management does not differ greatly between world regions. Upon suspicion of mucormycosis appropriate imaging is strongly recommended to document extent of disease and is followed by strongly recommended surgical intervention. First-line treatment with high-dose liposomal amphotericin B is strongly recommended, while intravenous isavuconazole and intravenous or delayed release tablet posaconazole are recommended with moderate strength. Both triazoles are strongly recommended salvage treatments. Amphotericin B deoxycholate is recommended against, because of substantial toxicity, but may be the only option in resource limited settings. Management of mucormycosis depends on recognising disease patterns and on early diagnosis. Limited availability of contemporary treatments burdens patients in low and middle income settings. Areas of uncertainty were identified and future research directions specified.
Identifiants
pubmed: 31699664
pii: S1473-3099(19)30312-3
doi: 10.1016/S1473-3099(19)30312-3
pmc: PMC8559573
mid: NIHMS1748809
pii:
doi:
Types de publication
Journal Article
Practice Guideline
Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
e405-e421Subventions
Organisme : NIAID NIH HHS
ID : R01 AI063503
Pays : United States
Informations de copyright
Copyright © 2019 Elsevier Ltd. All rights reserved.
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