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- W2066490140 abstract "Les mucormycoses sont des infections fongiques rares survenant surtout chez les immunodéprimés. Elles sont dues à des champignons filamenteux de type Mucorales. Les formes disséminées sont le plus souvent fatales. Le diagnostic, souvent difficile, doit être le plus précoce possible. La prise en charge consiste à instaurer rapidement un traitement antifongique avec la formulation lipidique d’amphotéricine B et à réaliser un large débridement chirurgical. En dépit d’un traitement optimal, la mortalité liée aux mucormycoses reste très importante. Nous rapportons un cas de mucormycose disséminée chez une patiente de 25 ans transplantée pulmonaire depuis neuf mois. Il existait une atteinte pulmonaire et thyroïdienne due à Absidia corymbifera. La patiente a survécu grâce à une chirurgie élargie, cervicale et thoracique, et à une bithérapie antifongique précoce associant la formulation lipidique d’amphotéricine B et posaconazole. L’émergence des mucormycoses chez les patients transplantés et leur mortalité importante incitent à trouver de nouvelles alternatives thérapeutiques. L’association du posaconazole avec la formulation lipidique d’amphotéricine B pourrait présenter un intérêt dans le traitement des mucormycoses disséminées. Mucormycosis is a rare fungal infection occurring most frequently in immunocompromised patients. The pathogens are filamentous fungi, order of Mucorales. Disseminated mucormycosis is a severe, life treating disease. Early diagnosis is a major determinant for prognosis, however, it remains difficult. The management consists in an early antifungal therapy using lipid formulation of amphotericin B associated with an extensive surgical debridement. Despite this therapeutic of choice, the mortality of disseminated mucormycosis remains high. We report the case of disseminated mucormycosis in a 25 years old woman 9 months after a pulmonary transplantation. The clinical presentation included pulmonary and thyroid localization and the pathogen was Absidia corymbifera. The patient survived thanks to a large surgical debridement, and an early antifungal bitherapy by lipid formulation of amphotericin B and posaconazole. The re-emergence and the high mortality of mucormycosis in solid organ transplant receiver show the necessity to find new therapeutic approaches. Posaconazole associated with liposomal amphotericin B could be an interesting option to treat disseminated mucormycosis and improve their outcome." @default.
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- W2066490140 date "2009-11-01" @default.
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- W2066490140 title "Mucormycose disséminée d’évolution favorable chez une greffée pulmonaire" @default.
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- W2066490140 doi "https://doi.org/10.1016/s0761-8425(09)73337-6" @default.
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