Shafiq Muhammad, Ali Zafar, Ukani Rehman, Brewer Joseph
Department of Internal Medicine, University of Missouri Kansas City (UMKC).
Department Chair - Infectious Disease, Saint Luke's hospital , Plaza , Kansas City , Missouri.
Cureus. 2018 Apr 29;10(4):e2547. doi: 10.7759/cureus.2547.
A patient with invasive mucormycosis whose disease progresses despite optimal treatment including surgical debridement, intravenous (IV) amphotericin B, and control of the predisposing factors can be clinically challenging. We report a case of a 67-year-old Caucasian man with invasive mucormycosis that did not respond to first-line treatment. He was subsequently started on isavuconazole in addition to amphotericin B. The patient's disease progression stopped; he then received IV amphotericin B for 50 days and isavuconazole for four months. Repeated magnetic resonance imaging (MRI) of the orbit and face nine months later, while off the antifungal medications, showed stable disease. This outcome is promising for patients with invasive mucormycosis who are either intolerant to amphotericin B or do not respond favorably to it.
一名患有侵袭性毛霉病的患者,尽管接受了包括手术清创、静脉注射两性霉素B以及控制诱发因素在内的最佳治疗,但其病情仍在进展,这在临床上具有挑战性。我们报告了一例67岁的白种男性侵袭性毛霉病患者,其对一线治疗无反应。随后,除了两性霉素B外,他开始使用艾沙康唑。患者的疾病进展停止;然后他接受了50天的静脉注射两性霉素B和四个月的艾沙康唑治疗。九个月后,在停用抗真菌药物的情况下,对眼眶和面部进行的重复磁共振成像(MRI)显示病情稳定。这一结果对于那些不耐受两性霉素B或对其反应不佳的侵袭性毛霉病患者来说是有希望的。