Zygomycosis medical therapy: Difference between revisions
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* Mucormycosis | * Mucormycosis | ||
:*Preferred regimen: Liposomal amphotericin B 5-10 mg/kg/day {{or}} [[Amphotericin B]] 1-1.5 mg/kg/day | :*Preferred regimen: Liposomal amphotericin B 5-10 mg/kg/day {{or}} [[Amphotericin B]] 1-1.5 mg/kg/day | ||
:*Alternative regimen: [[Posaconazole]] 400 mg PO bid with meals (if not taking meals, 200 mg PO qid) | :*Alternative regimen: [[Posaconazole]] 400 mg PO bid with meals (if not taking meals, 200 mg PO qid). | ||
:*Note(1): Total duration of therapy based on response: continue therapy until resolution of clinical signs and symptoms of infection, resolution or stabilization of radiographic abnormalities; and resolution of underlying immunosuppression | |||
:*Note(2): Posaconazole for secondary prophylaxis for those on immunosuppressive therapy | |||
==References== | ==References== | ||
Revision as of 13:59, 29 June 2015
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Zygomycosis Microchapters |
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Diagnosis |
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Treatment |
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Case Studies |
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Zygomycosis medical therapy On the Web |
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American Roentgen Ray Society Images of Zygomycosis medical therapy |
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Risk calculators and risk factors for Zygomycosis medical therapy |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
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Overview
If zygomycosis is suspected, prompt amphotericin B therapy should be administered due to the rapid spread and mortality rate of the disease. Amphotericin B (which works by damaging the cell walls of the fungi) is usually administered for a further 4-6 weeks after initial therapy begins to ensure eradication of the infection. Posaconazole has been shown to be effective against zygomycosis, perhaps more so than amphotericin B, but has not yet replaced it as the standard of care. After administration the patient must then be admitted to surgery for removal of the "fungus ball". The disease must be monitored carefully for any signs of reemergence. Treatment for skin lesions is traditionally with potassium iodide,[1] but itraconazole has also been used successfully.[2][3] Antifungal drugs show only limited effect on treatment of phycomycosis, but itraconazole and terbinafine hydrochloride are often used for two to three months following surgery. Humans with Basidiobolus infections have been treated with amphotericin B and potassium iodide. Immunotherapy has been used successfully in humans and horses with pythiosis.
Treatment
Antimicrobial Regimen
- Mucormycosis
- Preferred regimen: Liposomal amphotericin B 5-10 mg/kg/day OR Amphotericin B 1-1.5 mg/kg/day
- Alternative regimen: Posaconazole 400 mg PO bid with meals (if not taking meals, 200 mg PO qid).
- Note(1): Total duration of therapy based on response: continue therapy until resolution of clinical signs and symptoms of infection, resolution or stabilization of radiographic abnormalities; and resolution of underlying immunosuppression
- Note(2): Posaconazole for secondary prophylaxis for those on immunosuppressive therapy
References
- ↑ Nazir Z, Hasan R, Pervaiz S, Alam M, Moazam F. (1997). "Invasive retroperitoneal infection due to Basidiobolus ranarum with response to potassium iodide—case report and review of the literature". Ann Trop Paediatr. 17 (2): 161&ndash, 4. PMID 9230980.
- ↑ Yusuf NW, Assaf HM, Rotowa N (2003). "Invasive gastrointestinal Basidiobolus ranarum infection in an immunocompetent child (brief report)". Ped Infect Dis J. 22 (3): 281&ndash, 82.
- ↑ Mathew RM, Kumaravel S, Kuruvilla S; et al. (2005). "Successful treatment of extensive basidiobolomycosis with oral itraconazole in a child". Int J Dermatol. 44 (7): 572&ndash, 75.