Zygomycosis medical therapy

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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.

References

  1. 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.
  2. 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.
  3. 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.

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