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Rhino‐cerebral zygomycosis resistant to antimycotic treatment: a case report
Author(s) -
Vyzantiadis TimoleonAchilleas,
Kioumi Anna,
Papadakis Emmanouil,
Braimi Margarita,
Dermitzakis Emmanouil,
Tsitouridis Ioannis,
Antoniadis Antonios
Publication year - 2009
Publication title -
mycoses
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.13
H-Index - 69
eISSN - 1439-0507
pISSN - 0933-7407
DOI - 10.1111/j.1439-0507.2008.01536.x
Subject(s) - zygomycosis , medicine , voriconazole , posaconazole , amphotericin b , methylprednisolone , dermatology , rhizopus arrhizus , surgery , cellulitis , antibiotics , microbiology and biotechnology , antifungal , biochemistry , chemistry , lipase , biology , enzyme
Summary We report a fatal case of a rhino‐cerebral zygomycosis, caused by Rhizopus arrhizus (oryzae). The patient was suffering from idiopathic thrombopenic purpura, diagnosed 1 year earlier. He was already treated with methylprednisolone 5 months prior to his admission to the hospital for a loss of vision and pain in the left eye as well as left orbital cellulitis. After an initial empirical treatment with broad spectrum antibiotics and voriconazole (infection of unknown origin), the patient was treated with liposomal amphotericin as soon as a positive fungal culture revealed a zygomycete. Unfortunately, the mould was resistant to amphotericin B (MIC: 16 μg ml −1 ) and probably to posaconazole (MIC: 4 μg ml −1 ), which was co‐administrated a few days later.