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Palatal zygomycosis: experience of 21 cases
Author(s) -
Bonifaz A,
Macias B,
ParedesFarrera F,
Arias P,
Ponce RM,
Araiza J
Publication year - 2008
Publication title -
oral diseases
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.953
H-Index - 87
eISSN - 1601-0825
pISSN - 1354-523X
DOI - 10.1111/j.1601-0825.2007.01433.x
Subject(s) - zygomycosis , medicine , mucormycosis , amphotericin b , retrospective cohort study , fluconazole , surgery , itraconazole , mycosis , autopsy , dermatology , antifungal
Objective: To present a clinical report of palatal zygomycosis, its epidemiological, mycological features, and our treatment experience. Design: Retrospective report. Subjects and methods: This is a 25‐year long retrospective trial of clinically and mycologically proven cases of zygomycosis. Some patients underwent a biopsy of the palatal lesion and autopsy. This study reports the treatment experience with amphotericin B alone and in combination with itraconazole and fluconazole. Results: Twenty‐one cases (18.75%) of zygomycosis with palatal involvement were included in the study, from a total of 112 cases screened. Mean age was 36.5 years, with 18 adults and three children. The associated pre‐disposing factors were: ketoacidotic diabetes (five type‐1 and 15 type‐2), and acute leukaemia in one patient. The clinical varieties were as follows: 19 cases of rhinocerebral (RC) involvement and two disseminated cases. Palatal ulcers occurred in 3/21 early cases (14.3%) and in 16/21 cases after the nasal involvement. All patients received amphotericin B; in four patients, it was combined with itraconazole and four with fluconazole. Clinical and mycological cure was achieved in 4/21 patients (19.04%). Conclusion: Zygomycosis with palatal involvement occurs in around 18% of cases, usually associated with RC modalities; it has an acute and generally lethal course.