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Mucormycosis in a Severe Trauma Patient Treated with a Combination of Systemic Posaconazole and Topical Amphotericin B—Case Report

Mucormycosis is an opportunistic infection affecting mainly immunocompromised hosts. Infection in immunocompetent patients is rare, but may occur typically in trauma or burn victims. We report on a previously healthy young man suffering devastating trauma from an agricultural accident with the subse...

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Autores principales: Keller, Filip, Antoni, Helena, Minarcikova, Petra, Hrdy, Ondrej, Gal, Roman
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10604655/
https://www.ncbi.nlm.nih.gov/pubmed/37887190
http://dx.doi.org/10.3390/antibiotics12101489
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author Keller, Filip
Antoni, Helena
Minarcikova, Petra
Hrdy, Ondrej
Gal, Roman
author_facet Keller, Filip
Antoni, Helena
Minarcikova, Petra
Hrdy, Ondrej
Gal, Roman
author_sort Keller, Filip
collection PubMed
description Mucormycosis is an opportunistic infection affecting mainly immunocompromised hosts. Infection in immunocompetent patients is rare, but may occur typically in trauma or burn victims. We report on a previously healthy young man suffering devastating trauma from an agricultural accident with the subsequent development of a multifocal mucormycosis. Diagnosis was achieved by cultures obtained from non-healing wounds, some of them even covered by a macroscopic mold formation. Specific treatment was initiated soon after the preliminary results indicated mucormycosis. Aggressive surgical therapy, with concomitant use of systemic posaconazole and topical amphotericin B in a combination treatment, led to the elimination of the fungal infection. The remaining deep tissue defects were consequently reconstructed by a muscle flap and skin graft autotransplantation with a good overall outcome, which would not have been possible without the complete remission of mucormycosis. This case study presents the successful use of a combination treatment with systemic posaconazole and topical amphotericin B and underlines the importance of timely and aggressive surgical therapy.
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spelling pubmed-106046552023-10-28 Mucormycosis in a Severe Trauma Patient Treated with a Combination of Systemic Posaconazole and Topical Amphotericin B—Case Report Keller, Filip Antoni, Helena Minarcikova, Petra Hrdy, Ondrej Gal, Roman Antibiotics (Basel) Case Report Mucormycosis is an opportunistic infection affecting mainly immunocompromised hosts. Infection in immunocompetent patients is rare, but may occur typically in trauma or burn victims. We report on a previously healthy young man suffering devastating trauma from an agricultural accident with the subsequent development of a multifocal mucormycosis. Diagnosis was achieved by cultures obtained from non-healing wounds, some of them even covered by a macroscopic mold formation. Specific treatment was initiated soon after the preliminary results indicated mucormycosis. Aggressive surgical therapy, with concomitant use of systemic posaconazole and topical amphotericin B in a combination treatment, led to the elimination of the fungal infection. The remaining deep tissue defects were consequently reconstructed by a muscle flap and skin graft autotransplantation with a good overall outcome, which would not have been possible without the complete remission of mucormycosis. This case study presents the successful use of a combination treatment with systemic posaconazole and topical amphotericin B and underlines the importance of timely and aggressive surgical therapy. MDPI 2023-09-27 /pmc/articles/PMC10604655/ /pubmed/37887190 http://dx.doi.org/10.3390/antibiotics12101489 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Case Report
Keller, Filip
Antoni, Helena
Minarcikova, Petra
Hrdy, Ondrej
Gal, Roman
Mucormycosis in a Severe Trauma Patient Treated with a Combination of Systemic Posaconazole and Topical Amphotericin B—Case Report
title Mucormycosis in a Severe Trauma Patient Treated with a Combination of Systemic Posaconazole and Topical Amphotericin B—Case Report
title_full Mucormycosis in a Severe Trauma Patient Treated with a Combination of Systemic Posaconazole and Topical Amphotericin B—Case Report
title_fullStr Mucormycosis in a Severe Trauma Patient Treated with a Combination of Systemic Posaconazole and Topical Amphotericin B—Case Report
title_full_unstemmed Mucormycosis in a Severe Trauma Patient Treated with a Combination of Systemic Posaconazole and Topical Amphotericin B—Case Report
title_short Mucormycosis in a Severe Trauma Patient Treated with a Combination of Systemic Posaconazole and Topical Amphotericin B—Case Report
title_sort mucormycosis in a severe trauma patient treated with a combination of systemic posaconazole and topical amphotericin b—case report
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10604655/
https://www.ncbi.nlm.nih.gov/pubmed/37887190
http://dx.doi.org/10.3390/antibiotics12101489
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