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

Authors

KELLER Filip ANTONI Helena MINARČÍKOVÁ Petra HRDÝ Ondřej GÁL Roman

Year of publication 2023
Type Article in Periodical
Magazine / Source Antibiotics
MU Faculty or unit

Faculty of Medicine

Citation
Web https://www.mdpi.com/2079-6382/12/10/1489
Doi http://dx.doi.org/10.3390/antibiotics12101489
Keywords mucormycosis; posaconazole; amphotericin B; severe trauma; case report
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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