amphotericin-b and Muscular-Diseases

BACKGROUND Mucormycosis is a serious, potentially fatal fungal infection caused by species in the Mucorales order. Together with candidiasis and aspergillosis, it is one of the most significant fungal infection that carries a high rate of mortality. Early detection and initiation of antifungal therapy with adequate surgical debridement improves the clinical outcome. CASE REPORT We describe a case of mucormycosis in a patient with acute myeloid leukemia who developed disseminated lung disease with muscular involvement without any cutaneous manifestation. Successful treatment was achieved with surgical debridement, amphotericin B lipid-complex and posaconazole step-down therapy. CONCLUSIONS Mucormycosis can present in various clinical scenarios. Key to diagnosis depends on tissues diagnosis from the affected system, as was done with lung and muscle biopsy in our patient. Clinicians should maintain high suspicion for early diagnosis and prompt treatment.

Topics: Amphotericin B; Antifungal Agents; Female; Humans; Leukemia, Myeloid, Acute; Lung Diseases, Fungal; Middle Aged; Mucormycosis; Muscular Diseases; Opportunistic Infections

Opportunistic infections frequently develop in immunocompromised patients, such as those with hematological malignancies, causing significant mortality. Early diagnosis of invasive fungal infections is often important and difficult due to the difficult nature of confirming infection using cytologic and histologic findings. However, we report the first case of candidal infection leading to muscle abscesses in the legs of a patient with leukemia.. A 60-year-old man with acute myeloid leukemia (AML) presented with multifocal muscle abscesses of the legs.. Multifocal muscle candidiasis of the legs was confirmed by fine-needle aspiration biopsy of 2 of the calf lesions.. After treatment with amphotericin B and flucytosine for 1 month, the patient was administered intravenous caspofungin for 3 months.. A CT scan of the abdomen and an MRI of the lower calves showed significant improvement.. This case highlights that fungal infection should be considered when patients present with multiple abscesses, emphasizing the value of early biopsy to confirm diagnosis and facilitate precision treatment.

Topics: Abscess; Amphotericin B; Antifungal Agents; Antineoplastic Agents; Candida tropicalis; Candidiasis; Caspofungin; Flucytosine; Humans; Immunocompromised Host; Leg; Leukemia, Myeloid, Acute; Magnetic Resonance Imaging; Male; Middle Aged; Muscle, Skeletal; Muscular Diseases; Opportunistic Infections; Tomography, X-Ray Computed

Topics: Amphotericin B; Biopsy, Needle; Follow-Up Studies; Foot Dermatoses; Fungemia; Fusarium; Humans; Immunocompromised Host; Immunohistochemistry; Leukemia, Myeloid; Magnetic Resonance Imaging; Male; Middle Aged; Muscular Diseases; Mycoses; Opportunistic Infections; Risk Assessment; Severity of Illness Index; Toes; Treatment Outcome

A 30-year-old man with acute myeloid leukemia who was pancytopenic after undergoing intensive chemotherapy developed pyrexia and severe pain of both lower legs. We immediately started empiric therapy with cefepime, vancomycin, and fluconazole for febrile neutropenia. However, symptoms progressed. After 4 days, Trichosporon was isolated from venous blood cultures. MRI showed hyperintense lesions within both gastrocnemius muscles and demonstrated reactive vasodilatation and interstitial tissue edema, thought to be induced by hyperpermeability of vessel membranes due to the local fungal infection. Amphotericin B was very effective against this organism. Trichosporosis is a rare infectious disease generally occurring in immunocompromized hosts. To the best of our knowledge, this is first reported case of bilateral Trichosporon infection of lower leg muscles. Severe leg pain was one of the most important signs of fungal infection in this patient with hematologic malignancy.

Topics: Adult; Amphotericin B; Humans; Magnetic Resonance Imaging; Male; Muscle, Skeletal; Muscular Diseases; Mycoses; Trichosporon

Although aspergillosis remains the most common mould infection in patients with haematologic malignancies, disseminated Fusarium infection is an emerging problem with a poor prognosis in this patient population. The treatment options are limited due to relative resistance of the fungus to standard antifungals. We present a patient with acute lymphoblastic leukaemia successfully treated with AmBisome for a disseminated Fusarium solani infection that did not respond to first line treatment with voriconazole. Despite the fact that he received additional myelosuppressive chemotherapy and underwent two stem cell transplantations from HLA mismatched donors the Fusarium infection did not recur during the subsequent phases of neutropenia. The clinical presentation, diagnosis, prognosis and therapeutic options of fusariosis in immunocompromised patients are briefly discussed.

Topics: Abscess; Amphotericin B; Antibodies, Monoclonal; Antibodies, Monoclonal, Murine-Derived; Antifungal Agents; Antineoplastic Combined Chemotherapy Protocols; Benzamides; Combined Modality Therapy; Cytarabine; Foot Dermatoses; Fusarium; Humans; Imatinib Mesylate; Immunocompromised Host; Liposomes; Male; Middle Aged; Muscular Diseases; Onychomycosis; Peripheral Blood Stem Cell Transplantation; Piperazines; Precursor Cell Lymphoblastic Leukemia-Lymphoma; Pyrimidines; Recurrence; Remission Induction; Reoperation; Rituximab; Teniposide; Triazoles; Voriconazole

Mucormycosis is a rare fungal infection of childhood, occurring mainly in patients with chronic illnesses such as diabetes and malignancies. The fungus seldom grows in culture and confirmation of the diagnosis depends on histologic examination of infected tissues. To date, the reported natural history of the disease has been rapid progression and a fatal outcome. Therefore, the importance of early diagnosis by tissue biopsy and early treatment with surgical debridement and systemic antifungal therapy cannot be overemphasized. The pulmonary system is the most common site for mucormycosis in patients with leukemia. We report what we believe to be the first successfully treated case of isolated muscular mucormycosis occurring in a child with biphenotypic acute leukemia. The diagnosis was made promptly by tissue examination at the time of surgical debridement. The patient was also given systemic amphotericin-B therapy.

Topics: Acute Disease; Amphotericin B; Antifungal Agents; Child; Combined Modality Therapy; Debridement; Humans; Leukemia; Male; Mucormycosis; Muscular Diseases

Topics: Adult; Amphotericin B; Candidiasis; Female; Fever; Humans; Leukemia, Lymphoid; Muscular Diseases; Prognosis; Skin Diseases

The antimicrobial therapy of musculoskeletal infections does not differ in basic principles from the therapy of any infection. However, the chronic nature of certain of these infections and the need for long-term treatment make essential the proper selection and monitoring of the antimicrobial agents. This can be done only by obtaining proper specimens for microbiologic identification and, in many cases, by in vitro susceptibility tests of the infecting organisms. Thus, the least toxic, effective antimicrobial agent can be selected and administered without inadequate therapy or toxic side effects.

Topics: Aminoglycosides; Amphotericin B; Anti-Bacterial Agents; Bone Diseases; Cephalosporins; Chloramphenicol; Clindamycin; Erythromycin; Flucytosine; Humans; Infections; Lincomycin; Muscular Diseases; Nystatin; Penicillins; Tetracyclines

Topics: Adolescent; Amphotericin B; Calcium; Chlorides; Creatine Kinase; Female; Humans; Hypokalemia; Meningitis; Muscular Diseases; Potassium

Topics: Adult; Amphotericin B; Cryptococcosis; Humans; Hypokalemia; Kidney; Kidney Concentrating Ability; Male; Meningitis; Muscular Diseases; Myoglobinuria; Potassium; Potassium Chloride

Topics: Alkaline Phosphatase; Amphotericin B; Biopsy; Black People; Cryptococcosis; Hepatomegaly; Humans; Liver Diseases; Lymph Nodes; Mesenchymoma; Muscular Diseases; Neoplasms; Serologic Tests; Surgical Procedures, Operative; Thigh

Topics: Amphotericin B; Blood; Coccidioidomycosis; Humans; Hypokalemia; Kidney Diseases; Muscular Diseases; Paralysis; Pathology; Potassium; Statistics as Topic; Toxicology; Urine