TY - JOUR
T1 - Rhinocerebral mucormycosis treated with amphotericin B colloidal dispersion in three patients
AU - Moses, Allon E.
AU - Rahav, Galia
AU - Barenholz, Yechezkel
AU - Elidan, Josef
AU - Azaz, Badri
AU - Gillis, Shmuel
AU - Brickman, Masha
AU - Polacheck, Itzhack
AU - Shapiro, Mervyn
PY - 1998
Y1 - 1998
N2 - Rhinocerebral mucormycosis (zygomycosis) primarily affects diabetic or immunosuppressed patients and typically progresses rapidly; necessitating surgical excision and antifungal therapy with amphotericin B. Large doses of amphotericin B are required for cure, causing significant renal toxicity. Amphotericin B colloidal dispersion (ABCD; Amphocil, Sequus Pharmaceuticals, Menlo Park, CA) is a 1:1 complex of cholesteryl sulfate and amphotericin B, which results in significant reduction of toxicity, especially nephrotoxicity. We describe three patients with life-threatening rhinocerebral mucormycosis treated with ABCD. All patients had high serum creatinine levels due to prior treatment with anaphotericin B; these levels reverted to normal during treatment with ABCD. Two patients with diabetes mellitus were cured after receiving a combination of surgery and ABCD therapy. The third patient, who had myelodysplastic syndrome, had an initial good response, with cure of the fungal infection; however, he eventually died of his primary illness. To the best of our knowledge, this is the first detailed clinical description of the treatment of mucormycosis with ABCD.
AB - Rhinocerebral mucormycosis (zygomycosis) primarily affects diabetic or immunosuppressed patients and typically progresses rapidly; necessitating surgical excision and antifungal therapy with amphotericin B. Large doses of amphotericin B are required for cure, causing significant renal toxicity. Amphotericin B colloidal dispersion (ABCD; Amphocil, Sequus Pharmaceuticals, Menlo Park, CA) is a 1:1 complex of cholesteryl sulfate and amphotericin B, which results in significant reduction of toxicity, especially nephrotoxicity. We describe three patients with life-threatening rhinocerebral mucormycosis treated with ABCD. All patients had high serum creatinine levels due to prior treatment with anaphotericin B; these levels reverted to normal during treatment with ABCD. Two patients with diabetes mellitus were cured after receiving a combination of surgery and ABCD therapy. The third patient, who had myelodysplastic syndrome, had an initial good response, with cure of the fungal infection; however, he eventually died of his primary illness. To the best of our knowledge, this is the first detailed clinical description of the treatment of mucormycosis with ABCD.
UR - http://www.scopus.com/inward/record.url?scp=0031865501&partnerID=8YFLogxK
U2 - 10.1086/516349
DO - 10.1086/516349
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C2 - 9636875
AN - SCOPUS:0031865501
SN - 1058-4838
VL - 26
SP - 1430
EP - 1433
JO - Clinical Infectious Diseases
JF - Clinical Infectious Diseases
IS - 6
ER -