Renal mucormycosis complicating extracorporeal membrane oxygenation

Med Mycol. 2013 Feb;51(2):193-5. doi: 10.3109/13693786.2012.686069. Epub 2012 May 15.

Abstract

Zygomycosis can manifest as severe infections, particularly in immunocompromised patients, which can be nosocomial in nature resulting from complications of invasive procedures. We report the case of a 65-year-old woman with a medical history of unclassified inflammatory rheumatism who underwent arteriovenous extracorporeal membrane oxygenation because of a myocardial failure following the drainage of a tuberculous tamponade. This procedure was complicated by a superinfection of the scarpa which revealed a disseminated zygomycosis with renal involvement. A favorable outcome was achieved after 15 months of antifungal therapy involving the use of liposomal amphotericin B followed with posaconazole which involved the close monitoring of the concentrations of this antifungal. Extracorporeal membrane oxygenation is a frequent procedure which could be complicated with severe fungal nosocomial infections such as zygomycosis. The outcome of such complication can be favorable with the utilization of new antifungal therapies.

Publication types

  • Case Reports

MeSH terms

  • Acute Kidney Injury / drug therapy
  • Acute Kidney Injury / microbiology*
  • Aged
  • Amphotericin B / administration & dosage
  • Antifungal Agents / administration & dosage*
  • Cross Infection / drug therapy*
  • Cross Infection / microbiology
  • Extracorporeal Membrane Oxygenation / adverse effects*
  • Female
  • France
  • Heart Failure / therapy
  • Humans
  • Immunocompromised Host
  • Kidney / microbiology
  • Mucormycosis / drug therapy*
  • Mucormycosis / microbiology
  • Rheumatic Fever / complications
  • Rhizopus / drug effects*
  • Rhizopus / isolation & purification
  • Treatment Outcome
  • Triazoles / administration & dosage
  • Tuberculosis, Pulmonary / complications
  • Tuberculosis, Pulmonary / therapy

Substances

  • Antifungal Agents
  • Triazoles
  • liposomal amphotericin B
  • posaconazole
  • Amphotericin B