Mortality risk factors in patients with zygomycosis: a retrospective and multicentre study of 25 cases

• Published in: Enfermedades infecciosas y microbiologia clinica Vol. 29; no. 4; pp. 263 - 268
• Main Authors: Llorente, Andreu, Perez-Valero, Ignacio, García, E, Heras, I, Fraile, V, García, P, López, J, Salavert, M, Bobillo, F
• Format: Journal Article
• Language: English
• Published: Spain Elsevier Espana 01.04.2011
• Subjects: Adult; Aged; Anfotericina B; Antifungal Agents - therapeutic use; Central Nervous System Fungal Infections - drug therapy; Central Nervous System Fungal Infections - mortality; Combined Modality Therapy; Diabetes Complications - mortality; Factores de riesgo; Female; Fungemia - drug therapy; Fungemia - mortality; Hematologic Neoplasms - complications; Hematologic Neoplasms - epidemiology; Humans; Immunocompromised Host; Infectious Disease; Leukopenia - complications; Leukopenia - epidemiology; Liposomal amphotericin B; Male; Middle Aged; Mortalidad; Mortality; Neutropenia - complications; Neutropenia - epidemiology; Opportunistic Infections - drug therapy; Opportunistic Infections - microbiology; Opportunistic Infections - mortality; Opportunistic Infections - surgery; Retrospective Studies; Risk Factors; Soft Tissue Infections - drug therapy; Soft Tissue Infections - mortality; Spain - epidemiology; Young Adult; Zigomicosis; Zygomycosis; Zygomycosis - drug therapy; Zygomycosis - mortality; Zygomycosis - surgery; Spain; Zigomicosis; Liposomal amphotericin B; Mortality; Mortalidad; Factores de riesgo; Anfotericina B; Risk factors; Zygomycosis
• ISSN: 0213-005X; 1578-1852
• DOI: 10.1016/j.eimc.2010.09.008

Abstract Aim To investigate mortality risk factors in patients with zygomycosis. Patients and Methods Retrospective case history review of patients diagnosed with proven zygomicosis in 17 centres in Spain. We compared demographics and risk factors in patients who survived, and in those who died. Results We identified twenty-five patients with proven zygomycosis. The primary site of infection was rhino-orbito-cerebral (28%) and disseminated (20%) or cutaneous/soft infections (20%) of the patients. Eleven patients (44%) received preemptive or empirical antifungal treatment; of these patients, 4 received liposomal amphotericin B, 1 received amphotericin B lipid complex, and 6 received other antifungals. The overall mortality rate was 72%. In the univariate analysis factors associated with an increased risk of death were the presence of a haematological malignancy ( P = .03), neutropenia ( P = .03) and monocytopenia ( P = .008). Conclusion Our study supports previous research that has documented a high mortality rate among patients with invasive zygomycosis, especially among those with an underlying haematological malignancy, and the need for a rapid initiation of an effective antifungal treatment.