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KMID : 0882420100790050587
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Korean Journal of Medicine
2010 Volume.79 No. 5 p.587 ~ p.591
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A case of successful posaconazole salvage therapy for rhinocerebral mucormycosis after failure of amphotericin B
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Kim Woo-Jae
Han Song-Yee
Nam Young-Hee
Kim Jung-Min
Ahn Hee-Bae
Kim Soo-Jin
Lee Hyuck
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Abstract
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A 58-year-old man with uncontrolled type 2 diabetes mellitus developed rhinocerebral mucormycosis. The infection progressed to intracranial extension despite more than 5 weeks of treatment with amphotericin B. The patient then received oral posaconazole, 800 mg/d, in divided doses for 6 months. Salvage treatment with the new azole antifungal posaconazole resulted in dramatic clinical improvement as early as 1 week after the initiation of therapy. Oral posaconazole continued through 24 weeks of treatment, with marked clinical, mycological, and radiological improvements and no adverse events. Here we review the medical literature on rhinocerebral mucormycosis, which is a rapidly progressive and often fatal infection. The treatment of choice is amphotericin B, which failed in our patient. Our case report suggests that posaconazole appears to be a well tolerated and effective salvage treatment option for rhinocerebral mucormycosis, including disseminated disease.
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KEYWORD
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Rhinocerebral mucormycosis, Triazoles
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