A pooled analysis of 100 cases of mucormycosis from Turkey
Abstract number: R2635
Nazli A., Tasbakan M., Pullukcu H., Sipahi O., Yamazhan T., Arda B.
Objectives: In this study, it was aimed to review systematically the published mucormycosis cases from Turkey.
Method: Published mucormycosis cases from Turkey in national and international medical literature in the last fifteen years were retrieved from three national (Ulakbim, Turkish Medical Literature and Medline Plexus) and two international databases [Pubmed and Science Citation Index Expended (SCI)]. As keywords "mukor", "mukormikoz" were used in national databases and "mucor", "mucormycosis" adding "Turkey" in international databases. Data related to age, gender, comorbidities, signs, diagnostic tools, therapeutic modalities, and mortality were analysed from the retrieved articles.
Results: Data for a total of 100 mucormycosis patients (47 female, 53 male, aged 46.1) with definitive diagnosis of invasive fungal infections according to criteria of European Organization for Research and Treatment of Cancer (EORTC) were obtained from 48 reports (22 international, 26 national). We could not achieve the full texts of two reports published in international databases and three reports in national databases. In terms of common clinical findings, the most common symptom was swelling of eye and face (64%) followed by headache (56%), fever (54%), opthtalmoplegia (38%), loss of vision (31%) and other neurological signs (%27). The most common comorbidity was diabetes (53%) followed by, hematological malignancies and corticosteroid usage (33%). A total 40 of patients had mycological culture and in 21 it was positive. In radiologic imaging 76% of patients had findings in favor of fungal infection. Diagnosis was made by the help of histopathological investigation in 83 cases. Three patients had been diagnosed on autopsy. Both surgical debridement and antifungal therapy were administered in 85 patients. Five patients had received only surgical debridement and seven only antifungal therapy. Three patients died before treatment. Total mortality rate was %57. Although all patients treated by only surgical debridement were alive, seven patients who had only antifungal therapy died. Patients with diabetes had tendency of higher mortality according to others (Chi square test, p = 0.052).
Conclusion: Despite new diagnostic tools and therapeutic agents mucormycosis has still very high mortality. Suspicion of mucormycosis is crucial for early diagnosis. In the management, biopsy should be made immediately.
|Session name:||Abstracts of 21st ECCMID / 27th ICC|
|Location:||Milan, Italy, 7 - 10 May 2011|
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