Last generation triazoles for imported eumycetoma in eleven consecutive adults.
BACKGROUND:Optimal management of eumycetoma, a severely debilitating chronic progressive fungal infection of skin, disseminating to bone and viscera, remains challenging. Especially, optimal antifungal treatment and duration are ill defined. METHODOLOGY/PRINCIPAL FINDINGS:We conducted a monocentric...
Published in: | PLoS Neglected Tropical Diseases |
---|---|
Main Authors: | , , , , , , , , , , , , |
Format: | Article in Journal/Newspaper |
Language: | English |
Published: |
Public Library of Science (PLoS)
2014
|
Subjects: | |
Online Access: | https://doi.org/10.1371/journal.pntd.0003232 https://doaj.org/article/7c1fcd05062e4f66923c3a2da53020e9 |
id |
ftdoajarticles:oai:doaj.org/article:7c1fcd05062e4f66923c3a2da53020e9 |
---|---|
record_format |
openpolar |
spelling |
ftdoajarticles:oai:doaj.org/article:7c1fcd05062e4f66923c3a2da53020e9 2023-05-15T15:09:17+02:00 Last generation triazoles for imported eumycetoma in eleven consecutive adults. Yoann Crabol Sylvain Poiree Marie-Elisabeth Bougnoux Christophe Maunoury Stéphane Barete Valérie Zeller Cédric Arvieux Samuel Pineau Karima Amazzough Marc Lecuit Fanny Lanternier Olivier Lortholary French Mycosis Study Group 2014-10-01T00:00:00Z https://doi.org/10.1371/journal.pntd.0003232 https://doaj.org/article/7c1fcd05062e4f66923c3a2da53020e9 EN eng Public Library of Science (PLoS) http://europepmc.org/articles/PMC4191942?pdf=render https://doaj.org/toc/1935-2727 https://doaj.org/toc/1935-2735 1935-2727 1935-2735 doi:10.1371/journal.pntd.0003232 https://doaj.org/article/7c1fcd05062e4f66923c3a2da53020e9 PLoS Neglected Tropical Diseases, Vol 8, Iss 10, p e3232 (2014) Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 article 2014 ftdoajarticles https://doi.org/10.1371/journal.pntd.0003232 2022-12-31T00:59:15Z BACKGROUND:Optimal management of eumycetoma, a severely debilitating chronic progressive fungal infection of skin, disseminating to bone and viscera, remains challenging. Especially, optimal antifungal treatment and duration are ill defined. METHODOLOGY/PRINCIPAL FINDINGS:We conducted a monocentric retrospective study of 11 imported cases of eumycetoma treated by voriconazole or posaconazole for at least 6 months. Response to treatment was assessed through evolution of clinical and magnetic resonance imaging (MRI). (1→3) ß-D-glucan (BG) and positron emission tomography using [18F] fluorodeoxyglucose (PET/CT) results were also assessed. Identified species were Fusarium solani complex (n = 3); Madurella mycetomatis, (n = 3), and Exophiala jeanselmei, (n = 1). Moreover, two coelomycetes and one phaeohyphomycetes strains without species identification were retrieved. Serum BG and PET/CT were abnormal in 7/8 and 6/6 patients tested, respectively. Patients received last generation azoles for a mean duration of 25.9±18 months. Complete response (major clinical and MRI improvement) was observed in 5/11 patients, partial response (minor MRI improvement or stable MRI findings) in 5 and failure (MRI evidence of disease progression) in one, with a 73±39 [6-132] months mean follow-up. Relapse occurred in 2 patients after treatment discontinuation. Optimal outcome was associated with fungal species, initiation of last generation triazole therapy (<65 months since first symptoms), negative serum BG and PET/CT normalization. CONCLUSIONS/SIGNIFICANCE:MRI, PET/CT and serum BG appear as promising tools to assess optimal time of antifungal treatment for eumycetoma. Article in Journal/Newspaper Arctic Directory of Open Access Journals: DOAJ Articles Arctic PLoS Neglected Tropical Diseases 8 10 e3232 |
institution |
Open Polar |
collection |
Directory of Open Access Journals: DOAJ Articles |
op_collection_id |
ftdoajarticles |
language |
English |
topic |
Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 |
spellingShingle |
Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 Yoann Crabol Sylvain Poiree Marie-Elisabeth Bougnoux Christophe Maunoury Stéphane Barete Valérie Zeller Cédric Arvieux Samuel Pineau Karima Amazzough Marc Lecuit Fanny Lanternier Olivier Lortholary French Mycosis Study Group Last generation triazoles for imported eumycetoma in eleven consecutive adults. |
topic_facet |
Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 |
description |
BACKGROUND:Optimal management of eumycetoma, a severely debilitating chronic progressive fungal infection of skin, disseminating to bone and viscera, remains challenging. Especially, optimal antifungal treatment and duration are ill defined. METHODOLOGY/PRINCIPAL FINDINGS:We conducted a monocentric retrospective study of 11 imported cases of eumycetoma treated by voriconazole or posaconazole for at least 6 months. Response to treatment was assessed through evolution of clinical and magnetic resonance imaging (MRI). (1→3) ß-D-glucan (BG) and positron emission tomography using [18F] fluorodeoxyglucose (PET/CT) results were also assessed. Identified species were Fusarium solani complex (n = 3); Madurella mycetomatis, (n = 3), and Exophiala jeanselmei, (n = 1). Moreover, two coelomycetes and one phaeohyphomycetes strains without species identification were retrieved. Serum BG and PET/CT were abnormal in 7/8 and 6/6 patients tested, respectively. Patients received last generation azoles for a mean duration of 25.9±18 months. Complete response (major clinical and MRI improvement) was observed in 5/11 patients, partial response (minor MRI improvement or stable MRI findings) in 5 and failure (MRI evidence of disease progression) in one, with a 73±39 [6-132] months mean follow-up. Relapse occurred in 2 patients after treatment discontinuation. Optimal outcome was associated with fungal species, initiation of last generation triazole therapy (<65 months since first symptoms), negative serum BG and PET/CT normalization. CONCLUSIONS/SIGNIFICANCE:MRI, PET/CT and serum BG appear as promising tools to assess optimal time of antifungal treatment for eumycetoma. |
format |
Article in Journal/Newspaper |
author |
Yoann Crabol Sylvain Poiree Marie-Elisabeth Bougnoux Christophe Maunoury Stéphane Barete Valérie Zeller Cédric Arvieux Samuel Pineau Karima Amazzough Marc Lecuit Fanny Lanternier Olivier Lortholary French Mycosis Study Group |
author_facet |
Yoann Crabol Sylvain Poiree Marie-Elisabeth Bougnoux Christophe Maunoury Stéphane Barete Valérie Zeller Cédric Arvieux Samuel Pineau Karima Amazzough Marc Lecuit Fanny Lanternier Olivier Lortholary French Mycosis Study Group |
author_sort |
Yoann Crabol |
title |
Last generation triazoles for imported eumycetoma in eleven consecutive adults. |
title_short |
Last generation triazoles for imported eumycetoma in eleven consecutive adults. |
title_full |
Last generation triazoles for imported eumycetoma in eleven consecutive adults. |
title_fullStr |
Last generation triazoles for imported eumycetoma in eleven consecutive adults. |
title_full_unstemmed |
Last generation triazoles for imported eumycetoma in eleven consecutive adults. |
title_sort |
last generation triazoles for imported eumycetoma in eleven consecutive adults. |
publisher |
Public Library of Science (PLoS) |
publishDate |
2014 |
url |
https://doi.org/10.1371/journal.pntd.0003232 https://doaj.org/article/7c1fcd05062e4f66923c3a2da53020e9 |
geographic |
Arctic |
geographic_facet |
Arctic |
genre |
Arctic |
genre_facet |
Arctic |
op_source |
PLoS Neglected Tropical Diseases, Vol 8, Iss 10, p e3232 (2014) |
op_relation |
http://europepmc.org/articles/PMC4191942?pdf=render https://doaj.org/toc/1935-2727 https://doaj.org/toc/1935-2735 1935-2727 1935-2735 doi:10.1371/journal.pntd.0003232 https://doaj.org/article/7c1fcd05062e4f66923c3a2da53020e9 |
op_doi |
https://doi.org/10.1371/journal.pntd.0003232 |
container_title |
PLoS Neglected Tropical Diseases |
container_volume |
8 |
container_issue |
10 |
container_start_page |
e3232 |
_version_ |
1766340504829558784 |