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Cutaneous mucormycosis as result of insulin administration in an AML patient : case report and review of the literature

Anke Delie (UGent) , Philip Vlummens (UGent) , David Creytens (UGent) and EVA STEEL (UGent)
(2017) ACTA CLINICA BELGICA. 72(5). p.352-356
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Abstract
We present a case of cutaneous mucormycosis in a patient with several important risk factors precipitating disease, namely underlying acute myeloid leukaemia and poorly controlled secondary diabetes. Inoculation was most likely caused by repeated minor trauma (insulin injection) at the site of infection. Treatment consisted of surgical debridement and liposomal Amphotericin B (LAmB) during 71 days. Posaconazole had already been initiated prior to infection as primary antifungal prophylaxis but was discontinued during follow-up as susceptibility testing later revealed resistance to posaconazole. Additional treatment with caspofungin and G-CSF was associated because of poor initial result to treatment. Caspofungin was later continued as monotherapy when LAmB had to be interrupted because of renal toxicity. Treatment was completed after closure of the surgical site. The patient was successfully treated and remains infection free for one year after initial diagnosis.
Keywords
Mucomycosis, Zygomycosis, Rhizopus microsporus, Acute myeloid leukaemia, Diabetes, SIGNIFICANTLY INCREASES MORTALITY, ORBITAL-CEREBRAL MUCORMYCOSIS, F-18-FDG PET/CT, AMPHOTERICIN-B, DIAGNOSIS, ZYGOMYCOSIS, COMBINATION, CASPOFUNGIN

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MLA
Delie, Anke, Philip Vlummens, David Creytens, et al. “Cutaneous Mucormycosis as Result of Insulin Administration in an AML Patient : Case Report and Review of the Literature.” ACTA CLINICA BELGICA 72.5 (2017): 352–356. Print.
APA
Delie, A., Vlummens, P., Creytens, D., & STEEL, E. (2017). Cutaneous mucormycosis as result of insulin administration in an AML patient : case report and review of the literature. ACTA CLINICA BELGICA, 72(5), 352–356.
Chicago author-date
Delie, Anke, Philip Vlummens, David Creytens, and EVA STEEL. 2017. “Cutaneous Mucormycosis as Result of Insulin Administration in an AML Patient : Case Report and Review of the Literature.” Acta Clinica Belgica 72 (5): 352–356.
Chicago author-date (all authors)
Delie, Anke, Philip Vlummens, David Creytens, and EVA STEEL. 2017. “Cutaneous Mucormycosis as Result of Insulin Administration in an AML Patient : Case Report and Review of the Literature.” Acta Clinica Belgica 72 (5): 352–356.
Vancouver
1.
Delie A, Vlummens P, Creytens D, STEEL E. Cutaneous mucormycosis as result of insulin administration in an AML patient : case report and review of the literature. ACTA CLINICA BELGICA. 2017;72(5):352–6.
IEEE
[1]
A. Delie, P. Vlummens, D. Creytens, and E. STEEL, “Cutaneous mucormycosis as result of insulin administration in an AML patient : case report and review of the literature,” ACTA CLINICA BELGICA, vol. 72, no. 5, pp. 352–356, 2017.
@article{8510587,
  abstract     = {We present a case of cutaneous mucormycosis in a patient with several important risk factors precipitating disease, namely underlying acute myeloid leukaemia and poorly controlled secondary diabetes. Inoculation was most likely caused by repeated minor trauma (insulin injection) at the site of infection. Treatment consisted of surgical debridement and liposomal Amphotericin B (LAmB) during 71 days. Posaconazole had already been initiated prior to infection as primary antifungal prophylaxis but was discontinued during follow-up as susceptibility testing later revealed resistance to posaconazole. Additional treatment with caspofungin and G-CSF was associated because of poor initial result to treatment. Caspofungin was later continued as monotherapy when LAmB had to be interrupted because of renal toxicity. Treatment was completed after closure of the surgical site. The patient was successfully treated and remains infection free for one year after initial diagnosis.},
  author       = {Delie, Anke and Vlummens, Philip and Creytens, David and STEEL, EVA},
  issn         = {1784-3286},
  journal      = {ACTA CLINICA BELGICA},
  keywords     = {Mucomycosis,Zygomycosis,Rhizopus microsporus,Acute myeloid leukaemia,Diabetes,SIGNIFICANTLY INCREASES MORTALITY,ORBITAL-CEREBRAL MUCORMYCOSIS,F-18-FDG PET/CT,AMPHOTERICIN-B,DIAGNOSIS,ZYGOMYCOSIS,COMBINATION,CASPOFUNGIN},
  language     = {eng},
  number       = {5},
  pages        = {352--356},
  title        = {Cutaneous mucormycosis as result of insulin administration in an AML patient : case report and review of the literature},
  url          = {http://dx.doi.org/10.1080/17843286.2016.1266802},
  volume       = {72},
  year         = {2017},
}

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