Invasive mucormycosis in a tertiary care hospital in the western region of Saudi Arabia: 11-year retrospective chart review from 2009 to 2019
Background: Mucormycosis is a life-threatening, invasive fungal disease that mostly affects immunocompromised hosts. In this study, we aimed to assess the clinical presentations and outcomes of patients with mucormycosis in a tertiary care hospital in the western region of Saudi Arabia. Methods: A r...
| Main Authors: | , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2022-12-01
|
| Series: | Journal of Infection and Public Health |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S1876034122003045 |
| _version_ | 1811191095048011776 |
|---|---|
| author | Hassan Almarhabi Essam Al-Asmari Adeeb Munshi Fayssal Farahat Abdulfatah Al-Amri Hatim Q. Almaghraby Maher Alharbi Abulhakeem Althaqafi |
| author_facet | Hassan Almarhabi Essam Al-Asmari Adeeb Munshi Fayssal Farahat Abdulfatah Al-Amri Hatim Q. Almaghraby Maher Alharbi Abulhakeem Althaqafi |
| author_sort | Hassan Almarhabi |
| collection | DOAJ |
| description | Background: Mucormycosis is a life-threatening, invasive fungal disease that mostly affects immunocompromised hosts. In this study, we aimed to assess the clinical presentations and outcomes of patients with mucormycosis in a tertiary care hospital in the western region of Saudi Arabia. Methods: A retrospective chart review of patients diagnosed with mucormycosis was conducted from January 2009 to December 2019 at King Abdulaziz Medical City, a tertiary care facility in Jeddah, Saudi Arabia. We aimed to assess and analyze the characteristics of patients with mucormycosis, their clinical presentations, and treatment outcomes. Results: Fifteen cases were identified as proven or probable mucormycosis according to the revised European Organization for Research and Treatment of Cancer/Mycoses Study Group criteria. Most cases (n = 11, 73.3 %) were categorized as proven, whereas four cases (26.7 %) were categorized as probable. The median patient age was 29.5 years (range, 6–79 years). The most common underlying etiology was hematological malignancies (7 cases), followed by diabetes mellitus (5 cases), and trauma from a motor vehicle accident (4 cases). Cutaneous mucormycosis was the predominant presentation, as noted in seven cases (46.6 %), followed by rhino-orbito-cerebral mucormycosis in four cases (26.7 %), and pulmonary mucormycosis in two cases (13.3 %). Rhizopus (six cases) and Mucor (four cases) were the two main fungal isolates. Eight patients were treated with amphotericin B lipid complex (53.3 %) alone, and three patients were treated with a combination of amphotericin B lipid complex and posaconazole. Overall, 11 (73.3 %) patients died, two of whom died before a confirmed diagnosis. Conclusion: The mortality among patients with mucormycosis was high. Relatively better survival was observed among cutaneous cases. A combination of new diagnostic technologies, optimized use of available antifungal options, development of new antifungal agents, and consistent implementation of public health policies may help reduce mortality rates from mucormycosis in Saudi Arabia. |
| first_indexed | 2024-04-11T15:00:06Z |
| format | Article |
| id | doaj.art-ee786dcf11834adaa4cd796592b459b9 |
| institution | Directory Open Access Journal |
| issn | 1876-0341 |
| language | English |
| last_indexed | 2024-04-11T15:00:06Z |
| publishDate | 2022-12-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Journal of Infection and Public Health |
| spelling | doaj.art-ee786dcf11834adaa4cd796592b459b92022-12-22T04:17:02ZengElsevierJournal of Infection and Public Health1876-03412022-12-01151214661471Invasive mucormycosis in a tertiary care hospital in the western region of Saudi Arabia: 11-year retrospective chart review from 2009 to 2019Hassan Almarhabi0Essam Al-Asmari1Adeeb Munshi2Fayssal Farahat3Abdulfatah Al-Amri4Hatim Q. Almaghraby5Maher Alharbi6Abulhakeem Althaqafi7King Saud Bin Abdulaziz University for Health Sciences, Saudi Arabia; King Abdullah International Medical Research Center, Saudi Arabia; Department of Internal Medicine, King Abdulaziz Medical City, Ministry of National Guard Health Affairs, Jeddah, Saudi Arabia; Department of Infectious Diseases, King Abdulaziz Medical City, Ministry of National Guard Health Affairs, Jeddah, Saudi Arabia; Correspondence to: Infectious Diseases Department, King Abdulaziz Medical City, Ministry of National Guard Health Affairs, Jeddah, Saudi Arabia.Department of Infectious Diseases, Ministry of Health, Asser Region, Saudi ArabiaKing Saud Bin Abdulaziz University for Health Sciences, Saudi Arabia; King Abdullah International Medical Research Center, Saudi Arabia; Department of Internal Medicine, King Abdulaziz Medical City, Ministry of National Guard Health Affairs, Jeddah, Saudi Arabia; Department of Infectious Diseases, King Abdulaziz Medical City, Ministry of National Guard Health Affairs, Jeddah, Saudi ArabiaKing Saud Bin Abdulaziz University for Health Sciences, Saudi Arabia; King Abdullah International Medical Research Center, Saudi Arabia; Infection Prevention and Control, King Abdulaziz Medical City, Ministry of National Guard Health Affairs, Riyadh, Saudi ArabiaMicrobiology & Laboratory Medicine, King Abdulaziz Medical City, Jeddah, Saudi ArabiaKing Saud Bin Abdulaziz University for Health Sciences, Saudi Arabia; King Abdullah International Medical Research Center, Saudi Arabia; Pathology & Laboratory Medicine, King Abdulaziz Medical City, Jeddah, Saudi ArabiaKing Saud Bin Abdulaziz University for Health Sciences, Saudi Arabia; King Abdullah International Medical Research Center, Saudi Arabia; Department of Internal Medicine, King Abdulaziz Medical City, Ministry of National Guard Health Affairs, Jeddah, Saudi Arabia; Department of Infectious Diseases, King Abdulaziz Medical City, Ministry of National Guard Health Affairs, Jeddah, Saudi Arabia; Infection Prevention and Control, King Abdulaziz Medical City, Ministry of National Guard Health Affairs, Jeddah, Saudi ArabiaKing Saud Bin Abdulaziz University for Health Sciences, Saudi Arabia; King Abdullah International Medical Research Center, Saudi Arabia; Department of Internal Medicine, King Abdulaziz Medical City, Ministry of National Guard Health Affairs, Jeddah, Saudi Arabia; Department of Infectious Diseases, King Abdulaziz Medical City, Ministry of National Guard Health Affairs, Jeddah, Saudi ArabiaBackground: Mucormycosis is a life-threatening, invasive fungal disease that mostly affects immunocompromised hosts. In this study, we aimed to assess the clinical presentations and outcomes of patients with mucormycosis in a tertiary care hospital in the western region of Saudi Arabia. Methods: A retrospective chart review of patients diagnosed with mucormycosis was conducted from January 2009 to December 2019 at King Abdulaziz Medical City, a tertiary care facility in Jeddah, Saudi Arabia. We aimed to assess and analyze the characteristics of patients with mucormycosis, their clinical presentations, and treatment outcomes. Results: Fifteen cases were identified as proven or probable mucormycosis according to the revised European Organization for Research and Treatment of Cancer/Mycoses Study Group criteria. Most cases (n = 11, 73.3 %) were categorized as proven, whereas four cases (26.7 %) were categorized as probable. The median patient age was 29.5 years (range, 6–79 years). The most common underlying etiology was hematological malignancies (7 cases), followed by diabetes mellitus (5 cases), and trauma from a motor vehicle accident (4 cases). Cutaneous mucormycosis was the predominant presentation, as noted in seven cases (46.6 %), followed by rhino-orbito-cerebral mucormycosis in four cases (26.7 %), and pulmonary mucormycosis in two cases (13.3 %). Rhizopus (six cases) and Mucor (four cases) were the two main fungal isolates. Eight patients were treated with amphotericin B lipid complex (53.3 %) alone, and three patients were treated with a combination of amphotericin B lipid complex and posaconazole. Overall, 11 (73.3 %) patients died, two of whom died before a confirmed diagnosis. Conclusion: The mortality among patients with mucormycosis was high. Relatively better survival was observed among cutaneous cases. A combination of new diagnostic technologies, optimized use of available antifungal options, development of new antifungal agents, and consistent implementation of public health policies may help reduce mortality rates from mucormycosis in Saudi Arabia.http://www.sciencedirect.com/science/article/pii/S1876034122003045MucormycosisSaudi ArabiaClinical PresentationDiagnosisEpidemiology |
| spellingShingle | Hassan Almarhabi Essam Al-Asmari Adeeb Munshi Fayssal Farahat Abdulfatah Al-Amri Hatim Q. Almaghraby Maher Alharbi Abulhakeem Althaqafi Invasive mucormycosis in a tertiary care hospital in the western region of Saudi Arabia: 11-year retrospective chart review from 2009 to 2019 Journal of Infection and Public Health Mucormycosis Saudi Arabia Clinical Presentation Diagnosis Epidemiology |
| title | Invasive mucormycosis in a tertiary care hospital in the western region of Saudi Arabia: 11-year retrospective chart review from 2009 to 2019 |
| title_full | Invasive mucormycosis in a tertiary care hospital in the western region of Saudi Arabia: 11-year retrospective chart review from 2009 to 2019 |
| title_fullStr | Invasive mucormycosis in a tertiary care hospital in the western region of Saudi Arabia: 11-year retrospective chart review from 2009 to 2019 |
| title_full_unstemmed | Invasive mucormycosis in a tertiary care hospital in the western region of Saudi Arabia: 11-year retrospective chart review from 2009 to 2019 |
| title_short | Invasive mucormycosis in a tertiary care hospital in the western region of Saudi Arabia: 11-year retrospective chart review from 2009 to 2019 |
| title_sort | invasive mucormycosis in a tertiary care hospital in the western region of saudi arabia 11 year retrospective chart review from 2009 to 2019 |
| topic | Mucormycosis Saudi Arabia Clinical Presentation Diagnosis Epidemiology |
| url | http://www.sciencedirect.com/science/article/pii/S1876034122003045 |
| work_keys_str_mv | AT hassanalmarhabi invasivemucormycosisinatertiarycarehospitalinthewesternregionofsaudiarabia11yearretrospectivechartreviewfrom2009to2019 AT essamalasmari invasivemucormycosisinatertiarycarehospitalinthewesternregionofsaudiarabia11yearretrospectivechartreviewfrom2009to2019 AT adeebmunshi invasivemucormycosisinatertiarycarehospitalinthewesternregionofsaudiarabia11yearretrospectivechartreviewfrom2009to2019 AT fayssalfarahat invasivemucormycosisinatertiarycarehospitalinthewesternregionofsaudiarabia11yearretrospectivechartreviewfrom2009to2019 AT abdulfatahalamri invasivemucormycosisinatertiarycarehospitalinthewesternregionofsaudiarabia11yearretrospectivechartreviewfrom2009to2019 AT hatimqalmaghraby invasivemucormycosisinatertiarycarehospitalinthewesternregionofsaudiarabia11yearretrospectivechartreviewfrom2009to2019 AT maheralharbi invasivemucormycosisinatertiarycarehospitalinthewesternregionofsaudiarabia11yearretrospectivechartreviewfrom2009to2019 AT abulhakeemalthaqafi invasivemucormycosisinatertiarycarehospitalinthewesternregionofsaudiarabia11yearretrospectivechartreviewfrom2009to2019 |