Evaluating cardiac disorders associated with triazole antifungal agents based on the US Food and Drug Administration Adverse Event reporting system database

Frontiers in Pharmacology, Год журнала: 2024, Номер 15

Опубликована: Март 20, 2024

Introduction Triazole antifungal agents are widely used to treat and prevent systemic mycoses. With wide clinical use, the number of reported adverse events has gradually increased. The aim this study was analyze cardiac disorders associated with TAAs (fluconazole, voriconazole, itraconazole, posaconazole isavuconazole) based on data from US Food Drug Administration Adverse Event Reporting System FDA System. Methods Data were extracted FAERS database between first quarter 2004 third 2022. characteristics in TAA-associated AE reports analyzed. Disproportionality analysis performed evaluate potential association AEs using reporting odds ratio (ROR) proportional (PRR). Results Among 10,178,522 reports, 1719 as primary suspect drug. Most related fluconazole (38.34%), voriconazole (28.56%) itraconazole (26.76%). Itraconazole (N = 195, 42.39%) isavuconazole 2, 14.29%) had fewer serious outcome than three other drugs including fluconazole, posaconazole. 13, 11, 26, 5 1 signals detected for isavuconazole, respectively. new unrecorded drug label 9, 2 0 Conclusion Isavuconazole might be safest five AEs. may result outcomes. Therefore, addition label, we should pay attention during use TAAs.

Язык: Английский

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Isolated tracheal mucormycosis in diabetes mellitus and bronchoscopic management

Lung India, Год журнала: 2024, Номер 41(3), С. 226 - 227

Опубликована: Апрель 30, 2024

Dear Editor, We read the interesting case report on airway mucormycosis by Kaliya et al.[1] and accompanying literature review. Isolated tracheal or is indeed an uncommon entity. However, several cases,[2] including a recent systematic review topic, have been missed.[3] Thus, search strategy employed authors unclear. While discuss surgery anti-fungal therapy in managing isolated tracheobronchial (ITBM), bronchoscopic management was not highlighted. Notably, nearly 30% of subjects with ITBM may require therapeutic bronchoscopy.[3] illustrate role bronchoscopy describing critical central obstruction due to requiring stenting. A 49-year-old man presented fever, productive cough, noisy breathing developing over 10 days. He denied haemoptysis, facial swelling, trauma. There no hospitalization endotracheal intubation. had history smoking substance abuse. The physical examination unremarkable except for stridor at rest. poorly controlled diabetes, glycated haemoglobin 10.9% admission. Complete blood count, renal, liver function tests were normal. Computed tomography thorax [Figure 1] showed polypoidal enhancing soft tissue lesion arising from lateral wall along endoluminal component. patient's worsened, he required Bronchoscopy fleshy yellowish-grey material lower end trachea, extending 1 cm above carina 2a]. distal tree performed rigid under general anaesthesia, fleshy, unhealthy removed difficulty using forceps [Supplemental Video electrocautery snare. Once blackish necrotic content cleared underlying trachea appeared unhealthy, we deployed covered self-expanding metallic Y-stent 2b]. histopathology biopsy specimens revealed invasive 3]. Culture grew Rhizopus arrhizus. symptomatic relief after procedure successfully liberated ventilator 24 hours. After initial intravenous liposomal amphotericin B (5 mg/kg/day 12 days), maintenance posaconazole continued 2 months. stent removed, patient doing well year follow-up.Figure 1: Contrast-enhanced computed images showing (mediastinal window, a) right exophytic components. Air focus interspersed narrowing lumen are also noted. Lung window sections (b) show same finding (white arrows) small subpleural nodule upper lobe (black arrow)Figure 2: showing: a. arrowhead demonstrates wall, b shows carina, bilateral main bronchi deployment Y-stentFigure 3: Photomicrograph endobronchial bland necrosis fungal hyphae; b. High power broad aseptate angle branching hyphae conforming morphology mucor {"href":"Single Player","role":"media-player-id","content-type":"play-in-place","position":"float","orientation":"portrait","label":"Video 1","caption":"","object-id":[{"pub-id-type":"doi","id":""},{"pub-id-type":"other","content-type":"media-stream-id","id":"1_j166g66q"},{"pub-id-type":"other","content-type":"media-source","id":"Kaltura"}]} Critical relatively challenging diagnose, high index suspicion. In case, tumour suspected presentation radiology; however, did tumour. Instead, seen, suggesting possible non-malignant aetiology obstruction.[4] immuno-compromised subjects, aspergillosis can similar clinical presentation. Surgery pulmonary associated improved survival.[5,6] patients requires bronchoscopy, as case. Therapeutic mechanical debulking, cryotherapy, argon plasma coagulation, Nd: YAG LASER, snaring, extraction mucus plugs, has relieve luminal improve outcomes.[7-14] respiratory compromise, adjunctive therapies like inhaled instillation be considered.[15] Financial support sponsorship Nil. Conflicts interest conflicts interest.

Язык: Английский

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Clinical characteristics, outcome, and factors associated with mortality of pulmonary mucormycosis: a retrospective single-center study from Pakistan

Therapeutic Advances in Infectious Disease, Год журнала: 2024, Номер 11

Опубликована: Янв. 1, 2024

Introduction and objective: Pulmonary mucormycosis is a rare but rapidly progressive fatal disease. Limited data exist on the outcomes factors associated with poor prognosis of pulmonary mucormycosis. The objective this study was to evaluate clinical characteristics, mortality, at tertiary care hospital in Pakistan. Methods: This retrospective observational conducted Karachi, Medical records hospitalized patients diagnosed proven or probable between January 2018 December 2022 were reviewed. Univariate regression analyses performed identify mortality. Results: Fifty-three (69.8% male) included, mean age 51.19 ± 21.65 years. Diabetes mellitus most common comorbidity [ n = 26 (49.1%)]. Chronic lung diseases present 5 (9.4%)], 16 (30.2%)] had concurrent coronavirus disease 2019 (COVID-19) pneumonia. predominant isolated Mucorales Rhizopus 32 (60.3%)] Mucor species 9 (17%)]. Main radiological findings included consolidation 39 (73.6%)] nodules 14 (26.4%)]. Amphotericin B deoxycholate prescribed 38 (71.7%)], (26.4%)] received combined medical surgical treatment. median [interquartile range (IQR)] stay 15.0 (10.0–21.5) days. Intensive unit (ICU) required 30 (56.6%)] patients, (49.1%) needing mechanical ventilation. Overall mortality seen 29 (54.7%) patients. Significantly higher found among requiring ventilation 20/29 (69%, p 0.002). Immunosuppression ( 0.042), thrombocytopenia 0.004), 0.018) identified as risk for multivariable analysis. Conclusion: provides essential insights into outcomes, rate high (54.7%), particularly immunosuppression, thrombocytopenia, those who

Язык: Английский

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From Spores to Solutions: A Comprehensive Narrative Review on Mucormycosis

Diagnostics, Год журнала: 2024, Номер 14(3), С. 314 - 314

Опубликована: Янв. 31, 2024

Mucormycosis is an infrequent but fatal illness that mainly affects patients with uncontrolled diabetes mellitus, diabetic ketoacidosis, solid and hematologic neoplasms, organ transplantation, chronic steroid intake, prolonged neutropenia, iron overload states, neonatal prematurity, severe malnutrition, HIV. Many cases were reported across the world recently following COVID-19 pandemic. Recent research has led to a better understanding of pathogenesis disease, global guidelines are now available for managing this serious infection. Herein, we comprehensively review etiological agents, pathogenesis, clinical presentations, diagnosis, management mucormycosis.

Язык: Английский

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Prevalence of co‐existent COVID‐19‐associated pulmonary aspergillosis (CAPA) and its impact on early mortality in patients with COVID‐19‐associated pulmonary mucormycosis (CAPM)

Mycoses, Год журнала: 2024, Номер 67(5)

Опубликована: Май 1, 2024

Abstract Background Data on mixed mould infection with COVID‐19‐associated pulmonary aspergillosis (CAPA) and mucormycosis (CAPM) are sparse. Objectives To ascertain the prevalence of co‐existent CAPA in CAPM (mixed infection) whether is associated early mortality (≤7 days diagnosis). Methods We retrospectively analysed data collected from 25 centres across India mucormycosis. included only excluded subjects disseminated or rhino‐orbital defined if a respiratory specimen showed septate hyphae smear, histopathology culture grew Aspergillus spp. also compare demography, predisposing factors, severity COVID‐19, management patients without CAPA. Using case–control design, we assess (primary exposure) were CAPM. Results 105 The was 20% (21/105). Patients experienced (9/21 [42.9%] vs. 15/84 [17.9%]; p = 0.02) poorer survival at 6 weeks (7/21 [33.3] 46/77 [59.7%]; 0.03) than alone. On imaging, consolidation more commonly encountered infections Co‐existent (odds ratio [95% confidence interval], 19.1 [2.62–139.1]) independently after adjusting for hypoxemia during COVID‐19 other factors. Conclusion Coinfection not uncommon our portends worse prognosis. Prospective studies different countries required to know impact infection.

Язык: Английский

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Longitudinal Epidemiology of Mucormycosis Within the Veterans Health Administration: A Retrospective Cohort Study Over a 20‐Year Period

Mycoses, Год журнала: 2024, Номер 67(9)

Опубликована: Сен. 1, 2024

ABSTRACT Background Mucormycosis is a rare but critical infection. Due to its rarity, there scarce evidence about the longitudinal changes in epidemiology of mucormycosis US. Objectives We investigated epidemiology, detailed clinical characteristics, treatment and outcomes patients with within US Veterans Health Administration (VHA) over 20‐year period. Patients/Methods All adult who were admitted an acute‐care hospital diagnosis VHA from January 2003 December 2022. Results Our study included 201 68 hospitals. Incidence rates increased 1.9 per 100,000 hospitalisations 3.3 2022, peak incidence at 5.9 2021, when Delta wave COVID‐19 hit Rhino‐orbital (37.3%) pulmonary (36.8%) most common types Diabetes mellitus (59.1%) leukaemia (28.9%) comorbidities predisposing mucormycosis. Use posaconazole or isavuconazole time. The 90‐day 1‐year mortalities 35.3% 49.8%, respectively. mortality was lower more recent years (2013–2017, 2018–2022) compared earlier (2003–2007). Age ≥65 (adjusted odds ratio [aOR]: 3.47, 95% CI 1.59–7.40), as comorbidity (aOR: 2.66, 1.22–5.89) central nervous system infection 10.59, 2.81–44.57) significantly associated higher mortality. Conclusions cohort suggests increasing this

Язык: Английский

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Predicting COVID 19–Associated Pulmonary Aspergillosis Risk in Low- and Middle-Income Countries: A Matched Case-Control Study

Open Forum Infectious Diseases, Год журнала: 2024, Номер 11(7)

Опубликована: Июнь 28, 2024

Abstract Background Coronavirus disease 2019 (COVID-19)–associated pulmonary aspergillosis (CAPA) is a life-threatening fungal infection. Studies focusing on CAPA in low- and middle-income countries are limited. Methods This retrospective matched case-control study was conducted at tertiary care center South India. Cases of were classified using the 2020 European Confederation Medical Mycology/International Society for Human Animal Mycology consensus criteria. A total 95 cases 1:1 with COVID-19 patients without CAPA. Matching done based age period admission. Inverse probability weighting used to account imbalances severity intensive unit (ICU) Data demographics, clinical details, microbiologic radiologic data, treatment outcomes collected. predictive score developed from baseline risk factors. Results The identified lymphopenia, Organisation Research Treatment Cancer factors, broad-spectrum antibiotic use as main factors Positivity bacterial pathogens blood or bronchoalveolar lavage samples reduced model performed well cross-validation, an area under curve value 82%. diagnosis significantly increased mortality shift ICU. Conclusions derived current offers valuable tool clinicians, especially high-endemic countries, early identification With further validation, this could improve patient outcomes.

Язык: Английский

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Epidemiological Trends of Mucormycosis in Europe, Comparison with Other Continents

Mycopathologia, Год журнала: 2024, Номер 189(6)

Опубликована: Ноя. 20, 2024

Язык: Английский

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Profile of Nonresolving Pneumonia in a Tertiary Care Center in South India: A Prospective Study

Indian Journal of Respiratory Care, Год журнала: 2024, Номер 13(3), С. 163 - 171

Опубликована: Сен. 30, 2024

Язык: Английский

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Bacterial co-infections in mucormycosis in severely ill populations: an overlooked and complex challenge

Access Microbiology, Год журнала: 2024, Номер 6(11)

Опубликована: Ноя. 1, 2024

Mucormycosis is found in co-infection with bacteria >50% of the cases. Most these cases were reported among people haematological diseases. The two most frequent Pseudomonas aeruginosa and Klebsiella pneumoniae . Almost 40% identified as multidrug resistant.

Язык: Английский

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