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Widespread Lichtheimia Infection in a Patient with Extensive Burns: Opportunities for Novel Antifungal Agents

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Abstract

The Mucorales fungi—formerly classified as the zygomycetes—are environmentally ubiquitous fungi, but generally rare causes of clinical infections. In the immunocompromised host, however, they can cause invasive, rapidly spreading infections that confer a high risk of morbidity and mortality, often despite surgical and antifungal therapy. Patients with extensive burn injuries are particularly susceptible to skin and soft-tissue infections with these organisms. Here, we present a case of Lichtheimia infection in a patient with extensive full-thickness burns that required significant and repeated surgical debridement successfully treated with isavuconazole and adjunctive topical amphotericin B washes. We also review the available literature on contemporary antifungal treatment for Lichtheimia species and related Mucorales fungi.

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Author notes

  1. Beth K. Thielen and Aaron M. T. Barnes have contributed equally to this work.

Authors and Affiliations

  1. Department of Medicine (Division of Infectious Diseases and International Medicine), University of Minnesota School of Medicine, Minneapolis, MN, 55455, USA

    Beth K. Thielen, Arick P. Sabin & Glen T. Hansen

  2. Department of Pediatrics (Division of Pediatric Infectious Diseases and Immunology), University of Minnesota School of Medicine, Minneapolis, MN, 55455, USA

    Beth K. Thielen

  3. Department of Laboratory Medicine and Pathology, University of Minnesota School of Medicine, Minneapolis, MN, 55455, USA

    Aaron M. T. Barnes & Glen T. Hansen

  4. Department of Microbiology & Immunology, University of Minnesota School of Medicine, Minneapolis, MN, 55455, USA

    Aaron M. T. Barnes

  5. Department of Pathology & Laboratory Medicine, Hennepin County Medical Center, Minneapolis, MN, 55415, USA

    Becky Huebner, Susan Nelson, Elizabeth Wesenberg & Glen T. Hansen

Authors
  1. Beth K. Thielen
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Correspondence to Beth K. Thielen.

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Handling Editor: Nancy Wengenack.

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Thielen, B.K., Barnes, A.M.T., Sabin, A.P. et al. Widespread Lichtheimia Infection in a Patient with Extensive Burns: Opportunities for Novel Antifungal Agents. Mycopathologia 184, 121–128 (2019). https://doi.org/10.1007/s11046-018-0281-6

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  • DOI: https://doi.org/10.1007/s11046-018-0281-6

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