Methods: We performed a retrospective review of patients diagnosed with MC from 2013-2017 at University Medical Center of Southern Nevada in Las Vegas, Nevada. Data collected included patient demographics, comorbidities, and predisposing risk factors as well as treatment regimens. Patients were evaluated for outcome after treatment therapy with monotherapy (L-amphoPOSA or ISA) or combination therapy (L-ampho with ISA).
Results: From 2013 to 2017, 7 cases of MC were identified – 5 rhinocerebral (RC), 1 cutaneous (CT), and 1 pulmonary (PM). The most common risk factor was uncontrolled diabetes (5/7), followed by HIV (2/7) and non-Hodgkin lymphoma (1/7). 57% of patients received monotherapy and 43% received combination therapy (L-ampho/ISA). All the patients receiving combination therapy had RC. 71% of patients survived to discharge regardless of treatment regimen. 100% of combination therapy patients survived to discharge, whereas 50% of monotherapy patients survived to discharge. The 2 mortalities were patients with PM and CT MC.
Conclusion: MC is a rare infection with high mortality. For this reason, we are using ISA in combination with L-ampho as initial treatment to improve clinical outcomes. With our limited experience, combination therapy showed better rates of survival to discharge, without increasing adverse events. Our data suggests use of combination therapy may improve outcomes in MC, but a larger sample of patients treated with initial combination therapy is required to strengthen conclusions about patient outcomes.
K. D. Leuthner, None
S. Asad, None