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Title: Global guideline for the diagnosis and management of mucormycosis: an initiative of the European Confederation of Medical Mycology in cooperation with the Mycoses Study Group Education and Research Consortium
Authors: Oliver A. Cornely
Ana Alastruey-Izquierdo
Dorothee Arenz
Sharon C.A. Chen
Eric Dannaoui
Bruno Hochhegger
Martin Hoenigl
Henrik E. Jensen
Katrien Lagrou
Russell E. Lewis
Sibylle C. Mellinghoff
Mervyn Mer
Zoi D. Pana
Danila Seidel
Donald C. Sheppard
Roger Wahba
Murat Akova
Alexandre Alanio
Abdullah M.S. Al-Hatmi
Sevtap Arikan-Akdagli
Hamid Badali
Ronen Ben-Ami
Alexandro Bonifaz
Stéphane Bretagne
Elio Castagnola
Methee Chayakulkeeree
Arnaldo L. Colombo
Dora E. Corzo-León
Lubos Drgona
Andreas H. Groll
Jesus Guinea
Claus Peter Heussel
Ashraf S. Ibrahim
Souha S. Kanj
Nikolay Klimko
Michaela Lackner
Frederic Lamoth
Fanny Lanternier
Cornelia Lass-Floerl
Dong Gun Lee
Thomas Lehrnbecher
Badre E. Lmimouni
Mihai Mares
Georg Maschmeyer
Jacques F. Meis
Joseph Meletiadis
C. Orla Morrissey
Marcio Nucci
Rita Oladele
Livio Pagano
Alessandro Pasqualotto
Atul Patel
Zdenek Racil
Malcolm Richardson
Emmanuel Roilides
Markus Ruhnke
Seyedmojtaba Seyedmousavi
Neeraj Sidharthan
Nina Singh
János Sinko
Anna Skiada
Monica Slavin
Rajeev Soman
Brad Spellberg
William Steinbach
Ban Hock Tan
Andrew J. Ullmann
Jörg J. Vehreschild
Maria J.G.T. Vehreschild
Thomas J. Walsh
P. Lewis White
Nathan P. Wiederhold
Theoklis Zaoutis
Arunaloke Chakrabarti
Manchester University NHS Foundation Trust
Duke University Medical Center
Public Health Wales
Universidade Federal de Ciencias da Saúde de Porto Alegre
Fondazione Policlinico Universitario Agostino Gemelli IRCCS Università Cattolica del Sacro Cuore
Ministry of Health Oman
American University of Beirut Medical Center
Szent Laszlo Hospital
Hospital General Universitario Gregorio Marañon
Cancer Research Institute of Slovak Academy of Sciences
Peter Maccallum Cancer Centre
Universitätsklinikum Würzburg
Erasmus MC
KU Leuven– University Hospital Leuven
Hopital Europeen Georges-Pompidou
Københavns Universitet
University of California, San Diego
The Children's Hospital of Philadelphia
University of Southern California
Universite Paris Descartes
National and Kapodistrian University of Athens
Nijmegen Interdenominational Hospital Canisius-Wilhelmina
Alma Mater Studiorum Università di Bologna
Universidad Complutense de Madrid
University of Melbourne
Centro Nacional de Microbiologia
The University of Sydney
Université Paris-Sud
University of Cologne
University of Lagos College of Medicine
Centre Hospitalier Universitaire Vaudois
P.D. Hinduja National Hospital and Medical Research Centre
Monash University
Mohammed V University in Rabat
University of Texas Health Science Center at San Antonio
New York Presbyterian Hospital
Singapore General Hospital
North-Western State Medical University named after I.I. Mechnikov
Mazandaran University of Medical Sciences
Klinikum Ernst von Bergmann
National Institute of Allergy and Infectious Diseases
University of Witwatersrand
Harbor-UCLA Medical Center
IRCCS Istituto Giannina Gaslini - Ospedale Pediatrico
University of Aberdeen
Pontificia Universidade Catolica do Rio Grande do Sul
Hospital General de Mexico
Aristotle University of Thessaloniki
Universidade Federal de Sao Paulo
University of Pittsburgh Medical Center
Hacettepe University, Faculty of Medicine
Faculty of Medicine, Siriraj Hospital, Mahidol University
Tel Aviv Sourasky Medical Center
Uniklinik Köln
Medizinische Universitat Innsbruck
Amrita Institute of Medical Sciences India
Goethe-Universität Frankfurt am Main
Universitätsklinikum Münster
Medizinische Universität Graz
Tel Aviv University, Sackler Faculty of Medicine
University of Manchester
Hippokration General Hospital
Hospital General "Dr. Manuel Gea González"
Universitätsklinikum Heidelberg
The Catholic University of Korea
McGill University
Institute of Hematology and Blood Transfusion
Postgraduate Institute of Medical Education & Research, Chandigarh
Universidade Federal do Rio de Janeiro
Center of Expertise in Microbiology
Westerdijk Fungal Biodiversity Institute
German Center for Infection Research (DZIF), Partner Site Bonn-Cologne
Ion Ionescu de la Brad University
Vedanta Institute of Medical Sciences
Keywords: Medicine
Issue Date: 1-Dec-2019
Citation: The Lancet Infectious Diseases. Vol.19, No.12 (2019), e405-e421
Abstract: © 2019 Elsevier Ltd Mucormycosis is a difficult to diagnose rare disease with high morbidity and mortality. Diagnosis is often delayed, and disease tends to progress rapidly. Urgent surgical and medical intervention is lifesaving. Guidance on the complex multidisciplinary management has potential to improve prognosis, but approaches differ between health-care settings. From January, 2018, authors from 33 countries in all United Nations regions analysed the published evidence on mucormycosis management and provided consensus recommendations addressing differences between the regions of the world as part of the “One World One Guideline” initiative of the European Confederation of Medical Mycology (ECMM). Diagnostic management does not differ greatly between world regions. Upon suspicion of mucormycosis appropriate imaging is strongly recommended to document extent of disease and is followed by strongly recommended surgical intervention. First-line treatment with high-dose liposomal amphotericin B is strongly recommended, while intravenous isavuconazole and intravenous or delayed release tablet posaconazole are recommended with moderate strength. Both triazoles are strongly recommended salvage treatments. Amphotericin B deoxycholate is recommended against, because of substantial toxicity, but may be the only option in resource limited settings. Management of mucormycosis depends on recognising disease patterns and on early diagnosis. Limited availability of contemporary treatments burdens patients in low and middle income settings. Areas of uncertainty were identified and future research directions specified.
ISSN: 14744457
Appears in Collections:Scopus 2019

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