Evidence map›Paper›PMID 29942755›Full record

ArticleIDCases2018

Fatal breakthrough mucormycosis in a multivisceral transplant patient receiving micafungin: Case report and literature review.

John R Louis-Auguste, Christianne Micallef, Tim Ambrose, Sara Upponi, Andrew J Butler, Dunecan Massey, Stephen J Middleton, Neil Russell, Charlotte S Rutter, Lisa M Sharkey and 3 more

Open access · goldAbstract readCase Reports
In one paragraph

Article in IDCases, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
1.0field-weighted citation impact, top 26% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed, 12 citations in OpenAlex.

  1. Article
  2. Review
  3. Review
  4. Annals of the Royal College of Surgeons of England · 2021
    Article
  5. Global Epidemiology of Mucormycosis.Journal of fungi (Basel, Switzerland) · 2019
    Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors at 3 institutions in 1 country.

John R Louis-AugusteDepartment of Gastroenterology, St George's University Hospitals NHS Foundation Trust, London, UK.
Christianne MicallefClinical Microbiology & Public Health Laboratory, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK.
Tim AmbroseDepartment of Gastroenterology, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK.
Sara UpponiDepartment of Radiology, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK.
Andrew J ButlerDepartment of Surgery, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK.
Dunecan MasseyDepartment of Gastroenterology, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK.
Stephen J MiddletonDepartment of Gastroenterology, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK.
Neil RussellDepartment of Surgery, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK.
Charlotte S RutterDepartment of Gastroenterology, University Hospital Southampton NHS Foundation Trust, Southampton, UK.
Lisa M SharkeyDepartment of Gastroenterology, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK.
Jeremy WoodwardDepartment of Gastroenterology, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK.
Effrossyni Gkrania-KlotsasDepartment of Infectious Diseases, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK.
David A EnochClinical Microbiology & Public Health Laboratory, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK.
Cambridge University Hospitals NHS Foundation Trust · GBSt George’s University Hospitals NHS Foundation Trust · GBUniversity Hospital Southampton NHS Foundation Trust · GB

Funding

Medical Research Council G0701652
6 · The paper itself

Abstract

Introduction: Antifungal agents are routinely used in the post-transplant setting for both prophylaxis and treatment of presumed and proven fungal infections. Micafungin is an echinocandin-class antifungal with broad antifungal cover and favorable side effect profile but, notably, it has no activity against molds of the order Mucorales. Presentation of case: A 47-year-old woman underwent multivisceral transplantation for intestinal failure-associated liver disease. She had a prolonged post-operative recovery complicated by invasive candidiasis and developed an intolerance to liposomal amphotericin B. In view of her immunosuppression, she was commenced on micafungin as prophylaxis to prevent invasive fungal infection. However, she developed acute graft versus host disease with bone marrow failure complicated by disseminated mucormycosis which was only diagnosed post mortem. Discussion: Non- Conclusion: A high level of suspicion of invasive fungal infection is required at all times in immunosuppressed patients, even those receiving antifungal prophylaxis. Early biopsy is required. Even with early recognition and aggressive treatment of these infections, prognosis is poor.

Indexed as

Antifungal therapybd, twice dailyCMV, cytomegalovirusCT, computed tomography scanFungal infectionGvHD, graft-versus-host diseaseImmunosuppressionL-AmB, liposomal amphotericin BMicafunginMIC, minimum inhibitory concentrationMucormycosisMultivisceral transplantationod, once dailyspp., species

Identifiers

PMID29942755
PMCPMC6010962
OpenAlexW2792027293

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.