TY  - CHAP
M1  - Book, Section
TI  - Antifungal Agents
A1  - Sheppard, Don
A1  - Lampiris, Harry W.
A2  - Katzung, Bertram G.
A2  - Trevor, Anthony J.
PY  - 2015
T2  - Basic & Clinical Pharmacology, 13e
AB  - CASE  STUDYA  55-year-old  man  presents  to  the  emergency  department  with  a  2-week  history  of  an  expanding  ulcer  on  his  left  lower  leg.  He  has  a  history  of  chronic  neutropenia  and  transfusion-dependent  anemia  secondary  to  myelodysplastic  syndrome  requiring  chronic  therapy  with  deferoxamine  for  hepatic  iron  overload.  He  first  noticed  a  red  bump  on  his  leg  while  fishing  at  his  cabin  in  the  woods  and  thought  it  was  a  bug  bite.  It  rapidly  enlarged,  first  as  a  red  swollen  area,  and  then  began  to  ulcerate.  He  was  given  dicloxacillin  orally,  but  with  no  improvement.  In  the  emergency  department  he  is  febrile  to  39°C  (102.2°F),  and  looks  unwell.  On  his  left  leg  he  has  a  6  by  12  cm  black  ulcer  with  surrounding  swelling  and  erythema  that  is  quite  tender.  His  complete  blood  count  demonstrates  an  absolute  neutrophil  count  of  300  and  a  total  white  blood  cell  count  of  1000.  An  immediate  operative  debridement  yields  pathologic  specimens  demonstrating  broad  club-like  nonseptate  hyphae  and  extensive  tissue  necrosis.  What  initial  medical  therapy  would  be  most  appropriate?  
SN  - 
PB  - McGraw-Hill Medical
CY  - New York, NY
Y2  - 2021/03/07
UR  - accessmedicine.mhmedical.com/content.aspx?aid=1104848888
ER  -