{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,24]],"date-time":"2025-10-24T13:12:57Z","timestamp":1761311577247,"version":"3.40.5"},"reference-count":16,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2020,1,20]],"date-time":"2020-01-20T00:00:00Z","timestamp":1579478400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Mycoses"],"published-print":{"date-parts":[[2020,4]]},"abstract":"<jats:title>Summary<\/jats:title><jats:sec><jats:title>Objectives<\/jats:title><jats:p>Mucormycosis is a difficult\u2010to\u2010diagnose life\u2010threatening disease with high morbidity and mortality. Adherence to guidelines that lead through complex management and support clinical decisions is however rarely reported. By applying the EQUAL Score, our study evaluates the management of mucormycosis at the University Hospital of Cologne, Germany.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We performed a retrospective chart review of patients with mucormycosis at the University Hospital of Cologne. Data collection comprised items for quality assessment in mucormycosis management according to the EQUAL Mucormycosis Score and economics.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of 29 patients identified, 27 were documented retrospectively. Eight patients of 18 with neutropenia (&gt;10\u00a0days) or receiving allogeneic stem cell transplantation (44.4%) received mould active prophylaxis. Chest CT was done in 21 patients (77.8%), while BAL and direct microscopy of BAL fluid was performed in 22 patients (81.5%), culture in 22 (81.5%) and fungal PCR in 24 (88.9%). First\u2010line treatment was liposomal amphotericin B in 19 patients (70.4%). Isavuconazole or posaconazole with therapeutic drug monitoring was used in four (14.8%) and in one patient (3.7%), respectively. In our cohort, crude mortality was 51.9% (n\u00a0=\u00a014) with a median survival time of 113\u00a0days. During the management of the 27 patients, 450 points (53.8%) of the maximum EQUAL Mucormycosis Score were achieved (median 15 points, range 6\u201030).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>We observed management of mucormycosis aligning with current guidelines and hope to encourage other groups to use the EQUAL Score in routine clinical settings. Future studies will evaluate whether guideline adherence in mucormycosis management improves patient outcome.<\/jats:p><\/jats:sec>","DOI":"10.1111\/myc.13047","type":"journal-article","created":{"date-parts":[[2019,12,26]],"date-time":"2019-12-26T13:15:28Z","timestamp":1577366128000},"page":"343-351","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":15,"title":["Quantifying guideline adherence in mucormycosis management using the EQUAL score"],"prefix":"10.1111","volume":"63","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7386-7495","authenticated-orcid":false,"given":"Philipp","family":"Koehler","sequence":"first","affiliation":[{"name":"University of Cologne, Faculty of Medicine and University Hospital Cologne, Department I of Internal Medicine Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf Cologne Germany"},{"name":"University of Cologne Cologne Excellence Cluster on Cellular Stress Responses in Aging\u2010Associated Diseases (CECAD) Cologne Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3928-2503","authenticated-orcid":false,"given":"Sibylle C.","family":"Mellinghoff","sequence":"additional","affiliation":[{"name":"University of Cologne, Faculty of Medicine and University Hospital Cologne, Department I of Internal Medicine Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf Cologne Germany"},{"name":"University of Cologne Cologne Excellence Cluster on Cellular Stress Responses in Aging\u2010Associated Diseases (CECAD) Cologne Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9152-2469","authenticated-orcid":false,"given":"Jannik","family":"Stemler","sequence":"additional","affiliation":[{"name":"University of Cologne, Faculty of Medicine and University Hospital Cologne, Department I of Internal Medicine Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf Cologne Germany"},{"name":"University of Cologne Cologne Excellence Cluster on Cellular Stress Responses in Aging\u2010Associated Diseases (CECAD) Cologne Germany"},{"name":"German Centre for Infection Research Partner Site Bonn\u2010Cologne Cologne Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Felix","family":"Otte","sequence":"additional","affiliation":[{"name":"University of Cologne Cologne Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ariana","family":"Berkhoff","sequence":"additional","affiliation":[{"name":"University of Cologne Cologne Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nedim","family":"Beste","sequence":"additional","affiliation":[{"name":"University of Cologne Cologne Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sofia","family":"Budin","sequence":"additional","affiliation":[{"name":"University of Cologne Cologne Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Florian B.","family":"Cornely","sequence":"additional","affiliation":[{"name":"University of Cologne Cologne Germany"},{"name":"Medical University of Varna Varna Bulgaria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Johanna M.","family":"Evans","sequence":"additional","affiliation":[{"name":"University of Cologne Cologne Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Frieder","family":"Fuchs","sequence":"additional","affiliation":[{"name":"Institute for Medical Microbiology, Immunology and Hygiene Faculty of Medicine and University Hospital Cologne University of Cologne Cologne Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Luca","family":"Pesch","sequence":"additional","affiliation":[{"name":"University of Cologne Cologne Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Arvid W.","family":"Rebholz","sequence":"additional","affiliation":[{"name":"University of Cologne Cologne Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Omer","family":"Reiner","sequence":"additional","affiliation":[{"name":"University of Cologne Cologne Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marius","family":"Schmitt","sequence":"additional","affiliation":[{"name":"University of Cologne Cologne Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Julien","family":"Schuckelt","sequence":"additional","affiliation":[{"name":"University of Cologne Cologne Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Arlene","family":"Spiertz","sequence":"additional","affiliation":[{"name":"University of Cologne Cologne Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6766-8297","authenticated-orcid":false,"given":"Jon","family":"Salmanton\u2010Garc\u00eda","sequence":"additional","affiliation":[{"name":"University of Cologne, Faculty of Medicine and University Hospital Cologne, Department I of Internal Medicine Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf Cologne Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Florian","family":"Kron","sequence":"additional","affiliation":[{"name":"University of Cologne, Faculty of Medicine and University Hospital Cologne, Department I of Internal Medicine Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf Cologne Germany"},{"name":"FOM University of Applied Sciences Essen Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9599-3137","authenticated-orcid":false,"given":"Oliver A.","family":"Cornely","sequence":"additional","affiliation":[{"name":"University of Cologne, Faculty of Medicine and University Hospital Cologne, Department I of Internal Medicine Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf Cologne Germany"},{"name":"University of Cologne Cologne Excellence Cluster on Cellular Stress Responses in Aging\u2010Associated Diseases (CECAD) Cologne Germany"},{"name":"German Centre for Infection Research Partner Site Bonn\u2010Cologne Cologne Germany"},{"name":"Clinical Trials Centre Cologne (ZKS K\u00f6ln) University of Cologne Cologne 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