1/19. Rhinocerebral mucormycosis in a patient with cirrhosis and chronic renal failure.mucormycosis is an opportunistic fungal infection caused by mucorales. The disease is uncommon and produces serious and rapidly fatal infection in diabetic or immunocompromised patients. The classical presentation of rhinocerebral mucormycosis is involvement of nasal mucosa with invasion of paranasal sinuses and orbit. early diagnosis is based on (direct) histological examination and computed tomography scan. Unfortunately the clinical signs and symptoms do not occur in all cases. A high index of suspicion is needed not only in typical groups of immunocompromised patients or diabetics, but also in patients with serious chronic diseases. We report a patient who was not diabetic, but she had a history of cirrhosis and well compensated renal failure.- - - - - - - - - - ranking = 1keywords = mucormycosis (Clic here for more details about this article) |
2/19. Combined mucormycosis and aspergillosis of the rhinocerebral region.BACKGROUND: Opportunistic fungal infections are rare, life-threatening conditions and are a major cause of morbidity and mortality in immunocompromised hosts. Our experience in the management of a case of combined mucormycosis and aspergillosis of the rhinocerebral region is presented. patients AND methods: The infection developed a few weeks after tooth extraction, massively involving facial structures. After diagnosis, the patient underwent prolonged combined systemic antifungal treatment. Once the local and general conditions had stabilized, an extensive surgical debridement was performed, followed by reconstruction with a pedicled myocutaneous flap. RESULTS: This approach was curative with patient survival after 16 months. Conclusion: early diagnosis, early anti-fungal treatment and early stabilization of the patients' general condition are fundamental for patient survival. Surgery is necessary for fungal eradication, but must be performed according to the above conditions. Pedicled muscle flaps are considered the first reconstruction choice because of their excellent blood perfusion and resistance to fungal invasion.- - - - - - - - - - ranking = 1keywords = mucormycosis (Clic here for more details about this article) |
3/19. brain abscess by mycotic and bacterial infection in a diabetic patient: clinical report and review of literature.This report presents a case of lethal invasive mucormycosis, a rare fungal infection, which predominantly affects immunocompromised patients, and is reported in a 57-year-old female who presented with cerebral abscess. The patient, who had undiagnosed diabetes mellitus, presented with extensive right hemifacial deficiency of the bones and soft tissues consequent to surgical resection of the ethmoid-spheno-maxillo-orbital district after mucormycosis. A reconstruction with a pectoral pedunculated flap was performed. The maxillary swelling extended to the contiguous area, involving the palate and homolateral orbital floor. Mucous and cutaneous samples showed the presence of aspergillus fumigatus, and diagnosis of rhinocerebral mucormycosis was made. The patients also presented with a right hemiplegia consequent to a cerebral abscess by eikenella corrodens. The authors decided to position an intraoral prosthesis to restore palatal integrity and masticatory function and inserted four titanium fixtures for the retention of the bone-anchored facial prosthesis.- - - - - - - - - - ranking = 0.6keywords = mucormycosis (Clic here for more details about this article) |
4/19. Successful management of cerebral and pulmonary mucormycosis with liposomal amphotericin b in a 28-year-old woman with acute lymphoblastic leukemia.A 28-year-old woman with acute lymphoblastic leukemia developed fever and unilateral pleural based pulmonary infiltrate during prolonged chemotherapy induced neutropenia. CT-guided lung biopsy confirmed the diagnosis of pulmonary mucormycosis and liposomal amphotericin b therapy was started. A few days after the initial symptoms, the patient developed convulsions and a brain abscess was detected in computerized tomography and magnetic resonance imaging. Fungal hyphae detected in histopathological examination of a brain biopsy had identical morphology with those seen in previous lung biopsies. The patient was treated with liposomal amphotericin b for five months and cytotoxic chemotherapy was successfully completed during antifungal therapy. Pulmonary infiltrates and the brain abscess resolved and the patient received an allogeneic bone marrow transplantation from a matched, unrelated donor. Antifungal therapy was continued for one additional month after bone marrow transplantation to prevent a relapse of invasive mucormycosis. Follow-up of the patient revealed no signs of relapse of invasive mucormycosis but two months after successful bone marrow transplantation the patient developed lethal cytomegalovirus pneumonitis which was confirmed by autopsy. No signs of mucormycosis were detected at post-mortem.- - - - - - - - - - ranking = 1.6keywords = mucormycosis (Clic here for more details about this article) |
5/19. Rhinocerebral mucormycosis: use of liposomal amphotericin b.Rhinocerebral mucormycosis is a rare but often fatal condition characterized by an aggressive necrotizing infection spreading from the nose to the paranasal sinuses, orbit and hence to the central nervous system. A case is reported in which a diabetic male with advanced mucormycosis was successfully treated by a combination of surgery, supportive therapy and liposomal amphotericin b. Liposomal delivery allows the drug to be both less toxic and more effective, and this is the first reported case of its use in rhinocerebral mucormycosis.- - - - - - - - - - ranking = 1.4keywords = mucormycosis (Clic here for more details about this article) |
6/19. Fungal brain abscesses (aspergillosis/mucormycosis) in two immunosuppressed patients.Although the mortality rate for fungal brain abscesses in immunosuppressed patients remains unacceptably high, this figure may be reduced if computed tomography or magnetic resonance imaging scans are performed more promptly in susceptible individuals with seemingly mild intracranial complaints. Earlier presumptive amphotericin b treatment and more timely surgical debridement may minimize neurological injury and enhance survival. These assumptions were only tentatively supported by the clinical courses of two patients, one an alert patient with promyelocytic leukemia and an aspergillosis brain abscess who survived, and the other, a comatose intravenous drug abuser with mucormycosis who died.- - - - - - - - - - ranking = 1keywords = mucormycosis (Clic here for more details about this article) |
7/19. Multiple brain abscesses from isolated cerebral mucormycosis.A report is presented of a patient with cerebral mucormycosis without rhinosinusal or systemic evidence of the disease. The predisposing condition was drug-induced immunosuppression. Computed tomography (CT) showed focal areas of abnormal enhancement which correlated with necropsy findings of localised parenchymal brain damage; this represented encapsulated brain abscesses, a rare form of presentation of cerebral mucormycosis.- - - - - - - - - - ranking = 1.2keywords = mucormycosis (Clic here for more details about this article) |
8/19. Parkinsonism secondary to bilateral striatal fungal abscesses.A 24-year-old man with an 11-year history of i.v. drug use rapidly developed parkinsonism clinically indistinguishable from MPTP toxicity and Parkinson's disease. Although tests were negative for the human immunodeficiency virus, radiologic evaluation revealed bilateral striatal lesions. Stereotactic biopsy demonstrated septate hyphae consistent with either aspergillosis or mucormycosis. Gradual improvement followed systemic therapy with amphotericin b.- - - - - - - - - - ranking = 0.2keywords = mucormycosis (Clic here for more details about this article) |
9/19. Rhinocerebral mucormycosis with cerebral extension successfully treated with adjunctive hyperbaric oxygen therapy.Rhinocerebral mucormycosis is a devastating fungal disease with a high mortality rate. Extensive surgical debridement and amphotericin b are currently the mainstays of therapy. When cerebral extension of the fungus occurs, the disease is almost invariably fatal. Two patients with rhinocerebral mucormycosis had progression of their infection to brain abscesses despite aggressive debridement surgery and amphotericin b therapy. Both patients showed marked clinical improvement with the addition of adjunctive hyperbaric oxygen therapy. Both patients remained free of their disease 21 months after hospital discharge.- - - - - - - - - - ranking = 1.2keywords = mucormycosis (Clic here for more details about this article) |
10/19. brain stem mucormycosis in a narcotic addict with eventual recovery.In addition to the well-known infectious complications of intravenous narcotic abuse, a much rarer and more recently recognized association between intravenous narcotic addiction and mucormycotic abscesses of the central nervous system has been described. Only four cases have been cited in the literature, with a mortality rate of 100 percent in this group. This report describes a narcotic abuser who presented with obstructive hydrocephalus and a mucormycotic abscess of the brain stem, and recovered. central nervous system mucormycosis should be included in the differential diagnosis of drug abusers who present with a rapid deterioration in neurologic status.- - - - - - - - - - ranking = 1keywords = mucormycosis (Clic here for more details about this article) |
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