1/5. Paranasal sinus mucormycosis: a report of two cases.mucormycosis of the nose and paranasal sinuses is a rare invasive fungal infection, which often has a very fulminant course and characteristic clinical findings. The patients are usually immunocompromised, with diabetic ketoacidosis being the commonest underlying disorder. In some immunocompetent patients, the disease is associated with local predisposing factors, such as chronic sinusitis. Although the prognosis has improved in recent decades, the disease can still be fatal. The underlying disease is an important determinant of prognosis and correction of the metabolic disorder, if present, is essential. Herein we report two cases: one of our patients was immunocompetent but had earlier suffered from polypous rhinosinusitis whereas the other had mild adult-type diabetes. Both patients were successfully treated with surgical debridement and amphotericin b.- - - - - - - - - - ranking = 1keywords = mucormycosis (Clic here for more details about this article) |
2/5. Rhinocerebral mucormycosis: pathways of spread.Rhinocerebral mucormycosis is an invasive, opportunistic fungal infection usually seen in immunocompromised patients, and particularly in the setting of diabetes or immune deficiency. It is assumed that the port of entry is colonization of the nasal mucosa, allowing the fungus to spread via the paranasal sinuses into the orbit. Involvement of the brain and cavernous sinus occurs by way of the orbital apex; therefore, spheno-ethmoidectomy with or without maxillectomy seems to be the definitive method to eradicate this infection. We conducted a prospective study of ten patients with rhinocerebral mucormycosis from February 2000 to April 2004. Rhinocerebral mucormycosis was clinically diagnosed in 11 patients, 10 of whom were included in our study upon histopathological confirmation. Diabetes was the most common underlying disorder seen in nine out of ten patients. In this study, the patients were assessed for predisposing factors, presenting signs and symptoms, sites of extension, the number and sites of surgical debridement, as well as the outcome. Ocular, sinonasal and facial soft tissue involvement was common. Involvement of the pterygopalatine fossa at the time of debridement was evident in all patients. No invasion through the lamina papiracea or the walls of the maxillary sinus was identified. At the time of this communication, six out of ten patients were alive. For the four who died, the causes were hypokalemia, cardiac arrythmia and refractory pneumonia. pterygopalatine fossa is considered to be the main reservoir for rhinocerebral mucormycosis, and extension into the orbit and facial soft tissues usually follows this route. After proliferation in the nasal cavity, the mucor reaches the pterygo-palatine fossa, inferior orbital fissure and finally the retroglobal space of the orbit, resulting in ocular signs. The facial soft tissues, palate and infratemporal fossa can be infected through connecting pathways from the pterygo-palatine fossa; therefore, debridement of the pterygopalatine fossa seems to be the definitive method of managing this infection.- - - - - - - - - - ranking = 2keywords = mucormycosis (Clic here for more details about this article) |
3/5. mucormycosis in an immunocompetent patient: follow-up of 1 year after treatment.mucormycosis is a rare acute fatal fungal infection. It is typically observed in diabetic or immunocompromised patients but not in systemically healthy individuals. Here, we describe an unusual mucormycosis case in an immunocompetent patient who had clinical signs of a maxillary sinusitis and associated osteomyelitis at the first examination. He was treated by surgery and removal of the necrotic bone and amphotericin b medication. At 1-year follow-up he shows complete recovery.- - - - - - - - - - ranking = 0.25keywords = mucormycosis (Clic here for more details about this article) |
4/5. mucormycosis in an apparently normal host. Case study and literature review.mucormycosis refers to an opportunistic fungal infection most often related to predisposing conditions, especially uncontrolled diabetes. It can occur as a rapidly extending rhinocerebral infection presenting a high mortality rate. The same micro-organism has, however, been identified in benign paranasal infections in the absence of a general debilitating condition, suggesting that host factors are of the utmost importance in the outcome of paranasal mucormycosis.- - - - - - - - - - ranking = 0.25keywords = mucormycosis (Clic here for more details about this article) |
5/5. Rhinocerebral mucormycosis and internal carotid artery thrombosis in a previously healthy patient.mucormycosis is a very serious fungal infection caused by habitual saprophytes of the human organism, in many cases concomitant with various pathological conditions marked by immunodepression. The rhinocerebral variant habitually accompanies ketoacidotic diabetes. We report a case of rhinocerebral mucormycosis in a subject free from immunodepression and non-diabetic, in apparently normal health. Following treatment with amphotericin b combined with 5-fluorocytosine and surgery, remission of the disease was finally secured and about one year after the last operation there are no sign of resumption.- - - - - - - - - - ranking = 1.25keywords = mucormycosis (Clic here for more details about this article) |