1/56. mucormycosis, a threatening opportunistic mycotic infection.mucormycosis is a rare and invasive mycotic opportunistic infection, occurring mostly in predisposed patients, mainly diabetics and immunocompromised individuals. The evolution of this fungal infection is frequently fatal unless aggressive treatment is started, or predisposing factors are handled. Our first patient was a known diabetic who had ketoacidotic coma at admission, complicated with pulmonary mucormycosis, and needed surgical resection followed by antimycotic therapy. The second patient did not survive his severe aplastic anemia (with neutropenia) and hemochromatosis (treated with desferrioxamine), complicated with a systemic rhizopus infection, despite treatment with amphotericin b and granulocyte-colony-stimulating factors.- - - - - - - - - - ranking = 1keywords = mucormycosis (Clic here for more details about this article) |
2/56. mucormycosis of the central airways: CT findings in three patients.Computed tomographic (CT) findings are described in three diabetic patients with central airways mucormycosis. The CT findings of the tracheobronchial mucormycosis include enhancing areas of mural thickening (n = 3), luminal narrowing (n = 3), intramural air (n = 3), low-attenuation nonenhancing bronchial wall thickening (n = 2), and bronchonodal fistula formation (n = 1). These CT features in a diabetic patient should raise a high index of suspicion for tracheobronchial mucormycosis, particularly when typical radiographic features of pulmonary tuberculosis are absent.- - - - - - - - - - ranking = 3keywords = mucormycosis (Clic here for more details about this article) |
3/56. Combined anti-fungal therapy and surgical resection as treatment of pulmonary zygomycosis in allogeneic bone marrow transplantation.Opportunistic fungal infection is a rare but severe complication in allogeneic bone marrow transplant (BMT) recipients. We report a 49-year-old patient who developed pneumonitis after BMT, due to a mucorales fungus (class Zygomycetes), absidia corymbifera. Infections due to mucormycosis are likely to become increasingly recognized even though the occurrence after BMT has only been described sporadically. We postulate that the patient was contaminated before BMT despite no intensive drug treatment or other iatrogenic features, related to his poor living conditions and developed the infection during aplasia. He immediately received i.v. liposomal amphotericin b (AmBisome) and GM-CSF. Because there was no response, the infected area and necrotic tissue were resected. Despite initial clinical and biological improvement and the absence of Mucor on mycological examination post-surgery, the patient died 3 weeks later from bilateral pulmonary infection and multiorgan failure.- - - - - - - - - - ranking = 1keywords = mucormycosis (Clic here for more details about this article) |
4/56. Long-term survival of a patient with invasive cranial base rhinocerebral mucormycosis treated with combined endovascular, surgical, and medical therapies: case report.OBJECTIVE: Rhinocerebral mucormycosis is a clinical syndrome resulting from an opportunistic infection caused by a fungus of the order mucorales. The prognosis of rhinocerebral mucormycosis, once considered uniformly fatal, remains poor. Even with early diagnosis and aggressive surgical and medical therapy, the mortality rate is high. We present a patient with rhinocerebral mucormycosis involving the paranasal sinuses and cranial base who experienced long-term survival after multimodality treatment. Clinical characteristics of the disease are discussed, and the literature is reviewed. CLINICAL PRESENTATION: A 24-year-old diabetic man presented with invasive rhinocerebral mucormycosis involving the paranasal sinuses, right middle fossa, and right cavernous sinus. INTERVENTION: The patient underwent endovascular sacrifice of the involved carotid artery and radical resection of the cranial base, including exenteration of the cavernous sinus. Reconstruction with a local muscle flap was performed. He continued to receive intravenous and intrathecal administration of antibiotics. CONCLUSION: Long-term survival with invasive rhinocerebral mucormycosis is rare, but possible, with aggressive multimodality treatment, including carotid sacrifice for en bloc resection of the pathology, when indicated.- - - - - - - - - - ranking = 9keywords = mucormycosis (Clic here for more details about this article) |
5/56. Pulmonary rhizopus infection in a diabetic renal transplant recipient.Infectious complications after renal transplantation remain a major cause of morbidity and mortality. mucormycosis is a rare infection in renal transplant recipients; however, mortality is exceedingly high. risk factors predisposing to this disease include prolonged neutropenia, diabetes, and patients who are immunosuppressed (Singh N, Gayowski T, Singh J, Yu LV. Invasive gastrointestinal zygomycosis in a liver transplant recipient: case report and review of zygomycosis in solid-organ transplant recipients, Clin Infect Dis 1995: 20: 617). life-threatening infections can occur, as this fungus has the propensity to invade blood vessel endothelium, resulting in hematological dissemination. We report a case of cavitary rhizopus lung infection, 2 months after renal transplantation, where the patient was treated successfully with amphotericin b and surgical resection of the lesions with preservation of his allograft function. In this era of intensified immunosuppression, we may see an increased incidence of mucormycosis in transplant population. Invasive diagnostic work-up is mandatory in case of suspicion; amphotericin b and, in selected cases, surgical resection are the mainstays of therapy.- - - - - - - - - - ranking = 1keywords = mucormycosis (Clic here for more details about this article) |
6/56. liver and brain mucormycosis in a diabetic patient type II successfully treated with liposomial amphotericin b.A case of liver and brain mucormycosis in a 73-y-old diabetic patient is described. The patient presented with fever and a moderate, tender hepatomegaly and a C/T scan examination of the abdomen and brain showed multiple hepatic and cerebral nodular lesions. The largest of the liver lesions was aspirated and broad hyphae of mucor were demonstrated in the purulent material obtained. The patient was treated successfully (for 40 d) with intravenous liposomal amphotericin b and then with itraconazole for 3 months. To our knowledge, this is the first case of a diabetic patient with both liver and brain mucormycosis who has been treated successfully.- - - - - - - - - - ranking = 6keywords = mucormycosis (Clic here for more details about this article) |
7/56. zygomycosis in relapsed acute leukaemia.We would like to report the use of liposomal amphotericin in eradicating mucormycosis in two patients who had relapsed acute leukaemia. The first patient with relapsed acute myeloid leukaemia developed a rapidly expanding solitary necrotic neck lesion associated with opacity of maxilliary sinus at a time when he was profoundly pancytopenic following high dose chemotherapy. The second patient was a 3-year-old boy with pre-B acute lymphoblastic leukaemia who developed a central nervous system relapse whilst on his first line treatment and was treated with more aggressive chemotherapy on the Medical research Council Relapse Protocol. During a period of profound pancytopenia following re-induction therapy, including high dose steroids and prolonged course of antibiotics for proven septicaemia, he developed periorbital swelling and proptosis and a clinical diagnosis of rhinocerebral mucormycosis was made. Both patients were treated with high doses of liposomal amphotericin (Ambisome Nexstar). The doses were escalated to 10 and 15 mg/kg/day, resulting in successful eradication of the mucormycosis.- - - - - - - - - - ranking = 3keywords = mucormycosis (Clic here for more details about this article) |
8/56. Gastrointestinal mucormycosis in a renal transplant patient.The clinical course and management of a rare case of gastrointestinal mucormycosis occurring in a renal transplant patient are presented. The diagnosis was made on pathological examination of surgically resected tissue from the colon, spleen and stomach. The patient did not survive the infection. To the best of our knowledge, this is the 11th reported case of gastrointestinal mucormycosis in a solid organ transplant patient. The pathophysiology, incidence and prognosis of this disease are discussed.- - - - - - - - - - ranking = 6keywords = mucormycosis (Clic here for more details about this article) |
9/56. MR imaging of cavernous sinus invasion by mucormycosis: a case study.cavernous sinus thrombosis is a serious condition, which, if not recognized early, can lead to a fulminant course. knowledge of risk factors along with early recognition of signs and symptoms may alter the course of this condition. We present a case of a patient with cavernous sinus thrombosis with characteristic findings on MRI. biopsy of the sinuses revealed mucromycosis as the offending agent.- - - - - - - - - - ranking = 4keywords = mucormycosis (Clic here for more details about this article) |
10/56. Combined medical surgical therapy for pulmonary mucormycosis in a diabetic renal allograft recipient.mucormycosis is a rare opportunistic infection that complicates chronic debilitating diseases and immunosuppressed solid-organ transplant recipients. We present a case of life-threatening pulmonary mucormycosis in a diabetic renal allograft recipient who survived with reasonable renal function. Early recognition of this entity and prompt use of bronchoalveolar lavage (BAL) are critical to the outcome. Antifungal therapy combined with early surgical excision of infected, necrotic tissue appears to be the preferred course of action. Judicious withholding of immunosuppressants until fungemia cleared did not jeopardize allograft function.- - - - - - - - - - ranking = 5keywords = mucormycosis (Clic here for more details about this article) |
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