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Tandon M, Sheemar A, Bhatnagar K, Meena S, Shakrawal J. Central Retinal Artery Occlusion in Rhino-Orbital-Cerebral Mucormycosis: An Inflammatory-Prothrombotic State. Asia Pac J Ophthalmol (Phila) 2023; 12:16-20. [PMID: 36706330 DOI: 10.1097/apo.0000000000000593] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Accepted: 11/18/2022] [Indexed: 01/28/2023] Open
Abstract
PURPOSE The aim was to evaluate patient profiles of rhino-orbital-cerebral mucormycosis (ROCM) cases with central retinal artery occlusion (CRAO) postcoronavirus disease 2019. DESIGN A nonrandomized retrospective case-control study. METHODS The ROCM cases presenting with CRAO were compared with a control ROCM group without CRAO at a tertiary care center. Demography, systemic status, clinical features, histopathology, imaging, and blood profile were assessed for any specific risk factors. RESULTS A total of 12 patients were seen in the CRAO group and 16 in the non-CRAO group. The male-to-female ratio was 3:1 with a mean age of 49.5 years. In the CRAO group, 75% had diabetes mellitus with mean hemoglobin A1c of 9.03%, and 66.7% had received steroid treatment. All cases were histopathologically confirmed positive for mucor. There was a significant difference in mean D-dimer and serum ferritin between the 2 groups, with higher level in the CRAO group. All patients with CRAO had light perception-negative vision, with total ophthalmoplegia and proptosis seen in 66.7% of cases. Four patients had orbital apex involvement, 5 had cavernous sinus involvement, and 8 had intracranial involvement in the CRAO group. CONCLUSIONS Inflammatory markers D-dimer and serum ferritin were significantly associated with CRAO, suggestive of hyperinflammatory and hypercoagulable state. A high index of suspicion should be maintained in cases with elevated markers and prophylactic anticoagulants can be started to prevent CRAO in a subset of patients.
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Affiliation(s)
- Manjari Tandon
- All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
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Allport J, Choudhury R, Bruce-Wootton P, Reed M, Tate D, Malviya A. Efficacy of mupirocin, neomycin and octenidine for nasal Staphylococcus aureus decolonisation: a retrospective cohort study. Antimicrob Resist Infect Control 2022; 11:5. [PMID: 35012641 PMCID: PMC8744346 DOI: 10.1186/s13756-021-01043-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Accepted: 12/14/2021] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND Periprosthetic joint infection (PJI) causes significant morbidity. Methicillin sensitive Staphylococcus aureus (MSSA) is the most frequent organism, and the majority are endogenous. Decolonisation reduces PJIs but there is a paucity of evidence comparing treatments. Aims; compare 3 nasal decolonisation treatments at (1) achieving MSSA decolonisation, (2) preventing PJI. METHODS Our hospital prospectively collected data on our MSSA decolonisation programme since 2013, including; all MSSA carriers, treatment received, MSSA status at time of surgery and all PJIs. Prior to 2017 MSSA carriers received nasal mupirocin or neomycin, from August 2017 until August 2019 nasal octenidine was used. RESULTS During the study period 15,958 primary hip and knee replacements were performed. 3200 (20.1%) were MSSA positive at preoperative screening and received decolonisation treatment, 698 mupirocin, 1210 neomycin and 1221 octenidine. Mupirocin (89.1%) and neomycin (90.9%) were more effective at decolonisation than octenidine (50.0%, P < 0.0001). There was no difference in PJI rates (P = 0.452). CONCLUSIONS Mupirocin and neomycin are more effective than octenidine at MSSA decolonisation. There was poor correlation between the MSSA status after treatment (on day of surgery) and PJI rates. Further research is needed to compare alternative MSSA decolonisation treatments.
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Affiliation(s)
- J Allport
- Northumbria Healthcare NHS Trust, Department of Trauma and Orthopaedics, Wansbeck General Hospital, Woodhorn Lane, Ashington, NE63 9JJ, UK.
| | - R Choudhury
- Northumbria Healthcare NHS Trust, Department of Trauma and Orthopaedics, Wansbeck General Hospital, Woodhorn Lane, Ashington, NE63 9JJ, UK
| | - P Bruce-Wootton
- Northumbria Healthcare NHS Trust, Department of Trauma and Orthopaedics, Wansbeck General Hospital, Woodhorn Lane, Ashington, NE63 9JJ, UK
| | - M Reed
- Northumbria Healthcare NHS Trust, Department of Trauma and Orthopaedics, Wansbeck General Hospital, Woodhorn Lane, Ashington, NE63 9JJ, UK
| | - D Tate
- Northumbria Healthcare NHS Trust, Department of Trauma and Orthopaedics, Wansbeck General Hospital, Woodhorn Lane, Ashington, NE63 9JJ, UK
| | - A Malviya
- Northumbria Healthcare NHS Trust, Department of Trauma and Orthopaedics, Wansbeck General Hospital, Woodhorn Lane, Ashington, NE63 9JJ, UK
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Grach SL, Yetmar ZA, Rowan DJ, DeSimone DC. Rhinorbitocerebral Mucormycosis in Uncontrolled Diabetes. Mayo Clin Proc 2021; 96:2651-2652. [PMID: 34607635 DOI: 10.1016/j.mayocp.2021.06.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Revised: 06/07/2021] [Accepted: 06/21/2021] [Indexed: 10/20/2022]
Affiliation(s)
| | - Zach A Yetmar
- Division of Infectious Diseases, Mayo Clinic, Rochester, MN
| | - Daniel J Rowan
- Department of Laboratory Medicine and Pathology, Rochester, MN
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Zhou YB, Ma L, Xiao YY. A boy with annular erythema on the nose. BMJ 2021; 374:n1952. [PMID: 34407966 DOI: 10.1136/bmj.n1952] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Affiliation(s)
- Ya Bin Zhou
- Department of Dermatology, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China
| | - Lin Ma
- Department of Dermatology, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China
| | - Yuan Yuan Xiao
- Department of Dermatology, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China
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Nelwan EJ, Tunjungputri RN, Wardani RS, Wahyuningsih R. Black Fungus Complicated with COVID-19 in a Man with Underlying Non-Hodgkin's Lymphoma. Acta Med Indones 2021; 53:349-351. [PMID: 34611076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
COVID-19 is a disease reported to suppress cellular immunity. This may lead to the development of opportunistic infections, among others black fungus, or mucormycosis. On the other hand, pre-existing defect in immunity may render patients susceptible to both mucormycosis and COVID-19. Mucormycosis is a relatively rare fungal infection with rapid progression unless diagnosed promptly and treated adequately, and urgent surgical and medical intervention is lifesaving. The manifestation of mucormycosis largely depends on the presence of exposure to the pathogen and the existing risk factor of the host. As black fungus is locally invasive, the majority of cases will involve tissue damage with local destruction and contiguous spread to nearby structure. We here with present a case of black fungus complicated with COVID-19 in a man with underlying non-Hodgkin's lymphoma.
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Affiliation(s)
- Erni J Nelwan
- 1. Division of Tropical and Infectious Disease. Department of Internal Medicine, Faculty of Medicine Universitas Indonesia - Cipto Mangunkusumo Hospital, Jakarta, Indonesia. 2. Department of Internal Medicine, Faculty of Medicine Universitas Indonesia - Cipto Mangunkusumo Hospital, Jakarta, Indonesia.
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Mekonnen ZK, Ashraf DC, Jankowski T, Grob SR, Vagefi MR, Kersten RC, Simko JP, Winn BJ. Acute Invasive Rhino-Orbital Mucormycosis in a Patient With COVID-19-Associated Acute Respiratory Distress Syndrome. Ophthalmic Plast Reconstr Surg 2021; 37:e40-e80. [PMID: 33229953 PMCID: PMC7927902 DOI: 10.1097/iop.0000000000001889] [Citation(s) in RCA: 147] [Impact Index Per Article: 49.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/13/2020] [Indexed: 12/16/2022]
Abstract
Acute invasive fungal rhinosinusitis is a rare, although highly morbid, infection primarily affecting immunosuppressed individuals. The same population is at particularly high risk of complications and mortality in the setting of SARS-CoV-2 infection and coronavirus disease 2019 (COVID-19)-related acute respiratory distress syndrome. The authors present a case of acute invasive fungal rhino-orbital mucormycosis in a patient with COVID-19 and discuss the prevalence, diagnosis, and treatment of fungal coinfections in COVID-19. Prompt recognition, initiation of therapy, and consideration of the challenges of rapidly evolving COVID-19 therapy guidelines are important for improving patient survival.
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Affiliation(s)
| | | | - Tyler Jankowski
- Department of Pathology, University of California, San Francisco
| | | | | | | | - Jeffry P. Simko
- Department of Pathology, University of California, San Francisco
| | - Bryan J. Winn
- Department of Ophthalmology
- Ophthalmology Section, Surgical Service, San Francisco Veterans Affairs Medical Center, San Francisco, California, U.S.A
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Place DE, Briard B, Samir P, Karki R, Bhattacharya A, Guy CS, Peters JL, Frase S, Vogel P, Neale G, Yamamoto M, Kanneganti TD. Interferon inducible GBPs restrict Burkholderia thailandensis motility induced cell-cell fusion. PLoS Pathog 2020; 16:e1008364. [PMID: 32150572 PMCID: PMC7082077 DOI: 10.1371/journal.ppat.1008364] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2019] [Revised: 03/19/2020] [Accepted: 01/29/2020] [Indexed: 12/20/2022] Open
Abstract
Innate immunity responds to pathogens by producing alarm signals and activating pathways that make host cells inhospitable for pathogen replication. The intracellular bacterium Burkholderia thailandensis invades the cytosol, hijacks host actin, and induces cell fusion to spread to adjacent cells, forming multinucleated giant cells (MNGCs) which promote bacterial replication. We show that type I interferon (IFN) restricts macrophage MNGC formation during B. thailandensis infection. Guanylate-binding proteins (GBPs) expressed downstream of type I IFN were required to restrict MNGC formation through inhibition of bacterial Arp2/3-dependent actin motility during infection. GTPase activity and the CAAX prenylation domain were required for GBP2 recruitment to B. thailandensis, which restricted bacterial actin polymerization required for MNGC formation. Consistent with the effects in in vitro macrophages, Gbp2-/-, Gbp5-/-, GbpChr3-KO mice were more susceptible to intranasal infection with B. thailandensis than wildtype mice. Our findings reveal that IFN and GBPs play a critical role in restricting cell-cell fusion and bacteria-induced pathology during infection.
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Affiliation(s)
- David E. Place
- Department of Immunology, St. Jude Children’s Research Hospital, Memphis, Tennessee, United States of America
| | - Benoit Briard
- Department of Immunology, St. Jude Children’s Research Hospital, Memphis, Tennessee, United States of America
| | - Parimal Samir
- Department of Immunology, St. Jude Children’s Research Hospital, Memphis, Tennessee, United States of America
| | - Rajendra Karki
- Department of Immunology, St. Jude Children’s Research Hospital, Memphis, Tennessee, United States of America
| | - Anannya Bhattacharya
- Department of Immunology, St. Jude Children’s Research Hospital, Memphis, Tennessee, United States of America
| | - Clifford S. Guy
- Department of Immunology, St. Jude Children’s Research Hospital, Memphis, Tennessee, United States of America
| | - Jennifer L. Peters
- Cell and Tissue Imaging Center, St. Jude Children’s Research Hospital, Memphis, Tennessee, United States of America
| | - Sharon Frase
- Cell and Tissue Imaging Center, St. Jude Children’s Research Hospital, Memphis, Tennessee, United States of America
| | - Peter Vogel
- Veterinary Pathology Core, St. Jude Children’s Research Hospital, Memphis, Tennessee, United States of America
| | - Geoffrey Neale
- Hartwell Center for Bioinformatics & Biotechnology, St. Jude Children’s Research Hospital, Memphis, Tennessee, United States of America
| | - Masahiro Yamamoto
- Department of Immunoparasitology, Osaka University, 3–1 Yamadaoka, Suita, Osaka, Japan
| | - Thirumala-Devi Kanneganti
- Department of Immunology, St. Jude Children’s Research Hospital, Memphis, Tennessee, United States of America
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Abstract
Mucormycosis is a rare opportunistic fungal infection, often life-threatening. We report an unusual case of rhinocerebral mucormycosis in an immunocompetent patient. A 23-year-old male presented with headache, speech disturbance and hearing difficulty for 4 weeks. Magnetic resonance imaging (MRI) revealed right cerebellar abscess and enhancing soft tissue in the nasal cavity, extending to cranial and infratemporal fossae. Computed tomography (CT) revealed the widening of foramen rotundum and sclerosis involving the sphenoid and ethmoid sinuses. MR Spectroscopy revealed multiple peaks between 3.6 and 3.8 parts per million (ppm) which could represent trehalose. Nasal mucosa scrapings confirmed mucormycosis. Suspicion of a fungal infection needs to be considered even in the absence of immunocompromised status.
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Affiliation(s)
- Sagar Maheshwari
- Department of Radiodiagnosis, B J Govt. Medical College & Sassoon General Hospitals, Pune, India
| | - Monica Patil
- Department of Radiodiagnosis, B J Govt. Medical College & Sassoon General Hospitals, Pune, India
| | - Shweta Shendey
- Department of Radiodiagnosis, B J Govt. Medical College & Sassoon General Hospitals, Pune, India
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Belda B, Petrovitch N, Mathews KG. Sinonasal aspergillosis: Outcome after topical treatment in dogs with cribriform plate lysis. J Vet Intern Med 2018; 32:1353-1358. [PMID: 29957889 PMCID: PMC6060319 DOI: 10.1111/jvim.15219] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2017] [Revised: 03/29/2018] [Accepted: 04/25/2018] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Cribriform lysis has been considered a contraindication for topical treatment of sinonasal aspergillosis (SNA) because of concerns about drug extravasation with resultant neurologic signs or death. OBJECTIVE/HYPOTHESIS To describe dogs with SNA and cribriform plate lysis treated with topical antifungal medications. Our hypothesis was that the conventional dogma that topical therapy should be avoided in these cases is incorrect. ANIMALS Nine client-owned dogs with SNA and lysis of the cribriform plate, lysis of the floor of a frontal sinus or both detected by computed tomography (CT). METHODS A retrospective review of medical records was performed. Dogs that met inclusion criteria (ie, SNA confirmed by at least 1 laboratory test, braincase affected on CT, and topical treatment applied) were included. Size of lesions, ancillary diagnostic test results, topical therapy, and adjuvant PO treatments were recorded. Outcome was determined by phone calls. RESULTS Four dogs were alive at the time of the manuscript submission with follow-up ranging from 188 to 684 days without neurological signs observed. All dogs were discharged without major complication 1-7 days postoperatively. One dog that had presented with a history of seizures experienced seizure activity 2 months after treatment. CONCLUSIONS AND CLINICAL IMPORTANCE Topical therapy did not result in complications in these dogs in which lytic regions as large as 16 × 22 mm2 were noted. Sinonasal aspergillosis associated lysis of the cribriform plate; lysis of the floor of a frontal sinus or both detected on CT is not necessarily a contraindication to topical therapy.
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Affiliation(s)
- Beatriz Belda
- Department of Clinical SciencesCollege of Veterinary Medicine, North Carolina State UniversityRaleighNorth Carolina
| | - Nicholas Petrovitch
- Department of Molecular Biomedical SciencesCollege of Veterinary Medicine, North Carolina State UniversityRaleighNorth Carolina
| | - Kyle G. Mathews
- Department of Clinical SciencesCollege of Veterinary Medicine, North Carolina State UniversityRaleighNorth Carolina
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Shumilov E, Bacher U, Perske C, Mohr A, Eiffert H, Hasenkamp J, Trümper L, Wulf GG, Ströbel P, Ibrahim AS, Venkataramani V. In Situ Validation of the Endothelial Cell Receptor GRP78 in a Case of Rhinocerebral Mucormycosis. Antimicrob Agents Chemother 2018; 62:e00172-18. [PMID: 29483124 PMCID: PMC5923111 DOI: 10.1128/aac.00172-18] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Affiliation(s)
- Evgenii Shumilov
- Department of Hematology and Medical Oncology, University Medicine Göttingen (UMG), Göttingen, Germany
| | - Ulrike Bacher
- Center of Laboratory Medicine (ZLM)/University Institute of Clinical Chemistry, Inselspital, Bern University Hospital, Bern, Switzerland
- University Department of Hematology, Inselspital, Bern University Hospital, Bern, Switzerland
| | - Christina Perske
- Department of Pathology, University Medicine Göttingen, Göttingen, Germany
| | - Alexander Mohr
- Department of Neuroradiology, University Medicine Göttingen, Göttingen, Germany
- Department of Neuroradiology, University Heidelberg, Heidelberg, Germany
| | - Helmut Eiffert
- Department of Medical Microbiology, University Medicine Göttingen, Göttingen, Germany
| | - Justin Hasenkamp
- Department of Hematology and Medical Oncology, University Medicine Göttingen (UMG), Göttingen, Germany
| | - Lorenz Trümper
- Department of Hematology and Medical Oncology, University Medicine Göttingen (UMG), Göttingen, Germany
| | - Gerald G Wulf
- Department of Hematology and Medical Oncology, University Medicine Göttingen (UMG), Göttingen, Germany
| | - Philipp Ströbel
- Department of Pathology, University Medicine Göttingen, Göttingen, Germany
| | - Ashraf S Ibrahim
- Los Angeles Biomedical Research Institute at Harbor-University of California Los Angeles (UCLA) Medical Center, Division of Infectious Diseases, Torrance, California, USA
- David Geffen School of Medicine at UCLA, Los Angeles, California, USA
| | - Vivek Venkataramani
- Department of Hematology and Medical Oncology, University Medicine Göttingen (UMG), Göttingen, Germany
- Department of Pathology, University Medicine Göttingen, Göttingen, Germany
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Harjes L, Le Pommellet H, Hostnik E, Rudinsky A. Resolution of esophageal dysmotility following treatment of nasal disease in a dog. Can Vet J 2018; 59:147-151. [PMID: 29386673 PMCID: PMC5764207] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
A 2-year-old Rottweiler dog was evaluated for cough, regurgitation, and nasal discharge, and was subsequently diagnosed with sinonasal aspergillosis and secondary esophageal disease. Following treatment of sinonasal aspergillosis, all clinical signs resolved. To the authors' knowledge, this is the first report of resolution of esophageal dysfunction following treatment of sinonasal aspergillosis.
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Affiliation(s)
- Laura Harjes
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, The Ohio State University, 601 Vernon L Tharp Street, Columbus, Ohio 43210, USA
| | - Helene Le Pommellet
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, The Ohio State University, 601 Vernon L Tharp Street, Columbus, Ohio 43210, USA
| | - Eric Hostnik
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, The Ohio State University, 601 Vernon L Tharp Street, Columbus, Ohio 43210, USA
| | - Adam Rudinsky
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, The Ohio State University, 601 Vernon L Tharp Street, Columbus, Ohio 43210, USA
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Prabhu S, Alqahtani M, Al Shehabi M. A fatal case of rhinocerebral mucormycosis of the jaw after dental extractions and review of literature. J Infect Public Health 2017; 11:301-303. [PMID: 29107608 DOI: 10.1016/j.jiph.2017.09.026] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2017] [Revised: 09/01/2017] [Accepted: 09/30/2017] [Indexed: 11/18/2022] Open
Abstract
The purpose of presenting this case is to report a fatal case of rhinocerebral mucormycosis post-dental extraction in a patient with uncontrolled diabetes mellitus. Several cases of rhinocerebral mucormycosis have been reported, but mucocutaneous mucormycosis has not been commonly reported to be a part of polymicrobial wound infections at multifocal sites. To the best of author's knowledge, this is the second case of polymicrobial rhinocerebral infection involving mucormycosis.
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Affiliation(s)
- Shilpa Prabhu
- Department of Otorhinolaryngology, Royal Medical Services, Bahrain Defence Force Hospital, Bahrain.
| | - Manaf Alqahtani
- Department of Pathology, Royal College of Surgeons in Ireland-Bahrain Medical University, Royal Medical Services, Bahrain Defence Force Hospital, Bahrain.
| | - Mohammed Al Shehabi
- Department of Otorhinolaryngology, Royal Medical Services, Bahrain Defence Force Hospital, Bahrain.
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Helman SN, Filip P, Kamat A. Fungal granulomatous disease of the nasal cavity: A case report of a rare entity. Am J Otolaryngol 2017; 38:642-644. [PMID: 28550960 DOI: 10.1016/j.amjoto.2017.05.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2017] [Accepted: 05/07/2017] [Indexed: 11/30/2022]
Affiliation(s)
- Samuel N Helman
- Department of Otolaryngology/Head and Neck Surgery, New York Eye and Ear Infirmary, Mount Sinai Health System, 310 E. 14th St., 6th Floor, NY, NY 10003, United States.
| | - Peter Filip
- Loyola University of Chicago, Stritch School of Medicine, Maywood, IL 60153, United States
| | - Ameet Kamat
- Department of Otolaryngology/Head and Neck Surgery, Westchester Medical Center, ENT Faculty Practice, 100 Woods Rd., Valhalla, NY 10595, United States
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Dorn ES, Tress B, Suchodolski JS, Nisar T, Ravindran P, Weber K, Hartmann K, Schulz BS. Bacterial microbiome in the nose of healthy cats and in cats with nasal disease. PLoS One 2017; 12:e0180299. [PMID: 28662139 PMCID: PMC5491177 DOI: 10.1371/journal.pone.0180299] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2016] [Accepted: 06/13/2017] [Indexed: 12/22/2022] Open
Abstract
Background Traditionally, changes in the microbial population of the nose have been assessed using conventional culture techniques. Sequencing of bacterial 16S rRNA genes demonstrated that the human nose is inhabited by a rich and diverse bacterial microbiome that cannot be detected using culture-based methods. The goal of this study was to describe the nasal microbiome of healthy cats, cats with nasal neoplasia, and cats with feline upper respiratory tract disease (FURTD). Methodology/Principal findings DNA was extracted from nasal swabs of healthy cats (n = 28), cats with nasal neoplasia (n = 16), and cats with FURTD (n = 15), and 16S rRNA genes were sequenced. High species richness was observed in all samples. Rarefaction analysis revealed that healthy cats living indoors had greater species richness (observed species p = 0.042) and Shannon diversity (p = 0.003) compared with healthy cats living outdoors. Higher species richness (observed species p = 0.001) and Shannon diversity (p<0.001) were found in middle-aged cats in comparison to healthy cats in different age groups. Principal coordinate analysis revealed separate clustering based on similarities in bacterial molecular phylogenetic trees of 16S rRNA genes for indoor and outdoor cats. In all groups examined, the most abundant phyla identified were Proteobacteria, Firmicutes, and Bacteroidetes. At the genus level, 375 operational taxonomic units (OTUs) were identified. In healthy cats and cats with FURTD, Moraxella spp. was the most common genus, while it was unclassified Bradyrhizobiaceae in cats with nasal neoplasia. High individual variability was observed. Conclusion This study demonstrates that the nose of cats is inhabited by much more variable and diverse microbial communities than previously shown. Future research in this field might help to develop new diagnostic tools to easily identify nasal microbial changes, relate them to certain disease processes, and help clinicians in the decision process of antibiotic selection for individual patients.
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Affiliation(s)
- Elisabeth S. Dorn
- Clinic of Small Animal Medicine, LMU University of Munich, Munich, Germany
| | - Barbara Tress
- Clinic of Small Animal Medicine, LMU University of Munich, Munich, Germany
| | - Jan S. Suchodolski
- Gastrointestinal Laboratory, Department of Small Animal Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, Texas, United States of America
| | - Tariq Nisar
- Gastrointestinal Laboratory, Department of Small Animal Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, Texas, United States of America
| | - Prajesh Ravindran
- Gastrointestinal Laboratory, Department of Small Animal Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, Texas, United States of America
| | - Karin Weber
- Clinic of Small Animal Medicine, LMU University of Munich, Munich, Germany
| | - Katrin Hartmann
- Clinic of Small Animal Medicine, LMU University of Munich, Munich, Germany
| | - Bianka S. Schulz
- Clinic of Small Animal Medicine, LMU University of Munich, Munich, Germany
- * E-mail:
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Kennedy DW. Editorial. Int Forum Allergy Rhinol 2016; 5:875-6. [PMID: 26468693 DOI: 10.1002/alr.21659] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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Jetmore TM, Phan J, Yekinni AO. Blastomycosis of the nose: A case report. Ear Nose Throat J 2016; 95:E28-E30. [PMID: 27551850] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/06/2023] Open
Abstract
Blastomyces dermatitidis is a thermally dimorphic fungus endemic to the North American soil near the Mississippi, Ohio, and St. Lawrence river valleys, as well as the Great Lakes Basin. It is responsible for blastomycosis, a systemic pyogranulomatous disease. Blastomycosis of the head and neck is decidedly uncommon and often mistaken for cancer. There are only 3 previous case reports of blastomycosis presenting as an intranasal lesion. We report the unusual case of a 24-year-old man with blastomycosis presenting with a 4-week history of a progressively enlarging intranasal mass who had complete resolution of symptoms after treatment with itraconazole and surgical excision of the lesion.
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Affiliation(s)
- Thomas M Jetmore
- Department of Otolaryngology-Head and Neck Surgery, Indiana University School of Medicine, Gatch Hall, 1120 W. Michigan St., Suite 200, Indianapolis, IN 46202, USA.
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Bertin ML, Vinski J, Schmitt S, Sabella C, Danziger-Isakov L, McHugh M, Procop GW, Hall G, Gordon SM, Goldfarb J. Outbreak of Methicillin-Resistant Staphylococcus aureus Colonization and Infection in a Neonatal Intensive Care Unit Epidemiologically Linked to a Healthcare Worker With Chronic Otitis. Infect Control Hosp Epidemiol 2016; 27:581-5. [PMID: 16755477 DOI: 10.1086/504933] [Citation(s) in RCA: 62] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2005] [Accepted: 10/03/2005] [Indexed: 11/03/2022]
Abstract
Objective.To describe the investigation and interventions necessary to contain an outbreak of methicillin-resistant Staphylococcus aureus (MRSA) colonization and infection in a neonatal intensive care unit (NICU).Design.Retrospective case finding that involved prospective performance of surveillance cultures for detection of MRSA and molecular typing of MRSA by repetitive-sequence polymerase chain reaction (rep-PCR).Setting.Level III NICU in a tertiary care center.Participants.Three neonates in a NICU were identified with MRSA bloodstream infection on April 16, 2004. A point prevalence survey identified 6 additional colonized neonates (attack rate, 75% [9 of 12 neonates]). The outbreak strain was phenotypically unusual.Interventions.Cohorting and mupirocin therapy were initiated for neonates who had acquired MRSA during the outbreak. Contact precautions were introduced in the NICU, and healthcare workers (HCWs) were retrained in cleaning and disinfection procedures and hand hygiene. Noncolonized neonates and newly admitted patients had surveillance cultures performed 3 times per week.Results.Two new colonized neonates were identified 1 month later. HCW X, who had worked in the NICU since June 2003, was identified as having chronic otitis. MRSA was isolated from cultures of swab specimens from HCW X's ear canal and nares. HCW X was epidemiologically linked to the outbreak. Molecular typing (by rep-PCR) confirmed that the isolates from HCW X and from the neonates were more than 90% similar. Retrospective review of NICU isolates revealed that the outbreak strain was initially cultured from a neonate 2 months after HCW X began working on the unit. The epidemic strain was eradicated after removing HCW X from patient care in the NICU.Conclusion.An outbreak of MRSA colonization and infection in a NICU was epidemiologically linked to a HCW with chronic otitis externa and nasal colonization with MRSA. Eradication was not achieved until removal of HCW X from the NICU. Routine surveillance for MRSA may have allowed earlier recognition of the outbreak and is now standard practice in our NICU.
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Affiliation(s)
- Mary L Bertin
- Department of Infection Control and Epidemiology, Division of Nursing, The Cleveland Clinic, Cleveland, OH 44195, USA.
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Asakura T, Ishii M, Kikuchi T, Kameyama K, Namkoong H, Nakata N, Sugita K, Tasaka S, Shimizu T, Hoshino Y, Okamoto S, Betsuyaku T, Hasegawa N. Disseminated Mycobacterium marinum Infection With a Destructive Nasal Lesion Mimicking Extranodal NK/T Cell Lymphoma: A Case Report. Medicine (Baltimore) 2016; 95:e3131. [PMID: 26986167 PMCID: PMC4839948 DOI: 10.1097/md.0000000000003131] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Mycobacterium marinum is a ubiquitous waterborne organism that mainly causes skin infection in immunocompetent patients, and its disseminated infection is rare. Extranodal NK/T cell lymphoma, nasal type (ENKL) usually localizes at the nasal and/or paranasal area, but occasionally disseminates into the skin/soft tissue and gastrointestinal tract. Compromised immunity is a risk factor for developing nontuberculous mycobacterial (NTM) infection and malignant lymphoma, and the 2 diseases may share similar clinical presentation; however, only a few reports have described NTM infection mimicking malignant lymphoma.A 43-year-old Japanese man presented to our hospital complaining of multiple progressive skin nodules and purulent nasal discharge for 3 weeks. He was diagnosed with Crohn disease with refractory enteropathic arthritis and has been treated with anti-tumor necrosis factor alpha agents for 25 years. Fiberoptic nasal examination revealed septal perforation with hemorrhagic mucus and purulent rhinorrhea. Histological examination of the nasal septum revealed the infiltration of atypical medium-to-large-sized cells with erosion. The cells were positive for cytoplasmic CD3, granzyme B, and Epstein-Barr virus-encoded small RNA. Histological examination of the skin nodules and auricle also showed infiltration of atypical lymphocytes. The patient was tentatively diagnosed with ENKL, and chemotherapy was considered. However, the skin lesions decreased in size after discontinuation of immunosuppressive agents and minocycline administration. Two weeks later, nasal septum and lavage fluid and left leg skin cultures were positive for M marinum, and minocycline was discontinued. The skin and the nasal lesions improved after 2 months. To the best of our knowledge, this is the first case of disseminated M marinum infection with a destructive nasal lesion mimicking ENKL. The differentiation between M marinum infection and ENKL is clinically important because misdirected treatment leads to a poor prognosis. NTM infections including M marinum should be considered in differential diagnosis of ENKL. Bacterial cultures, pathological analysis, and close monitoring are required for the differentiation of ENKL and disseminated M marinum infection; both are serious diseases and early diagnostic distinction between them and immediate appropriate treatment will improve the patient's prognosis.
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Affiliation(s)
- Takanori Asakura
- From the Divisions of Pulmonary Medicine (TA, MI, HN, ST, TB) and Hematology (TK, TS, SO), Department of Medicine; Division of Diagnostic Pathology (KK); and Center for Infectious Diseases and Infection Control (KS, NH), Keio University School of Medicine; Department of Mycobacteriology, Leprosy Research Center, National Institute of Infectious Diseases (NN, YH), Tokyo, Japan
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Udassi S, Udassi JP, Giordano BP, Lew JF. An Unusual Cause of Neonatal Meningitis. J Pediatr Health Care 2015; 29:547-50. [PMID: 25825073 DOI: 10.1016/j.pedhc.2015.03.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2015] [Revised: 03/01/2015] [Accepted: 03/01/2015] [Indexed: 11/29/2022]
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Varshney S, Gupta P, Bist SS, Bhagat S. Conidiobolus coronatus granuloma of the right inferior turbinate: A rare presentation. Ear Nose Throat J 2015; 94:E32-E35. [PMID: 25923283] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023] Open
Abstract
Fungal infections are common in tropical countries such as India. Very few clinical cases caused by the Entomophthorales Zygomycetes have been reported. Rhinofacial infection is a rare form of zygomycosis in humans, and only limited information regarding optimal treatment is available. We report here a rare case of rhinofacial Conidiobolus coronatus infection in a previously healthy 18-year-old man who presented with a fungal granuloma of the right inferior turbinate and face. Diagnosis was confirmed by microbiologic culture from a tissue biopsy. The infection was successfully treated with surgery and itraconazole therapy for 12 months. The clinical presentation and treatment of this rare, chronic, indolent form of fungal infection are highlighted in this article.
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Affiliation(s)
- Saurabh Varshney
- Department of ENT, All India Institute of Medical Sciences, Rishikesh - 249201, India.
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Ruiz JN, Belum VR, Boers-Doets CB, Kamboj M, Babady NE, Tang YW, Valdez TA, Lacouture ME. Nasal vestibulitis due to targeted therapies in cancer patients. Support Care Cancer 2015; 23:2391-8. [PMID: 25876156 DOI: 10.1007/s00520-014-2580-x] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2014] [Accepted: 12/18/2014] [Indexed: 11/24/2022]
Abstract
BACKGROUND AND PURPOSE Cancer patients treated with targeted therapies (e.g., epidermal growth factor receptor inhibitors) are susceptible to dermatologic adverse events (AEs) including secondary skin infections. Whereas infections such as paronychia and cellulitis have been reported, nasal vestibulitis (NV) has not been described with the use of these agents. The aim of our study was to characterize NV in cancer patients treated with targeted therapies. METHODS We utilized a retrospective chart review of cancer patients who had been referred to dermatology and were diagnosed with NV. We recorded data including demographics, referral reason, underlying malignancy, targeted anticancer regimen, NV treatment, and nasal bacterial culture results. RESULTS One Hundred Fifteen patients were included in the analysis, of which 13 % experienced multiple NV episodes. Skin rash was the most common reason (90 %) for a dermatology referral. The most common underlying malignancies were lung (43 %), breast (19 %), and colorectal (10 %) cancer. Sixty-eight percent of patients had been treated with an EGFRI-based regimen. Nasal cultures were obtained in 60 % of episodes, of which 94 % were positive for one or more organisms. Staphylococcus aureus was the most commonly isolated organism [methicillin-sensitive S. aureus 43 %; methicillin-resistant S. aureus 3 %]. CONCLUSIONS We report the incidence and characteristics of an unreported, yet frequent dermatologic condition in cancer patients treated with targeted therapies. These findings provide the basis for additional studies to describe the incidence, treatment, and consequences of this event. A better understanding of NV would mitigate its impact on patients' quality of life and risk for additional dermatologic AEs.
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Affiliation(s)
- Janelle N Ruiz
- Dermatology Service, Memorial Sloan Kettering Cancer Center, 60th Street Outpatient Center, Suite 407, Room 4312, 16 East 60th St., New York, NY, 10022, USA
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Abstract
Concha bullosa is characterized by pneumatization of the middle turbinate and is one of the most common variations of the sinonasal anatomy. It is most often asymptomatic. A fungus ball in the concha bullosa is extremely rare, with only two reported cases in the English literature. This article describes a patient with such a fungus ball in the concha bullosa that caused right periorbital pain, specifically in the right medial canthal area, similar to mucosal contact point headache.
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Zhang H, Liu G, Hang W, Zhang J. [Rhino-orbito-cerebral mucormycosis: report of 9 cases]. Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 2014; 49:446-451. [PMID: 25241859] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
OBJECTIVE To present the clinical characteristics and combination therapy of rhino-orbito-cerebral mucormycosis. METHODS The clinical data of 9 patients with rhino-orbito-cerebral mucormycosis treated between January 2008 and January 2013 were analyzed retrospectively. The clinical features, diagnosis, pathological characteristics, surgical technique and combination therapy were summarized. All the patients were treated with nasal endoscopic surgery and combined drug therapy. RESULTS Nine patients were under the state of systemic immunosuppression. Two patients died of intracranial infection. One patient with the symptom of headache was first alleviated after treatment, with visual acuity recovered partially, but this patient died 4 months later due to recurrence of mucormycosis and intracranial infection. Two patients with headache recovered after treatment, the visual acuity recovered to the hand movement, endoscopic examination of surgical cavity was clean and epithelialized, with no recurrence, still alive 5 years up to now. The symptom of headache in another 4 patients disappeared after treatment, visual acuity improved significantly, endoscopic surgical cavity was clean, follow-up with no recurrence, survived more than 2 years, and were still in the treatment of primary disease. CONCLUSION Rhino-orbito-cerebral mucormycosis is a serious chance infectious disease under the state of systemic immunosuppression, the development is rapid and the mortality rate is high, early diagnosis and combined treatment with nasal endoscopic surgery is necessary.
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Affiliation(s)
- Hai Zhang
- Department of Otorhinolaryngology Head and Neck Surgery, Tianjin HuanHu Hospital, Tianjin 300060, China
| | - Gang Liu
- Department of Otorhinolaryngology Head and Neck Surgery, Tianjin HuanHu Hospital, Tianjin 300060, China.
| | - Wei Hang
- Department of Otorhinolaryngology Head and Neck Surgery, Tianjin HuanHu Hospital, Tianjin 300060, China
| | - Jinling Zhang
- Department of Otorhinolaryngology Head and Neck Surgery, Tianjin HuanHu Hospital, Tianjin 300060, China
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Twizeyimana E, Chauty A, Pihet M, Ardant MF, Adeye A, Zidane M, de Gentile L, Saint-André JP, Chabasse D. [Rhinofacial conidiobolomycosis associated with cervical, thoracic and brachial localizations: one clinical case in Nigeria]. J Mycol Med 2014; 24:48-55. [PMID: 24440611 DOI: 10.1016/j.mycmed.2013.12.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2013] [Revised: 12/02/2013] [Accepted: 12/05/2013] [Indexed: 01/19/2023]
Abstract
We report here the clinical case of a Nigerian adult patient who received medical care during October 2010, at the Center for Diagnosis and Treatment of Buruli ulcer in Pobè (Benin). He presented a massive facial tumor associated with several subcutaneous (cervical, thoracic and upper limbs) nodules, evolving since several years. Tissue samples collected at Pobè medical center were addressed to the mycology and histology laboratories of Angers University Hospital (France), according to the medical exchange agreement between the two institutions about the diagnosis and treatment of Buruli ulcer disease. Histological examination showed a Splendore-Hoeppli phenomenon, consisting of a granulomatous reaction made of eosinophilic polynuclear cells surrounding rare, large and irregular, non-septate hyphae. A filamentous fungus was isolated by cultivation of the clinical samples, which was identified as Conidiobolus coronatus. The patient was treated orally with daily doses of ketoconazole (400 mg per day). After 4 months of treatment, a marked regression of the facial lesion was obtained. A first constructive facial surgery was achieved, but the patient did not attend the second step. This case report allows us to remind the mycological diagnosis of this exotic mycosis, but also to emphasize the main difficulties encountered in medical management in the developing countries.
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Affiliation(s)
- E Twizeyimana
- Laboratoire de parasitologie-mycologie, institut de biologie en santé, centre hospitalier universitaire, 4, rue Larrey, 49933 Angers cedex 9, France
| | - A Chauty
- Centre de diagnostic et de traitement de l'ulcère de Buruli, Pobè, Bénin
| | - M Pihet
- Laboratoire de parasitologie-mycologie, institut de biologie en santé, centre hospitalier universitaire, 4, rue Larrey, 49933 Angers cedex 9, France.
| | - M-F Ardant
- Centre de diagnostic et de traitement de l'ulcère de Buruli, Pobè, Bénin
| | - A Adeye
- Centre de diagnostic et de traitement de l'ulcère de Buruli, Pobè, Bénin
| | - M Zidane
- Laboratoire d'anatomie pathologique, institut de biologie en santé, centre hospitalier universitaire, 4, rue Larrey, 49933 Angers cedex 9, France
| | - L de Gentile
- Laboratoire de parasitologie-mycologie, institut de biologie en santé, centre hospitalier universitaire, 4, rue Larrey, 49933 Angers cedex 9, France
| | - J-P Saint-André
- Laboratoire d'anatomie pathologique, institut de biologie en santé, centre hospitalier universitaire, 4, rue Larrey, 49933 Angers cedex 9, France
| | - D Chabasse
- Laboratoire de parasitologie-mycologie, institut de biologie en santé, centre hospitalier universitaire, 4, rue Larrey, 49933 Angers cedex 9, France
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Kanada KN, Schwartz BS, Pincus LB, Berger TG, Jacobs RA, Shinkai K. A therapeutic trial of antituberculous therapy for suspected lupus vulgaris: How long does it take to see clinical improvement? J Am Acad Dermatol 2013; 69:e252-e254. [PMID: 24124850 DOI: 10.1016/j.jaad.2013.06.018] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2013] [Revised: 06/13/2013] [Accepted: 06/16/2013] [Indexed: 11/19/2022]
Affiliation(s)
| | - Brian S Schwartz
- Division of Infectious Diseases, University of California, San Francisco
| | - Laura B Pincus
- Department of Dermatology, University of California, San Francisco; Department of Pathology, University of California, San Francisco
| | - Timothy G Berger
- Department of Dermatology, University of California, San Francisco
| | - Richard A Jacobs
- Division of Infectious Diseases, University of California, San Francisco
| | - Kanade Shinkai
- Department of Dermatology, University of California, San Francisco.
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Parker K, Snead E, Anthony J, Silver T. Oronasal blastomycosis in a golden retriever. Can Vet J 2013; 54:748-752. [PMID: 24155474 PMCID: PMC3711161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
Blastomycosis is one of the most common systemic fungal infections in dogs in North America Pulmonary manifestations are most common; localized disease is rare. A case of localized oronasal blastomycosis mimicking oral neoplasia is described. Long-term therapy with itraconazole resulted in clinical cure.
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Affiliation(s)
- Kristen Parker
- Address all correspondence to Dr. Kristen Parker; e-mail:
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Vazquez-Lopez F, Fueyo-Casado A, Gonzalez-Lara L. Lupus Vulgaris Erythematoides: report of a patient initially misdiagnosed as dermatitis. Dermatol Online J 2013; 19:18187. [PMID: 24011284] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2013] [Accepted: 05/14/2013] [Indexed: 06/02/2023] Open
Abstract
A small percentage of patients with tuberculosis present with cutaneous findings, which may be difficult to diagnose. We present a patient diagnosed with a rare, non-scarring form of cutaneous tuberculosis (CTB), classically termed as lupus vulgaris erythematoides.
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Cheng L, Lu MP, Zhou H. [Minutes of the Chinese Symposium on Infection, Allergy & Tumor of the Nose 2012]. Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 2013; 48:168-170. [PMID: 23710874] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
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Li Z, Zhang S. [A case of rhinolith and actinomycosis]. Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 2013; 27:103. [PMID: 23650717] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
The patient presented with right nasal obstruction, purulent secretion in nasal meatus and dull headache for 3 years. A dark brown mass, irregular in shape, surface roughness and purulent secretion adherent, was seen in the nose, touched as coal tar stone. CT examination showed high density in the right nasal meatus. Postoperative pathological examination proved to be rhinolith and actinomycosis.
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Baig WW, Nagaraja MV, Varma M. Spontaneous cerebrospinal fluid rhinorrhea with pneumocephalus: an unusual manifestation of nasal tuberculosis. Korean J Intern Med 2012; 27:350-2. [PMID: 23019402 PMCID: PMC3443730 DOI: 10.3904/kjim.2012.27.3.350] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2008] [Revised: 07/21/2008] [Accepted: 09/11/2008] [Indexed: 11/27/2022] Open
Abstract
An unusual case of spontaneous cerebrospinal fluid (CSF) rhinorrhea with a pneumocephalus is described in a middle-aged woman who presented with a watery nasal discharge for 1 week and headache, vomiting, and fever for 1 day. The neurological examination revealed meningeal signs and bilateral papilledema. The CSF picture suggested pyogenic meningitis, and computed tomography of the brain revealed pneumocephalus. Diagnostic nasal endoscopy showed outpouching of the dura from the left olfactory cleft with a CSF leak and granular nasal mucosa. The defect was repaired surgically, and a biopsy of that area revealed granulomatous changes suggestive of tuberculosis. The patient recovered completely with standard four-drug antitubercular therapy. To our knowledge spontaneous CSF rhinorrhea with pneumocephalus occurring secondary to nasal tuberculosis has not been previously reported.
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Affiliation(s)
- Waqas Wahid Baig
- Department of Medicine, Manipal University Kasturba Medical College, Karnataka, India.
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Van den Eede A, Hermans K, Van den Abeele A, Floré K, Dewulf J, Vanderhaeghen W, Crombé F, Butaye P, Gasthuys F, Haesebrouck F, Martens A. Methicillin-resistant Staphylococcus aureus (MRSA) on the skin of long-term hospitalised horses. Vet J 2012; 193:408-11. [PMID: 22264643 DOI: 10.1016/j.tvjl.2011.12.004] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2011] [Revised: 11/04/2011] [Accepted: 12/14/2011] [Indexed: 11/17/2022]
Abstract
Given the significance of methicillin-resistant Staphylococcus aureus (MRSA) infections for both horses and staff in equine veterinary hospitals, protocols are required to minimise the risk of nosocomial transmission, including the screening of the skin and nasal chambers of equine patients for evidence of infection. The objective of this study was to clarify the potential existence and extent of MRSA on the skin of horses requiring long-term hospitalisation (≥ 6 months). Thirty such horses were sampled at eight different locations on their skin and from their nasal chambers. MRSA was isolated from 12 animals (40%), with all sample sites testing positive on at least one occasion. Organisms were most frequently detected in the nasal chambers (relative sensitivity, 83.3%; 34.5% positive horses; isolation rate 33.3%). Skin presence was found in 30% of animals with the highest isolation rates found at the carpus (16.7%), neck, withers and croup (13.3% each). To achieve a relative screening sensitivity of >90%, at least one skin site was required in addition to nasal sampling. This evidence of skin as well as nasal reservoirs of MRSA in long-term hospitalised horses should facilitate the design of effective screening and containment protocols.
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Affiliation(s)
- A Van den Eede
- Department of Surgery and Anaesthesiology of Domestic Animals, Faculty of Veterinary Medicine, Ghent University, Salisburylaan 133, 9820 Merelbeke, Belgium.
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Tiraboschi I, Bravo M, Fernández N, Stecher D, Melero M, Lasala M. [Mucormycosis. An emergent mycosis]. Medicina (B Aires) 2012; 72:23-27. [PMID: 22257452] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2023] Open
Abstract
Mucormycosis is an opportunistic infection caused by fungi of the order Mucorales. It is characterized by rapid progression and high morbidity and mortality in the absence of early diagnosis and prompt treatment. It was an infrequent disease, but in recent years, its incidence appears to have increased. The aim of this paper is to report the cases of mucormycosis diagnosed from 1982 to 2010 at the Hospital de Clinicas José de San Martín, University of Buenos Aires. We diagnosed 10 cases of mucormycosis; the first three between 1982 and 2004 and the last 7 between 2005 and 2010. The incidence from 1980 to 2004 was 0.13 patient-years and the frequency 0.1/10 000 discharges (95% CI 0.00- 0.3). In the period 2005 to 2010, the incidence was 0.86 patients per year with 1.1/10 000 discharges (95% CI 0.5-2.4). There was a pulmonary mucormycosis case (in a patient treated with corticosteroids) and nine rhinocerebral cases, two in neutropenic and seven in diabetic patients. The diagnosis was made by observation of cenocytic hyphae in 10/10 patients. Mucorales were recovered in 8/9 cultures (5 Rhizopus spp and 3 Mucor spp.). In one case diagnosis of pulmonary mucormycosis was made post-mortem. Nine patients were treated with amphotericin B deoxycholate (in 3 patients supplemented with liposomal amphotericin B) and surgery. Three patients underwent hyperbaric chamber. Seven patients had favorable outcome. In conclusion, mucormycosis is a rare disease, but its incidence has increased over the past five years. A good evolution of the patients is linked to early diagnosis and treatment.
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Affiliation(s)
- Iris Tiraboschi
- División Infectología, Hospital de Clínicas José de San Martín, Universidad de Buenos Aires, Argentina.
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Ouarssani A, Atoini F, Lhou FA, Hommadi A, Rguibi MI. [Multifocal tuberculosis: a particular association]. Rev Prat 2012; 62:8. [PMID: 22335058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Affiliation(s)
- Aziz Ouarssani
- Service de pneumologie, hôpital militaire Moulay-Ismail, Meknès, Maroc.
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Viterbo S, Fasolis M, Garzino-Demo P, Griffa A, Boffano P, Iaquinta C, Tanteri G, Modica R. Management and outcomes of three cases of rhinocerebral mucormycosis. ACTA ACUST UNITED AC 2011; 112:e69-74. [PMID: 21862361 DOI: 10.1016/j.tripleo.2011.04.048] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2011] [Accepted: 04/19/2011] [Indexed: 11/18/2022]
Abstract
Mucormycosis is a rare opportunistic infection caused by fungi belonging to Mucorales order. The infection usually starts in the middle or inferior nasal meatus and then spreads to the paranasal sinuses and the orbit. Then it reaches the brain through the ethmoid and the orbit apex and can lead to lethargy, paralysis, and death. The majority of cases of rhinocerebral mucormycosis are diagnosed in patients with immunologic and metabolic disorders. Early diagnosis is fundamental, and so is medical therapy with amphotericin B along with surgical toilet of the compromised tissues. This article presents and discusses the management of 3 cases of rhinocerebral mucormycosis with different onsets, progressions, and outcomes.
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Affiliation(s)
- Stefano Viterbo
- Division of Maxillofacial Surgery, Head and Neck Department, San Giovanni Battista Hospital, University of Turin, Turin, Italy
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Arda B, Erdem A, Sipahi OR, Işıkgöz Taşbakan M, Pullukçu H, Taşbakan MS, Ceylan N, Metin DY, Midilli R, Yamazhan T, Ulusoy S. [Mucormycosis: retrospective evaluation of 12 cases]. MIKROBIYOL BUL 2011; 45:504-511. [PMID: 21935783] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
Mucormycosis is a rare and often fatal invasive fungal infection. Disseminated or pulmonary forms are common in patients with immune deficiency while rhinocerebral form is common in diabetes mellitus. The aim of this study was to evaluate retrospectively the adult mucormycosis cases which were followed up in our hospital between 2007-2010. The cases were evaluated in terms of demographic characteristics, underlying diseases, laboratory, clinical and treatment results. A total of 12 mucormycosis cases (6 were male; age range: 18-74 years; mean age: 50.83 ± 18.27 years) were evaluated. Ten of the 12 cases had definitive diagnosis of invasive fungal infection according to EORTC/MSG (European Organization for Research and Treatment of Cancer/Mycoses Study Group) criteria whereas two had possible mucormycosis. Six cases had rhinoorbital, four had rhinocerabral, one had pulmonary and one had rhinocerebral and pulmonary mucormycosis. Fever (n= 10; 83%), edema in face (n= 8; 67%) and eyes (n= 6; 50%) were the most common symptoms and findings. Mycologic culture was performed in ten cases and was found positive in five cases (four cases had Rhizopus spp. one case had Mucor). In two cases direct microscopy revealed mycelium but culture did not yield any pathogen. Two cases had concomitant Aspergillus spp. growth. Overall mortality rate was determined as 50% (6/12). All of the cases received antifungal therapy (liposomal amphotericin B and posaconazole or itraconazole), however, surgical intervention was applied to five cases. Mean duration of antifungal treatment was 60.8 ± 47.4 days. Mortality rate was lower in cases who received concomitant surgical therapy, but the difference was not found statistically significant (2/5 vs. 4/7, p> 0.05). Hematologic diseases (n= 6) and diabetes mellitus (n= 3) were the most common underlying diseases in mucormycosis cases. Voriconazole prophylaxis applied to three cases with hematologic diseases was detected as a risk factor. Development of mucormycosis in those cases who were under voriconazole prophylaxis, deserves attention. Since this is the largest 3-years series of adult mucormycosis cases reported from a single center and includes the first cases treated with posaconazole, the results of this evaluation may aid to the management of patients with mucormycosis.
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Affiliation(s)
- Bilgin Arda
- Ege University Faculty of Medicine, Department of Infectious Diseases and Clinical Microbiology, İzmir, Turkey
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Aswani VH, Shukla SK. Prevalence of Staphylococcus aureus and lack of its lytic bacteriophages in the anterior nares of patients and healthcare workers at a rural clinic. Clin Med Res 2011; 9:75-81. [PMID: 20974887 PMCID: PMC3134439 DOI: 10.3121/cmr.2010.954] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2010] [Revised: 09/21/2010] [Accepted: 10/07/2010] [Indexed: 11/18/2022]
Abstract
BACKGROUND Nearly 30% of people in the United States are colonized with Staphylococcus aureus and 1% to 2% with methicillin-resistant Staphylococcus aureus (MRSA) in the anterior nares. However, it is not known if lytic bacteriophages against S. aureus are present in the anterior nares, and if they are, what the prevalence rate is, or if they interfere with S. aureus colonization. The aim of this study was to determine the prevalence of nasal carriage of S. aureus and MRSA and to screen for S. aureus lytic bacteriophages in healthcare environment workers and ambulatory patients. METHODS We enrolled 202 individuals into this study. The anterior nares were swabbed to isolate S. aureus, MRSA, and any lytic S. aureus bacteriophages that may be present. Putative S. aureus colonies on blood agar plates were identified using gram stain, catalase and coagulase tests, and confirmed by S. aureus-specific PCR. Presence of staphylococcal lytic bacteriophages were screened by a plaque assay technique using a methicillin-sensitive reference S. aureus strain ATCC 29213. RESULTS Of the 49 (24%) individuals who screened positive for S. aureus, two (1%) were positive for MRSA. None of the samples were positive for lytic bacteriophages against S. aureus. Subgroup analysis found no significant difference in the prevalence of S. aureus in the house staff compared to other healthcare environment workers or ambulatory patients of the clinic. Similarly, no significant difference in colonization was noted across the population with respect to age, sex, body mass index, or presence of diabetes mellitus. CONCLUSION The prevalence of nasal carriage of S. aureus and MRSA in the studied population was 24% and 1%, respectively, similar to the rate of prevalence in the United States. The study also showed that the anterior nares do not seem to harbor lytic bacteriophages against S. aureus.
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Affiliation(s)
- Vijay H Aswani
- Marshfield Clinic, Department of Internal Medicine & Pediatrics, WI 54449, USA.
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Ikram M, Iqbal M, Khan MA, Khan E, Shah M, Smego RA. Rhinocerebral zygomycosis in Pakistan: clinical spectrum, management, and outcome. J PAK MED ASSOC 2011; 61:477-480. [PMID: 22204184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
OBJECTIVE To study the disease spectrum and salient management features of 36 patients with histopathologically-confirmed rhinocerebral zygomycosis seen at our academic center over a 16-year period. METHODS Retrospective review of patients admitted to the Aga Khan University Hospital in Karachi, Pakistan from January 1991 to December 2006 with histopathologically-confirmed zygomycosis of the head and neck. RESULTS Mean patient age was 40 +/- 5.0 years (range, 34-63 years), and 23 (64%) patients were male. Thirty-two (89%) patients were referred from clinical services other than otolaryngology. Underlying predisposing conditions included diabetes mellitus (21 patients), haematologic diseases (9), and renal failure (6). Twenty (55%) patients had limited sinonasal disease, ten (28%) had orbital involvement, and six (17%) had intracranial extension. All patients underwent rigid nasal endoscopy and biopsy, and black necrotic tissue was seen in 22 (61%) instances warranting endoscopic or open surgical debridement. Four of 6 patients undergoing open surgery required orbital exenteration. Overall patient survival was 56% (20/36 patients). Diabetic patients had improved survival (17/21, or 81%) compared to patients with haematologic disorders (3/9, or 33%) (p = 0.001). All six patients with intracerebral disease died. Eighteen of the 22 (82%) patients treated with surgery plus amphotericin B survived vs. two of 14 (14%) receiving amphotericin B alone (p < 0.001). CONCLUSIONS In rhinocerebral zygomycosis, an aggressive, multidisciplinary, diagnostic and therapeutic approach that utilizes CT or MRI staging, and combines endoscopic or open surgical debridement with amphotericin B-based antifungal therapy offers the best chance of recovery.
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Affiliation(s)
- Mubasher Ikram
- Departments of Otolaryngology, The Aga Khan University, Karachi, Pakistan
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Tănase A, Varady Z, Coriu D, Orban C, Ghiţă C, Grasu M, Streinu Cercel A, Del Bono V. Rhino-cerebral zygomycosis after allogeneic transplant: case report and literature review. Rom J Morphol Embryol 2011; 52:715-718. [PMID: 21655666] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
The proportion of patients with hematological malignancies (HM) who develop rare invasive fungal infections (IFI) has increased worldwide over the past few decades. Zygomycosis is an opportunistic fungal infection, which begins in the nose and paranasal sinuses due to inhalation of fungal spores. Rhino-cerebral zygomycosis is the most common form of the disease, it typically develops in diabetic or immunocompromised patients and presents as an acute fulminate infection, which is often lethal. We report a case of rhino-cerebral zygomycosis in an allotransplanted patient to emphasize early diagnosis and treatment of this potentially fatal fungal infection. We discuss different risk factors, specific diagnosis procedures and review the current concepts in management of zygomycosis.
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Affiliation(s)
- Alina Tănase
- Bone Marrow Transplantation Unit, Fundeni Clinical Institute, Bucharest, Romania.
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Mbarek C, Zribi S, Khamassi K, Hariga I, Ouni H, Ben Amor M, Ben Gamra O, El Khedim A. Rhinocerebral mucormycosis: five cases and a literature review. B-ENT 2011; 7:189-193. [PMID: 22026140] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2023] Open
Abstract
OBJECTIVE In this retrospective study, we describe our experience in the diagnosis and management of rhinocerebral mucormycosis (RCM), a rapidly lethal fungal infection. METHODOLOGY Between 1997 and 2007, five patients hospitalized for suspicion of RCM. Computed tomography was performed in all cases, and diagnosis was confirmed after anatomopathological or mycological examination. All patients underwent medical and surgical treatment. Follow-up was clinical and radiological with a mean period of 17 months. RESULTS All patients were diabetic. Exophthalmia, rhinorrhea, and ophthalmoplegia were the most frequent symptoms observed. One patient had loss of visual acuity and another exhibited peripheral facial palsy. One patient had extensive hemifacial cutaneous necrosis. Nasal endoscopy revealed black necrotic lesions in one case, and another patient had a tumefaction localised in the left middle meatus. Necrotic lesions were most often found in the orbit, the maxillary and the ethmoidal sinuses on computed tomography (four cases for each site). One patient had thrombophlebitis of the cavernous sinus, and another had an intracranial extension. All patients were administered ordinary insulin and intravenous amphotericin B. Surgical debridement of the nasal cavity and the involved sinuses was performed through lateral rhinotomy (four cases) or endoscopy (one case). Unilateral orbital exenteration was associated in two cases. Progression was favourable in four cases; one patient died from sepsis despite aggressive treatment. CONCLUSION Early diagnosis is crucial for the management of RCM. Treatment of underlying disorders, use of intravenous amphotericin B, and aggressive surgical intervention are key in reducing morbidity and mortality rates.
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Affiliation(s)
- C Mbarek
- Department of Otorhinolaryngology-Head and Neck Surgery, Habib Thameur Hospital, Tunis, Tunisia
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Singh AP, Malhotra V, Brar T, Agarwal AK, Khurana N. Primary tuberculosis of nose with intracranial extension: a rare presentation. Indian J Tuberc 2010; 57:220-222. [PMID: 21141342] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
Tuberculosis continues to be a major public health problem. This disease has varying presenting features. We here present a case of primary tuberculosis of the nose with intracranial extension, a very rare presenting feature of tuberculosis.
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Affiliation(s)
- Amit Pal Singh
- Department of ENT, Maulana Azad Medical College and Associated L.N. Hospital, New Delhi
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Morais P, Ferreira O, Nogueira A, Bettencourt H, Azevedo F. A nodulo-ulcerative lesion on the nose. Dermatol Online J 2010; 16:11. [PMID: 20804688] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/29/2023] Open
Abstract
Lupus vulgaris (LV) is a chronic, progressive, and potentially destructive form of cutaneous tuberculosis commonly seen in previously sensitized individuals with moderate to high immunity. We present a case of LV located on the nose of an 84-year-old female patient, discuss the diagnosis and treatment modalities, and emphasize the importance of having a high index of suspicion for this condition.
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Affiliation(s)
- Paulo Morais
- Department of Dermatology and Venereology, Faculty of Medicine, University of Porto, Porto, Portugal
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Oikawa F, Carvalho D, Matsuda NM, Yamada AT. Histoplasmosis in the nasal septum without pulmonary involvement in a patient with acquired immunodeficiency syndrome: case report and literature review. SAO PAULO MED J 2010; 128:236-8. [PMID: 21120437 PMCID: PMC10938995 DOI: 10.1590/s1516-31802010000400012] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2009] [Revised: 06/10/2010] [Accepted: 06/11/2010] [Indexed: 11/22/2022] Open
Abstract
CONTEXT Histoplasmosis is a fungal disease caused by inhaling spores of the fungus Histoplasma capsulatum. The spores can be found in soil contaminated with bird, bat or chicken feces. Histoplasmosis occurs worldwide and is one of the most common pulmonary and systemic mycoses. CASE REPORT We report here the case of a 37-year-old man with acquired immune deficiency syndrome and histoplasmosis in the nasal septum, without pulmonary involvement, that evolved rapidly to disseminated infection, multiple organ failure and death.
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Affiliation(s)
- Fernando Oikawa
- MD. Resident physician, Hospital Municipal de Campo Limpo "Dr. Fernando Mauro Pires da Rocha", São Paulo, SP, Brazil.
| | - Daniela Carvalho
- MD. Resident physician, Hospital Municipal de Campo Limpo "Dr. Fernando Mauro Pires da Rocha", São Paulo, SP, Brazil.
| | - Nilce Mitiko Matsuda
- MD, PhD. Research associate, Department of Surgery and Anatomy, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo (FMRP-USP), Ribeirão Preto, SP, Brazil.
| | - Alice Tatsuko Yamada
- MD, PhD. Cardiologist, Instituto do Coração (InCor), Hospital das Clínicas (HC), School of Medicine, Universidade de São Paulo (USP), São Paulo, and Hospital Municipal de Campo Limpo "Dr. Fernando Mauro Pires da Rocha", São Paulo, SP, Brazil.
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Garg A, Wadhera R, Gulati SP, Singh J. Lupus vulgaris of external nose with septal perforation--a rarity in antibiotic era. Indian J Tuberc 2010; 57:157-159. [PMID: 21043315] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
Lupus vulgaris (LV) is the commonest morphological variant of cutaneous tuberculosis. Case of LV of external nose extending to internal nose causing septal perforation is documented here. Histopathology of biopsy taken confirmed the diagnosis of LV. Patient responded well to Anti-tubercular therapy (ATT).
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Affiliation(s)
- Ajay Garg
- Department of Otorhinolaryngology & Pediatrics, PT.BDS PGIMS, Rohtak, Haryana
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He CY, Jin YL, Liu HG. [Rhinocerebral mucormycosis: report of two cases]. Zhonghua Bing Li Xue Za Zhi 2010; 39:345-346. [PMID: 20654161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
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Bhandare CA, Barad PS. Lupus vulgaris with endopthalmitis--a rare manifestation of extrapulmonary tuberculosis in India. Indian J Tuberc 2010; 57:98-101. [PMID: 21114178] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
We report a case of 17-year-old girl who presented with gradual destruction of the nose along with endopthalmitis and loss of vision of the left eye. On nasal examination, left alae nasi and nasal cartilage was destroyed. Left eye showed signs of endopthalmitis with pthisis bulbi with complete loss of vision. Skin biopsy, FNAC of the lymph nodes were suggestive of tubercular etiology. However, patient did not have any evidence of pulmonary TB. We report this case due to the rare clinical features. The importance of a high index of suspicion and prompt treatment in such atypical forms to prevent morbidity cannot be over-emphasised.
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Affiliation(s)
- Chirag A Bhandare
- Department of Tuberculosis and Chest Diseases, Goa Medical College, Goa.
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Scheepers MA, Keel S, Michaelides M. Bilateral necrotising fasciitis of the ocular adnexa secondary to Pseudomonas aeruginosa septicaemia in a HIV-positive child. Orbit 2010; 29:63-64. [PMID: 20302416 DOI: 10.3109/01676830903258847] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
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