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Biomedical subjects

Saad J Taj-Aldeen

Publications and source records attributed to Saad J Taj-Aldeen.

6 recordsLinked to original sources

Global guideline for the diagnosis and management of candidiasis: an initiative of the ECMM in cooperation with ISHAM and ASM.

Candida species are the predominant cause of fungal infections in patients treated in hospital, contributing substantially to morbidity and mortality. Candidaemia and other forms of invasive candidiasis primarily affect patients who are immunocompromised or critically ill. In contrast, mucocutaneous forms of candidiasis, such as oral thrush and vulvovaginal candidiasis, can occur in otherwise healthy individuals. Although mucocutaneous candidiasis is generally not life-threatening, it can cause considerable discomfort, recurrent infections, and complications, particularly in patients with underlying conditions such as diabetes or in those taking immunosuppressive therapies. The rise of difficult-to-treat Candida infections is driven by new host factors and antifungal resistance. Pathogens, such as Candida auris (Candidozyma auris) and fluconazole-resistant Candida parapsilosis, pose serious global health risks. Recent taxonomic revisions have reclassified several Candida spp, potentially causing confusion in clinical practice. Current management guidelines are limited in scope, with poor coverage of emerging pathogens and new treatment options. In this Review, we provide updated recommendations for managing Candida infections, with detailed evidence summaries available in the appendix.

Humans↗

Gangrenous necrosis of the diabetic foot caused by Fusarium acutatum.

Foot infections are common and serious complications of diabetic patients. We report the case of a 68-year-old patient with a diabetic foot infection that developed into a gangrenous necrosis. Fusarium spp. was isolated on two successive occasions with no other associated microorganisms. Histopathology demonstrated invasion of the fungus into the tisssue. These findings suggested an infection rather than colonization. A detailed morphological study showed that the isolate was Fusarium acutatum, which was confirmed by rDNA sequencing. This fungus is found only in Asia and has not been previously reported as a human pathogen.

Aged↗

Co-isolation of Trichosporon inkin and Candida parapsilosis from a scalp white piedra case.

White piedra is a rare fungal infection of the hair shaft characterized by small, firm, irregular white-brown nodules. The infection is caused by basidiomycetous yeasts in the genus Trichosporon. We report a case of a 28-year-old female patient who acquired the infection in Qatar. In this case, the scalp was the only site affected, but infection at that site was extensive. The hair had a Saccharomyces-like yeast odor and appeared to be beaded, with light-brown nodules of varying sizes up to 2 mm long. Trichosporon sp. accompanied by Candida parapsilosis grew out along hair shafts planted in primary isolation media. Molecular identification of the Trichosporon carried out by analyzing the 26S ribosomal gene gave a 100% match with Trichosporon inkin, a major cause of pubic white piedra. The patient was treated with daily applications of ketoconazole shampoo followed by econazole shampoo and cream, and was considered clinically and mycologically cured after 2 months. Novel findings in the present case are the first identification of T. inkin as an agent of scalp white piedra, and the heavy outgrowth of C. parapsilosis from the concretions, although in the latter case it is not clear if the co-occurring yeast was etiologically contributory to the pathogenesis of the white piedra.

Adult↗

Rhinoorbital mucormycosis secondary to Rhizopus oryzae: a case report and literature review.

Mucormycosis is a form of fulminant invasive fungal infection of the sinonasal tract that often extends to the orbit, brain, palate, and skin. It is caused by members of the order Mucorales, and it is considered to be the most fatal fungal infection known to man because it is rapidly disseminated by the blood vessels. It is most commonly associated with diabetic ketoacidosis, hematologic malignancies, acquired immunodeficiency syndrome, and immunosuppressive therapy. This rare opportunistic infection exists in many forms, the most common of which is rhinocerebral mucormycosis. Treatment includes aggressive surgical debridement of the necrotic tissue combined with systemic antifungal therapy. In this case report, we describe the successful management of rhinoorbital mucormycosis, a subtype of the rhinocerebral variety, secondary to Rhizopus oryzae that developed in a patient with lymphoma. We review the diagnostic work-up and discuss the literature with respect to the presentation, pathophysiology, management, and outcome of the disease.

Antifungal Agents↗

Allergic Aspergillus flavus rhinosinusitis: a case report from Qatar.

Fungal involvement in rhinosinusitis is classified into four major forms: allergic, mycetoma, chronic invasive (indolent) and acute invasive (fulminant). It can become life threatening if not diagnosed and treated properly. The preliminary diagnosis is usually made by nasal endoscopy and computed tomography (CT) imaging, but tissue biopsy and culture are of vital importance in confirming the disease and in planning treatment. We present a case of allergic fungal rhinosinusitis (AFS) caused by Aspergillus flavus. The clinical manifestation of the disease was the presence of an extensive left nasal polyp. An allergic workup revealed systemic eosinophilia (11.7%), high serum IgE levels (1,201 IU/ml) and a positive skin test for Aspergillus. CT scan showed a total opacification and expansion of the left nasal cavity and sinuses, with a secondary inflammatory reaction on the right side. There was no bony erosion beyond the sinus walls. The patient was operated on using an endoscopic approach (polypectomy and ethmoidectomy), where an abundant amount of allergic fungal mucin and dark crusts were found filling the sinuses. Fungal hyphae were evident in histopathological sections of the removed mucin. Culture of the debris resulted in the growth of Aspergillus flavus. The patient received a full course of systemic and topical steroids. The serum IgE level had dropped to 353 IU/ml and the peripheral eosinophil count to normal (1.38%) by the 10th postoperative month. Surgical debridement and corticosteroids may keep the disease quiescent for a long time.

Aged↗

Allergic fungal rhinosinusitis: a report of 8 cases.

Eight patients presented with clinical manifestations such as polyps and mucin were reported to have allergic fungal rhinosinusitis (AFS). Histopathologic sections from tissue samples containing mucin from the paranasal sinuses obtained by endoscopic operation showed scattered hyphal elements within the allergic mucin but no tissue invasion. Associated fungi were 4 cases of Aspergillus flavus; a case each of Aspergillus niger and Bipolaris hawaiiensis, mixed colonization with B. hawaiiensis, and Curvularia lunata; and 1 case of Bipolaris species. Elevated immunoglobulin E level was reported in some patients ranging from (706 to 1969 IU/mL). All patients underwent endoscopic surgery; polypectomy and clearance of all affected sinuses were performed. Medical treatment involved the use of local and systemic corticosteroids. The patients have done well, with no evidence of recurrent disease.

Adolescent↗