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At least 253 records · Page 14Linked to original sources

PubMed1990

Rhinocerebral mucormycosis: management and survival after carotid occlusion.

Rhinocerebral mucormycosis is a rare but often fatal fungal infection. We present 2 patients with mucormycosis complicated by internal carotid artery thrombosis. Magnetic resonance imaging was superior to computed tomography in localizing the pathological process. Subtotal resection of devitalized tissue and intravenous amphotericin B therapy resulted in a successful outcome for both patients. Prompt recognition of this disorder by using modern diagnostic and therapeutic modalities promises to improve survival rates.

Adult↗

PubMed2008

Invasive rhino-maxillary mucormycosis diagnosed before HSCT.

We report a case of successful allogeneic hematopoietic stem cell transplantation (HSCT) with full myeloablative conditioning in a patient with pre-existing invasive mucormycosis. The mucormycosis involved the maxilla, the nasal septum, and the hard palate. Sustained antifungal therapy and aggressive surgery both before and after HSCT were required.

Adolescent↗

PubMed1985

Myocardial infarct in disseminated mucormycosis: case report with special emphasis on the pathogenic mechanisms.

A case of myocardium infarction in generalized mucormycosis is reported in a patient suffering from chronic renal failure and receiving a cadaver kidney transplant. At autopsy we found a recent necrotic myocardium, coronary vessels occluded by mucor hyphae and a striking absence of inflammatory cells, chiefly neutrophils. Ultrastructural studies revealed thick-walled fungus that participate in the thrombus and cross the coronary artery in a 'corkscrew' pattern, without important cellular degeneration. Thin-walled irregularly branching structures were observed occluding the microcirculation of still preserved cardiac areas. These structures could be originated from the fungus cells that had lost their thick laminated wall, leaving the plasmatic membrane as external coat. Special emphasis is given to the relation between the poor coronary vascular protection against mucormycosis and the neutrophilic disfunction. The lungs are the main site of primary infection. This disease is underdiagnosed in vivo and leads always to death.

Adult↗

PubMed1996

Nonsurgical cure of isolated cerebral mucormycosis in an intravenous drug user.

The case of a 30-year-old, female, HIV-positive intravenous drug user who suffered from isolated cerebral mucormycosis is reported. Treatment with amphotericin B at an accumulative dose of 5.5 grams led to significant recovery, and there was no recurrence of disease over a follow-up period of six months. Patients with isolated cerebral mucormycosis in whom surgery would be a high-risk or impossible procedure could be managed medically with prolonged courses of intravenous amphotericin B.

Adult↗

PubMed1994

Isolated renal mucormycosis in two AIDS patients.

Two cases of mucormycosis in patients with exclusively renal involvement and advanced HIV infection are reported. In both cases the clinical course was relatively benign; in one case a tendency towards regression with no specific treatment was observed, and in the other case the infection resolved after nephrectomy and antifungal therapy. Renal mucormycosis should be considered in the differential diagnosis of diffuse renal enlargement in HIV-infected patients.

AIDS-Related Opportunistic Infections↗

PubMedDate not supplied

Massive renal infarction due to mucormycosis in an AIDS patient.

Isolated renal infection by Mucor spp. occurs very rarely, even in the immunocompromised host. The mortality of the different forms of mucormycosis reaches 75-100% in most series. Infection of the kidney is usually diagnosed post-mortem. Thus, when renal infection is recognized, aggressive treatment including surgery and amphotericin B is required. We present a case in which a massive left renal infarction was the unique manifestation of mucormycosis in an AIDS patient. Administration of amphotericin B and left nephrectomy were necessary to achieve satisfactory outcome.

Acquired Immunodeficiency Syndrome↗

PubMed2004

Outbreak of gastric mucormycosis associated with the use of wooden tongue depressors in critically ill patients.

OBJECTIVE: To describe a nosocomial outbreak of gastric mucormycosis caused by Rhizopus microsporus var. rhizopodiformis in five adult patients admitted to an intensive care unit (ICU). DESIGN: Epidemiological surveillance study. SETTING: A 12-bed polyvalent ICU of an acute care teaching hospital in Pamplona, Spain. PATIENTS: Five patients admitted to the ICU requiring artificial ventilation, diagnosis on admission severe pneumonia in four patients and one polytrauma patient, within a 14-week period, were diagnosed with gastric mucormycosis based on microbiological and/or histopathological characteristics. Upper gastrointestinal bleeding was the presenting manifestation in 80% of patients. INTERVENTIONS: Filamentous fungi isolated at the microbiology laboratory of the hospital were examined at the national Mycology Reference Laboratory in Madrid. MEASUREMENTS AND RESULTS: Rhizopus microsporus var. rhizopodiformis growth was detected in gastric aspiration samples, environmental samples, wooden tongue depressors used to prepare oral medications (and given to patients through a nasogastric catheter), and in some tongue depressors stored in unopened boxes unexposed to the ICU environment. All depressors were purchased from the same supplier. R. microsporus was not isolated from batches purchased at different times from the same supplier and from another supplier. The outbreak terminated when contaminated tongue depressors were withdrawn from use. CONCLUSIONS: Wooden tongue depressors contaminated by R. microsporus var. rhizopodiformis used to prepare oral medications caused an outbreak of fungal gastritis with an attributable mortality of 40%. Wooden material should not be used in the hospital setting.

APACHE↗

PubMed2005

Mucormycosis spondylodiscitis after lumbar disc puncture.

Vertebral osteomyelitis due to mucormycosis is a rare but fulminant and fatal disease. Only one case has been reported in literature, with postmortem diagnosis. The present paper reports a female case of mucormycosis spondylodiscitis and vertebral osteomyelitis after lumbar disc puncture and radio frequency nucleoplasty. She subsequently underwent two surgical debridements, continuous local irrigation and drainage, together with local and systemic Amphotericin B treatments. The infection was controlled 4 months after the second debridement; however, there was no improvement in the neurological function at the most recent follow-up, 16 months after the surgery. The experience of this patient, though a single case, supports early recognition, surgical debridement, systemic and local antifungal treatment, closed irrigation and drainage as the keys to successful treatment.

Antifungal Agents↗

PubMed2006

Mucormycosis resulting in gastric perforation in a patient with acute myelogenous leukemia: report of a case.

Mucormycosis is an uncommon opportunistic fungal infection that may develop in immunocompromised patients with conditions such as diabetes mellitus, leukemia, lymphoma, or human immunodeficiency virus (HIV), or after transplantation with immunosupperessive therapy. We report a case of gastric perforation caused by a mucormycosis infection in a patient with acute myelogenous leukemia (AML). The patient was treated successfully with gastrectomy and the aggressive use of intravenous amphotericin B. He is still alive 1 year after his operation.

Amphotericin B↗

PubMed1998

Two cases of disseminated mucormycosis in patients with hematological malignancies and literature review.

Two cases of disseminated mucormycosis in patients with underlying hematological disease are described. Both patients presented with fever and pulmonary infiltrates which did not respond to empirical treatment with broad-spectrum antibiotics and antifungal agents, and in both patients there was rapid progression with a fatal outcome. All cultures were negative and the diagnosis was made postmortem. A review of the literature revealed only three recent reports of successful treatment of disseminated mucormycosis. Survival correlated with control of the underlying disease and early diagnosis based on histological examination of biopsy specimens from suspected lesions. Therapy consisted of surgical debridement and amphotericin B. Standard therapeutic schedules need to be defined for this infection.

Adult↗

PubMed2003

Pulmonary resection with chest wall removal and reconstruction for invasive pulmonary mucormycosis during antileukemia chemotherapy.

A 54-year-old woman undergoing chemotherapy for acute myeloid leukemia developed invasive pulmonary mucormycosis in the right upper lobe at the neutropenic nadir. Amphotericin B therapy became ineffective after an abscess formed in the affected lung, and insufficient infection control compelled us to interrupt chemotherapy. The lesion was suspected of invading the anterior chest wall. After right upper lobectomy combined with the anterior chest wall resection, the chest wall defect was reconstructed using autologous free rib grafts. Successful control of the fungal infection by resection enabled us to restart chemotherapy with concomitant use of Amphotericin B. In selected cases of leukemia-associated pulmonary mucormycosis refractory to Amphotericin B therapy, aggressive surgical intervention may facilitate anti-leukemia chemotherapy and prolong survival.

Female↗

PubMed1994

Postoperative intramyocardial abscess caused by mucormycosis.

We report the case of an intramyocardial abscess caused by mucormycosis that arose after cardiac operation. Several causes of immunosuppression in a 71-year-old woman were exacerbated after she underwent coronary revascularization. Before she died of multiple organ system dysfunction, a variety of supraventricular and ventricular arrhythmias, as well as complete heart block, developed, but the cause was not clear until autopsy revealed a large septal myocardial abscess due to mucormycosis.

Abscess↗

PubMed1975

Rhinocerebral mucormycosis: diagnosis and treatment. Report of two cases.

Rhinocerebral mucormycosis (phycomycetes), a human fungal disease with oral and perioral findings, has an extremely high morbidity and mortality. The disease is most frequently seen in patients with poorly controlled diabetes. The symptoms, findings, and treatment of rhinocerebral mucormycosis are discussed, and two case histories are presented.

Adult↗

PubMed1980

Rhinomaxillary mucormycosis in a kidney transplant patient.

Rhinomaxillary mucormycosis is an uncommon but important pathologic entity with a rapidly fatal course if treatment is delayed. This is of particular interest to dentists, since many of the earliest clinical signs appear in the oral and perioral regions. Successful therapy demands early diagnosis by biopsy, institution of amphotericin B therapy, and surgical débridement. A case of nonfatal rhinomaxillary mucormycosis is presented, and all other reported cases in transplant patients are reviewed.

Adult↗

PubMed1982

Mucormycosis in leukemia.

Rhinocerebral mucormycosis is a virulent, rapidly progressive, potentially fatal illness which demands early diagnosis and aggressive medical and possible surgical therapy. Although most commonly reported in persons with poorly controlled diabetes, it may occur in other immunosuppressed hosts. In persons with leukemia the disease has been uniformly fatal. A well-documented case of fatal rhinocerebral mucormycosis in a leukemic patient is presented to illustrate the diagnostic and therapeutic dilemmas often faced. A review of the 233 cases thus far reported in the literature is used as a spring-board for a discussion of the pathogenesis, diagnosis, and management of this disease.

Adult↗

PubMed1989

Orofacial mucormycosis.

Two cases of orofacial mucormycosis are reported. The first patient represents the typical progression of rhinocerebral mucormycosis with infiltration of the sinuses, the orbit, and the brain. The second patient had a tumorous maxillary lesion resembling fibrous dysplasia clinically and radiographically. Microscopically, the fungal infection in case 2 was associated with new bone formation. The significance of this phenomenon is discussed, and the importance of early diagnosis and possible treatment regimens are highlighted.

Adolescent↗

PubMed1987

Prosthetic mitral valve mucormycosis caused by Mucor species.

We report, to the best of our knowledge the first case of prosthetic mitral valve mucormycosis caused by Mucor species in an 18-year-old female after mitral valve replacement. She was successfully treated with surgery and antifungal treatment. Mucormycosis was documented by direct demonstration, isolation and histopathological findings of the fungus from embolus and prosthetic mitral valve thrombus.

Adolescent↗

PubMed1993

Cutaneous mucormycosis resembling superficial granulomatous pyoderma in an immunocompetent host.

Primary cutaneous mucormycosis is uncommon and occurs mainly in immunosuppressed or diabetic patients or after localized trauma. We report a case of cutaneous mucormycosis in an immunocompetent man in whom no definite precipitating factors could be identified; initially, superficial granulomatous pyoderma was suspected clinically. The lesion was successfully treated with debridement, local wound care, parenteral administration of amphotericin B, and ultimately by surgical excision and split-thickness skin grafting.

Dermatomycoses↗