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PubMed1989

Subacute disseminated mucormycosis in a diabetic male.

Mucormycosis is an opportunistic invasive infection caused by fungi of the order Mucorales. Rhizopus, Absidia, and Mucor are the most commonly encountered genera. Disease is characterized by vascular invasion, thrombosis, and tissue necrosis. Rhinocerebral disease is the most common manifestation but pulmonary, cutaneous, gastrointestinal, and widely disseminated forms have been reported. Pulmonary and disseminated disease are usually seen in neutropenic patients with leukemia or lymphoma. Both present as fever and unexplained pulmonary infiltrates unresponsive to antibacterials and corticosteroids. Disease is usually fulminant and has a high mortality rate. Diagnosis is most commonly made at autopsy. A single case of disseminated disease is reported that is unusual in its subacute course and its occurrence in an otherwise healthy non-neutropenic diabetic male.

Diabetes Mellitus, Type 1↗

PubMed1982

Rhinocerebral mucormycosis.

We report a case of rhinocerebral mucormycosis associated with diabetic ketoacidosis. The features of this rare, fulminating, fungal infection were not appreciated because of ignorance about the condition. The typical features include continued drowsiness in spite of correction of the diabetic ketoacidosis, black ulcer of the palate, septum or turbinate, facial pain, and cellulitis with varying eye and neurological signs. The general aspects of the infection are discussed, emphasizing that the mainstay of treatment is correction of the underlying condition, surgical debridement, and intravenous amphotericin B. Awareness of the condition will enable early diagnosis and adequate treatment to ensure the best chance of survival.

Brain Diseases↗

PubMed1999

Rhinocerebral mucormycosis: report of two cases.

Rhinocerebral mucormycosis is a rare opportunistic infection caused by fungi. It is commonly fatal and aggressive infection localised paranasal sinuses and orbit. We report two cases had necrotising infection on the left nasolabial region. Despite aggressive surgical debridement and medical treatment, the patients died 6 and 7 days after admission. Plastic Surgeons should be aware when they have a patient with rapidly developing soft tissue infection over the paranasal sinuses and periorbital region. Combined treatment is mandatory for these patients. It usually results in death, but powerful efforts may save the patient.

Adult↗

PubMed2001

Successful treatment of rhino-orbital mucormycosis without exenteration: the use of multiple treatment modalities.

PURPOSE: To describe the successful management of rhino-orbital mucormycosis without the use of orbital exenteration. METHOD: Case report. RESULTS: The patient had successful eradication of the fungal infection with retention of normal vision and ocular function. CONCLUSIONS: The use of multiple treatment modalities including aggressive surgical debridement guided by intraoperative frozen section monitoring, intravenous liposomal amphotericin B, intraorbital regular amphotericin B and hyperbaric oxygen may allow complete resolution of orbital phycomycosis and spare the patient from the blindness and disfigurement associated with exenteration.

Adult↗

PubMedDate not supplied

Rhinocerebral mucormycosis: MR manifestations.

Magnetic resonance (MR) examinations of three patients with rhinocerebral mucormycosis are reviewed. The clinical course is outlined and the MR characteristics are analyzed in light of the known pathology. The major MR findings include sinus and orbital disease followed by deep facial extension. Involvement of basal portions of the hemispheres, brain stem, and hypothalamus occurred rapidly following ipsilateral facial or orbital invasion in all three cases. Regions of intracerebral inflammation were hyperintense compared with normal parenchyma on T2-weighted and proton density-weighted images. Septic cavernous sinus and internal carotid artery thrombosis was diagnosed by MR in one case. Magnetic resonance demonstrated partial resolution of intracerebral abnormalities that accompanied clinical improvement in the one surviving patient.

Adolescent↗

PubMed1987

Primary cutaneous mucormycosis in trauma patients.

Primary cutaneous mucormycosis in trauma patients has been rarely reported. We describe three cases occurring in noncompromised hosts and review the literature. Prompt diagnosis and aggressive treatment with vigorous local care and appropriate antibiotics are recommended.

Adult↗

PubMed1994

Isolated cerebral mucormycosis: case report and therapeutic considerations.

Cerebral mucormycosis (without associated involvement of and invasion from the nasal sinuses and turbinates) is an extremely rare opportunistic infection of the central nervous system. We report the case of an intravenous drug abuser (who was negative for the human immunodeficiency virus) who presented with hemiparesis on the right side, slurred speech, altered mental status, and an unsteady gait. Imaging studies revealed a large left-side basal ganglia lesion. A stereotactic biopsy obtained a tissue sample that revealed wide, nonseptated hyphal fragments with granulomatous inflammation. The patient was treated with 3 gm of amphotericin B during a 5-month period. The patient had no residual neurological dysfunction after treatment. Open surgical resection was not employed. This case suggests that stereotactic biopsy followed by long-term amphotericin B therapy, in lieu of open surgical resection, represents a viable treatment option for this rare disorder.

Adult↗

PubMed1988

Rhinocerebral mucormycosis in an anephric patient.

We have described a fatal case of rhinocerebral mucormycosis in a stable anephric patient who was not diabetic and was not receiving immunosuppressive therapy. In a literature search from 1966 to the present, ours is only the second case of a stable dialysis patient reported with this illness, and it is the only reported fatality.

Adult↗

PubMed1988

Thrombosis of the aorta caused by mucormycosis.

We have reported the case of a 57-year-old man with a myelodysplastic syndrome who had sudden paraplegia and paresthesias of both legs. Myelogram was normal, but an aortogram showed thrombosis of the abdominal aorta. Thrombectomy disclosed a clot composed of nonseptate hyphae with right angle branching, characteristic of the family Mucoraceae. Though angioinvasion and septic thrombosis are characteristic features of mucormycosis, aortic thrombosis has not previously been reported with this infection.

Aorta, Abdominal↗

PubMed1998

Gastric perforation due to mucormycosis after heart-lung and heart transplantation.

BACKGROUND: Gastrointestinal complications are a well-documented source of morbidity and mortality after heart and lung transplantation. METHODS: We report on two patients who presented with gastric perforation caused by mucormycosis during the first 2 months after heart-lung and heart transplantation. RESULTS: In the first patient, the clinical presentation was insidious and the diagnosis was made at an advanced stage of the disease. Despite surgery and aggressive antifungal treatment, the patient died. In the second patient, the diagnosis was made promptly, but despite antifungal treatment, he presented with gastric perforation within a week. CONCLUSIONS: These cases illustrate that fungal invasive disease may be a cause of early gastrointestinal perforation after solid organ transplantation.

Adult↗

PubMed1995

Zygomycosis (mucormycosis) and HIV infection: report of three cases and review.

We report three cases of zygomycosis (mucormycosis) occurring in three individuals infected with the human immunodeficiency virus (HIV) and review 12 other published cases. We present the only two case reports of disseminated zygomycosis in AIDS patients, and the only AIDS patient with renal zygomycosis to survive without nephrectomy, receiving intravenous (i.v.) amphotericin alone. Coinfection with zygomycosis and HIV is rare, occurs primarily in patients with low CD4+ lymphocyte counts, does not always require the usual predisposing conditions for zygomycosis, and may be the presenting opportunistic infection among HIV-infected persons. Transient episodes of neutropenia occurring within 4 months before presentation may be a risk factor for this disease. Zygomycosis may arise in multiple sites including the basal ganglia, cutaneous tissue, kidney, respiratory tract, and may be disseminated. Occurring more commonly in, but not restricted to, injection drug users, it is significantly associated with sites other than basal ganglia in those patients with advanced HIV disease or AIDS. The presenting symptoms are related to the site of involvement, and the illness may develop insidiously or progress rapidly to a fulminant course. Successful therapy usually consists of surgical debridement and intravenous amphotericin B. Overall mortality in this review is 40%, and is significantly associated with sites of disease inaccessible to surgical debridement.

AIDS-Related Opportunistic Infections↗

PubMed1999

Primary cutaneous mucormycosis in a trauma patient.

We report a rare case of primary cutaneous mucormycosis caused by Rhizopus oryzae that occurred in an immunocompetent trauma patient. The patient had encrusted erythematous plaques with pustules on the left shin, which had been abraded in a traffic accident. Histologic examination revealed widespread granulomatous inflammation and characteristic broad, non-septate hyphae with right-angle branching in the dermis. The infection was cured with intravenous amphotericin B therapy.

Accidents, Traffic↗

PubMed1999

Cutaneous mucormycosis.

The patient, a 59-year-old male, had been diagnosed as having alcoholic hepatopathy 20 years previously. He noticed localized swelling on his left leg after fishing in a river. The patient was diagnosed as having cutaneous mucormycosis upon histological and mycological examination of the skin. Gradual improvement of the symptoms was noted four weeks after administration of itraconazole and fruconazole; these were discontinued after five months.

Dermatomycoses↗

PubMed1989

Rhizopus oligosporus as a cause of mucormycosis in man.

After a fracture of the spinal column a 49-year-old male developed a mucormycosis due to Rhizopus oligosporus. This appears to be the first report of a disease caused by this thermotolerant Rhizopus species in a human being.

Cervical Vertebrae↗

PubMed1989

Mucormycosis of the bovine udder.

Nine cross-bred cows suffering from mucormycosis of the udder were observed. Histopathological and cultural examination of the lesions revealed the presence of Mucor spec.

Animals↗

PubMed1996

[Disseminated aspergillosis and mucormycosis. A case report].

This paper reports a simultaneous pulmonary infection due to Aspergillus fumigatus and Rhizomucor pusillus which evolved to disseminated aspergillosis and mucormycosis in a leukaemic and neutropenic 40-year-old woman. Both fungi were cultured ante mortem from bronchial secretion. Although high doses of intravenous amphotericin B were administered, the course of the infection was fatal. At autopsy, aspergilli were demonstrated by histology in lungs and brain, and zygomycetes were found to have invaded liver and kidneys.

Adult↗

PubMed1986

Fatal rhinocerebral mucormycosis in newly diagnosed diabetic.

A 48-year-old male developed fever and sore throat while in Spain and was admitted to hospital, dehydrated, ketotic, pyrexial, and with a blood glucose of 35 mmol/l. Despite treatment with intravenous fluids, insulin, cephalosporin, potassium and bicarbonate he returned to Britain 7 days later, underhydrated and acidotic, though euglycaemic. His face was discoloured, there was painless nasal and maxillary swelling, oral candidiasis, and he went on to develop ophthalmoplegia and sudden blindness. Staphylococcus albus and mycelial fungus were isolated, the latter was identified as Mucor hiemalis, but despite treatment with amphotericin B co-ordinated with radical maxillary-facial surgery he died 31 days after the initial symptoms. Rhinocerebral mucormycosis is a recognized complication of ketoacidosis which is rarely reported in the UK. The organism invades arteries aggressively, therefore radical therapy must be started early to prevent the high mortality.

Brain Diseases↗

PubMed1998

Gastrointestinal mucormycosis mimicking ischemic colitis in a patient with systemic lupus erythematosus.

This report describes the case of a 42-yr-old woman with systemic lupus erythematosus who presented with septic shock. Initially, a source of infection could not be found and the patient was started on stress dose corticosteroids and antibiotics. A CAT scan revealed thickened colon and endoscopy revealed possible ischemic colitis. She soon developed peritonitis, and was taken to surgery where gastrointestinal mucormycosis was found. The patient died despite amphotericin therapy.

Adult↗