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PubMed2002

[Facial mucormycosis: observations from three cases].

The mucormycosis is a rare opportunistic invasive infection caused by fungi of the order Mucorales and characterized by vascular invasion and tissue necrosis. It affects generally the subjects with altered natural resistances, particularly the diabetics patients. The cerebro-rhino-orbital region is the most common site. The clinical signs depend on the intra-tissular and intra-vascular evolution of the fungi. The diagnosis of this disease is asserted by the mycological and anatomo-pathological exams. The treatment is based on the antifungic and the surgical excision of necrotic tissues. We report three observations: one man (42 years) and two women (59 and 60 years). Diabetes was found in two cases. The diagnosis was in every case anatomo-pathologic. Our objective was to study the epidemiological and clinico-pathologic aspects of this serious affection and to discuss its prognosis.

Adult↗

PubMedDate not supplied

[A severe rhinological mycosis: mucormycosis. A report of 3 cases].

Mucormycosis is a fungal infection, the most frequent form begins in the nose and the paranasal sinus and can rich the brain. It is a fulminant and often fatal disease, not well known by many specialists. The authors present three cases with positive cultures, histology and postmortem studies, drawing attention to the importance of its prompt diagnosis and aggressive treatment.

Aged↗

PubMed2003

Isolated fatal renal mucormycosis in a patient with chronic obstructive pulmonary disease and tuberculosis.

Renal mucormyosis is a rare entity and normally diagnosed at postmortem. Isolated cases diagnosed antemortem are even rarer and only a few cases have been reported. The disease is associated with a high mortality rate, especially in patients with underlying disease. Clinical presentation is non-specific and includes flank pain, fever and pyuria with or without haematuria. Identifying fungal hyphae microscopically is essential for diagnosis. We present a rare isolated fatal case of renal mucormycosis in a 77-year-old man with chronic obstructive pulmonary disease (COPD) and old tuberculosis (TB) who had been diagnosed after a right nephrectomy. We believe early diagnosis and appropriate treatment for fungal infection, together with the predisposing underlying disease, is crucial for survival.

Aged↗

PubMed1992

Dialysis associated mucormycosis and desferrioxamine treatment: a case report with review of the role of oxygen radicals.

A hemodialysis patient with pulmonary and cerebral mucormycosis is reported. Recently the occurrence of this infection in dialysis patients has been associated with desferrioxamine (DFO) treatment. A causal relation seems likely, but has not been proved. Several pathogenetic mechanisms are discussed, in particular the influence of DFO on host neutrophil defenses through a decreased oxygen radical production.

Adult↗

PubMed2004

[A case of endobronchial mucormycosis with peculiar bronchoscopic findings].

Small cell lung cancer was diagnosed in a 54-year-old man in 1997. He had received 5 cycles of systemic chemotherapy and thoracic irradiation since 1997, and a favorable response had been achieved. In August 2001, pro-GRP was again elevated, and he was readmitted. Bronchoscopic findings revealed a white dendritic endobronchial mass on a cheese-like plug obstructing the left upper bronchus division. Numerous mucor hyphe and cancer cells were detected by transbronchial biopsy, and a fungal culture disclosed mucor. Although no antifungal drug was administered, the bronchial lesion disappeared after removal with biopsy forceps and 2 cycles of systemic anticancer chemotherapy. Endobronchial involvement of mucormycosis is rare and this case is unique because of the peculiar bronchoscopic finding with the endobronchial lesion.

Antineoplastic Combined Chemotherapy Protocols↗

PubMed2005

[A case of healed orbito-facial mucormycosis with dental origin].

A case and the treatment of a 42-year-old male patient with orbito-facial mucormycosis are presented by the authors. The most important steps in the treatment of this opportunistic infection--with a lethality rate of 30-50 %--are as follows: immediate diagnosis, specific antimycotic therapy (Amphotericin-B treatment), a series of extensive surgical interventions and adequate control of patient's diabetes mellitus.

Adult↗

PubMedDate not supplied

Combined mucormycosis and Aspergillosis of the rhinocerebral region.

BACKGROUND: Opportunistic fungal infections are rare, life-threatening conditions and are a major cause of morbidity and mortality in immunocompromised hosts. Our experience in the management of a case of combined mucormycosis and aspergillosis of the rhinocerebral region is presented. PATIENTS AND METHODS: The infection developed a few weeks after tooth extraction, massively involving facial structures. After diagnosis, the patient underwent prolonged combined systemic antifungal treatment. Once the local and general conditions had stabilized, an extensive surgical debridement was performed, followed by reconstruction with a pedicled myocutaneous flap. RESULTS: This approach was curative with patient survival after 16 months. CONCLUSION: Early diagnosis, early anti-fungal treatment and early stabilization of the patients' general condition are fundamental for patient survival. Surgery is necessary for fungal eradication, but must be performed according to the above conditions. Pedicled muscle flaps are considered the first reconstruction choice because of their excellent blood perfusion and resistance to fungal invasion.

Amphotericin B↗

PubMed2006

Rhino-orbito-cerebral mucormycosis: a treatment dilemma.

A case of rhino-orbito-cerebral mucormycosis is presented showing its aggressive nature and progression of disease. The typical clinical features, neuroimaging and histological findings are highlighted in this report. Amphotericin B and surgical debridement remain the mainstay of treatment. However, associated co-morbidities need to be addressed.

Amphotericin B↗

PubMed2006

[Renal mucormycosis].

The authors report a case of disseminated mucormycosis presenting with left renal and muscular involvement in a 20-year-old immunocompetent man. The patient died rapidly before the diagnosis, established on histopathological examination of the nephrectomy specimen. This case illustrates the diagnostic difficulties and poor prognosis of this rare fungal infection.

Adult↗

PubMed2006

Mucormycosis in a patient with low risk myelodysplasia treated with anti-TNF-alpha.

Accelerated programmed cell death or apoptosis appears to play an important role in the pathogenesis of myelodysplasia. As overexpression of TNF-alpha has been described to induce cell death in myelodysplasia, treatment with anti-TNF-alpha is currently being explored. Caution is needed because of an increased risk of opportunistic infection during anti-TNF-alpha treatment. We here describe a patient who was treated with anti-TNF-alpha for low risk myelodysplasia and died of invasive mucormycosis.

Anemia, Refractory↗

PubMed1991

Rhinocerebral mucormycosis associated with diabetic ketoacidosis.

Rhinocerebral mucormycosis with hemiparesis occurred in a young woman who was not a known diabetic. Rhyzopus species grew from the initial nasal biopsy. The patient was treated with amphotericin B, in addition to control of diabetic ketoacidosis. Surgical intervention was not done. The patient died on the fourth day of hospitalisation.

Adult↗

PubMed1991

[Disseminated mucormycosis in pediatrics].

The case of a 14 month-old infant presenting with hereditary lymphohistiocytosis is reported. After several days of post-chemotherapy aplasia a peritoneal, cutaneous (blackish necrosis), then pleuropulmonary involvement occurred. Fiberendoscopy showed an esophageal necrosis responsible for a pleural fistula. The child died after a few weeks, despite antifungal treatment. Post mortem examination found disseminated abscesses related to mucormycosis. The 41 pediatric cases in the world-wide literature are recorded.

Female↗

PubMed1991

[Disseminated mucormycosis in a hemodialyzed female patient treated with deferoxamine].

A case is presented of a patient affected of chronic renal failure caused by multiple myeloma who was under a chelating treatment with Depreroxamine as a consequence of iron intoxication and suffered a disseminated mucormycosis. We performed a literature search of previous cases and discuss the probable relation between this opportunistic infection and depheroxamine treatment.

Deferoxamine↗

PubMed1991

[Rhinocerebral mucormycosis. Apropos a case].

We present a case of rhinocerebral mucormycosis in a 47 years old woman without diabetic or immunodepression past. The diagnosis was confirmed through a histological study of the material obtained after surgery. The treatment with amphotericin B and radical surgery showed ineffective. The patient died two weeks after entrance. We make an evaluation of the etiopathological, clinical and therapeutic aspects and also a revision of the relevant literature.

Amphotericin B↗

PubMed1990

Rhinocerebral mucormycosis: report of two cases.

Rhinocerebral mucormycosis developed in two poorly controlled diabetic patients with clinical manifestations of frontal headache, ophthalmoplegia, ptosis, proptosis, epistaxis and facial numbness. Early computed tomography (CT) of the head revealed fluid accumulation in paranasal sinuses. The diagnosis of this disease relied upon CT of the head, and biopsy or culture of the mucosa of sinuses. Remarkable improvement was noted following prompt surgical debridement and amphotericin-B therapy. We conclude that early diagnosis and aggressive treatment is the only way to save patient's life.

Aged↗

PubMed1990

[Naso-orbito-cerebral mucormycosis. A more & more common disease].

A typical case of naso-orbital-cerebral mucormycosis is described. This rare but serious disease mainly occurs in fragile patients, notably diabetics or those undergoing an immunosuppressant treatment. The cases recorded are therefore increasingly frequent. Mucorales, normally saprophytic, germinate in the nasal cavities due to an infection and then colonize the sinuses, the orbit, followed by the meninges. The diagnosis must be made before meningeal impairment when faced with a peri-orbital edema, the beginning of exophtalmy or oculomotor paralysis in high-risk patients with sinusal opacity. The diagnosis is based on the histology and the mucology which must be directed by the clinician: indeed, the histology of the naso-sinusal mucosa samples must be performed using special stains. The mycological samples must also be taken from special environments. Once the diagnosis is confirmed, the required treatment with high doses of intravenous Amphotericine B must be administered immediately, otherwise the evolution is fatal.

Brain Diseases↗

PubMedDate not supplied

Gastric mucormycosis.

A case of gastric mucormycosis proven on culture and histologic examination and successfully treated with resectional surgery and Amphotericin B is described.

Adult↗

PubMedDate not supplied

[Rhinocerebral mucormycosis. Apropos of a case].

We present a 43-year-old patient with a history of immunodepression secondary to a renal transplant, chronic herpetic hepatitis and steroid diabetes, who showed sudden symptomatology suggestive of rhinocerebral mucormycosis, which was confirmed through cultures of the material obtained after a Caldwell-Luc operation of the affected sinus. Once the diagnosis was confirmed, a radical left superior maxillectomy was performed and medical treatment with progressive doses of amphotericin B was given. The patient improved markedly and left the hospital four months later.

Adult↗