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Chamilos G, Marom EM, Lewis RE, Lionakis MS, Kontoyiannis DP. Predictors of pulmonary zygomycosis versus invasive pulmonary aspergillosis in patients with cancer. Clin Infect Dis 2005; 41:60-6. [PMID: 15937764 DOI: 10.1086/430710] [Citation(s) in RCA: 229] [Impact Index Per Article: 12.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2004] [Accepted: 02/11/2005] [Indexed: 01/03/2023] Open
Abstract
BACKGROUND Pulmonary zygomycosis (PZ), an emerging mycosis among patients with cancer, has a clinical manifestation similar to that of invasive pulmonary aspergillosis (IPA). Most cases of PZ in such patients develop as breakthrough infections if treatment with antifungal agents effective against Aspergillus species is administered. However, clinical criteria to differentiate PZ from IPA are lacking. METHODS We retrospectively reviewed the clinical characteristics and computed tomography (CT) findings for 16 patients with cancer and PZ and for 29 contemporaneous patients with cancer and IPA at the time of infection onset (2002-2004). Patients with mixed infections were excluded. Parameters predictive of PZ by univariate analysis were included in a logistic regression model. RESULTS Almost all patients with PZ (15 of 16) and IPA (28 of 29) had underlying hematological malignancies and typical risk factors for invasive mold infections. In logistic regression analysis of clinical characteristics, concomitant sinusitis (odds ratio [OR], 25.7; 95% confidence interval [CI], 1.47-448.15; P = .026) and voriconazole prophylaxis (OR, 7.76; 95% CI, 1.32-45.53; P = .023) were significantly associated with PZ. The presence of multiple (> or = 10) nodules (OR, 19.8; 95% CI, 1.94-202.29; P = .012) and pleural effusion (OR, 5.07; 95% CI, 1.06-24.23; P = .042) at the time that the patient underwent the initial CT were both independent predictors of PZ in the logistic regression analysis of radiological parameters. No difference occurred in the frequency of other CT findings suggestive of pulmonary mold infections (e.g., masses, cavities, halo sign, or air-crescent sign) between the 2 patient groups. CONCLUSIONS PZ in immunocompromised patients with cancer could potentially be distinguished from IPA on the basis of clinical and radiological parameters; prospective validation is needed.
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Ercan I, Cakir BO, Civelek S, Turgut S. Rhinocerebral mucormycosis: a report of two cases. KULAK BURUN BOGAZ IHTISAS DERGISI : KBB = JOURNAL OF EAR, NOSE, AND THROAT 2005; 15:40-4. [PMID: 16340291] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/05/2023]
Abstract
Rhinocerebral mucormycosis is an aggressive fungal disease that involves the nose, paranasal sinuses, orbit and central nervous system. It may rapidly be fatal. This infection usually occurs secondary to immune suppression, diabetic ketoacidosis, and prolonged use of antibiotics, steroids, and cytotoxic drugs. Management of the condition consists of treatment of the underlying disease and surgical debridement combined with intravenous amphotericin B. This paper presents two patients with rhinocerebral mucormycosis, both suffering from diabetes. Complete recovery was achieved in one patient with surgical debridement of necrotic tissue combined with systemic antifungal treatment, whereas in the other, the disease was complicated with subarachnoid hemorrhage and the patient died on the third day of treatment.
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Singh SK, Wadhwa P, Sakhuja V. Isolated bilateral renal mucormycosis. Urology 2004; 63:979-80. [PMID: 15134995 DOI: 10.1016/j.urology.2003.11.020] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2003] [Revised: 11/07/2003] [Accepted: 11/07/2003] [Indexed: 11/24/2022]
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Pauls DR, Ravenel JG, Judson MA. A neutropenic patient with rapidly progressive lung lesion. Chest 2004; 126:1364-7. [PMID: 15486405 DOI: 10.1378/chest.126.4.1364] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
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Reid VJ, Solnik DL, Daskalakis T, Sheka KP. Management of Bronchovascular Mucormycosis in a Diabetic: A Surgical Success. Ann Thorac Surg 2004; 78:1449-51. [PMID: 15464515 DOI: 10.1016/s0003-4975(03)01406-1] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/03/2003] [Indexed: 11/30/2022]
Abstract
Although cases of pulmonary mucor are scarce, diabetics account for a large percentage of these patients. The synergism of diabetes mellitus and mucormycosis poses potentially devastating bronchopulmonary complications, warranting urgent intervention. This report reviews the efficient workup, along with successful medical and surgical management, of a patient with pulmonary mucormycosis, with evidence of superior vena cava invasion.
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Mehta P, Augustson B, Krishnamurthy S, Jacob A, Roy D, Olliff J, Cook M, Craddock C, Mahendra P. Successful allogeneic haematopoietic stem cell transplantation in patients with poor-risk leukaemia and prior invasive fungal infection. Bone Marrow Transplant 2004; 34:825-6. [PMID: 15361904 DOI: 10.1038/sj.bmt.1704685] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Franquet T, Giménez A, Hidalgo A. Imaging of opportunistic fungal infections in immunocompromised patient. Eur J Radiol 2004; 51:130-8. [PMID: 15246518 DOI: 10.1016/j.ejrad.2004.03.007] [Citation(s) in RCA: 64] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2004] [Revised: 02/26/2004] [Accepted: 03/01/2004] [Indexed: 01/15/2023]
Abstract
Opportunistic fungal infection is a common cause of serious morbidity and mortality in the immunocompromised host. Combination of pattern recognition with knowledge of the clinical setting is the best approach to pulmonary infectious processes. The aim of this article is to assess the chest radiographs and CT imaging features of different opportunistic fungal infections in immunocompromised patients.
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Thomas PA, Geraldine P. Rhino-orbito-cerebral mucormycosis. Indian J Ophthalmol 2004; 52:171-2; author reply 172. [PMID: 15283230] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/30/2023] Open
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Nithyanandam S, Jacob MS, Battu RR, Thomas RK, Correa MA, D'Souza O. Rhino-orbito-cerebral mucormycosis. A retrospective analysis of clinical features and treatment outcomes. Indian J Ophthalmol 2003; 51:231-6. [PMID: 14601848] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/27/2023] Open
Abstract
OBJECTIVE The conventional management of rhino-orbito-cerebral (ROC) mucormycosis includes control of metabolic abnormality, administration of amphotericin B and surgery that spans simple sinus clearance, radical debridement and orbital exenteration. Recent literature includes anecdotal descriptions of successful treatment with conservative management of involved orbits. We evaluated the clinical features and outcome of treatment for the different stages of ROC mucormycosis. METHOD In this retrospective case series, 34 case records of patients with a histopathological diagnosis of ROC mucormycosis treated between 1992 and 2000 were reviewed. Three clinical stages and three treatment groups were identified. Patients with limited sino-nasal disease (Clinical stage I) underwent sino-nasal debridement (Treatment group A). Patients with limited rhino-orbital disease (Clinical stage II) underwent either sino-nasal debridement alone (Treatment group A) or orbital exenteration in addition to sino-nasal debridement (Treatment group B). Patients with rhino-orbito-cerebral disease (Clinical stage III) did not undergo any surgical procedure (Treatment group C). Thirty-three patients received intravenous amphotericin B. Outcome for each group was measured as "Treatment success" (disease free, stable patient with metabolic abnormality under control) and "Treatment failure" (progression of disease with worsening general condition or mortality due to the disease). RESULTS Uncontrolled diabetes in 30 (88.2%) of 34 patients was the commonest underlying disease and 16 (53.3%) of 30 diabetics had ketoacidosis. Chronic renal failure (n = 4), hepatic disease (n = 3) and idiopathic thrombocytopenia (n = 1) were the other underlying diseases. Eleven patients had stage I disease, 16 patients had stage II disease and seven patients had stage III disease. All 11 patients with stage I disease received treatment A; of 16 patients with stage II disease, 7 received treatment A and the remaining with stage III disease received treatment B; 7 patients with stage II disease received treatment C. Ten of 11 patients (91%) with stage I disease had treatment success. In patients with stage II disease, 7 of 7 (100%) with treatment A and 1 of 9 (11.1%) with treatment B had treatment success. All seven patients with stage III disease had treatment failure. CONCLUSION Debridement of the sinuses is necessary in all cases of rhino-orbito-cerebral mucormycosis. Diagnosis in the early stage needs a high degree of suspicion. There is a definite role for retention of orbits in patients whose metabolic derangement is rapidly controlled and orbital involvement is non-progressive.
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Aboutanos MB, Joshi M, Scalea TM. Isolated pulmonary mucormycosis in a patient with multiple injuries: a case presentation and review of the literature. THE JOURNAL OF TRAUMA 2003; 54:1016-9. [PMID: 12777921 DOI: 10.1097/01.ta.0000023169.90650.6b] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Hamilton JF, Bartkowski HB, Rock JP. Management of CNS mucormycosis in the pediatric patient. Pediatr Neurosurg 2003; 38:212-5. [PMID: 12646741 DOI: 10.1159/000069101] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2002] [Accepted: 11/14/2002] [Indexed: 11/19/2022]
Abstract
Rhinocerebral mucormycosis (RM) is a rare, rapidly progressive disorder caused by fungi from the Mucoraceae family. With extensive central nervous system involvement, this disease is uniformly fatal within weeks. Mucormycosis normally presents in poorly controlled diabetics, intravenous drug abusers and immunocompromised patients. Many have advocated radical surgical resection (i.e. exenteration of the cavernous sinus with carotid sacrifice and en bloc resection) with administration of amphotericin B. We present a case of mucormycosis involving the paranasal sinuses and cranial base in a pediatric patient who experienced long-term survival with a more limited resection. We also present a review of the relevant literature. A 14-year-old diabetic male presented with RM with involvement of the bilateral frontal lobes, right basal ganglia and temporal lobe. Additionally, there was involvement of the sphenoid sinus and right cavernous sinus with extension into the posterior fossa along the course of the trigeminal nerve and encasement with narrowing of the right carotid artery. The patient underwent sinus endoscopy with debridement of necrotic fungal tissue and bone. This was followed by craniotomy with evacuation of bifrontal, right temporal and basal ganglia abscesses in such a way that all abscess cavities communicated. An Ommaya reservoir was placed into the largest cavity. The patient continued to receive intrathecal and intravenous antibiotics as well as hyperbaric oxygen therapy. The patient was clinically and radiographically free of disease 1 year after diagnosis. While invasive RM is generally a fatal disease, this rare disorder can be treated successfully without radical resection, particularly if multimodality treatment options are implemented.
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Lee P, Stark P. Diagnostic case study: radiographic findings in the progression of pulmonary mucormycosis. SEMINARS IN RESPIRATORY INFECTIONS 2003; 18:61-3. [PMID: 12652456 DOI: 10.1053/srin.2003.50009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Kim N, Barrie J, Raymond G. Residents' corner. Answer to case of the month #87: Pulmonary mucormycosis with angioinvasion of the left subclavian artery. Can Assoc Radiol J 2002; 53:312-4. [PMID: 12500387] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/28/2023] Open
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Dökmetaş HS, Canbay E, Yilmaz S, Elaldi N, Topalkara A, Oztoprak I, Yildiz E. Diabetic ketoacidosis and rhino-orbital mucormycosis. Diabetes Res Clin Pract 2002; 57:139-42. [PMID: 12062859 DOI: 10.1016/s0168-8227(02)00021-9] [Citation(s) in RCA: 41] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Mucormycosis often develops in immunocompromised patients, particularly in patients with diabetic ketoacidosis. Unless early diagnosis and treatment is established mucormycosis leads rapidly to death. A 38-year-old woman was admitted to the hospital with a severe diabetic ketoacidosis. Her clinical status improved in 4 days as a result of aggressive medical treatment. She has complained left cheek pain on the 10th day and had a swelling of her left cheek, facial edema, a black eschar on the palate and nasal cavity in association with visual disturbance and total ophthalmology in a short time. CT scan revealed left orbital cellulitis and pansinusitis. Excessive surgical treatment was performed and liposomal amphotericin-B, 4 mg/(kg day) was applied. Extensive fungal invasion of the orbit and the sinuses was demonstrated in the pathological species and Rhizomucor species were yielded with culture. Repeated superficial debridement was also performed. After 10 weeks, she was discharged with suggestion of insulin treatment and liposomal amphotericin-B with progressively decreasing doses. At the 13th month following the presentation, the patient was free of disease as confirmed by serial imaging and under good glycaemic control with insulin treatment. Although mucormycosis is a fatal infection, early diagnosis and aggressive treatment may decrease mortality.
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Donado-Uña JR, Díaz-Hellín V, López-Encuentra A, Echave-Sustaeta JM. Persistent cavitations in pulmonary mucormycosis after apparently successful amphotericin B. Eur J Cardiothorac Surg 2002; 21:940-2. [PMID: 12062298 DOI: 10.1016/s1010-7940(02)00081-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
A 67-year-old diabetic male developed bilateral pulmonary mucormycosis (PM). After long-term treatment with amphotericin B (cumulative dose of 30.6 g), clinical resolution was obtained, but small radiographic cavitations persisted. A late relapse occurred and bilateral lobectomy led to a definitive cure. Amphotericin B is not able to penetrate properly into PM cavitations. We suggest that persistence of cavitations should lead to consideration of surgery, even after a good response to amphotericin B.
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MacKenzie KM, Baumgarten KL, Helm BM, McFadden PM, Deduska NJ, Loss GE, Eason JD. Innovative medical management with resection for successful treatment of pulmonary mucormycosis despite diagnostic delay. THE JOURNAL OF THE LOUISIANA STATE MEDICAL SOCIETY : OFFICIAL ORGAN OF THE LOUISIANA STATE MEDICAL SOCIETY 2002; 154:82-5. [PMID: 12014459] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/25/2023]
Abstract
We present a case of primary pulmonary mucormycosis infection in a renal transplant recipient diagnosed serendipitously by computed tomography scan. Treatment included discontinuation of immunosuppressive regimen, initiation of antifungal therapy with amphotericin B lipid complex, administration of granulocyte-macrophage colony stimulating factor, surgical excision of the involved lobe, and outpatient treatment with amphotericin B with dialysis. The patient ultimately required transplant nephrectomy as a result of immunosuppression discontinuation.
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Sohail MA, Al Khabori M, Hyder J, Verma A. Acute fulminant fungal sinusitis: clinical presentation, radiological findings and treatment. Acta Trop 2001; 80:177-85. [PMID: 11600098 DOI: 10.1016/s0001-706x(01)00174-7] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Acute fulminant fungal sinusitis is characterized by acute symptoms and rapid progress with a mortality rate of 60-80%. A large number of survivors have permanent neurological, visual and cosmetic disabilities. This clearly underscores the need of early recognition of this disease in at risk population in order to start urgent treatment. The at-risk population of diabetics, AIDS and other immunosuppressed is likely to increase, as will the incidence of acute fulminant fungal sinusitis. In the present study we have reviewed nine cases of acute fulminant fungal sinusitis to determine clinical presentation, related radiological picture and optimum treatment. Most common presenting features were fever, headache, facial swelling and proptosis. Many patients presented with blindness, facial paralysis and meningitis. Predisposing causes were uncontrolled diabetes with ketoacidosis in four out of six cases, post renal transplant immunosuppression and leukemia. All patients were treated with amphotericin B or liposomal amphotericin B (AmBisome). Diagnosis was confirmed by biopsy and culture of sinus mucosa, soft tissues of cheek, or orbit. Mucor (Zygomycetes) was identified on culture or histopathology in all cases. Surgical debridement was performed in seven cases. Six out of nine patients survived but morbidity was high: only two patients survived without any permanent disability.
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Björkholm M, Runarsson G, Celsing F, Kalin M, Petrini B, Engervall P. Liposomal amphotericin B and surgery in the successful treatment of invasive pulmonary mucormycosis in a patient with acute T-lymphoblastic leukemia. SCANDINAVIAN JOURNAL OF INFECTIOUS DISEASES 2001; 33:316-9. [PMID: 11345227 DOI: 10.1080/003655401300077469] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
Pulmonary mucormycosis is a usually fatal opportunistic infection in immunocompromised patients. We describe the first case of an adult patient with hematological malignancy and profound neutropenia to survive a disseminated pulmonary Rhizomucor pusillus infection. Early diagnostic procedures combined with high doses of liposomal amphotericin B and surgical resection may have contributed to the successful outcome.
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Wohlrab JL, Anderson ED, Read CA. A patient with myelodyplastic syndrome, pulmonary nodules, and worsening infiltrates. Chest 2001; 120:1014-7. [PMID: 11555540 DOI: 10.1378/chest.120.3.1014] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
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Mani NB, Sood BP, Suri S, Vasishta RK. Mucormycosis of rectum - computed tomography findings. Clin Radiol 2001; 56:680-2. [PMID: 11467873 DOI: 10.1053/crad.1999.0456] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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72
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Bakshi NA, Volk EE. Pulmonary mucormycosis diagnosed by fine needle aspiration cytology. A case report. Acta Cytol 2001; 45:411-4. [PMID: 11393076 DOI: 10.1159/000327640] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
BACKGROUND The usefulness of fine needle aspiration cytology (FNAC) in the diagnosis of lung lesions is well documented. Fungal lesions are among nonneoplastic lesions of the lung in which FNAC has proven a useful technique in both immunocompromised and immunocompetent patients. These include cryptococcosis, aspergillosis, histoplasmosis and coccidiodomycosis. Pulmonary mucormycosis, an aggressive fungal infection, is rarely diagnosed on FNAC. We report a case of isolated pulmonary mucormycosis diagnosed on FNAC. CASE A 62-year-old renal transplant recipient with diabetes mellitus and hypertension, asymptomatic for four months, presented with tachypnea, generalized malaise and weakness. Radiologic studies showed an enlarging, cavitating lesion in the right lung. Computed tomography-guided fine needle aspiration performed on the lung lesion showed fungal profiles with broad, ribbonlike, aseptate hyphae with right-angled branching consistent with the Zygomycetes class of fungi, which includes Rhizopus and Mucor species. Fungal cultures confirmed the presence of Rhizopus. The patient underwent right pneumonectomy, was placed on liposomal amphotericin B therapy and discharged with good pulmonary status and stable kidney function. CONCLUSION FNAC is a useful technique in the diagnosis of pulmonary mucormycosis.
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Lahiri TK, Agarwal D, Reddy GE, Bajoria A. Pulmonary mucoraceous fungal ball. THE INDIAN JOURNAL OF CHEST DISEASES & ALLIED SCIENCES 2001; 43:107-10. [PMID: 11529408] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/21/2023]
Abstract
A case of opportunistic pulmonary infection in the form of fungal ball produced by the family of mucoraceae in the class of phycomycetes having nonseptate hyphae (cellophane tubules) with haphazard branching in a post-tubercular immunocompetent patient is described. Clinical course was chronic with right upper lobe cavity invaded by fungi of mucor species, pathology was granuloma with blood vessel thrombosis, and a fungus ball. The host had no associated predisposing diseases. Segmental resectional surgery of the right upper lobe along with removal of fungus ball under the coverage of modified dose of amphotericin B was performed. Literature scanning revealed rarity of mucormycosis in immunocompetent host.
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Holtom PD, Obuch AB, Ahlmann ER, Shepherd LE, Patzakis MJ. Mucormycosis of the tibia: a case report and review of the literature. Clin Orthop Relat Res 2000:222-8. [PMID: 11127659] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
Mucormycosis is an uncommon but highly aggressive fungal infection most commonly occurring in hosts who are immunologically predisposed to infection. Only seven previously documented cases of tibial osteomyelitis attributable to Mucorales infection exist in the literature. An unusual case is reported of mucormycosis osteomyelitis developing in a patient who was immunocompromised after routine tibial Steinmann pin placement for the application of traction. Surgical debridement and amphotericin B were not sufficient to control the infection, and the patient subsequently underwent above-knee amputation. To the authors' knowledge this is the first description of mucormycosis causing osteomyelitis as a result of Steinmann pin tract infection.
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Lee JH, Ha HK, Yoo E, Yang SK, Min YI, Auh YH. CT and sonographically guided biopsy in a patient with intestinal mucormycosis. AJR Am J Roentgenol 2000; 175:129-31. [PMID: 10882261 DOI: 10.2214/ajr.175.1.1750129] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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