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de Guimarães JA, Boasquevisque GS, Gaspar GG, Podolsky-Gondim GG, Mello FLV, Valera FCP, Chahud F, Cruz AAVE. Progressive chronic calvarial osteomyelitis in rhino-orbital mucormycosis associated with COVID-19. Orbit 2024; 43:119-125. [PMID: 35642653 DOI: 10.1080/01676830.2022.2080233] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Accepted: 05/16/2022] [Indexed: 10/18/2022]
Abstract
We describe two cases of extensive indolent calvarial osteomyelitis after rhino-orbital-mucormycosis in diabetic patients previously diagnosed with COVID-19. Both patients presented with acute rhino-orbital symptoms about one month after being diagnosed with COVID-19. Treatment with intravenous liposomal Amphotericin B and prompt radical surgical debridement was instituted, but calvarial osteomyelitis ensued and persisted chronically despite maintenance of antifungal therapy and partial debridement of necrotic calvarial bone. The patients were discharged to continue antifungal therapy on a day-hospital regime. After more than 8 months of treatment, they remain with radiological signs of osteomyelitis but with no symptoms or intracranial extension of the infection. Calvarial indolent osteomyelitis secondary to mucormycosis is extremely rare, and little is known regarding its treatment. We believe it can be controlled with medical treatment and partial bony debridement although more studies are necessary to better define therapy.
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Affiliation(s)
- Juliana Albano de Guimarães
- Division of Ophthalmology, Department of Ophthalmology, Otorhinolaryngology, and Head and Neck Surgery, School of Medicine of Ribeirão Preto - University of São Paulo, São Paulo, Brazil
| | | | - Gilberto Gambero Gaspar
- Division of Infectious Diseases, Department of Internal Medicine, School of Medicine of Ribeirão Preto - University of São Paulo, São Paulo, Brazil
| | - Guilherme Gozzoli Podolsky-Gondim
- Division of Neurosurgery, Department of Surgery and Anatomy, School of Medicine of Ribeirão Preto - University of São Paulo, São Paulo, Brazil
| | - Fábio Longarini Veríssimo Mello
- Division of Head and Neck Surgery, Department of Ophthalmology, Otorhinolaryngology and Head and Neck Surgery, School of Medicine of Ribeirão Preto - University of São Paulo, São Paulo, Brazil
| | - Fabiana Cardoso Pereira Valera
- Division of Otorhinolaryngology, Department of Ophthalmology, Otorhinolaryngology, and Head and Neck Surgery, School of Medicine of Ribeirão Preto - University of São Paulo, São Paulo, Brazil
| | - Fernando Chahud
- Department of Pathology, School of Medicine of Ribeirão Preto - University of São Paulo, São Paulo, Brazil
| | - Antonio Augusto Velasco E Cruz
- Division of Ophthalmology, Department of Ophthalmology, Otorhinolaryngology, and Head and Neck Surgery, School of Medicine of Ribeirão Preto - University of São Paulo, São Paulo, Brazil
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Stornaiuolo A, Iodice R, De Simone R, Russo C, Rubino M, Braca S, Miele A, Tozza S, Nolano M, Manganelli F. Multiple cranial neuropathy due to varicella zoster virus reactivation without vesicular rash: a challenging diagnosis. Neurol Sci 2023; 44:3687-3689. [PMID: 37156980 PMCID: PMC10495477 DOI: 10.1007/s10072-023-06833-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Accepted: 04/26/2023] [Indexed: 05/10/2023]
Abstract
Ramsay Hunt syndrome is due to reactivation of varicella zoster virus (VZV) dormant in the geniculate ganglion of the facial nerve. The diagnosis is typically based on clinical triad of ipsilateral facial paralysis, otalgia, and vesicles in the auditory canal or the auricle. However, Ramsay Hunt syndrome may occur without skin eruption in up to one third of patients. Moreover, the involvement of other cranial nerves in addition to the facial nerve has been also reported. Herein, we reported a case report of a man who developed a multiple cranial neuropathy caused by VZV reactivation without skin vesicular eruption. The present case underlines a possible diagnostic challenge that clinicians may hit when facing a common disorder such as peripheral facial palsy. Indeed, clinicians must be aware that Ramsay Hunt syndrome may develop without skin vesicular eruption as well it may be complicated by multiple cranial nerve involvement. Antiviral therapy is effective in VZV reactivation for recovery of nerve function.
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Affiliation(s)
- Antonio Stornaiuolo
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University Federico II of Naples, 80131, Naples, Italy.
| | - Rosa Iodice
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University Federico II of Naples, 80131, Naples, Italy
| | - Roberto De Simone
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University Federico II of Naples, 80131, Naples, Italy
| | - Cinzia Russo
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University Federico II of Naples, 80131, Naples, Italy
| | - Marica Rubino
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University Federico II of Naples, 80131, Naples, Italy
| | - Simone Braca
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University Federico II of Naples, 80131, Naples, Italy
| | - Angelo Miele
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University Federico II of Naples, 80131, Naples, Italy
| | - Stefano Tozza
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University Federico II of Naples, 80131, Naples, Italy
| | - Maria Nolano
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University Federico II of Naples, 80131, Naples, Italy
| | - Fiore Manganelli
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University Federico II of Naples, 80131, Naples, Italy
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Xu K, Charles D, Ismael S, Zhang J. A Case of Severe Chronic Multifocal Osteomyelitis of the Skull Caused by Klebsiella pneumoniae in Mali. Infect Drug Resist 2023; 16:6139-6143. [PMID: 37719648 PMCID: PMC10505023 DOI: 10.2147/idr.s426775] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2023] [Accepted: 09/07/2023] [Indexed: 09/19/2023] Open
Abstract
Highly invasive infections caused by Klebsiella pneumonia, which includes bacteremia, liver abscess, meningitis, septic arthritis, and osteomyelitis, in not commonly seen in adult immunocompetent and immunocompromised patients. Here, we report an adult case of chronic multifocal osteomyelitis with severe cranial involvement caused by Klebsiella pneumonia. The patient has a 5-year history of orbital abscess and multiple scalp traumas. CT scan showed right temporal and periorbital osteolysis, multiple parietal osteolysis. The pus was collected twice and routine culture was positive for Klebsiella pneumoniae. Good clinical outcome was achieved with debridement and antibiotic treatment. Microbiologists and clinicians should promptly perform bacteriological cultures on biopsy specimens to facilitate diagnosis when imaging or intraoperative findings of bone infection are suspected, especially in the Mali population.
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Affiliation(s)
- Ke Xu
- Laboratory Medicine Center, Department of Clinical Laboratory, Zhejiang Provincial People’s Hospital (Affiliated People’s Hospital, Hangzhou Medical College), Hangzhou, People’s Republic of China
- Laboratory and Anatomical Pathology Department of the Mali Hospital, Bamako, Mali
| | - Dara Charles
- Neurosurgery Department of the Mali Hospital, Bamako, Mali
| | - Salami Ismael
- Neurosurgery Department of the Mali Hospital, Bamako, Mali
| | - Jun Zhang
- Department of Orthopedics, Zhejiang Provincial People’s Hospital Bijie Hospital, Bijie, Guizhou, People’s Republic of China
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Santangelo OE, Gianfredi V, Provenzano S. Impact on online research on celebrities' uncommon diseases: the curious case of Justin Bieber and Ramsay Hunt syndrome. ZEITSCHRIFT FUR GESUNDHEITSWISSENSCHAFTEN = JOURNAL OF PUBLIC HEALTH 2023:1-9. [PMID: 37361302 PMCID: PMC10202347 DOI: 10.1007/s10389-023-01940-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Accepted: 05/07/2023] [Indexed: 06/28/2023]
Abstract
Aim We investigated how to use Internet user searches to gauge the impact of a celebrity illness on global public interest. Methods The study design is cross-sectional. Data on Internet searches were obtained from Google Trends (GT) for the period between 2017-2022 using the search words "Ramsay Hunt syndrome" (RHS), "Ramsay Hunt syndrome type 2," "Herpes zoster," and "Justin Bieber." The frequency of specific page views for "Ramsay Hunt syndrome," "Ramsay Hunt syndrome type 1," Ramsay Hunt syndrome type 2," Ramsay Hunt syndrome type 3," "Herpes zoster," and "Justin Bieber" were collected via a Wikipedia analysis tool that shows the number of times a specific page is viewed. Statistical analyses were performed using the Pearson (r) and Spearman's rank correlation coefficient (rho). Results GT data, in 2022, show a strong correlation for Justin Bieber and RHS or RHS type 2 (r = 0.75); similarly, Wikipedia data show a strong correlation for Justin Bieber and the others explored terms (r > 0.75). Furthermore, the correlation was strong between GT and Wikipedia for RHS (rho = 0.89) and RHS type 2 (rho = 0.88). Conclusions The peak search times for the GT and Wikipedia pages were during the same period. Useful new tools and analyses of Internet traffic data may be effective in assessing the impact of announced celebrity uncommon illnesses on global public interest.
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Affiliation(s)
- Omar Enzo Santangelo
- Regional Health Care and Social Agency of Lodi, ASST Lodi, piazza Ospitale 10, 26900 Lodi, Italy
| | - Vincenza Gianfredi
- Department of Biomedical Sciences for Health, University of Milan, Via Pascal, 36, 20133 Milan, Italy
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Muacevic A, Adler JR. Ramsay Hunt Syndrome: An Introduction, Signs and Symptoms, and Treatment. Cureus 2023; 15:e33688. [PMID: 36793818 PMCID: PMC9925029 DOI: 10.7759/cureus.33688] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Accepted: 01/12/2023] [Indexed: 01/15/2023] Open
Abstract
Ramsay Hunt syndrome is the complication of the virus varicella-zoster and the infection caused by it, which shows apparent geniculate ganglion involvement. This article discusses the etiology, epidemiology, and pathology of Ramsay Hunt syndrome. Clinically it may be presented as a vesicular rash on the ear or even in the mouth, pain in the ear, and facial paralysis. Some other rare symptoms may also be present, which are also discussed in this article. Skin involvement is also seen in some cases as patterns due to anastomoses between cervical and cranial nerves. This article provides an overview of how the varicella-zoster virus causes facial paralysis and other neurological symptoms. Knowing about this condition and its clinical features is essential to make an early diagnosis and, thus, provide a good prognosis. A good prognosis is required to reduce the nerve damage, prevent further complications, and start an early therapy of acyclovir and corticosteroid. This review also presents a clinical picture of the disease and its complications. The incidence of Ramsay Hunt syndrome has gradually decreased over time because of the development of the varicella-zoster vaccine and better health facilities. The paper also talks about how the diagnosis of Ramsay Hunt syndrome is made and the various treatment options available. Facial paralysis in Ramsay Hunt syndrome presents differently than Bell's Palsy. If not treated for too long, it may cause permanent muscle weakness and may also cause a loss of hearing. It may be confused with simple herpes simplex virus outbreaks or contact dermatitis.
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Viral Bone Infection: A Neglected Disease? Microorganisms 2020; 8:microorganisms8060797. [PMID: 32466516 PMCID: PMC7356793 DOI: 10.3390/microorganisms8060797] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2020] [Revised: 05/14/2020] [Accepted: 05/21/2020] [Indexed: 12/28/2022] Open
Abstract
Bone structures reveal viral DNA/RNA, but little is known of the interaction and pathogenesis of viruses and bone diseases. Their detection and identification is often overlooked and not considered by many clinicians and researchers. In this Editorial, we suggest the role of viruses in some inflammatory bone conditions and their possible role as aetiological agents in bone and joint infections.
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