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Shao Y, Shen M, Peng D, Cheng W, Mao C, Zhang H, Sun Y. Observation of a Bone Invasion Model of Aspergillus fumigatus In Vitro and Analysis of the Antifungal Susceptibility. Mycopathologia 2024; 189:4. [PMID: 38231458 DOI: 10.1007/s11046-023-00817-y] [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: 09/16/2023] [Accepted: 12/13/2023] [Indexed: 01/18/2024]
Abstract
BACKGROUND Recently, the prevalence of invasive fungal infections has been on the rise, and one of the prevalent symptoms frequently observed is bone deterioration and bone loss. MATERIALS AND METHODS Using an in vitro model we studied how Aspergillus fumigatus invades the bone. Pathological analysis was then employed to observe the structure and distinctive features of the invading fungal elements within the bone invasion model. Meanwhile, the antifungal effects of itraconazole, voriconazole, posaconazole, and amphotericin B were evaluated. RESULTS The pathological findings showed that in the experimental group, fungal spores and hyphae invaded the bone tissue or were observed growing in the vicinity of the bone edge tissues, as indicated by both HE and PAS staining. In contrast, no fungal elements were observed in the control group, indicating that the in vitro bone invasion model of A. fumigatus was successfully constructed. Furthermore, the findings from the antifungal sensitivity test demonstrated that the lowest effective concentrations of antifungal drugs against the bone invasion model were as follows: 4 μg/ml for itraconazole, 0.5 μg/ml for voriconazole, 2 μg/ml for posaconazole, and 2 μg/ml for amphotericin B. DISCUSSION The successful construction of the bone invasion model of A. fumigatus has provided a solid basis for future investigations into the mechanisms underlying A. fumigatus bone invasion and the study of its virulence factors. Utilizing bone models is of utmost importance in advancing the development of novel antifungal treatment approaches, as well as in effectively preventing and treating fungal bone invasion and osteolytic diseases.
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Affiliation(s)
- Yan Shao
- Department of Orthopedics, Jingzhou Hospital Affiliated to Yangtze University, Jingzhou, Hubei, China
| | - Min Shen
- Department of Otolaryngology Head and Neck Surgery, Jingzhou Hospital Affiliated to Yangtze University, Jingzhou, Hubei, China
| | - Dan Peng
- Department of Otolaryngology Head and Neck Surgery, Jingzhou Hospital Affiliated to Yangtze University, Jingzhou, Hubei, China
| | - Wenxu Cheng
- Department of Otolaryngology Head and Neck Surgery, Jingzhou Hospital Affiliated to Yangtze University, Jingzhou, Hubei, China
| | - Chenggang Mao
- Department of Otolaryngology Head and Neck Surgery, Jingzhou Hospital Affiliated to Yangtze University, Jingzhou, Hubei, China
| | - Heng Zhang
- Department of Dermatology, Jingzhou Hospital Affiliated to Yangtze University, Jingzhou, 434020, Hubei, China
| | - Yi Sun
- Department of Dermatology, Jingzhou Hospital Affiliated to Yangtze University, Jingzhou, 434020, Hubei, China.
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Minenkov GO, Nasyrov VA, Islamov IM, Solodchenko NV, Skorobogatova OV. [The modern possibilities for the application of multispiral computed tomography in diagnostics of paranasal sinuses mycetomas]. Vestn Otorinolaringol 2017. [PMID: 28631674 DOI: 10.17116/otorino201782322-24] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The objective of the present study was the analysis of the health status of 20 patients presenting with histologically verified paranasal sinuses mycetomas (fungus balls) with special reference to CT-semiotics characteristic of the fungal ball as early as during the pre-verification period. The surgical strategy for the management of this condition has been substantiated. It is concluded that the final verification of the pathological process in question is possible only based on the results of the histological studies.
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Affiliation(s)
- G O Minenkov
- Radiology Department, TOMEX Imaging Centre, Bishkek, Kyrgyz Republic, 720040
| | - V A Nasyrov
- I.K. Akhunbaev ENT Department, Kyrgyz State Medical Academy, Bishkek, Kyrgyz Republic, 720020
| | - I M Islamov
- I.K. Akhunbaev ENT Department, Kyrgyz State Medical Academy, Bishkek, Kyrgyz Republic, 720020
| | - N V Solodchenko
- I.K. Akhunbaev ENT Department, Kyrgyz State Medical Academy, Bishkek, Kyrgyz Republic, 720020
| | - O V Skorobogatova
- I.K. Akhunbaev ENT Department, Kyrgyz State Medical Academy, Bishkek, Kyrgyz Republic, 720020
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Tanon AK, Assouan C, Anzouan-Kacou E, N'guessan D, Salami A, Boni S, Konan E. [Pseudo-tumoral invasive fungus infection of the maxillary sinus in Abidjan]. J Mycol Med 2017; 27:285-289. [PMID: 28336168 DOI: 10.1016/j.mycmed.2017.02.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2016] [Revised: 02/21/2017] [Accepted: 02/22/2017] [Indexed: 10/19/2022]
Abstract
INTRODUCTION The invasive fungal infection of the maxillary sinus is a rare and serious disease generally favored by immunosuppression. We report an exceptional case of pseudotumoral invasive fungal infection of the maxillary sinus in an immunocompetent patient. OBSERVATION A 32-year-old patient consulted for labial and left temporal swelling associated with proptosis and chemosis that has been developing for 18 months. The scanner objectified a filling of the left maxillary sinus, and the ipsilateral orbital cavity, and the surrounding muscles. Histological examination of the surgical specimen revealed invasive fungal infection of the left maxillary sinus. The relevant antifungal therapy, namely voriconazole, could not be administered due to the unavailability of the medicine. However, the patient has received 200mg of itraconazole every 12hours for three weeks. The change proved disappointing with recurrence and significant sequelae, sort of sagging of the right hemifacial, severe limitation of mouth opening and functional loss of the right eye. CONCLUSION The invasive fungus infections of the maxillary sinus and the orbit are exceptional in immunocompetent patient. Healing is based on early diagnosis and administration of the reference antifungal to face the risk of recurrence.
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Affiliation(s)
- A K Tanon
- Service des maladies infectieuses et tropicales, CHU de Treichville, BP V3, Abidjan, Côte d'Ivoire; Unité de formation et de recherche en sciences médicales, université Félix-Houphouet, Boigny de Cococdy, Abidjan, Côte d'Ivoire.
| | - C Assouan
- Service de stomatologie et chirurgie maxilllo-faciale, CHU de Treichville, BP V3, Abidjan, Côte d'Ivoire; Unité de formation et de recherche en sciences médicales, université Félix-Houphouet, Boigny de Cococdy, Abidjan, Côte d'Ivoire.
| | - E Anzouan-Kacou
- Service de stomatologie et chirurgie maxilllo-faciale, CHU de Treichville, BP V3, Abidjan, Côte d'Ivoire; Unité de formation et de recherche en sciences médicales, université Félix-Houphouet, Boigny de Cococdy, Abidjan, Côte d'Ivoire.
| | - D N'guessan
- Service de stomatologie et chirurgie maxilllo-faciale, CHU de Treichville, BP V3, Abidjan, Côte d'Ivoire; Unité de formation et de recherche en sciences médicales, université Félix-Houphouet, Boigny de Cococdy, Abidjan, Côte d'Ivoire.
| | - A Salami
- Service de stomatologie et chirurgie maxilllo-faciale, CHU de Treichville, BP V3, Abidjan, Côte d'Ivoire.
| | - S Boni
- Service d'ophtalmologie, CHU de Treichville, BP V3, Abidjan, Côte d'Ivoire; Unité de formation et de recherche en sciences médicales, université Félix-Houphouet, Boigny de Cococdy, Abidjan, Côte d'Ivoire.
| | - E Konan
- Service de stomatologie et chirurgie maxilllo-faciale, CHU de Treichville, BP V3, Abidjan, Côte d'Ivoire; Unité de formation et de recherche en sciences médicales, université Félix-Houphouet, Boigny de Cococdy, Abidjan, Côte d'Ivoire.
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Guivarc'h M, Ordioni U, Catherine JH, Campana F, Camps J, Bukiet F. Implications of Endodontic-related Sinus Aspergillosis in a Patient Treated by Infliximab: A Case Report. J Endod 2015; 41:125-9. [DOI: 10.1016/j.joen.2014.09.022] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2014] [Revised: 09/22/2014] [Accepted: 09/23/2014] [Indexed: 11/28/2022]
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Lim SH, Sung SH, Lim KH. A Case of Invasive Aspergillosis Involving the Orbital Apex and Occipital Lobe:Successful Treatment with Voriconazole. JOURNAL OF THE KOREAN OPHTHALMOLOGICAL SOCIETY 2013. [DOI: 10.3341/jkos.2013.54.3.540] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Affiliation(s)
- Sun Hee Lim
- Department of Ophthalmology, Mokdong Hospital, Ewha Womans University School of Medicine, Seoul, Korea
| | - Sun Hee Sung
- Department of Pathology, Mokdong Hospital, Ewha Womans University School of Medicine, Seoul, Korea
| | - Key Hwan Lim
- Department of Ophthalmology, Mokdong Hospital, Ewha Womans University School of Medicine, Seoul, Korea
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Zainine R, Ennaili M, Anane S, Khlifa Z, Kedous S, Chahed H, Beltaief N, Besbes G. La rhinosinusite aspergillaire invasive granulomateuse. J Mycol Med 2012; 22:316-21. [DOI: 10.1016/j.mycmed.2012.09.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2012] [Revised: 09/06/2012] [Accepted: 09/21/2012] [Indexed: 11/26/2022]
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Abir B, Abouchadi A, Hamama J, Oukabli M, Nassih M, Rzin A. [Invasive aspergillosis of the maxillary sinus in an immunocompetent patient]. ACTA ACUST UNITED AC 2012; 113:127-30. [PMID: 22285744 DOI: 10.1016/j.stomax.2011.12.011] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2010] [Revised: 06/06/2011] [Accepted: 12/23/2011] [Indexed: 10/14/2022]
Abstract
INTRODUCTION Invasive aspergillosis of the maxillary sinus is a severe infection most commonly observed in immunocompromised patients. We report a pseudo-tumoral presentation of invasive aspergillosis of the maxillary sinus, in immunocompetent adult. CASE REPORT A 70-year-old female patient consulted for chronic rhino-sinusitis resistant to medical treatment. Computed tomography scan revealed a hyperdense mass filling the left maxillary antrum, with erosion of sinus walls. The ethmoidal and right frontal sinuses were involved. The histological and mycological examination of the surgical resection confirmed the diagnosis of invasive aspergillosis. The patient was given voriconazole as first line treatment. The outcome was good at 18 months. DISCUSSION Invasive aspergillosis of the maxillary sinus is a rare disease, usually observed in immunodepressed patients. It is very rarely observed in immunocompetent patients.
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Affiliation(s)
- B Abir
- Service de chirurgie plastique et stomatologie, hôpital militaire d'instruction Mohamed-V, Rabat, Maroc.
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Zainine R, Hachicha A, Gamra S, Beltaief N, Sahtout S, Besbes G. Aspergillose sphénoïdale chez deux patients immunocompétents. J Mycol Med 2011. [DOI: 10.1016/j.mycmed.2011.03.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Clinical features and outcomes of four patients with invasive fungal sinusitis. Auris Nasus Larynx 2011; 38:289-94. [DOI: 10.1016/j.anl.2010.08.003] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2009] [Revised: 07/20/2010] [Accepted: 08/02/2010] [Indexed: 11/20/2022]
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Akhaddar A, Gazzaz M, Albouzidi A, Lmimouni B, Elmostarchid B, Boucetta M. Invasive Aspergillus terreus sinusitis with orbitocranial extension: case report. SURGICAL NEUROLOGY 2008; 69:490-5; discussion 495. [PMID: 18262257 DOI: 10.1016/j.surneu.2007.02.059] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/25/2007] [Accepted: 02/24/2007] [Indexed: 11/16/2022]
Abstract
BACKGROUND Aspergillosis of the paranasal sinuses is infrequent and usually involves the species Aspergillus fumigatus and A. flavus. The maxillary sinus is the most common sinus to be affected. Invasive cranio-orbital aspergillosis originating in the sphenoid sinus is rare and mostly occurs in immunocompromised patients with poor outcomes. We present a case of invasive A. terreus sphenoidal sinusitis with intraorbital and intracranial extension in an immunocompetent patient. CASE DESCRIPTION This 62-year-old man presented with a 2-month history of left retroorbital pain followed by rapid decreasing vision and 2 episodes of epistaxis. Ophthalmologic examination revealed no light perception left. Computed tomographic scan and MR images demonstrated an enhanced sphenoid lesion within the left sphenoid sinus with bone destruction and intraorbital and cavernous sinus extensions. A malignant tumor was suspected. The patient underwent a transphenoidal biopsy of the sphenoid mass. Histologic analysis revealed numerous Aspergillus hyphea, and the species A. terreus was isolated from fungal cultures of specimens. No systemic fungal infection was found, and the patient had no evidence of immunosuppression. After 3 months' administration of oral voriconazole, the patient became well, and the orbitocranial mass regressed in size. It was stabilized on the ninth postoperative month. CONCLUSION A. terreus sinusitis with orbitocranial extension had never been reported in the literature. Even in an immunocompetent host, ISOA is difficult to eradicate using surgical debridement combined with optimal antifungal agents because of the intracranial extension and the relative resistance of conventional antifungal therapy. Early diagnosis is important to prevent an unfavorable outcome of this emergent infection.
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Affiliation(s)
- Ali Akhaddar
- Department of Neurosurgery, Mohammed V Military Hospital, Rabat, Morocco.
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Pawankar R, Nonaka M. Inflammatory mechanisms and remodeling in chronic rhinosinusitis and nasal polyps. Curr Allergy Asthma Rep 2007; 7:202-8. [PMID: 17448332 DOI: 10.1007/s11882-007-0073-4] [Citation(s) in RCA: 88] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Chronic rhinosinusitis (CRS) is presently classified into two subgroups: CRS without and CRS with nasal polyps. A variety of inflammatory mediators, including cytokines and chemokines, as well as adhesion molecules and matrix metalloproteinases, are upregulated in both subgroups of CRS; remodeling is also observed in both. However, there are also characteristic differences. Whereas CRS without nasal polyps has more neutrophilic infiltration, in CRS with nasal polyps (especially when associated with allergy/asthma) eosinophil infiltration is strikingly increased. Although several features of remodeling (eg, squamous metaplasia, basement membrane thickening, collagen deposition, hyperplasia of mucous glands, and goblet cells) are features seen in both subgroups of CRS, epithelial shedding as observed in asthma is not seen in either subgroup. Furthermore, pseudocyst formation seen in CRS with nasal polyps is not seen in CRS without nasal polyps.
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Affiliation(s)
- Ruby Pawankar
- Department of Otolaryngology, Nippon Medical School, 1-1-5, Sendagi, Bunkyo-Ku, Tokyo 113-8603, Japan. pawankar_ruby/
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Pellacchia V, Terenzi V, Moricca LM, Buonaccorsi S, Indrizzi E, Fini G. Brain abscess by mycotic and bacterial infection in a diabetic patient: clinical report and review of literature. J Craniofac Surg 2006; 17:578-84. [PMID: 16770203 DOI: 10.1097/00001665-200605000-00034] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
This report presents a case of lethal invasive mucormycosis, a rare fungal infection, which predominantly affects immunocompromised patients, and is reported in a 57-year-old female who presented with cerebral abscess. The patient, who had undiagnosed diabetes mellitus, presented with extensive right hemifacial deficiency of the bones and soft tissues consequent to surgical resection of the ethmoid-spheno-maxillo-orbital district after mucormycosis. A reconstruction with a pectoral pedunculated flap was performed. The maxillary swelling extended to the contiguous area, involving the palate and homolateral orbital floor. Mucous and cutaneous samples showed the presence of Aspergillus fumigatus, and diagnosis of rhinocerebral mucormycosis was made. The patients also presented with a right hemiplegia consequent to a cerebral abscess by Eikenella corrodens. The authors decided to position an intraoral prosthesis to restore palatal integrity and masticatory function and inserted four titanium fixtures for the retention of the bone-anchored facial prosthesis.
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Affiliation(s)
- Valentina Pellacchia
- Second Faculty of Medicine and Surgery, University of Rome La Sapienza, Azienda Ospedaliera S. Andrea, Maxillo-Facial Surgery, Rome, Italy.
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Pawankar R, Nonaka M, Yamagishi S, Yagi T. Pathophysiologic mechanisms of chronic rhinosinusitis. Immunol Allergy Clin North Am 2004; 24:75-85. [PMID: 15062428 DOI: 10.1016/s0889-8561(03)00109-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Affiliation(s)
- Ruby Pawankar
- Department of Otolaryngology, Nippon Medical School, 1-1-5, Sendagi, Bunkyo-Ku, Tokyo, 113-8603, Japan.
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