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Barbosa JD, Barbosa CC, Ferreira Filho CEDS, Moran JFG, Oliveira CMC, Bomjardim HDA, da Costa PSC, Brito MDF, Paz MC, Lamego EC, Spanamberg A, Driemeier D. Cutaneous Mucormycosis in Buffalos in the Brazilian Amazon Biome. Animals (Basel) 2024; 14:1327. [PMID: 38731337 PMCID: PMC11083279 DOI: 10.3390/ani14091327] [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: 02/16/2024] [Revised: 03/12/2024] [Accepted: 03/14/2024] [Indexed: 05/13/2024] Open
Abstract
This is the first description of cutaneous mucormycosis in buffalo in the Brazilian Amazon biome. All buffalo showed apathy, inappetence, weight loss, reluctance to move, and prolonged sternal decubitus. Of the four affected animals, two died 15 and 30 days after the appearance of clinical signs. In the initial phase, the skin lesions were rounded areas with dry central regions, sensitive to palpation, with protruding edges and diameters ranging from 8 cm to 15 cm. These areas of necrosis were isolated or coalescing and present mainly on the limbs and sides. In an advanced stage of the disease, there was detachment of the skin from the necrotic areas with extensive wound formation, which sometimes exposed the subcutaneous tissue. The histopathology of the skin showed a multifocal inflammatory infiltrate composed of intact and degenerated eosinophils surrounded by epithelioid macrophages. At the center of these areas was a focally extensive area of epidermal ulceration characterized by intact and degenerated neutrophils, the necrosis of epithelial cells, and the accumulation of fibrin and erythrocytes. The mycological culture was positive for Rhizopus sp. The diagnosis of cutaneous dermatitis caused by Rhizopus sp. was based on clinical signs, macroscopic and histopathological findings, and the identification of the fungus by mycological and molecular techniques.
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Affiliation(s)
- José Diomedes Barbosa
- Instituto de Medicina Veterinária, Universidade Federal do Pará (UFPA), Castanhal 68740-970, Brazil; (C.C.B.); (C.E.d.S.F.F.); (J.F.G.M.); (C.M.C.O.)
| | - Camila Cordeiro Barbosa
- Instituto de Medicina Veterinária, Universidade Federal do Pará (UFPA), Castanhal 68740-970, Brazil; (C.C.B.); (C.E.d.S.F.F.); (J.F.G.M.); (C.M.C.O.)
| | | | - José Francisco Gimenez Moran
- Instituto de Medicina Veterinária, Universidade Federal do Pará (UFPA), Castanhal 68740-970, Brazil; (C.C.B.); (C.E.d.S.F.F.); (J.F.G.M.); (C.M.C.O.)
| | - Carlos Magno Chaves Oliveira
- Instituto de Medicina Veterinária, Universidade Federal do Pará (UFPA), Castanhal 68740-970, Brazil; (C.C.B.); (C.E.d.S.F.F.); (J.F.G.M.); (C.M.C.O.)
| | - Henrique dos Anjos Bomjardim
- Faculdade de Medicina Veterinária, Instituto de Estudos do Trópico Úmido da Universidade Federal do Sul e Sudeste do Pará (Unifesspa), Xinguara 68557-335, Brazil;
| | | | - Marilene de Farias Brito
- Departamento de Epidemiologia e Saúde Pública (DESP), Instituto de Veterinária, Universidade Federal Rural do Rio de Janeiro (UFRRJ), Seropédica 23890-000, Brazil;
| | - Milena Carolina Paz
- Setor de Patologia Veterinária, Faculdade de Veterinária, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre 91540-000, Brazil; (M.C.P.); (E.C.L.); (D.D.)
| | - Eryca Ceolin Lamego
- Setor de Patologia Veterinária, Faculdade de Veterinária, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre 91540-000, Brazil; (M.C.P.); (E.C.L.); (D.D.)
| | - Andréia Spanamberg
- Setor de Micologia, Faculdade de Veterinária, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre 91540-000, Brazil;
| | - David Driemeier
- Setor de Patologia Veterinária, Faculdade de Veterinária, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre 91540-000, Brazil; (M.C.P.); (E.C.L.); (D.D.)
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Meena V, Barath S, Singh S, Jakhar P, Patel T. Role of Imaging Spectrum Along With Other Diagnostic Modalities in Rhino-Orbital-Cerebral Mucormycosis (ROCM). Cureus 2024; 16:e53962. [PMID: 38469024 PMCID: PMC10926969 DOI: 10.7759/cureus.53962] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/09/2024] [Indexed: 03/13/2024] Open
Abstract
OBJECTIVES Rhino-orbito-cerebral mucormycosis (ROCM), a rare angio-invasive fungal infection, had become a major outbreak during the second wave of the coronavirus disease (COVID-19) pandemic in India, with over 28,000 reported cases. The purpose of this study was to describe the imaging spectrum of ROCM, which may prove useful in prompt diagnosis, considering its grave prognosis in populations with a high load of immunosuppressed patients (e.g., COVID-19, HIV-AIDS, etc.). MATERIAL AND METHODS Evaluation of the clinical data and imaging of patients with symptoms suspicious of mucormycosis of the craniofacial region was done. The diagnosis was made using computed tomography (CT) or magnetic resonance (MR) imaging, a biopsy, and culture. The data analysis was done using descriptive statistical methods. RESULTS The sample group consisted of a total of 36 patients ranging from 33 years to 75 years of age, out of which 31 (86.11%) were male and five (13.8%) were female. A total of 30 (83.33%) patients had a positive correlation with COVID-19 infection, and 29 (80.55%) patients had a positive correlation with diabetes. The major presenting complaints were facial pain and swelling (20 patients; 55.55%). The intracranial spread was seen in 14 (38.88%) patients. Our study demonstrated a mortality rate of 38.88% (14 patients). CONCLUSION ROCM, once considered to occur predominantly in diabetics, is increasingly being seen in other immunosuppressive patients, such as COVID-19. CT and MR imaging help provide an early diagnosis in conjunction with pathologic and microbiological correlations. Immediate correction of immunosuppression with the initiation of amphotericin B therapy combined with extensive and diligent surgical debridement of the diseased tissue is required.
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Affiliation(s)
| | - Sitaram Barath
- Radiology, Geetanjali Medical College & Hospital, Udaipur, IND
| | | | - Prateek Jakhar
- Radiodiagnosis, Geetanjali Medical College & Hospital, Udaipur, IND
| | - Tarang Patel
- Pathology, All India Institute of Medical Sciences (AIIMS) Rajkot, Rajkot, IND
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Barrs VR, Beczkowski PM, Talbot JJ, Hobi S, Teoh SN, Hernandez Muguiro D, Shubitz LF, Sandy J. Invasive Fungal Infections and Oomycoses in Cats: 1. Diagnostic approach. J Feline Med Surg 2024; 26:1098612X231219696. [PMID: 38189288 PMCID: PMC10949879 DOI: 10.1177/1098612x231219696] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2024]
Abstract
CLINICAL RELEVANCE In contrast to superficial fungal infections, such as dermatophytosis, invasive fungal infections (IFIs) are characterised by penetration of tissues by fungal elements. Disease can spread locally within a region or can disseminate haematogenously or via the lymphatics. The environment is the most common reservoir of infection. Since fungal spores are airborne, indoor cats are also susceptible to IFIs. Some environmental fungi are ubiquitous and present globally, while others are endemic or hyperendemic within specific geographic regions. Zoonotic pathogens include Microsporum canis, Sporothrix schenckii and Sporothrix brasiliensis. AIM In the first of a two-part article series, the approach to the investigation of feline IFIs and oomycoses is reviewed. As well as tips for diagnosis, and information on the ecological niche and distribution of fungal pathogens, the review covers clinical presentation of the most common IFIs, including cryptococcosis, histoplasmosis, blastomycosis, coccidioidomycosis, sporotrichosis, phaeohyphomycosis, aspergillosis and dermatophytic pseudomycetoma, as well as the oomycoses pythiosis, lagenidiosis and paralagenidiosis. In Part 2, the spectrum of activity, mechanisms of action, pharmacokinetic and pharmacodynamic properties and adverse effects of antifungal drugs are reviewed, and the treatment and prognosis for specific IFIs and oomycoses are discussed. EVIDENCE BASE The review draws on published evidence and the authors' combined expertise in feline medicine, mycology, dermatology, clinical pathology and anatomical pathology.
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Affiliation(s)
- Vanessa R Barrs
- Department of Veterinary Clinical Sciences, Jockey Club College of Veterinary Medicine and Life Sciences, City University of Hong Kong, Kowloon Tong, Hong Kong, SAR China
- Centre for Animal Health and Welfare, City University of Hong Kong, Kowloon Tong, Hong Kong, SAR China
| | - Paweł M Beczkowski
- Department of Veterinary Clinical Sciences, Jockey Club College of Veterinary Medicine and Life Sciences, City University of Hong Kong, Kowloon Tong, Hong Kong, SAR China
| | | | - Stefan Hobi
- Department of Veterinary Clinical Sciences, Jockey Club College of Veterinary Medicine and Life Sciences, City University of Hong Kong, Kowloon Tong, Hong Kong, SAR China
| | - Shu Ning Teoh
- Veterinary Specialists Aotearoa, Henderson, Auckland, New Zealand
| | | | - Lisa F Shubitz
- Valley Fever Center for Excellence, The University of Arizona, AZ, USA
| | - Jeanine Sandy
- Department of Veterinary Clinical Sciences, Jockey Club College of Veterinary Medicine and Life Sciences, City University of Hong Kong, Kowloon Tong, Hong Kong, SAR China
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Munasinghe KVP, Silva FHDS. Rhinocerebral Mucormycosis with Extensive Cranial Nerve Palsies in a Diabetic Patient. Cureus 2023; 15:e50451. [PMID: 38222179 PMCID: PMC10786188 DOI: 10.7759/cureus.50451] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/12/2023] [Indexed: 01/16/2024] Open
Abstract
Mucormycosis is a common opportunistic fungal infection with a disseminated nature. Despite being a devastating disease with the involvement of multiple upper cranial nerves, the implications of the seventh cranial nerve have been infrequently encountered. Although the radiological evidence with sinus destruction supports the diagnosis, histological specimen showing fungal elements confirms it as fungal culture doesn't always demonstrate a high diagnostic yield. Early detection and multimodal treatment are mandatory to prevent detrimental outcomes and to control the disease progression. We, hereby present a rare case of rhinocerebral mucormycosis with multiple cranial nerve involvement including the facial nerve in a 70-year-old female with long-standing poorly controlled diabetes mellitus.
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Affiliation(s)
- K V P Munasinghe
- General Medicine, Colombo South Teaching Hospital Kalubowila, Colombo, LKA
| | - F H D S Silva
- Medicine, Faculty of Medical Sciences, Colombo South Teaching Hospital Kalubowila, University of Sri Jayewardenepura, Colombo, LKA
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Chaudhari HS, Palkar OS, Abha Mishra KM, Sethi KK. An extensive review on antifungal approaches in the treatment of mucormycosis. J Biochem Mol Toxicol 2023; 37:e23417. [PMID: 37345721 DOI: 10.1002/jbt.23417] [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: 07/18/2022] [Revised: 03/14/2023] [Accepted: 06/08/2023] [Indexed: 06/23/2023]
Abstract
During the period of COVID-19, the occurrences of mucormycosis in immunocompromised patients have increased significantly. Mucormycosis (black fungus) is a rare and rapidly progressing fungal infection associated with high mortality and morbidity in India as well as globally. The causative agents for this infection are collectively called mucoromycetes which are the members of the order Mucorales. The diagnosis of the infection needs to be performed as soon as the occurrence of clinical symptoms which differs with types of Mucorales infection. Imaging techniques magnetic resonance imaging or computed tomography scan, culture testing, and microscopy are the approaches for the diagnosis. After the diagnosis of the infection is confirmed, rapid action is needed for the treatment in the form of antifungal therapy or surgery depending upon the severity of the infection. Delaying in treatment declines the chances of survival. In antifungal therapy, there are two approaches first-line therapy (monotherapy) and combination therapy. Amphotericin B (1) and isavuconazole (2) are the drugs of choice for first-line therapy in the treatment of mucormycosis. Salvage therapy with posaconazole (3) and deferasirox (4) is another approach for patients who are not responsible for any other therapy. Adjunctive therapy is also used in the treatment of mucormycosis along with first-line therapy, which involves hyperbaric oxygen and cytokine therapy. There are some drugs like VT-1161 (5) and APX001A (6), Colistin, SCH 42427, and PC1244 that are under clinical trials. Despite all these approaches, none can be 100% successful in giving results. Therefore, new medications with favorable or little side effects are required for the treatment of mucormycosis.
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Affiliation(s)
- Hrushikesh S Chaudhari
- Department of Medicinal Chemistry, National Institute of Pharmaceutical Education and Research (NIPER), Guwahati, Assam, India
| | - Omkar S Palkar
- Department of Medicinal Chemistry, National Institute of Pharmaceutical Education and Research (NIPER), Guwahati, Assam, India
| | - K M Abha Mishra
- Department of Medicinal Chemistry, National Institute of Pharmaceutical Education and Research (NIPER), Guwahati, Assam, India
| | - Kalyan K Sethi
- Department of Medicinal Chemistry, National Institute of Pharmaceutical Education and Research (NIPER), Guwahati, Assam, India
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Meagher RB, Lewis ZA, Ambati S, Lin X. DectiSomes: C-type lectin receptor-targeted liposomes as pan-antifungal drugs. Adv Drug Deliv Rev 2023; 196:114776. [PMID: 36934519 PMCID: PMC10133202 DOI: 10.1016/j.addr.2023.114776] [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: 01/04/2023] [Revised: 03/03/2023] [Accepted: 03/07/2023] [Indexed: 03/19/2023]
Abstract
Combatting the ever-increasing threat from invasive fungal pathogens faces numerous fundamental challenges, including constant human exposure to large reservoirs of species in the environment, the increasing population of immunocompromised or immunosuppressed individuals, the unsatisfactory efficacy of current antifungal drugs and their associated toxicity, and the scientific and economic barriers limiting a new antifungal pipeline. DectiSomes represent a new drug delivery platform that enhances antifungal efficacy for diverse fungal pathogens and reduces host toxicity for current and future antifungals. DectiSomes employ pathogen receptor proteins - C-type lectins - to target drug-loaded liposomes to conserved fungal cognate ligands and away from host cells. DectiSomes represent one leap forward for urgently needed effective pan-antifungal therapy. Herein, we discuss the problems of battling fungal diseases and the state of DectiSome development.
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Affiliation(s)
- Richard B Meagher
- Department of Genetics, University of Georgia, Athens, GA 30602, USA
| | - Zachary A Lewis
- Department of Genetics, University of Georgia, Athens, GA 30602, USA; Department of Microbiology, University of Georgia, Athens, GA 30602, USA
| | - Suresh Ambati
- Department of Genetics, University of Georgia, Athens, GA 30602, USA
| | - Xiaorong Lin
- Department of Microbiology, University of Georgia, Athens, GA 30602, USA.
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Benlamkaddem S, Zdaik G, Doughmi D, Bennis A, Chraibi F, Berdai MA, Abdellaoui M, Benatiya Andaloussi I, Harandou M. Rhino-Orbital Cerebral Mucormycosis: A Fatal Evolution. Cureus 2023; 15:e37837. [PMID: 37214071 PMCID: PMC10198304 DOI: 10.7759/cureus.37837] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/19/2023] [Indexed: 05/23/2023] Open
Abstract
Rhino-orbital cerebral mucormycosis is a rare and serious fungal infection caused by fungi of the Mucorales order, most commonly by the species Rhizopus oryzae. It occurs generally in an immunocompromised host, and the contamination of healthy subjects remains exceptional. The clinical presentation is not specific. The diagnosis of rhino-orbital cerebral mucormycosis is difficult based on a range of clinical, microbiological, and radiological arguments. Imaging studies may include CT/MRI of the orbit, brain, and sinuses and show signs of aggressiveness, intracranial complications, and evolution under treatment. The standard treatment is antifungal therapy and necrosectomy. We report a case of a 30-year-old patient admitted to intensive care for the management of postpartum hemorrhage complicating severe preeclampsia who presented with rhinocerebral mucormycosis with left orbital extension. Adequate therapeutic management in the intensive care unit was provided; however, the patient died within seven days of septic shock with multiorgan failure. The mortality is determined by the correction of risk factors, the timing of initiation of the antifungal therapy, and surgical debridement.
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Affiliation(s)
- Said Benlamkaddem
- Maternal and Pediatric Critical Care Unit, Hassan II University Hospital, Fez, MAR
- Faculty of Medicine and Pharmacy, Sidi Mohamed Ben Abdellah University, Fez, MAR
| | - Ghita Zdaik
- Department of Ophthalmology, Hassan II University Hospital, Fez, MAR
| | - Djoudline Doughmi
- Maternal and Pediatric Critical Care Unit, Hassan II University Hospital, Fez, MAR
- Faculty of Medicine and Pharmacy, Sidi Mohamed Ben Abdellah University, Fez, MAR
| | - Ahmed Bennis
- Department of Ophthalmology, Hassan II University Hospital, Fez, MAR
- Faculty of Medicine and Pharmacy, Sidi Mohamed Ben Abdellah University, Fez, MAR
| | - Fouad Chraibi
- Department of Ophthalmology, Hassan II University Hospital, Fez, MAR
- Faculty of Medicine and Pharmacy, Sidi Mohamed Ben Abdellah University, Fez, MAR
| | - Mohamed Adnane Berdai
- Maternal and Pediatric Critical Care Unit, Hassan II University Hospital, Fez, MAR
- Faculty of Medicine and Pharmacy, Sidi Mohamed Ben Abdellah University, Fez, MAR
| | - Meriem Abdellaoui
- Department of Ophthalmology, Hassan II University Hospital, Fez, MAR
- Faculty of Medicine and Pharmacy, Sidi Mohamed Ben Abdellah University, Fez, MAR
| | - Idriss Benatiya Andaloussi
- Department of Ophthalmology, Hassan II University Hospital, Fez, MAR
- Faculty of Medicine and Pharmacy, Sidi Mohamed Ben Abdellah University, Fez, MAR
| | - Mustapha Harandou
- Maternal and Pediatric Critical Care Unit, Hassan II University Hospital, Fez, MAR
- Faculty of Medicine and Pharmacy, Sidi Mohamed Ben Abdellah University, Fez, MAR
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Sykes BA, Krause H, Lamparelli M, Austin D. Saksenaea mucormycosis: a rare and dangerous cause of necrotising fasciitis. BMJ Case Rep 2023; 16:e254183. [PMID: 36878619 PMCID: PMC9990665 DOI: 10.1136/bcr-2022-254183] [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] [Indexed: 03/08/2023] Open
Abstract
Necrotising fasciitis is a rapidly progressing soft tissue infection requiring early and adequate surgical debridement and appropriate antibiotic cover. The present case highlights bacterial fasciitis associated with fungal (Mucor) infection with insidious angioinvasive nature (Saksenaea vasiformis) which required amputation, negative-pressure vacuum dressings and amphotericin B for definitive treatment. This demonstrates a relatively rare case of the group IV classification of necrotising fasciitis, which we must consider when there is slowly progressing tissue death despite seemingly adequate treatment.
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Affiliation(s)
| | - Hans Krause
- Clinical Pathology, Rockhampton Hospital, Rockhampton, Queensland, Australia
| | - Michael Lamparelli
- General Surgery, Rockhampton Hospital, Rockhampton, Queensland, Australia
| | - David Austin
- Intensive Care Unit, Rockhampton Hospital, Rockhampton, Queensland, Australia
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Gamaletsou MN, Rammaert B, Brause B, Bueno MA, Dadwal SS, Henry MW, Katragkou A, Kontoyiannis DP, McCarthy MW, Miller AO, Moriyama B, Pana ZD, Petraitiene R, Petraitis V, Roilides E, Sarkis JP, Simitsopoulou M, Sipsas NV, Taj-Aldeen SJ, Zeller V, Lortholary O, Walsh TJ. Osteoarticular Mycoses. Clin Microbiol Rev 2022; 35:e0008619. [PMID: 36448782 PMCID: PMC9769674 DOI: 10.1128/cmr.00086-19] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
Osteoarticular mycoses are chronic debilitating infections that require extended courses of antifungal therapy and may warrant expert surgical intervention. As there has been no comprehensive review of these diseases, the International Consortium for Osteoarticular Mycoses prepared a definitive treatise for this important class of infections. Among the etiologies of osteoarticular mycoses are Candida spp., Aspergillus spp., Mucorales, dematiaceous fungi, non-Aspergillus hyaline molds, and endemic mycoses, including those caused by Histoplasma capsulatum, Blastomyces dermatitidis, and Coccidioides species. This review analyzes the history, epidemiology, pathogenesis, clinical manifestations, diagnostic approaches, inflammatory biomarkers, diagnostic imaging modalities, treatments, and outcomes of osteomyelitis and septic arthritis caused by these organisms. Candida osteomyelitis and Candida arthritis are associated with greater events of hematogenous dissemination than those of most other osteoarticular mycoses. Traumatic inoculation is more commonly associated with osteoarticular mycoses caused by Aspergillus and non-Aspergillus molds. Synovial fluid cultures are highly sensitive in the detection of Candida and Aspergillus arthritis. Relapsed infection, particularly in Candida arthritis, may develop in relation to an inadequate duration of therapy. Overall mortality reflects survival from disseminated infection and underlying host factors.
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Affiliation(s)
- Maria N. Gamaletsou
- Laiko General Hospital of Athens and Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Blandine Rammaert
- Université de Poitiers, Faculté de médecine, CHU de Poitiers, INSERM U1070, Poitiers, France
| | - Barry Brause
- Hospital for Special Surgery, Weill Cornell Medicine, New York, New York, USA
| | - Marimelle A. Bueno
- Far Eastern University-Dr. Nicanor Reyes Medical Foundation, Manilla, Philippines
| | | | - Michael W. Henry
- Hospital for Special Surgery, Weill Cornell Medicine, New York, New York, USA
| | - Aspasia Katragkou
- Nationwide Children’s Hospital, Columbus, Ohio, USA
- The Ohio State University School of Medicine, Columbus, Ohio, USA
| | | | - Matthew W. McCarthy
- Weill Cornell Medicine of Cornell University, New York, New York, USA
- New York Presbyterian Hospital, New York, New York, USA
| | - Andy O. Miller
- Hospital for Special Surgery, Weill Cornell Medicine, New York, New York, USA
| | | | - Zoi Dorothea Pana
- Hippokration General Hospital, Aristotle University School of Health Sciences, Thessaloniki, Greece
- Faculty of Medicine, Aristotle University School of Health Sciences, Thessaloniki, Greece
| | - Ruta Petraitiene
- Weill Cornell Medicine of Cornell University, New York, New York, USA
| | | | - Emmanuel Roilides
- Hippokration General Hospital, Aristotle University School of Health Sciences, Thessaloniki, Greece
- Faculty of Medicine, Aristotle University School of Health Sciences, Thessaloniki, Greece
| | | | - Maria Simitsopoulou
- Hippokration General Hospital, Aristotle University School of Health Sciences, Thessaloniki, Greece
- Faculty of Medicine, Aristotle University School of Health Sciences, Thessaloniki, Greece
| | - Nikolaos V. Sipsas
- Laiko General Hospital of Athens and Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | | | - Valérie Zeller
- Groupe Hospitalier Diaconesses-Croix Saint-Simon, Paris, France
| | - Olivier Lortholary
- Université de Paris, Faculté de Médecine, APHP, Hôpital Necker-Enfants Malades, Paris, France
- Institut Pasteur, Unité de Mycologie Moléculaire, CNRS UMR 2000, Paris, France
| | - Thomas J. Walsh
- Hospital for Special Surgery, Weill Cornell Medicine, New York, New York, USA
- Weill Cornell Medicine of Cornell University, New York, New York, USA
- New York Presbyterian Hospital, New York, New York, USA
- Center for Innovative Therapeutics and Diagnostics, Richmond, Virginia, USA
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10
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Smith JA, Quesada T, Alake G, Anger N. Transcontinental Dispersal of Nonendemic Fungal Pathogens through Wooden Handicraft Imports. mBio 2022; 13:e0107522. [PMID: 35766379 PMCID: PMC9426497 DOI: 10.1128/mbio.01075-22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Accepted: 06/07/2022] [Indexed: 12/03/2022] Open
Abstract
This study examined the viability and diversity of fungi harbored in imported wooden handicraft products sold in six retail stores in Florida, United States. Despite being subjected to trade regulations that require various sterilization/fumigation protocols, our study demonstrates high survival and diversity of fungi in wood products originating from at least seven countries on three continents. Among these fungi were nonendemic plant and human pathogens, as well as mycotoxin producers. Several products that are sold for use in food preparation and consumption harbored a novel (to North America) plant and human pathogen, Paecilomyces formosus. In addition, a high number of species isolated were thermophilic and included halophilic species, suggesting adaptability and selection through current wood treatment protocols that utilize heat and/or fumigation with methyl-bromide. This research suggests that current federal guidelines for imports of wooden goods are not sufficient to avoid the transit of potential live pathogens and demonstrates the need to increase safeguards at both points of origin and entry for biosecurity against introduction from invasive fungal species in wood products. Future import regulations should consider living fungi, their tolerance to extreme conditions, and their potential survival in solid substrates. Mitigation efforts may require additional steps such as more stringent fumigation and/or sterilization strategies and limiting use of wood that has not been processed to remove bark and decay. IMPORTANCE This study, the first of its kind, demonstrates the risk of importation of nonendemic foreign fungi on wooden handicrafts into the United States despite the application of sanitation protocols. Previous risk assessments of imported wood products have focused on potential for introduction of invasive arthropods (and their fungal symbionts) or have focused on other classes of wood products (timber, wooden furniture, garden products, etc.). Little to no attention has been paid to wooden handicrafts and the fungal pathogens (of plants and humans) they may carry. Due to the large size and diversity of this market, the risk for introduction of potentially dangerous pathogens is significant as illustrated by the results of this study.
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Affiliation(s)
- Jason A. Smith
- School of Forest, Fisheries and Geomatics Sciences, University of Florida, Gainesville, Florida, USA
| | - Tania Quesada
- School of Forest, Fisheries and Geomatics Sciences, University of Florida, Gainesville, Florida, USA
| | - Gideon Alake
- School of Forest, Fisheries and Geomatics Sciences, University of Florida, Gainesville, Florida, USA
| | - Nicolas Anger
- School of Forest, Fisheries and Geomatics Sciences, University of Florida, Gainesville, Florida, USA
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Niyazi D, Toncheva B, Tonchev T, Dzhenkov D, Kalchev K, Stoeva T. First report of rhino-orbital-cerebral mucormycosis after COVID-19 infection in Bulgaria. Future Microbiol 2022; 17:1107-1113. [PMID: 35899489 PMCID: PMC9332908 DOI: 10.2217/fmb-2022-0030] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
Mucormycosis is a relatively rare infection but with a high mortality rate due to the difficult and time-consuming diagnostic and therapeutic process. The authors present the first case of rhino-orbital-cerebral mucormycosis, histologically and microbiologically proven, in a patient after COVID-19 infection in Bulgaria.
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Affiliation(s)
- Denis Niyazi
- Laboratory of Clinical Microbiology, University Hospital 'St. Marina', Varna, Bulgaria.,Medical University, Varna, Bulgaria
| | - Borislava Toncheva
- Maxillofacial Surgery Clinic, University Hospital 'St. Marina', Varna, Bulgaria.,Medical University, Varna, Bulgaria
| | - Tsvetan Tonchev
- Maxillofacial Surgery Clinic, University Hospital 'St. Marina', Varna, Bulgaria.,Medical University, Varna, Bulgaria
| | - Deyan Dzhenkov
- General & clinical pathology clinic, University Hospital 'St. Marina', Varna, Bulgaria.,Medical University, Varna, Bulgaria
| | - Kalin Kalchev
- General & clinical pathology clinic, University Hospital 'St. Marina', Varna, Bulgaria.,Medical University, Varna, Bulgaria
| | - Temenuga Stoeva
- Laboratory of Clinical Microbiology, University Hospital 'St. Marina', Varna, Bulgaria.,Medical University, Varna, Bulgaria
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12
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Mendonça A, Carvalho-Pereira J, Franco-Duarte R, Sampaio P. Optimization of a Quantitative PCR Methodology for Detection of Aspergillus spp. and Rhizopus arrhizus. Mol Diagn Ther 2022; 26:511-525. [PMID: 35710958 PMCID: PMC9202985 DOI: 10.1007/s40291-022-00595-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/02/2022] [Indexed: 11/25/2022]
Abstract
Introduction Multiplex quantitative polymerase chain reaction (qPCR) methods for the detection of Aspergillus spp. based only on SYBR Green and melting curve analysis of PCR products are difficult to develop because most targets are located within ITS regions. The aim of this study was to adapt our previously developed methodology based on a multiplex PCR assay coupled with GeneScan analysis to provide a qPCR method. Methods A SYBR Green-based real-time PCR assay was optimized to detect A. fumigatus, A. flavus, A. niger, A. terreus, and R. arrhizus in a multiplex assay and applied to cultured fungi and spiked plasma. Results Different melting temperatures allowed identification of all five pathogens and discrimination between them, even in samples with low amounts of fungal gDNA (from 1.3 to 33.0 pg/μL), which has been reported previously as problematic. No false-positive results were obtained for non-target species, including bacteria and human DNA. This method allowed detection of fungal pathogens in human plasma spiked with fungal DNA and in coinfections of A. niger/R. arrhizus. Discussion This work provides evidence for the use of a qPCR multiplex method based on SYBR Green and melting curve analysis of PCR products for the detection of A. fumigatus, A. flavus, A. niger, A. terreus, and R. arrhizus. The proposed method is simpler and less expensive than available kits based on fluorescent probes and can be used for aiding diagnosis of the most relevant invasive filamentous fungi, particularly in low-income health care institutions. Supplementary Information The online version contains supplementary material available at 10.1007/s40291-022-00595-1.
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Affiliation(s)
- Alexandre Mendonça
- CBMA (Centre of Molecular and Environmental Biology), Department of Biology, University of Minho, Braga, Portugal
| | - Joana Carvalho-Pereira
- CBMA (Centre of Molecular and Environmental Biology), Department of Biology, University of Minho, Braga, Portugal
| | - Ricardo Franco-Duarte
- CBMA (Centre of Molecular and Environmental Biology), Department of Biology, University of Minho, Braga, Portugal.
| | - Paula Sampaio
- CBMA (Centre of Molecular and Environmental Biology), Department of Biology, University of Minho, Braga, Portugal
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13
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Passi N, Wadhwa AC, Naik S. Radiological spectrum of invasive mucormycosis in COVID-19. BJR Case Rep 2022; 7:20210111. [PMID: 35300232 PMCID: PMC8906162 DOI: 10.1259/bjrcr.20210111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2021] [Revised: 07/29/2021] [Accepted: 08/27/2021] [Indexed: 11/30/2022] Open
Abstract
Mucormycosis, commonly known as the “black fungus” is recently emerging as a deadly complication in COVID patients in the Indian subcontinent. A growing number of cases are being reported from all over the country, with a majority of the patients either undergoing treatment or having recovered from COVID. Here, we report three cases of multisystem mucormycosis in COVID positive patients showing, rhino-orbital, cerebral, pulmonary, and genitourinary involvement. The first is a case of a 41-year-old male patient who during his treatment developed left periorbital swelling with ecchymosis and headache. CT and CE-MRI of the paranasal sinuses and brain revealed features of pan fungal sinusitis and subsequent invasion into the left orbit. The second case is of a 52-year-old male patient who after complaining of a severe left-sided hemicranial headache was diagnosed with cavernous sinus thrombosis. The third is of a 57-year-old male patient who presented with left flank pain and dysuria. HRCT (High-resolution CT) chest revealed a thick-walled cavitary lesion, and NCCT KUB (Non-contrast CT of Kidneys, ureters, and bladder) revealed left-sided pyelonephritis. A cystoscopic and microbiological evaluation revealed fungal growth. In all three patients, a biopsy from the involved area revealed broad aseptate filamentous fungal hyphae suggestive of mucormycosis, which was confirmed on culture. These are all unusual cases and physicians should be aware of the possibility of secondary invasive fungal infections in patients with COVID-19 infection.
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Affiliation(s)
- Nandini Passi
- Department of Radio-diagnosis, Batra Hospital and Medical Research Centre (BHMRC), New Delhi, India
| | - Anshu C Wadhwa
- Department of Radio-diagnosis, Batra Hospital and Medical Research Centre (BHMRC), New Delhi, India
| | - Swati Naik
- Department of Radio-diagnosis, Batra Hospital and Medical Research Centre (BHMRC), New Delhi, India
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14
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Geng C, Yu K, Li F. Necrotizing Fasciitis Caused by Mucormycosis: A Case Report and Literature Review. INT J LOW EXTR WOUND 2022:15347346221080940. [PMID: 35167382 DOI: 10.1177/15347346221080940] [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: 11/15/2022]
Abstract
We present a rare case of Necrotizing fasciitis (NF) caused by mucor. The limb was debrided multiple times and the patient received antifungal treatment. The clinical manifestations and laboratory test results of mucor infections, which were significantly different from those caused by common bacteria, are of great value.
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Affiliation(s)
| | - Kai Yu
- 426111Liaocheng People's Hospital, Liaocheng, China
| | - Feng Li
- 487555Fourth Medical Center of PLA General Hospital, Beijing, China
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15
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Dogra S, Arora A, Aggarwal A, Passi G, Sharma A, Singh G, Barnwal RP. Mucormycosis Amid COVID-19 Crisis: Pathogenesis, Diagnosis, and Novel Treatment Strategies to Combat the Spread. Front Microbiol 2022; 12:794176. [PMID: 35058909 PMCID: PMC8763841 DOI: 10.3389/fmicb.2021.794176] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2021] [Accepted: 11/30/2021] [Indexed: 01/01/2023] Open
Abstract
The havoc unleashed by COVID-19 pandemic has paved way for secondary ominous fungal infections like Mucormycosis. It is caused by a class of opportunistic pathogens from the order Mucorales. Fatality rates due to this contagious infection are extremely high. Numerous clinical manifestations result in damage to multiple organs subject to the patient's underlying condition. Lack of a proper detection method and reliable treatment has made the management of this infection troublesome. Several reports studying the behavior pattern of Mucorales inside the host by modulation of its defense mechanisms have helped in understanding the pathogenesis of this angio-invasive infection. Many recent advances in diagnosis and treatment of this fungal infection have not been much beneficial. Therefore, there is a need to foster more viable strategies. This article summarizes current and imminent approaches that could aid effective management of these secondary infections in these times of global pandemic. It is foreseen that the development of newer antifungal drugs, antimicrobial peptides, and nanotechnology-based approaches for drug delivery would help combat this infection and curb its spread.
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Affiliation(s)
- Shreya Dogra
- Department of Biophysics, Panjab University, Chandigarh, India
| | - Akanksha Arora
- Department of Biophysics, Panjab University, Chandigarh, India
| | - Aashni Aggarwal
- Department of Biophysics, Panjab University, Chandigarh, India
| | - Gautam Passi
- Department of Biophysics, Panjab University, Chandigarh, India
| | - Akanksha Sharma
- Department of Biophysics, Panjab University, Chandigarh, India
- University Institute of Pharmaceutical Sciences, Panjab University, Chandigarh, India
| | - Gurpal Singh
- University Institute of Pharmaceutical Sciences, Panjab University, Chandigarh, India
| | - Ravi P. Barnwal
- Department of Biophysics, Panjab University, Chandigarh, India
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16
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Sarfraz Z, Sarfraz A, Jaiswal V, Poudel S, Bano S, Hanif M, Singh Shrestha P, Sarfraz M, Michel G, Cherrez-Ojeda I. The Past, Present and Future of COVID-19 Associated Mucormycosis: A Rapid Review. J Prim Care Community Health 2022; 13:21501319221099476. [PMID: 35587142 PMCID: PMC9127848 DOI: 10.1177/21501319221099476] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
Coronavirus disease 2019 (COVID-19) is caused by SARS-CoV-2, which is known for the multiple mutations and forms that have rapidly spread across the world. With the imminent challenges faced by low- and middle-income countries in curbing the public health fallbacks due to limited resources, mucormycosis emerged as a fungal infection associated with high mortality. In this rapid review, we explored MEDLINE, Cochrane, Web of Science, WHO Global Database, and the search engine—Google Scholar for articles listed until July 2021 and presented a narrative synthesis of findings from 39 articles. The epidemiology, causative factors, incidence parameters, pharmacological treatment, and recommendations for low- and middle-income countries are enlisted. This study concludes that a majority of the globally reported COVID-19 associated mucormycosis cases stemmed from India. Individuals receiving systemic corticosteroids or who have a history of diabetes mellitus are more prone to contracting the disease. Public health authorities in LMIC are recommended to strengthen antifungal therapies for COVID-19 associated mucormycosis and to strategize reduction in diabetes mellitus prevalence.
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Affiliation(s)
- Zouina Sarfraz
- Larkin Community Hospital, South Miami, FL, USA.,Fatima Jinnah Medical University, Lahore, Pakistan
| | - Azza Sarfraz
- Larkin Community Hospital, South Miami, FL, USA.,The Aga Khan University, Karachi, Pakistan
| | | | | | - Shehar Bano
- Larkin Community Hospital, South Miami, FL, USA.,Fatima Jinnah Medical University, Lahore, Pakistan
| | | | | | | | | | - Ivan Cherrez-Ojeda
- Universidad Espíritu Santo, Samborondón, Ecuador.,Respiralab Research Center, Guayaquil, Ecuador
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17
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Fungal Invasive Co-Infection Due to Aspergillus fumigatus and Rhizopus arrhizus: A Rhino-Orbital Presentation. J Fungi (Basel) 2021; 7:jof7121096. [PMID: 34947078 PMCID: PMC8704653 DOI: 10.3390/jof7121096] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2021] [Revised: 12/10/2021] [Accepted: 12/11/2021] [Indexed: 12/30/2022] Open
Abstract
Aspergillosis and mucormycosis are filamentous fungal infections occurring predominantly in immunocompromised patients. Fulminant process with rapid infiltration of the contiguous tissue is distinctive for both type of fungi. The rhinocerebral co-infection by Aspergillus and Mucorales is very rare and is usually associated in immunocompromised patients with a high mortality rate. This rare co-infection leads to difficulties in diagnosis, and therapeutic delays can result in a poor prognosis. Overall, the treatment of choice is surgical debridement and liposomal amphotericin B. This paper describes a combined aspergillosis and mucormycosis case in a diabetes mellitus type 2 patient with chronic ulcerations of the palatal and cheek. To our knowledge, this is the first report of an uncommon co-infection of Aspergillus fumigatus and Rhizopus arrhizus in a rhino-orbital presentation.
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18
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Ray SK, Mukherjee S. COVID-19-Associated Mucormycosis, A New Incident in Recent Time: Is An Emerging Disease in The Near Future Impending? Avicenna J Med 2021; 11:210-216. [PMID: 34881204 PMCID: PMC8648408 DOI: 10.1055/s-0041-1735383] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Abstract
Mucormycosis (also known as black fungus) is caused by fungi of the Zygomycetes class and is the third most common invasive mycosis after candidiasis and aspergillosis. They colonize a large number of patients without invading them. Systemic glucocorticoids are currently used to treat severe Coronavirus disease 19 (COVID-19). In such patients, opportunistic fungal infections are a problem. Although COVID-19-related pulmonary aspergillosis is becoming more common, mucormycosis is still uncommon. Mucormycosis normally appears 10 to 14 days after being admitted to the hospital. Mucormycosis is a rare but dangerous infection that can make extreme COVID-19 worse. Mucormycosis is more likely to occur in people who have diabetes mellitus and other risk factors. Mucormycosis is most likely exacerbated by concurrent glucocorticoid treatment. To improve outcomes, a high index of suspicion and aggressive management is required. Excessive usage of steroids, monoclonal antibodies, and broad-spectrum antibiotics might cause the formation or worsen of a fungal infection. A high index of suspicion and aggressive management are needed. In patients with COVID-19 infection, physicians should be vigilant of the likelihood of subsequent invasive fungal infections. To enhance results in pulmonary mucormycosis, early diagnosis and treatment are critical. Confirmation of the clinical form necessitates a combination of symptoms that are consistent with tissue invasion histologically. Combining various clinical data and the isolation of the fungus from clinical samples in culture is needed for the probable diagnosis of mucormycosis. The organism that causes mucormycosis is identified using macroscopic and microscopic morphological criteria, carbohydrate assimilation, and the maximum temperature at which they can expand. Mucormycosis must be treated with antifungal medication prescribed by a doctor. It may necessitate surgery in some circumstances, and it can result in the loss of the upper jaw and, in some situations, an eye.
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Affiliation(s)
- Suman Kumar Ray
- Department of Applied Sciences, Indira Gandhi Technological and Medical Sciences University, Arunachal Pradesh, India
| | - Sukhes Mukherjee
- Department of Biochemistry, All India Institute of Medical Sciences, Bhopal, Madhya Pradesh, India
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19
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Mehta R, Nagarkar NM, Ksbs KS, Ty SS, Arora RD, Aggarwal A. Facial Nerve Palsy in COVID-19-Associated Mucormycosis Patients: A Case Series. Cureus 2021; 13:e19208. [PMID: 34873538 PMCID: PMC8638780 DOI: 10.7759/cureus.19208] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/29/2021] [Indexed: 12/02/2022] Open
Abstract
Sinonasal mucormycosis is a deadly fungal illness that primarily affects diabetics who are uncontrolled. Numerous cranial nerves can be involved; however, facial nerve palsy has only been observed in a few cases. The main objective of this research is to highlight facial nerve involvement as a clinical sign of sinonasal mucormycosis. Nasal stuffiness, headaches, eye pain, orbital edema, ophthalmoplegia, and vision loss are common symptoms in these mucormycosis patients. The study was done in the Department of Otolaryngology & Head and Neck Surgery, All India Institute of Medical Sciences (AIIMS), Raipur, India. Nevertheless, 17 patients with facial nerve palsy (lower motor nerve palsy) and sinonasal mucormycosis arrived at our department. All patients were diabetic, and a majority of patients got Schirmer's test positive with severe stage. In the case of mucormycosis, facial nerve palsy is an unusual but noteworthy symptom. This could be misinterpreted as a cerebrovascular accident (CVA), causing the therapy to be delayed. This is critical as early identification, surgical debridement, and adequate therapy of the underlying metabolic imbalance, as well as amphotericin B, are critical for a successful treatment outcome in mucormycosis.
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Affiliation(s)
- Rupa Mehta
- Otolaryngology, All India Institute of Medical Sciences, Raipur, Raipur, IND
| | - Nitin M Nagarkar
- Otolaryngology, All India Institute of Medical Sciences, Raipur, Raipur, IND
| | | | - Sree Sudha Ty
- Pharmacology, Shri Shankaracharya Institute of Medical Sciences, Bhilai, IND
| | - Ripu Daman Arora
- Otolaryngology, All India Institute of Medical Sciences, Raipur, Raipur, IND
| | - Aakash Aggarwal
- Otolaryngology, All India Institute of Medical Sciences, Raipur, Raipur, IND
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20
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Panwar P, Gupta A, Kumar A, Gupta B, Navriya SC. Mucormycosis in COVID Diabetic Patients: A Horrifying Triad! Indian J Crit Care Med 2021; 25:1314-1317. [PMID: 34866832 PMCID: PMC8608646 DOI: 10.5005/jp-journals-10071-24025] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Infectious diseases with the coronavirus disease-2019 (COVID-19) can be linked to various microbial and fungal coinfections. Mucormycosis is an invasive opportunistic infection that enters as inhalation of fungal spores through the nose or paranasal sinuses in diabetic and immunocompromised patients. We present our experience of managing seven cases of recent COVID-19 infection with uncontrolled diabetes who developed rhino-orbital mucormycosis. All patients were diagnosed by clinical examination and imaging and managed by emergency surgical debridement and liposomal amphotericin-B. A lethal triad of impaired immunity due to COVID-19 infection, state of hyperglycemia, increased use of steroids, or rampant broad-spectrum antimicrobials works as fertile soil and may assist in the growth or alleviation of a fungal infection. Healthcare professionals must be aware of the potential of secondary invasive fungal infections in diabetic patients with moderate to severe category of COVID-19 infectious disease, especially on steroid therapy.
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Affiliation(s)
- Parshika Panwar
- Department of General Medicine, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Anish Gupta
- Department of CTVS, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Amit Kumar
- Department of ENT, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Bhavna Gupta
- Department of Anaesthesia, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Shiv C Navriya
- Department of Urology, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
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21
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Zainea V, Ionita I, Pituru S, Pietroșanu C, Rusescu A, Stefanescu C, Gherghiceanu F, Anghelina F, Palade D, Hainarosie R. Endoscopic assessment of sinonasal mucormycosis with SPIES: The ‘battlefield’ sign. Exp Ther Med 2021; 23:77. [DOI: 10.3892/etm.2021.11000] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Accepted: 08/17/2021] [Indexed: 11/06/2022] Open
Affiliation(s)
- Viorel Zainea
- Department of ENT, ‘Carol Davila’ University of Medicine and Pharmacy, 050474 Bucharest, Romania
| | - Irina Ionita
- Allergy Department, ‘Carol Davila’ University of Medicine and Pharmacy, 050474 Bucharest, Romania
| | - Silviu Pituru
- Department of ENT, ‘Carol Davila’ University of Medicine and Pharmacy, 050474 Bucharest, Romania
| | - Cătălina Pietroșanu
- Department of ENT, ‘Carol Davila’ University of Medicine and Pharmacy, 050474 Bucharest, Romania
| | - Andreea Rusescu
- Department of ENT, ‘Carol Davila’ University of Medicine and Pharmacy, 050474 Bucharest, Romania
| | - Cristian Stefanescu
- Department of ENT, ‘Carol Davila’ University of Medicine and Pharmacy, 050474 Bucharest, Romania
| | - Florentina Gherghiceanu
- Department of ENT, ‘Carol Davila’ University of Medicine and Pharmacy, 050474 Bucharest, Romania
| | - Florin Anghelina
- Department of ENT, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania
| | - Dragos Palade
- Department of ENT, ‘Grigore T. Popa’ University of Medicine and Pharmacy, 700115 Iasi, Romania
| | - Razvan Hainarosie
- Department of ENT, ‘Carol Davila’ University of Medicine and Pharmacy, 050474 Bucharest, Romania
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22
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Dos Santos RLO, Elchin CB, Guiguer-Pinto VA, Vasconcelos DDM, Ferreira MD, Dias RB, Sugaya NN, Paula CR, Coto NP. Diagnosis, treatment and maxillofacial rehabilitation in rhinocerebral mucormycosis patient: A case report and review of the literature. J Mycol Med 2021; 32:101211. [PMID: 34763149 DOI: 10.1016/j.mycmed.2021.101211] [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: 12/22/2020] [Revised: 09/22/2021] [Accepted: 10/08/2021] [Indexed: 11/16/2022]
Abstract
Mucormycosis is an aggressive, rare and opportunistic infectious disease, with a high mortality rate. Etiologic agents are filamentous fungi, and infection among humans normally occurs through spore inhalation. A 61-year-old male individual, presenting left eye amaurosis, dark epistaxis, hyperalgesia and malodor underwent clinical examination, which detected ulcerative lesion and wide bone exposure in the hard palate and alveolar ridge. Direct microbiological examination, microbiological culture and lesion biopsy were performed. Non-septate smooth fungal hyphae forming right angles with each other were observed through the direct microbiological examination. Microbiological culture revealed fast-growing fungal colonies with cottony texture, identified as Rhizopus sp. Histopathological examination exhibited necrosis areas, intense mononuclear inflammatory infiltrate and bulky hyphae, thus concluding the mucormycosis diagnosis. Amphotericin B antifungal therapy and surgical intervention were adopted as treatment. The patient was then rehabilitated with maxillofacial prosthesis, subsequently to the healing of the surgical wound.
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Affiliation(s)
| | - Cintia Baena Elchin
- Department of Maxillofacial Surgery, Prosthetics and Traumatology, School of Dentistry - University of São Paulo, Av. Lineu Prestes, São Paulo 2227, Brazil
| | - Vítor Ancheschi Guiguer-Pinto
- Department of Maxillofacial Surgery, Prosthetics and Traumatology, School of Dentistry - University of São Paulo, Av. Lineu Prestes, São Paulo 2227, Brazil
| | | | - Maurício Domingues Ferreira
- Department of Dermatology, School of Medicine - University of São Paulo, Av. Dr. Arnaldo, São Paulo 455, Brazil
| | - Reinaldo Brito Dias
- Department of Maxillofacial Surgery, Prosthetics and Traumatology, School of Dentistry - University of São Paulo, Av. Lineu Prestes, São Paulo 2227, Brazil
| | - Norberto Nobuo Sugaya
- Department of Stomatology, School of Dentistry - University of São Paulo, Av. Lineu Prestes, São Paulo 2227, Brazil
| | - Claudete Rodrigues Paula
- Department of Stomatology, School of Dentistry - University of São Paulo, Av. Lineu Prestes, São Paulo 2227, Brazil
| | - Neide Pena Coto
- Department of Maxillofacial Surgery, Prosthetics and Traumatology, School of Dentistry - University of São Paulo, Av. Lineu Prestes, São Paulo 2227, Brazil
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23
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Choudhary NK, Jain AK, Soni R, Gahlot N. Mucormycosis: A deadly black fungus infection among COVID-19 patients in India. CLINICAL EPIDEMIOLOGY AND GLOBAL HEALTH 2021; 12:100900. [PMID: 34746515 PMCID: PMC8559302 DOI: 10.1016/j.cegh.2021.100900] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2021] [Revised: 08/04/2021] [Accepted: 10/28/2021] [Indexed: 01/10/2023] Open
Abstract
After first phase of Covid-19, the second wave affects a lot to the Indians with mysterious fungal infection known as Mucormycosis. Here, we reviewed clinical pathogenesis, signs, symptoms and treatment against black fungus. The conclusion revealed that use of immunosuppressant to combat Covid-19 also increases the risk to get infected with mucormycosis. Patients with hyperglycemia, ketoacidosis, solid organ or bone marrow transplantion, liver cirrhosis, neutropenia are more susceptible to get attacked by Mucormycosis moulds. Early diagnosis, removal of predisposing factors, timely antifungal therapy with surgical removal of all infected tissues and adjunctive therapies are four major factors to eradicate Mucormycosis.
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Affiliation(s)
| | - Amit K Jain
- B R Nahata College of Pharmacy, Mandsaur University, Mandsaur, 458001, India
| | - Rupesh Soni
- B R Nahata College of Pharmacy, Mandsaur University, Mandsaur, 458001, India
| | - Neha Gahlot
- B R Nahata College of Pharmacy, Mandsaur University, Mandsaur, 458001, India
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24
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Saidha PK, Kapoor S, Das P, Gupta A, Kakkar V, Kumar A, Arya V. Mucormycosis of Paranasal Sinuses of Odontogenic Origin Post COVID19 Infection: A Case Series. Indian J Otolaryngol Head Neck Surg 2021; 74:3437-3441. [PMID: 34178609 PMCID: PMC8211306 DOI: 10.1007/s12070-021-02638-1] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Accepted: 05/16/2021] [Indexed: 12/13/2022] Open
Abstract
The Severe acute respiratory syndrome and the Middle East respiratory syndromes emerged in 2002 and 2012 respectively. Currently the world is witnessing a global pandemic caused by a novel coronavirus, the severe acute respiratory syndrome coronavirus 2 (SARS CoV- 2) causing the Coronavirus 2019 (COVID-19). Mucormycosis is a fungal infection primarily affecting individuals with an immunocompromised state like diabetes mellitus, malignancies etc. Patients who have or have had COVID-19 infection with pre-existing uncontrolled Type 2 Diabetes mellitus are presumably more vulnerable for emergence of fungal infections cases. This article presents a report of 6 cases with histopathological proven mucormycosis associated with COVID-19 and uncontrolled Diabetes mellitus.
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Affiliation(s)
- Poonam Kumar Saidha
- Department of ENT at SGT Hospital, SGT University, C.V Raman Hostel, Gurgaon, India
| | - Sahil Kapoor
- Department of ENT at SGT Hospital, SGT University, C.V Raman Hostel, Gurgaon, India
| | - Pooja Das
- Department of ENT at SGT Hospital, SGT University, C.V Raman Hostel, Gurgaon, India
| | - Ayushi Gupta
- Department of ENT at SGT Hospital, SGT University, C.V Raman Hostel, Gurgaon, India
| | - Vikas Kakkar
- Department of ENT at SGT Hospital, SGT University, C.V Raman Hostel, Gurgaon, India
| | - Arun Kumar
- Department of ENT at SGT Hospital, SGT University, C.V Raman Hostel, Gurgaon, India
| | - Varun Arya
- Department of ENT at SGT Hospital, SGT University, C.V Raman Hostel, Gurgaon, India
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25
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Galletta K, Alafaci C, D'Alcontres FS, Maria ME, Cavallaro M, Ricciardello G, Vinci S, Grasso G, Granata F. Imaging features of perineural and perivascular spread in rapidly progressive rhino-orbital-cerebral mucormycosis: A case report and brief review of the literature. Surg Neurol Int 2021; 12:245. [PMID: 34221576 PMCID: PMC8247725 DOI: 10.25259/sni_275_2021] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Accepted: 04/30/2021] [Indexed: 12/16/2022] Open
Abstract
Background: Rhinocerebral mucormycosis (ROCM) is an opportunistic fungal infection originating from the paranasal sinuses with extension to the brain. A delayed diagnosis can rapidly result in a poor prognosis. ROCM commonly affects patients with diabetes or immunocompromised states with a variable progression. Case Description: We report the case of a 59-year old patient with an untreated diabetes who developed a ROCM with rapidly progressive neurological symptoms. From the onset of sinus pain, nasal congestion, he rapidly developed facial swelling and masticatory dysfunction. The patient underwent sinus surgery which allowed Rhizopus oryzae to be isolated. Accordingly, a systemic therapy by intensive intravenous amphotericin B was started. Nevertheless, the infection rapidly resulted in bilateral cavernous sinuses thrombosis and occlusion of the left internal carotid artery providing the subsequent patient death. Conclusion: Mucormycosis is a life-threatening fungal infection in diabetic and/or immunosuppressed patients. Our case demonstrates the three main mechanisms for infection spreading that are direct, perineural, and perivascular diffusion. Clear identification of the main risk factors, proper assessment of clinical features, and radiological findings may improve the chance for an early diagnosis and patient survival.
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Affiliation(s)
- Karol Galletta
- Department of Biomedical, Dental Science and Morphological and Functional Images, Messina, Italy
| | - Concetta Alafaci
- Department of Biomedical Sciences and Morphological and Functional Imaging, Section of Neurosurgery, Messina, Italy
| | | | - Mormina Enrico Maria
- Department of Biomedical, Dental Science and Morphological and Functional Images, Messina, Italy
| | - Marco Cavallaro
- Department of Biomedical, Dental Science and Morphological and Functional Images, Messina, Italy
| | - Giorgia Ricciardello
- Department of Biomedical, Dental Science and Morphological and Functional Images, Messina, Italy
| | - Sergio Vinci
- Department of Biomedical, Dental Science and Morphological and Functional Images, Messina, Italy
| | - Giovanni Grasso
- Department of Biomedicine, Neurosciences and Advanced Diagnostics, Section of Neurosurgery, University of Palermo, Palermo, Italy
| | - Francesca Granata
- Department of Biomedical, Dental Science and Morphological and Functional Images, Messina, Italy
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Panchanatheeswaran K, Ram D, Prasad S, Srinivas BH, Rath D, SaiChandran BV, Munuswamy H. Thoracic mucormycosis in immunocompetent patients. J Card Surg 2021; 36:1183-1188. [PMID: 33470008 DOI: 10.1111/jocs.15332] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2020] [Revised: 11/17/2020] [Accepted: 01/05/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND Mucormycosis is an invasive fungal infection. It is rare and commonly associated with fatal outcomes. METHODS We report two cases of thoracic mucormycosis in immunocompetent patients. First, is an immunocompetent child with mediastinal mass and extension into the pericardium and left atrium. The second is a young woman with a left pulmonary artery pseudoaneurysm. RESULTS The first patient could not be salvaged while the second patient was successfully managed with surgical intervention and systemic antifungal treatment. CONCLUSION Mucormycosis should be considered as a differential diagnosis in the management of immunocompetent patients in patients with pyrexia of unknown origin and a mediastinal mass. Early and aggressive surgical management along with systemic antifungal treatment improves the survival in this subset of patients.
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Affiliation(s)
- Karthik Panchanatheeswaran
- Department of Cardiothoracic Surgery, Velammal Medical College Hospital & Research Institute, Madurai, India
| | - Duvuru Ram
- Green Lane Cardiothoracic Unit, Auckland City Hospital, New Zealand
| | - Sreevathsa Prasad
- Department of Cardiothoracic and Vascular Surgery, JIPMER, Pondicherry, India
| | | | - Durgaprasad Rath
- Department of Cardiothoracic and Vascular Surgery, JIPMER, Pondicherry, India
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Magray AR, Hafeez S, Ganai BA, Lone SA, Dar GJ, Ahmad F, Siriyappagouder P. Study on pathogenicity and characterization of disease causing fungal community associated with cultured fish of Kashmir valley, India. Microb Pathog 2021; 151:104715. [PMID: 33444698 DOI: 10.1016/j.micpath.2020.104715] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2020] [Revised: 12/19/2020] [Accepted: 12/21/2020] [Indexed: 01/21/2023]
Abstract
Cultured fisheries of developing countries are continously challenged by a number of pathogenic microbes. Among microbial diseases, fungal and fungal like pathogen outbreaks lead to negative social and economic impacts on stakeholders. The cultured fisheries of Kashmir valley are also facing challenge from fungal pathogens, leading to tremendous socio-economic lossess to the fish farmer community hence, yearns to boost the sector with efficient management strategy. Our study was aimed at investigating the diversity of fungal communities infecting cultured rainbow trout and carp fish species. We employed classical microbiology, macro and micro morphological characteristics, and molecular analysis (multilocus typing) for fungal identification. Also histopathological approach was used to examine the pathogenicity patterns of diverse fungal groups. The study revealed that the infection in fish was predisposed to both superficial as well as visceral organs. However, skin, gills and head were predominantly infected compared to internal organs. The microbiological investigation of infected fish by culture dependent approach helped us to obtain the total of 250 fungal isolates. Out of these isolates, 21 different species were identified belonging to three diverse fungal groups which mostly included 14 species among Ascomycetes, 03 species of Oomycetes and 04 species of Zygomycetes. The majority of fungi which were infectious to cultured fish of valley are biotrophic or opportunistic soil fungi, and some of them being exclusive pathogens of fish.
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Affiliation(s)
- Aqib Rehman Magray
- Centre of Research for Development, University of Kashmir, Srinagar, 190006, India.
| | - Sabira Hafeez
- Centre of Research for Development, University of Kashmir, Srinagar, 190006, India; Department of Environmental Science, University of Kashmir, Srinagar, 190006, India
| | - Bashir Ahmad Ganai
- Centre of Research for Development, University of Kashmir, Srinagar, 190006, India; Department of Environmental Science, University of Kashmir, Srinagar, 190006, India.
| | - Showkat Ahmad Lone
- Centre of Research for Development, University of Kashmir, Srinagar, 190006, India
| | - Gulam Jeelani Dar
- Centre of Research for Development, University of Kashmir, Srinagar, 190006, India
| | - Fayaz Ahmad
- Department of Environmental Science, University of Kashmir, Srinagar, 190006, India; Department of Zoology, University of Kashmir, Srinagar, 190006, India
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28
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Dharmshaktu G, Ansari T, Pangtey T. Musculoskeletal mucormycosis and COVID-19 pandemic – caution in the crisis. JOURNAL OF ORTHOPAEDIC DISEASES AND TRAUMATOLOGY 2021. [DOI: 10.4103/jodp.jodp_10_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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29
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Boukari M, Zhioua Braham I, Kaouel H, El Amri-Mezghanni K, Ayedi O, Maalej R, Mili Boussen I, Ammous I, Zhioua R. [Rhino-orbito-cerebral mucormycosis, a diagnostic and therapeutic emergency]. J Fr Ophtalmol 2020; 43:e153-e155. [PMID: 32145933 DOI: 10.1016/j.jfo.2019.11.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2019] [Revised: 10/24/2019] [Accepted: 11/13/2019] [Indexed: 10/24/2022]
Affiliation(s)
- M Boukari
- Tunis El Manar university, faculty of medicine of Tunis, department of ophthalmology, Charles-Nicolle university hospital of Tunis.
| | - I Zhioua Braham
- Tunis El Manar university, faculty of medicine of Tunis, department of ophthalmology, Charles-Nicolle university hospital of Tunis
| | - H Kaouel
- Tunis El Manar university, faculty of medicine of Tunis, department of ophthalmology, Charles-Nicolle university hospital of Tunis
| | - K El Amri-Mezghanni
- Tunis El Manar university, faculty of medicine of Tunis, department of ophthalmology, Charles-Nicolle university hospital of Tunis
| | - O Ayedi
- Tunis El Manar university, faculty of medicine of Tunis, department of ophthalmology, Charles-Nicolle university hospital of Tunis
| | - R Maalej
- Tunis El Manar university, faculty of medicine of Tunis, department of ophthalmology, Charles-Nicolle university hospital of Tunis
| | - I Mili Boussen
- Tunis El Manar university, faculty of medicine of Tunis, department of ophthalmology, Charles-Nicolle university hospital of Tunis
| | - I Ammous
- Tunis El Manar university, faculty of medicine of Tunis, department of ophthalmology, Charles-Nicolle university hospital of Tunis
| | - R Zhioua
- Tunis El Manar university, faculty of medicine of Tunis, department of ophthalmology, Charles-Nicolle university hospital of Tunis
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30
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Giacobbe DR, Riccardi N, Vena A, Bassetti M. Mould Infections of Traumatic Wounds: A Brief Narrative Review. Infect Dis Ther 2020; 9:1-15. [PMID: 32072492 PMCID: PMC7054562 DOI: 10.1007/s40121-020-00284-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2019] [Indexed: 01/06/2023] Open
Abstract
Mould infections may follow traumatic injuries, with direct fungal inoculum in the site of injury and subsequent angioinvasion, possibly resulting in tissue necrosis and systemic dissemination. The pathogenesis of mould infections following trauma injuries presents unique features compared with classical mould infections occurring in neutropenic or diabetic patients, because a large fraction of post-traumatic mould infections is observed in previously healthy individuals. Most of the published clinical experience and research on mould infections following traumatic injuries regards soldiers and infections after natural disasters. However, following trauma and soil contamination (e.g., agricultural or automotive injuries) other immunocompetent individuals may develop mould infections. In these cases, delays in correct diagnosis and treatment may occur if pertinent signs such as necrosis and absent or reduced response to antibacterial therapy are not promptly recognized. Awareness of mould infections in at-risk populations is needed to rapidly start adequate laboratory workflow and early antifungal therapy in rapidly evolving cases to improve treatment success and reduce mortality.
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Affiliation(s)
- Daniele Roberto Giacobbe
- Department of Health Sciences (DISSAL), University of Genoa, Genoa, Italy. .,Clinica Malattie Infettive, Ospedale Policlinico San Martino, IRCCS, Genoa, Italy.
| | - Niccolò Riccardi
- Department of Infectious, Tropical Diseases and Microbiology, IRCCS Sacro Cuore Don Calabria Hospital, Negrar di Valpolicella, Verona, Italy
| | - Antonio Vena
- Department of Health Sciences (DISSAL), University of Genoa, Genoa, Italy.,Clinica Malattie Infettive, Ospedale Policlinico San Martino, IRCCS, Genoa, Italy
| | - Matteo Bassetti
- Department of Health Sciences (DISSAL), University of Genoa, Genoa, Italy.,Clinica Malattie Infettive, Ospedale Policlinico San Martino, IRCCS, Genoa, Italy
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31
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Prakash H, Ghosh AK, Rudramurthy SM, Singh P, Xess I, Savio J, Pamidimukkala U, Jillwin J, Varma S, Das A, Panda NK, Singh S, Bal A, Chakrabarti A. A prospective multicenter study on mucormycosis in India: Epidemiology, diagnosis, and treatment. Med Mycol 2019; 57:395-402. [PMID: 30085158 DOI: 10.1093/mmy/myy060] [Citation(s) in RCA: 185] [Impact Index Per Article: 37.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2018] [Revised: 06/21/2018] [Accepted: 07/12/2018] [Indexed: 09/13/2023] Open
Abstract
Mucormycosis due to Mucorales is reported at large numbers in uncontrolled diabetics across India, but systematic multicenter epidemiological study has not been published yet. The present prospective study was conducted at four major tertiary care centers of India (two in north and two in south India) during 2013-2015 to compare the epidemiology, treatment strategies and outcome of mucormycosis between the two regions. Molecular techniques were employed to confirm the identity of the isolates or to identify the agent in biopsy samples. A total of 388 proven/probable mucormycosis cases were reported during the study period with overall mortality at 46.7%. Uncontrolled diabetes (n = 172, 56.8%) and trauma (n = 31, 10.2%) were the common risk factors. Overall, Rhizopus arrhizus (n = 124, 51.9%) was the predominant agent identified, followed by Rhizopus microsporus (n = 30, 12.6%), Apophysomyces variabilis (n = 22, 9.2%) and Rhizopus homothallicus (n = 6, 2.5%). On multivariate analysis, the mortality was significantly associated with gastrointestinal (OR: 18.70, P = .005) and pulmonary infections (OR: 3.03, P = .015). While comparing the two regions, majority (82.7%) cases were recorded from north India; uncontrolled diabetes (n = 157, P = .0001) and post-tubercular mucormycosis (n = 21, P = .006) were significantly associated with north Indian cases. No significant difference was noted among the species of Mucorales identified and treatment strategies between the two regions. The mortality rate was significantly higher in north Indian patients (50.5%) compared to 32.1% in south India (P = .016). The study highlights higher number of mucormycosis cases in uncontrolled diabetics of north India and emergence of R. microsporus and R. homothallicus across India causing the disease.
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Affiliation(s)
- Hariprasath Prakash
- Department of Medical Microbiology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Anup Kumar Ghosh
- Department of Medical Microbiology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | | | - Pankaj Singh
- Department of Medical Microbiology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Immaculata Xess
- Department of Microbiology, All India Institute of Medical Sciences, New Delhi, India
| | - Jayanthi Savio
- Department of Microbiology, St. John's Medical College, Bengaluru, Karnataka, India
| | - Umabala Pamidimukkala
- Department of Microbiology, Nizam's Institute of Medical Sciences, Hyderabad, Telangana, India
| | - Joseph Jillwin
- Department of Medical Microbiology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Subhash Varma
- Department of Internal medicine, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Ashim Das
- Department of Pathology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Naresh K Panda
- Department of Otolaryngology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Surjit Singh
- Department of Paediatric Medicine, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Amanjit Bal
- Department of Pathology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Arunaloke Chakrabarti
- Department of Medical Microbiology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
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32
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Manji F, Lam JC, Meatherall BL, Church D, Missaghi B. Severe facial necrosis in a type 1 diabetic patient secondary to mucormycosis masquerading as an internal maxillary artery occlusion: a case report. BMC Infect Dis 2019; 19:184. [PMID: 30795757 PMCID: PMC6387511 DOI: 10.1186/s12879-019-3822-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2018] [Accepted: 02/15/2019] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Mucormycosis is a group of rare but life threatening angioinvasive infections caused by fungi of the order Mucorales that often occurs in immunocompromised patients and individuals with poorly controlled diabetes. Rhinocerebral mucormycosis can mimic sinusitis but can rapidly progress to deeper disease and cause facial necrosis. Facial vascular thrombosis is a rare complication of mucormycosis and can confound diagnosis of the disease. CASE PRESENTATION We report the case of a 25-year-old female with poorly controlled type 1 diabetes mellitus who initially presented with symptoms of sinusitis but rapidly progressed with signs of left-sided facial necrosis due to occlusion of the left internal maxillary artery. Early surgical debridement did not yield a microbiological diagnosis. Deeper surgical debridements ultimately revealed angioinvasive fungal disease consistent with mucormycosis. The patient recovered after repeated surgical intervention and aggressive parenteral antifungal therapy. CONCLUSION This case illustrates an atypical complication of mucormycosis, and emphasizes that a high index of suspicion in vulnerable patient populations aids in the diagnosis of this life-threatening infection.
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Affiliation(s)
- Farheen Manji
- Alberta Health Services, Calgary, Canada. .,University of Calgary, Calgary, Canada.
| | - John C Lam
- Alberta Health Services, Calgary, Canada.,University of Calgary, Calgary, Canada
| | - Bonnie L Meatherall
- Alberta Health Services, Calgary, Canada.,University of Calgary, Calgary, Canada
| | | | - Bayan Missaghi
- Alberta Health Services, Calgary, Canada.,University of Calgary, Calgary, Canada
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Sękowska A, Prażyńska M, Twarużek M, Deptuła A, Zastempowska E, Soszczyńska E, Gospodarek-Komkowska E. Fulminant mucormycosis after a traffic accident: a case report. Folia Microbiol (Praha) 2018; 64:429-433. [PMID: 30552581 DOI: 10.1007/s12223-018-00671-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2018] [Accepted: 12/03/2018] [Indexed: 12/28/2022]
Abstract
Mucormycosis is a rare fungal infection in immunocompetent patients, whereas in immunocompromised, it may be systemic and disseminated infection associated with high mortality. Mucormycosis is one of the most rapidly progressing and fulminant forms of fungal infections; Mucor circinelloides is rarely isolated species, also from immunocompromised patients. The reported case of mucormycosis after a traffic accident indicates that it may be the result of a contamination of wound by M. circinelloides coming from the environment. The fungal strain was identified by phenotypic methods and confirmed by molecular methods. Etest method was used for susceptibility testing of the fungal strain. No mycotoxins were detected in the analyzed sample. The infection was successfully treated with amphotericin B, but amputation of the lower limb was necessary.
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Affiliation(s)
- Alicja Sękowska
- Department of Microbiology, Ludwik Rydygier Collegium Medicum, Nicolaus Copernicus University, 9 M. Sklodowska-Curie Street, 85-094, Bydgoszcz, Poland.
| | - Małgorzata Prażyńska
- Department of Microbiology, Ludwik Rydygier Collegium Medicum, Nicolaus Copernicus University, 9 M. Sklodowska-Curie Street, 85-094, Bydgoszcz, Poland
| | - Magdalena Twarużek
- Department of Physiology and Toxicology, Institute of Experimental Biology, Faculty of Natural Sciences, Kazimierz Wielki University, Chodkiewicza 30, 85-064, Bydgoszcz, Poland
| | - Aleksander Deptuła
- Department of Microbiology, Ludwik Rydygier Collegium Medicum, Nicolaus Copernicus University, 9 M. Sklodowska-Curie Street, 85-094, Bydgoszcz, Poland
| | - Ewa Zastempowska
- Department of Physiology and Toxicology, Institute of Experimental Biology, Faculty of Natural Sciences, Kazimierz Wielki University, Chodkiewicza 30, 85-064, Bydgoszcz, Poland
| | - Ewelina Soszczyńska
- Department of Physiology and Toxicology, Institute of Experimental Biology, Faculty of Natural Sciences, Kazimierz Wielki University, Chodkiewicza 30, 85-064, Bydgoszcz, Poland
| | - Eugenia Gospodarek-Komkowska
- Department of Microbiology, Ludwik Rydygier Collegium Medicum, Nicolaus Copernicus University, 9 M. Sklodowska-Curie Street, 85-094, Bydgoszcz, Poland
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34
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Sawardekar KP. Gangrenous Necrotizing Cutaneous Mucormycosis in an Immunocompetent Neonate: A Case Report from Oman. J Trop Pediatr 2018; 64:548-552. [PMID: 29253258 DOI: 10.1093/tropej/fmx094] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
We describe a case of progressive cutaneous mucormycosis, which caused gangrenous necrotizing fasciitis, in an immunocompetent neonate from Oman. Extensive wound contamination and a favorable environment for the growth of Mucorales were the predisposing factors. Early aggressive management including frequent wound debridement, targeted pharmacotherapy with liposomal amphotericin B and supportive care is pivotal for improved outcomes.
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35
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Mane R, Patil B, Mohite A, Mohanty R. Facial Nerve Palsy: An Unusual Presentation in Patients with Rhino Cerebral Mucormycosis. Indian J Otolaryngol Head Neck Surg 2018; 71:2110-2113. [PMID: 31763303 DOI: 10.1007/s12070-018-1530-1] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2018] [Accepted: 11/08/2018] [Indexed: 11/28/2022] Open
Abstract
The aim of this study is to highlight involvement of facial nerve as a presenting symptom in rhino cerebral mucormycosis. A retrospective longitudinal study was carried out for a period of 1 year from May 2017 to May 2018 in Department of Otorhinolaryngology of Dr. D. Y. Patil Medical College and Hospital, Kolhapur. The usual presentation include nasal stuffiness, headache, eye pain and orbital swelling, ophthalmoplegia and visual loss. However we had four patients who presented to our OPD with facial nerve palsy and rhino cerebral mucormycosis. All four patients were diabetic. The available clinical and laboratory data was retrospectively collected and analyzed. Facial nerve palsy is an unusual but significant sign in presentation of mucormycosis. It could be misdiagnosed as CVA with subsequent delay in the treatment. A high index of suspicion for mucormycosis in diabetic patients presenting with facial palsy will be helpful in achieving early and accurate diagnosis with prompt management and better outcome.
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Affiliation(s)
- Rajashri Mane
- Department of Otorhinolaryngology, Dr. D. Y. Patil Medical College and Hospital, Kolhapur, India
| | - Balasaheb Patil
- Department of Otorhinolaryngology, Dr. D. Y. Patil Medical College and Hospital, Kolhapur, India
| | - Anjana Mohite
- Department of Otorhinolaryngology, Dr. D. Y. Patil Medical College and Hospital, Kolhapur, India
| | - Roshni Mohanty
- Department of Otorhinolaryngology, Dr. D. Y. Patil Medical College and Hospital, Kolhapur, India
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36
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Nezafati S, Kazemi A, Asgari K, Bahrami A, Naghili B, Yazdani J. Rhinocerebral mucormycosis, risk factors and the type of oral manifestations in patients referred to a University Hospital in Tabriz, Iran 2007-2017. Mycoses 2018; 61:764-769. [PMID: 29896908 DOI: 10.1111/myc.12802] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2018] [Revised: 06/10/2018] [Accepted: 06/11/2018] [Indexed: 12/12/2022]
Abstract
Inadequate data are available on the global epidemiology of mucormycosis, mainly derived from the evaluation of specific population groups. Rhinocerebral mucormycosis is an invading and fatal mycosis, particularly among diabetic patients. In the present study, patients hospitalised in Imam Reza Hospital in Tabriz, from 2007 to 2017, were evaluated. The hospital information system (HIS) was used to collect the records of the patients. A total of 42 patients with a diagnosis of mucormycosis were included in the study, 40 cases (95%) of which had a diagnosis of the rhinocerebral form. Of these 40 patients, 21 (52.5%) and 19 (47.5%) were male and female, respectively. Seven cases (17.5%) of rhinocerebral mucormycosis were due to dental procedures. The most predisposing factor in the patients was diabetes with 36 (90%) cases. In our study, the role of tooth extraction in patients with uncontrolled diabetes was identified as an important factor. It may show the important role of dentists in preventing of the disease in diabetic patients.
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Affiliation(s)
- Saeed Nezafati
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Abdolhassan Kazemi
- Department of Parasitology and Medical Mycology, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Kasra Asgari
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Amir Bahrami
- Department of Endocrinology and Metabolism, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Behrooz Naghili
- Department of Tropical and Infectious Diseases, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Javad Yazdani
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Tabriz University of Medical Sciences, Tabriz, Iran
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37
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El Hachem G, Chamseddine N, Saidy G, Choueiry C, Afif C. Successful Nonsurgical Eradication of Invasive Gastric Mucormycosis. CLINICAL LYMPHOMA MYELOMA & LEUKEMIA 2018; 16 Suppl:S145-8. [PMID: 27521312 DOI: 10.1016/j.clml.2016.02.020] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/09/2016] [Accepted: 02/09/2016] [Indexed: 10/21/2022]
Affiliation(s)
- Georges El Hachem
- Division of Hematology/Oncology, Department of Clinical Medicine, Saint George Hospital University Medical Center, Beirut, Lebanon.
| | - Nabil Chamseddine
- Division of Hematology/Oncology, Department of Clinical Medicine, Saint George Hospital University Medical Center, Beirut, Lebanon
| | - Ghada Saidy
- Division of Hematology/Oncology, Department of Clinical Medicine, Saint George Hospital University Medical Center, Beirut, Lebanon
| | - Camil Choueiry
- Department of Pathology, Saint George Hospital University Medical Center, Beirut, Lebanon
| | - Claude Afif
- Division of Infectious Disease, Department of Clinical Medicine, Saint George Hospital University Medical Center, Beirut, Lebanon
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38
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Loganathan S, Ajay G, Thyagarajan U, Gokul R. Invasive fungal infection in immunocompetent trauma patients - A case series. J Clin Orthop Trauma 2018; 9:S10-S14. [PMID: 29628692 PMCID: PMC5883914 DOI: 10.1016/j.jcot.2017.10.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2017] [Revised: 06/21/2017] [Accepted: 10/07/2017] [Indexed: 10/18/2022] Open
Abstract
Zygomycosis is the third leading cause of invasive fungal infection after candidiasis and aspergillosis. Although zygomycosis mostly affects immunocompromised individuals trauma may potentiate infection in immunocompetent individuals. The mortality rate of Zygomycosis is around 50% due to angioinvasion. Here we report a series of 5 cases of angio invasive fungal infection in immunocompetent individuals who sustained trauma in urban areas, out of which only one patient survived following high above knee amputation.
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Avelar Rodriguez D, Ochoa Virgen G, Miranda Ackerman RC. A tip from the nose: rhinocerebral mucormycosis in a patient with alcoholic liver cirrhosis and cocaine abuse, an uncommon association. BMJ Case Rep 2017; 2017:bcr-2017-220730. [PMID: 28784893 DOI: 10.1136/bcr-2017-220730] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
We present the case of a 28-year-old man with a long-standing history of cocaine abuse and Child-Pugh class C alcoholic liver cirrhosis who developed severe lower respiratory tract infection complicated with septic shock and multiple organ dysfunction. He was managed in the intensive care unit. On the eighth day after admission, he developed a nose discolouration, which was initially thought to be associated with high-dose vasopressors. Despite the reduction of vasopressors, the lesion progressed rapidly. It was later diagnosed as rhinocerebral mucormycosis. Amphotericin B was administered, but unfortunately the patient succumbed to the complications postinfection. The association between alcoholic liver cirrhosis and rhinocerebral mucormycosis should be known and prompt recognition warrants immediate treatment.
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Kronen R, Liang SY, Bochicchio G, Bochicchio K, Powderly WG, Spec A. Invasive Fungal Infections Secondary to Traumatic Injury. Int J Infect Dis 2017; 62:102-111. [PMID: 28705753 DOI: 10.1016/j.ijid.2017.07.002] [Citation(s) in RCA: 42] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2017] [Revised: 06/30/2017] [Accepted: 07/05/2017] [Indexed: 12/20/2022] Open
Abstract
Invasive fungal infection (IFI) is a rare but serious complication of traumatic injury. The purpose of this article is to review the epidemiology, natural history, mycology, risk factors, diagnosis, treatment, and outcomes associated with post-traumatic IFI in military and civilian populations. The epidemiology of post-traumatic IFI is poorly characterized, but incidence appears to be rising. Patients often suffer from severe injuries and require extensive medical interventions. Fungi belonging to the order Mucorales are responsible for most post-traumatic IFI in both civilian and military populations. Risk factors differ between these cohorts but include specific injury patterns and comorbidities. Diagnosis of post-traumatic IFI typically follows positive laboratory results in the appropriate clinical context. The gold standard of treatment is surgical debridement in addition to systemic antifungal therapy. Patients with post-traumatic IFI may be at greater risk of amputation, delays in wound healing, hospital complications, and death as compared to trauma patients who do not develop IFI. More research is needed to understand the factors surrounding the development and management of post-traumatic IFI to reduce the significant morbidity and mortality associated with this disease.
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Affiliation(s)
- Ryan Kronen
- Division of Infectious Diseases, Department of Medicine, Washington University School of Medicine, 660 S. Euclid Ave., St. Louis, MO, USA.
| | - Stephen Y Liang
- Division of Infectious Diseases, Department of Medicine, Washington University School of Medicine, 660 S. Euclid Ave., St. Louis, MO, USA; Division of Emergency Medicine, Washington University School of Medicine, 660 S. Euclid Ave., St. Louis, MO, USA
| | - Grant Bochicchio
- Section of Acute and Critical Care Surgery, Washington University School of Medicine, 660 S. Euclid Ave., St. Louis, MO, USA
| | - Kelly Bochicchio
- Section of Acute and Critical Care Surgery, Washington University School of Medicine, 660 S. Euclid Ave., St. Louis, MO, USA
| | - William G Powderly
- Division of Infectious Diseases, Department of Medicine, Washington University School of Medicine, 660 S. Euclid Ave., St. Louis, MO, USA
| | - Andrej Spec
- Division of Infectious Diseases, Department of Medicine, Washington University School of Medicine, 660 S. Euclid Ave., St. Louis, MO, USA.
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Samarei R, Gharebaghi N, Zayer S. Evaluation of 30 cases of mucormycosis at a university hospital in Iran. Mycoses 2017; 60:426-432. [PMID: 28321926 DOI: 10.1111/myc.12614] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2016] [Revised: 12/17/2016] [Accepted: 02/15/2017] [Indexed: 12/15/2022]
Abstract
Mucormycosis is a deadly invasive fungal infection and mainly affects immunocompromised patients. To investigate the clinical features of patients who developed mucormycosis and to determine the parameters, which influenced the outcome following mycotic infection. The current investigation retrospectively evaluated the demographic characteristics, clinical features, therapeutic data, as well as the outcomes of treatment in all cases of proven and probable mucormycosis diagnosed from 2002 until 2016 in our hospital. A total of thirty cases were recorded. Rhizopus spp. was the predominant pathogen among the identified Mucorales (26.7%). Diabetes mellitus (46.7%) and haematological malignancy (40%), were the most common underlying diseases. With regard to predisposing factors, neutropenia (43.3%) and chemotherapy (40%) were the leading concomitant parameters. The most frequent sites of infection were lung (30%) and sinus (26.7%), whereas disseminated infection was also found in nine of 30 patients (30%). Neutropenia remained the only independent factor associated with mortality (Relative Risk=3.557, 95% CI=1.365-9.271, P=.009). Diagnostic delay -either due to delayed presentation of patients to our centre or insufficient awareness about invasive fungal infection among our clinicians- is a likely explanation for such a high mortality rate in our series.
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Affiliation(s)
- Reza Samarei
- Department of Otolaryngology, Faculty of Medicine, Imam Khomeini Hospital, Urmia University of Medical Sciences, Urmia, Iran
| | - Naser Gharebaghi
- Department of Infectious Diseases, Urmia University of Medical Sciences, Urmia, Iran
| | - Salar Zayer
- Department of Cardiology, Urmia University of Medical Sciences, Urmia, Iran
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42
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Cutaneous mucormycosis secondary to penetrative trauma. Injury 2016; 47:1383-7. [PMID: 27126769 DOI: 10.1016/j.injury.2016.03.011] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2016] [Revised: 03/05/2016] [Accepted: 03/07/2016] [Indexed: 02/02/2023]
Abstract
INTRODUCTION Mucormycosis is a rare but serious sequelae of penetrating trauma [1-5]. In spite of aggressive management, mortality remains high due to dissemination of infection. We completed a review of literature to determine the most optimal treatment of cutaneous mucormycosis which occurs secondary to penetrating trauma. METHODS We completed a review regarding the management of mucormycosis in trauma patients. We selected a total of 36 reports, of which 18 were case-based, for review. RESULTS Surgical debridement is a primary predictor of improved outcomes in the treatment of mucormycosis [3,6,7]. Anti-fungal therapy, especially lipid soluble formulation of Amphotericin B, is helpful as an adjunct or when surgical debridement has been maximally achieved. Further research is needed to fully evaluate the impact of topical dressings; negative pressure wound therapy is helpful. CONCLUSION An aggressive and early surgical approach, even at the expense of disfigurement, is necessary to reduce mortality in the setting of cutaneous mucormycosis that results from penetrating trauma [4,8,9]. Anti-fungal therapy and negative pressure wound therapy are formidable adjuncts.
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Kumar NS, Padala RK, Tirupati S, Tatikonda AK. Rhinocerebral Mucormycosis with Top of Basilar Artery Syndrome. J Stroke Cerebrovasc Dis 2016; 25:378-82. [DOI: 10.1016/j.jstrokecerebrovasdis.2015.10.009] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2015] [Revised: 10/09/2015] [Accepted: 10/09/2015] [Indexed: 01/13/2023] Open
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Lopez-Pastorini A, Koryllos A, Brockmann M, Windisch W, Stoelben E. Pseudoaneurysm of the pulmonary artery with massive haemoptysis due to an invasive pulmonary mucormycosis. Thorax 2015; 71:199-200. [DOI: 10.1136/thoraxjnl-2015-207713] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2015] [Accepted: 09/03/2015] [Indexed: 11/04/2022]
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45
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Salami A, Assouan C, Kouyaté M, Kadre A, Yavo-Dosso N, N'Guessan ND. [Sinonasal mucormycosis revealed by a necrotic velar ulceration]. J Mycol Med 2015; 25:204-7. [PMID: 26142709 DOI: 10.1016/j.mycmed.2015.06.001] [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: 12/18/2014] [Revised: 06/01/2015] [Accepted: 06/01/2015] [Indexed: 10/23/2022]
Abstract
INTRODUCTION Mucormycosis is a deep mycosis which has been spreading out in recent years. It is still poorly understood and poorly described in sub-Saharan Africa. The authors report a case of sinonasal localization, of fatal evolution and late diagnosis in a young child. OBSERVATION It is about a 13-year-old child suffering from chronic rhinosinus syndrome for two years. He was observed in stomatology for a necrotic velar ulceration that have occurred for three months. The clinical, radiological and histological explorations were in favor of a sinonasal mucormycosis. The administration of amphotericin B and the surgical treatment did not slow down the fatal evolution. CONCLUSION Mucormycosis should not be dealt with any diagnostic error and no therapeutic improvisation. It has to be thought about when dealing with a rhinosinusal syndrome with cleft ulceration.
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Affiliation(s)
- A Salami
- Service de stomatologie et chirurgie maxillo-faciale, CHU de Treichville, Abidjan, Côte d'Ivoire.
| | - C Assouan
- Service de stomatologie et chirurgie maxillo-faciale, CHU de Treichville, Abidjan, Côte d'Ivoire
| | - M Kouyaté
- Service d'anatomie et cytologie pathologiques, CHU de Treichville, Abidjan, Côte d'Ivoire
| | - A Kadre
- Service de stomatologie et chirurgie maxillo-faciale, CHU de Treichville, Abidjan, Côte d'Ivoire
| | - N Yavo-Dosso
- Service d'oto-rhino-laryngologie et chirurgie cervico-faciale, CHU de Treichville, Abidjan, Côte d'Ivoire
| | - N D N'Guessan
- Service de stomatologie et chirurgie maxillo-faciale, CHU de Treichville, Abidjan, Côte d'Ivoire
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Severe mycosis as a rare infection after a corn auger injury of the hand: a case report. Patient Saf Surg 2015; 9:22. [PMID: 28428824 PMCID: PMC5395855 DOI: 10.1186/s13037-015-0061-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2014] [Accepted: 04/15/2015] [Indexed: 11/19/2022] Open
Abstract
Mucormycosis is a rare but serious infection that can be seen in immunocompetent individuals who experience traumatic injury. The authors report a case in a 28 year-old man who sustained a mangling hand injury in a corn augur accident. After initial aggressive debridement ongoing tissue necrosis was seen, and in subsequent biopsies invasive mucormycosis was diagnosed. The patient was successfully managed with immediate surgical debridement and antifungal medication and showed no sign of infection at six-month follow-up.
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47
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Kim YI, Kang HC, Lee HS, Choi JS, Seo KH, Kim YH, Na J. Invasive Pulmonary Mucormycosis With Concomitant Lung Cancer Presented With Massive Hemoptysis by Huge Pseudoaneurysm of Pulmonary Artery. Ann Thorac Surg 2014; 98:1832-5. [DOI: 10.1016/j.athoracsur.2013.12.051] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2013] [Revised: 10/13/2013] [Accepted: 12/02/2013] [Indexed: 10/24/2022]
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Singh AK, Goel MM, Gupta C, Kumar S. Isolated renal zygomycosis in an immunocompetent patient. BMJ Case Rep 2014; 2014:bcr2013200060. [PMID: 24903721 PMCID: PMC4054109 DOI: 10.1136/bcr-2013-200060] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/17/2014] [Indexed: 11/03/2022] Open
Abstract
Zygomycosis is a rare opportunistic fungal infection in immunocompetent patients. Isolated renal involvement by zygomycosis is extremely rare and diagnosed mainly during postmortem study. We report a case of a 22-year-old man with right upper quadrant pain and fever. The CT of the abdomen revealed renal cell carcinoma and subsequent nephrectomy was performed. The histopathological diagnosis of nephrectomy established zygomycosis. After that patient was given 2 months antifungal therapy and is living well even after her 1 year follow-up.
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Affiliation(s)
- Ajay Kr Singh
- Department of Pathology, KGMU, Lucknow, Uttar Pradesh, India
| | - Madhu Mati Goel
- Department of Pathology, KGMU, Lucknow, Uttar Pradesh, India
| | - Chani Gupta
- Department of Pathology, KGMU, Lucknow, Uttar Pradesh, India
| | - Suresh Kumar
- Department of Surgery, KGMU, Lucknow, Uttar Pradesh, India
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Fulminant mucormycosis involving paranasal sinuses: a rare case report. Case Rep Dent 2014; 2014:465919. [PMID: 24523970 PMCID: PMC3912639 DOI: 10.1155/2014/465919] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2013] [Accepted: 12/16/2013] [Indexed: 11/24/2022] Open
Abstract
Mucormycosis is an opportunistic fulminant fungal infection, which has the ability to cause significant morbidity and frequently mortality in the susceptible patient. Common predisposing factors include diabetes mellitus and immunosuppression. The infection begins in the nose and paranasal sinuses due to inhalation of fungal spores. The fungus invades the arteries leading to thrombosis that subsequently causes necrosis of the tissue. The infection can spread to orbital and intracranial structures either by direct invasion or through the blood vessels. Here we describe a case of mucormycosis of maxillary antrum extending to ethmoidal and frontal sinus and also causing necrosis of left maxilla in an uncontrolled diabetic individual to emphasize early diagnosis and treatment of this fatal fungal infection.
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Thornton CR, Wills OE. Immunodetection of fungal and oomycete pathogens: established and emerging threats to human health, animal welfare and global food security. Crit Rev Microbiol 2013; 41:27-51. [PMID: 23734714 DOI: 10.3109/1040841x.2013.788995] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Filamentous fungi (moulds), yeast-like fungi, and oomycetes cause life-threatening infections of humans and animals and are a major constraint to global food security, constituting a significant economic burden to both agriculture and medicine. As well as causing localized or systemic infections, certain species are potent producers of allergens and toxins that exacerbate respiratory diseases or cause cancer and organ damage. We review the pathogenic and toxigenic organisms that are etiologic agents of both animal and plant diseases or that have recently emerged as serious pathogens of immunocompromised individuals. The use of hybridoma and phage display technologies and their success in generating monoclonal antibodies for the detection and control of fungal and oomycete pathogens are explored. Monoclonal antibodies hold enormous potential for the development of rapid and specific tests for the diagnosis of human mycoses, however, unlike plant pathology, their use in medical mycology remains to be fully exploited.
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