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Singh R, Mittal G, Kakati B, Koul N. An Observational Study of Fungal Infections in COVID-19: Highlighting the Role of Mucormycosis in Tertiary Healthcare Settings. Cureus 2024; 16:e57295. [PMID: 38690487 PMCID: PMC11059081 DOI: 10.7759/cureus.57295] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/30/2024] [Indexed: 05/02/2024] Open
Abstract
Background Fungal infections, especially mucormycosis, have remarkably surged during the coronavirus disease 2019 (COVID-19) era, especially during the second wave peak of the pandemic raising the concern of the clinicians for the admitted patients. Steroid therapy, diabetes, and other immunocompromised states are more commonly associated with COVID-19-associated mucormycosis (CAM). Aim and objective The aim of this study is to ascertain the prevalence of fungal infections amidst the second wave of the COVID-19 pandemic and discern the associated risk factors. Materials and methods During the second peak of COVID-19, samples were received in the microbiology laboratory from all clinically suspected mucormycosis patients. These samples underwent processing for potassium hydroxide (KOH) wet mount, fungal culture on Sabouraud's dextrose agar (SDA) medium, and COVID-19 reverse transcription-polymerase chain reaction (RT-PCR) testing. All relevant clinical and associated risk factors were tabulated and analyzed. Results Among the 107 suspected cases of mucormycosis, 39 (36.4%) were confirmed positive for COVID-19 via RT-PCR, while 68 (63.6%) tested negative. Males exhibited a predominant infection rate, with the rhinocerebral system being the most commonly affected site. Significantly higher mortality rates were observed in COVID-19-associated mucormycosis (CAM) patients (33.4%) compared to those without COVID-19 (5.9%), with a notable p-value of 0.0005. CAM patients also demonstrated a higher frequency of ICU admissions (77%) compared to non-COVID-19-associated mucormycosis patients (21.4%), a statistically significant finding (p-value of 0.007). Additionally, immunocompromised states, diabetes, and the administration of oxygen therapy were identified as significant risk factors in CAM (p < 0.05). Notably, mucormycosis accounted for the majority of fungal isolates (48.27%) among COVID-19 patients. Conclusion Mucormycosis infection is more commonly seen in COVID-19-infected patients as compared to non-COVID-19 patients, especially with comorbidities such as diabetes mellitus, steroid usage, and other immunocompromised states.
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Affiliation(s)
- Rajender Singh
- Microbiology, Himalayan Institute of Medical Sciences, Swami Rama Himalayan University, Dehradun, IND
| | - Garima Mittal
- Microbiology, Himalayan Institute of Medical Sciences, Swami Rama Himalayan University, Dehradun, IND
| | - Barnali Kakati
- Microbiology, Himalayan Institute of Medical Sciences, Swami Rama Himalayan University, Dehradun, IND
| | - Nupur Koul
- Microbiology, Himalayan Institute of Medical Sciences, Swami Rama Himalayan University, Dehradun, IND
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2
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Pereira R, Neves S, Ruão M, Gonçalves C, Teixeira C. Pulmonary Mucormycosis: Beyond Classic COVID-19-Associated Fungal Infections. Cureus 2024; 16:e52849. [PMID: 38406002 PMCID: PMC10884720 DOI: 10.7759/cureus.52849] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/23/2024] [Indexed: 02/27/2024] Open
Abstract
Coronavirus disease 2019 (COVID-19) is often linked to a broad range of opportunistic bacterial and fungal infections. The second wave of the COVID-19 pandemic has witnessed an unprecedented surge in mucormycosis cases, predominantly in India, while the disease remained relatively rare in Europe. The authors describe the case of a 62-year-old female patient admitted to the hospital for consolidation therapy with chemotherapy as a part of the treatment protocol for acute myeloid leukemia. During hospitalization, she was diagnosed with nosocomial COVID-19, which later progressed to respiratory deterioration. COVID-19 with bacterial superinfection was presumed, leading to the initiation of empirical antibiotic therapy. A bronchoscopy was performed several days later due to a lack of improvement, revealing an infection by the Rhizopus microsporus complex. Despite antifungal treatment, the patient experienced an unfavorable clinical course and ultimately died. Given the high index of suspicion required to diagnose pulmonary mucormycosis, which can lead to delays in appropriate treatment and increase the burden of disease, the authors are aiming to enhance its awareness.
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Affiliation(s)
- Rita Pereira
- Anesthesiology, Intensive Care and Emergency Department, Centro Hospitalar Universitário de Santo António, Porto, PRT
| | - Sara Neves
- Infectious Diseases Department, Centro Hospitalar Universitário de Santo António, Porto, PRT
| | - Maria Ruão
- Anesthesiology, Intensive Care and Emergency Department, Centro Hospitalar Universitário de Santo António, Porto, PRT
| | - Celina Gonçalves
- Infectious Diseases Department, Centro Hospitalar Universitário de Santo António, Porto, PRT
- Anesthesiology, Intensive Care and Emergency Department, Centro Hospitalar Universitário de Santo António, Porto, PRT
| | - Carla Teixeira
- Anesthesiology, Intensive Care and Emergency Department, Centro Hospitalar Universitário de Santo António, Porto, PRT
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3
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Alqarihi A, Kontoyiannis DP, Ibrahim AS. Mucormycosis in 2023: an update on pathogenesis and management. Front Cell Infect Microbiol 2023; 13:1254919. [PMID: 37808914 PMCID: PMC10552646 DOI: 10.3389/fcimb.2023.1254919] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Accepted: 09/05/2023] [Indexed: 10/10/2023] Open
Abstract
Mucormycosis (MCR) is an emerging and frequently lethal fungal infection caused by the Mucorales family, with Rhizopus, Mucor, and Lichtheimia, accounting for > 90% of all cases. MCR is seen in patients with severe immunosuppression such as those with hematologic malignancy or transplantation, Diabetes Mellitus (DM) and diabetic ketoacidosis (DKA) and immunocompetent patients with severe wounds. The recent SARS COV2 epidemy in India has resulted in a tremendous increase in MCR cases, typically seen in the setting of uncontrolled DM and corticosteroid use. In addition to the diversity of affected hosts, MCR has pleiotropic clinical presentations, with rhino-orbital/rhino-cerebral, sino-pulmonary and necrotizing cutaneous forms being the predominant manifestations. Major insights in MCR pathogenesis have brought into focus the host receptors (GRP78) and signaling pathways (EGFR activation cascade) as well as the adhesins used by Mucorales for invasion. Furthermore, studies have expanded on the importance of iron availability and the complex regulation of iron homeostasis, as well as the pivotal role of mycotoxins as key factors for tissue invasion. The molecular toolbox to study Mucorales pathogenesis remains underdeveloped, but promise is brought by RNAi and CRISPR/Cas9 approaches. Important recent advancements have been made in early, culture-independent molecular diagnosis of MCR. However, development of new potent antifungals against Mucorales remains an unmet need. Therapy of MCR is multidisciplinary and requires a high index of suspicion for initiation of early Mucorales-active antifungals. Reversal of underlying immunosuppression, if feasible, rapid DKA correction and in selected patients, surgical debulking are crucial for improved outcomes.
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Affiliation(s)
- Abdullah Alqarihi
- Division of Infectious Diseases, The Lundquist Institute for Biomedical Innovation at Harbor-University of California Los Angeles (UCLA) Medical Center, Torrance, CA, United States
| | - Dimitrios P Kontoyiannis
- Department of Infectious Diseases, Infection Control and Employee Health, The University of Texas M.D. Anderson Cancer Center, Houston, Texas, United States
| | - Ashraf S Ibrahim
- Division of Infectious Diseases, The Lundquist Institute for Biomedical Innovation at Harbor-University of California Los Angeles (UCLA) Medical Center, Torrance, CA, United States
- Department of Medicine, David Geffen School of Medicine at UCLA, Los Angeles, CA, United States
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4
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Singh R. Editorial: Research advances in mucormycosis. Front Cell Infect Microbiol 2023; 13:1280784. [PMID: 37743863 PMCID: PMC10512212 DOI: 10.3389/fcimb.2023.1280784] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Accepted: 08/28/2023] [Indexed: 09/26/2023] Open
Affiliation(s)
- Rachna Singh
- Vallabhbhai Patel Chest Institute, University of Delhi, Chandigarh, India
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5
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Verma R, Chakraborty R, Keerthiraj DB, Pal US. Rhino orbital cerebral mucormycosis in settings of COVID-19 infection: A case series of thirteen patients. Natl J Maxillofac Surg 2023; 14:311-316. [PMID: 37661985 PMCID: PMC10474550 DOI: 10.4103/njms.njms_20_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2022] [Revised: 08/11/2022] [Accepted: 08/22/2022] [Indexed: 09/05/2023] Open
Abstract
Rhino orbital cerebral mucormycosis (ROCM) is an important infectious disease encountered in large numbers in this recent post-COVID-19 era. An alteration in the defense immune system during COVID-19 illness; in the presence of uncontrolled hyperglycemia has led to the new epidemic of ROCM, especially in developing nations such as India. This case series of thirteen patients illustrates the various clinical presentations, laboratory parameters, imaging features and outcomes of patients with ROCM admitted to a tertiary care hospital in Northern India. In our case series, a total of 13 newly diagnosed cases of rhino-orbital-cerebral mucormycosis were studied. A history of COVID-19 illness was observed in seven cases (53.8%) with a mean duration of mucormycosis after 25 ± 3.6 days, the use of steroids during COVID-19 illness was seen in 5 cases (38.5%), and oxygen therapy was given in 4 cases (30.8%). A comorbid state in the form of diabetes mellitus was present in 12 cases (92.3%) with a mean duration of 16.69 months, with an important finding of seven cases (53.85%) having new-onset diabetes; hypertension was present in three cases (23.1%). Magnetic resonance imaging of paranasal sinuses showed involvement of multiple sinuses in all 13 cases (100%), including maxillary and ethmoidal sinuses, with frontal involvement in 12 cases (92.3%), sphenoidal involvement in 11 cases (84.6%), symmetric involvement in 9 cases (69.2%), mastoiditis in four cases (30.8%), maxillary space involvement in four cases (30.8%), and palatal involvement in one case (7.7%). On statistical analysis, there was a significant association of new-onset diabetes, optic neuropathy and high C reactive protein with blindness (P-value < 0.05) in our study. However, there were no statistically significant association for the involvement of nervous system in our study. Multispecialty approach treatment was given in the liposomal amphotericin B therapy in all the patients along with thorough endo-nasal debridement done in all cases, transcutaneous retrobulbar amphotericin B in six cases (46.2%) with exenteration done in seven patients (53.9%). At 3 months of follow-up, there was substantial clinical improvement in all cases. There should be definite emphasis on high suspicion of mucor clinically for early diagnosis and aggressive management at the initial state of diagnosis for better outcomes. The need for sustained proper glycemic control during the COVID-19 era along with judicious use of steroids and public awareness of early symptoms and manifestations of mucor can curb the magnitude of such potentially opportunistic epidemics to a substantial rate. New-onset diabetes mellitus, optic neuropathy and high C reactive protein (>50 mg/L) showed statistically significant association with blindness. The longer the infection remains undetected, the greater the devastation ROCM can impose, of which blindness is an important hazard.
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Affiliation(s)
- Rajesh Verma
- Department of Neurology, King George’s Medical University, Lucknow, Uttar Pradesh, India
| | - Rajarshi Chakraborty
- Department of Neurology, King George’s Medical University, Lucknow, Uttar Pradesh, India
| | - D. B. Keerthiraj
- Department of Neurology, King George’s Medical University, Lucknow, Uttar Pradesh, India
| | - Uma S Pal
- Department of Oral and Maxillofacial Surgery, King George’s Medical University, Lucknow, Uttar Pradesh, India
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6
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Valle A, Tagoe C. A Case of Microscopic Polyangiitis Complicated by Mucormycosis: A Dangerous Balancing Act. Cureus 2023; 15:e34941. [PMID: 36938279 PMCID: PMC10016741 DOI: 10.7759/cureus.34941] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/12/2023] [Indexed: 02/16/2023] Open
Abstract
Microscopic polyangiitis (MPA) is a rare antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis marked by renal involvement, which often leads to rapidly progressive glomerulonephritis. Immunosuppressive treatment is necessary to prevent irreparable organ damage. On the other hand, mucormycosis is a rare and devastating opportunistic fungal infection with a high mortality rate in both immunosuppressed and immunocompetent individuals. It requires a high index of suspicion at the time of diagnosis since any delay in treatment may lead to severe morbidity or death. Here, we present the case of a diabetic patient diagnosed with MPA who received partial induction treatment, subsequently developed mucormycosis, survived, yet required continued immunosuppressive treatment for active MPA while imaging was concerning for a persistent mucormycosis infection. This case highlights the barriers to early mucormycosis detection specific to vasculitis patients, mucormycosis considerations unique to the rheumatologic population, and discusses how to balance immunosuppressive treatment in the setting of a deadly opportunistic infection.
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Affiliation(s)
- Ana Valle
- Division of Internal Medicine, Montefiore Medical Center, Bronx, USA
| | - Clement Tagoe
- Division of Rheumatology, Montefiore Medical Center, Bronx, USA
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7
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Moshayedi A, Lee RB, Tisdale L, Crimmins J. Angioinvasive mucormycosis in a patient with aplastic anemia. JAAD Case Rep 2022; 32:71-73. [PMID: 36691587 PMCID: PMC9860379 DOI: 10.1016/j.jdcr.2022.11.035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Affiliation(s)
- Aref Moshayedi
- Virginia Commonwealth University, School of Medicine, Richmond, Virginia
- Correspondence to: Aref Moshayedi, BS, Virginia Commonwealth University, School of Medicine, 1201 E Marshall St, Richmond, VA 23298.
| | - Rachel B. Lee
- Department of Dermatology, Virginia Commonwealth University, Richmond, Virginia
| | - Lauren Tisdale
- Department of Dermatology, Virginia Commonwealth University, Richmond, Virginia
| | - Jennifer Crimmins
- Department of Dermatopathology, Virginia Commonwealth University, Richmond, Virginia
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8
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Abstract
We report a case of a 57-year-old Vietnamese gentleman who presented with chest pain and shortness of breath for four weeks. The patient had a history of diabetes mellitus and kidney transplant in the past year and was currently on immunosuppressive agents. The patient's condition worsened despite broad-spectrum antibiotics, so amphotericin was added. Further evaluation with bronchoscopy and transbronchial biopsy was suggestive of Rhizopus mucormycosis. Despite antifungal therapy, his condition worsened, resulting in multi-organ failure and eventual mortality.
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Affiliation(s)
| | - Nicholas Nguyen
- Internal Medicine, Methodist Dallas Medical Center, Dallas, USA
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9
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Trybula M, Wang D, Baumann L, Pritts TA, Hambley BC. Rhizopus microsporus typhlitis in a patient with acute myelogenous leukemia. Clin Case Rep 2021; 9:e04290. [PMID: 34194794 PMCID: PMC8223889 DOI: 10.1002/ccr3.4290] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Revised: 04/11/2021] [Accepted: 04/27/2021] [Indexed: 11/27/2022] Open
Abstract
While patients undergoing treatment for hematologic malignancies are at risk for a variety of infections, gastrointestinal mucormycosis is a rare and feared complication. Diagnosis requires a high index of suspicion and timely evaluation. Prompt treatment improves patient outcomes.
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Affiliation(s)
- Marcus Trybula
- Department of Internal MedicineUniversity of CincinnatiCincinnatiOHUSA
| | - Diping Wang
- Department of Pathology & Laboratory MedicineUniversity of CincinnatiCincinnatiOHUSA
| | - Lauren Baumann
- Department of SurgeryUniversity of CincinnatiCincinnatiOHUSA
| | | | - Bryan C. Hambley
- Division of Hematology/OncologyDepartment of Internal MedicineUniversity of CincinnatiCincinnatiOHUSA
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10
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Abstract
Mucormycosis is an aggressive fungal disease that can occur in individuals with certain predisposing factors, such as diabetes mellitus and pharmacologic immunosuppression. An astounding aspect of this disease is the speed at which it can spread to surrounding structures once it begins to germinate inside the human body. This case involves a 24-year-old male patient who presented to the emergency room complaining of a headache after a dental procedure who developed fulminant rhinocerebral mucormycosis within days. The objective of this report is to shed light on how fast this disease spreads, discuss current management of rhinocerebral mucormycosis, and illustrate the subtle, but critical radiographic findings to raise clinical awareness for this life-threatening disease.
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Affiliation(s)
- Donovan Tran
- Diagnostic Radiology, University of Arizona College of Medicine - Tucson, Tucson, USA
| | - Berndt Schmit
- Radiology, University of Arizona College of Medicine - Tucson, Tucson, USA
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11
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Abstract
Opportunistic fungal infections are rare but life-threatening in immunocompromised patients. We discuss a case of an immunocompromised patient with multiple myeloma who presented with shortness of breath, fever, ocular palsy, and hemiplegia. She was found to have influenza A respiratory tract infection complicated by invasive aspergillosis and mucormycosis. Investigation revealed invasive fungal sinusitis and cerebritis. Serum biomarkers, beta-d-glucan, and galactomannan failed to detect fungal disease. We believe that our case is unique as there is limited data available regarding the occurrence of invasive fungal infections after Influenza infections. Furthermore, it highlights the hurdles in the diagnosis of disseminated fungal infection.
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Affiliation(s)
- Anum Aqsa
- Internal Medicine, Staten Island University Hospital, Staten Island, USA
| | - Sami Droubi
- Internal Medicine, Staten Island University Hospital, Staten Island, USA
| | - Allison Glaser
- Internal Medicine, Northwell Health-Staten Island University Hospital, Staten Island, USA
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12
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Badin DJ, Baker C, Simmons BJ, Yan S, Zug KA. The elusive nature of mucormycosis in an immunocompetent host and the role of a dermatology consult. Clin Case Rep 2019; 7:2187-2189. [PMID: 31788276 PMCID: PMC6878074 DOI: 10.1002/ccr3.2479] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2019] [Revised: 08/11/2019] [Accepted: 09/01/2019] [Indexed: 12/02/2022] Open
Abstract
Mucormycosis infection in the immunocompetent host typically occurs in the setting of trauma and presents a diagnostic challenge. The earliest signs of infection are often cutaneous, but can easily be misinterpreted, which can be a fatal mistake. Dermatology has tools to help recognize these infections and initiate earlier therapy.
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Affiliation(s)
- Dylan J. Badin
- Section of Dermatology Department of SurgeryDartmouth Hitchcock Medical CenterLebanonNHUSA
| | - Catherine Baker
- Section of Dermatology Department of SurgeryDartmouth Hitchcock Medical CenterLebanonNHUSA
| | - Brian J. Simmons
- Section of Dermatology Department of SurgeryDartmouth Hitchcock Medical CenterLebanonNHUSA
| | - Shaofeng Yan
- Department of PathologyDartmouth Hitchcock Medical CenterLebanonNHUSA
| | - Kathryn A. Zug
- Section of Dermatology Department of SurgeryDartmouth Hitchcock Medical CenterLebanonNHUSA
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13
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Johnson VE, Boyd AS. Primary cutaneous Rhizopus folliculitis in an immunocompetent woman. JAAD Case Rep 2018; 4:36-37. [PMID: 29296649 PMCID: PMC5739175 DOI: 10.1016/j.jdcr.2017.10.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Affiliation(s)
- Vanessa E Johnson
- Department of Medicine (Dermatology), Vanderbilt University Medical Center, Nashville, Tennessee
| | - Alan S Boyd
- Department of Medicine (Dermatology), Vanderbilt University Medical Center, Nashville, Tennessee.,Department of Pathology, Microbiology, and Immunology, Vanderbilt University Medical Center, Nashville, Tennessee
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14
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Carter J, Lenahan J, Ishak G, Geyer JR, Pollard J, Englund JA. Medical management of invasive fungal infections of the central nervous system in pediatric cancer patients. Pediatr Blood Cancer 2015; 62:1095-8. [PMID: 25407593 PMCID: PMC4405402 DOI: 10.1002/pbc.25331] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2013] [Accepted: 10/02/2014] [Indexed: 02/01/2023]
Abstract
Fungal infections of the central nervous system (CNS) are associated with high mortality rates in immunocompromised patients. Surgical intervention is a mainstay of therapy, but not always possible. We describe the use of medical therapy for the treatment of CNS fungal infections in four pediatric cancer patients. Definitive resection was not performed in any patient. All patients initially received combination antifungal therapy with good clinical response; long-term survival was documented in two patients able to transition to long-term azole therapy. Prolonged antifungal therapy is an important option for treating invasive CNS fungal infections when surgery is not feasible.
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Affiliation(s)
- John Carter
- Division of Pediatric Hematology/Oncology, Seattle Children’s Hospital, Seattle, WA,Fred Hutchinson Cancer Research Center, Seattle, WA,University of Washington, Seattle, WA
| | - Jennifer Lenahan
- Division of Pediatric Infectious Diseases, Seattle Children’s Hospital, Seattle, WA
| | - Gisele Ishak
- University of Washington, Seattle, WA,Department of Radiology, Seattle Children’s Hospital, University of Washington
| | - J. Russell Geyer
- Division of Pediatric Hematology/Oncology, Seattle Children’s Hospital, Seattle, WA,Fred Hutchinson Cancer Research Center, Seattle, WA,University of Washington, Seattle, WA
| | - Jessica Pollard
- Division of Pediatric Hematology/Oncology, Seattle Children’s Hospital, Seattle, WA,Fred Hutchinson Cancer Research Center, Seattle, WA,University of Washington, Seattle, WA
| | - Janet A. Englund
- Fred Hutchinson Cancer Research Center, Seattle, WA,University of Washington, Seattle, WA,Division of Pediatric Infectious Diseases, Seattle Children’s Hospital, Seattle, WA
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15
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Abstract
Mucormycosis is a fungal disease that may rarely invade the gastrointestinal tract of newborn, resulting in high morbidity and mortality. Clinically, it may be indistinguishable from the neonatal necrotizing enterocolitis and the diagnosis is usually made on autopsy or histopathology of excised surgical specimen. We report a neonatal survivor of the illness.
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Affiliation(s)
- Yogesh Kumar Sarin
- Department of Pediatric Surgery, Maulana Azad Medical College, New Delhi - 110 002, India
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