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Vinay K, Bhattacharjee R, Bishnoi A, Chatterjee D, Rudramurthy S, Dogra S. Dermatoscopic features of cutaneous sporotrichosis. J Eur Acad Dermatol Venereol 2020; 34:e718-e720. [PMID: 32343442 DOI: 10.1111/jdv.16539] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2020] [Revised: 04/16/2020] [Accepted: 04/21/2020] [Indexed: 01/19/2023]
Affiliation(s)
- K Vinay
- Department of Dermatology, Venereology and Leprology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - R Bhattacharjee
- Department of Dermatology, Venereology and Leprology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - A Bishnoi
- Department of Dermatology, Venereology and Leprology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - D Chatterjee
- Department of Histopathology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - S Rudramurthy
- Mycology Division, Department of Medical Microbiology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - S Dogra
- Department of Dermatology, Venereology and Leprology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
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Patel A, Kaur H, Xess I, Michael JS, Savio J, Rudramurthy S, Singh R, Shastri P, Umabala P, Sardana R, Kindo A, Capoor MR, Mohan S, Muthu V, Agarwal R, Chakrabarti A. A multicentre observational study on the epidemiology, risk factors, management and outcomes of mucormycosis in India. Clin Microbiol Infect 2019; 26:944.e9-944.e15. [PMID: 31811914 DOI: 10.1016/j.cmi.2019.11.021] [Citation(s) in RCA: 174] [Impact Index Per Article: 34.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2019] [Revised: 11/12/2019] [Accepted: 11/17/2019] [Indexed: 12/28/2022]
Abstract
OBJECTIVES To describe the epidemiology, management and outcome of individuals with mucormycosis; and to evaluate the risk factors associated with mortality. METHODS We conducted a prospective observational study involving consecutive individuals with proven mucormycosis across 12 centres from India. The demographic profile, microbiology, predisposing factors, management and 90-day mortality were recorded; risk factors for mortality were analysed. RESULTS We included 465 patients. Rhino-orbital mucormycosis was the most common (315/465, 67.7%) presentation followed by pulmonary (62/465, 13.3%), cutaneous (49/465, 10.5%), and others. The predisposing factors included diabetes mellitus (342/465, 73.5%), malignancy (42/465, 9.0%), transplant (36/465, 7.7%), and others. Rhizopus species (231/290, 79.7%) were the most common followed by Apophysomyces variabilis (23/290, 7.9%), and several rare Mucorales. Surgical treatment was performed in 62.2% (289/465) of the participants. Amphotericin B was the primary therapy in 81.9% (381/465), and posaconazole was used as combination therapy in 53 (11.4%) individuals. Antifungal therapy was inappropriate in 7.6% (30/394) of the individuals. The 90-day mortality rate was 52% (242/465). On multivariate analysis, disseminated and rhino-orbital (with cerebral extension) mucormycosis, shorter duration of symptoms, shorter duration of antifungal therapy, and treatment with amphotericin B deoxycholate (versus liposomal) were independent risk factors of mortality. A combined medical and surgical management was associated with a better survival. CONCLUSIONS Diabetes mellitus was the dominant predisposing factor in all forms of mucormycosis. Combined surgical and medical management was associated with better outcomes. Several gaps surfaced in the management of mucormycosis. The rarer Mucorales identified in the study warrant further evaluation.
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Affiliation(s)
- A Patel
- Department of Infectious Diseases, Sterling Hospital, Ahmedabad, India; Department of Internal Medicine, University of South Florida, Tampa, FL, USA
| | - H Kaur
- Department of Microbiology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - I Xess
- Department of Microbiology, All India Institute of Medical Sciences, New Delhi, India
| | - J S Michael
- Department of Clinical Microbiology, Christian Medical College, Vellore, India
| | - J Savio
- St John's Medical College Hospital, Bangalore, India
| | - S Rudramurthy
- Department of Microbiology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - R Singh
- Department of Microbiology, JIPMER, Pondicherry, India
| | - P Shastri
- Intensive Care Medicine, Sir Ganga Ram Hospital, New Delhi, India
| | - P Umabala
- Department of Microbiology, Nizam's Institute of Medical Sciences, Hyderabad, India
| | - R Sardana
- Department of Microbiology, Indraprastha Apollo Hospital, New Delhi, India
| | - A Kindo
- Department of Microbiology, Sri Ramachandra Medical College, Chennai, India
| | - M R Capoor
- Vardhman Mahaveer Medical College and Safdarjang Hospital, New Delhi, India
| | - S Mohan
- Department of Microbiology, Christian Medical College, Ludhiana, India
| | - V Muthu
- Department of Pulmonary Medicine, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - R Agarwal
- Department of Pulmonary Medicine, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - A Chakrabarti
- Department of Microbiology, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
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Goel G, Chandy M, Bhattacharyya A, Banerjee S, Chatterjee S, Mullick S, Sinha S, Sengupta K, Dhar K, Bhattacharya S, Rudramurthy S, Chakrabarti A. Mortality associated with candidemia in non-neutropenic cancer patients is not less compared to a neutropenic cohort of cancer patients. Eur J Clin Microbiol Infect Dis 2017; 36:2533-2535. [PMID: 28801726 DOI: 10.1007/s10096-017-3078-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2017] [Accepted: 07/24/2017] [Indexed: 10/19/2022]
Affiliation(s)
- G Goel
- Department of Microbiology, Tata Medical Center, 14 Major Arterial Road (E-W), New Town, Kolkata, 700 156, India
| | - M Chandy
- Department of Clinical Hematology, Tata Medical Center, Kolkata, India
| | - A Bhattacharyya
- Department of Pediatric Oncology, Tata Medical Center, Kolkata, India
| | - S Banerjee
- Department of Gastro-intestinal and Hepato-Pancreatic-Biliary Surgery, Tata Medical Center, Kolkata, India
| | - S Chatterjee
- Department of Radiation Oncology, Tata Medical Center, Kolkata, India
| | - S Mullick
- Department of Critical Care, Tata Medical Center, Kolkata, India
| | - S Sinha
- Department of Statistics, Tata Medical Center, Kolkata, India
| | - K Sengupta
- Department of Microbiology, Tata Medical Center, 14 Major Arterial Road (E-W), New Town, Kolkata, 700 156, India
| | - K Dhar
- Department of Microbiology, Tata Medical Center, 14 Major Arterial Road (E-W), New Town, Kolkata, 700 156, India
| | - S Bhattacharya
- Department of Microbiology, Tata Medical Center, 14 Major Arterial Road (E-W), New Town, Kolkata, 700 156, India.
| | - S Rudramurthy
- Department of Microbiology, Post-graduate Institute of Medical Education and Research, Chandigarh, India
| | - A Chakrabarti
- Department of Microbiology, Post-graduate Institute of Medical Education and Research, Chandigarh, India
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