scholarly journals Disease Entities in Mucormycosis

2019 ◽  
Vol 5 (1) ◽  
pp. 23 ◽  
Author(s):  
Alexandra Serris ◽  
François Danion ◽  
Fanny Lanternier
Keyword(s):  
Hematological Malignancy ◽  
Clinical Symptoms ◽  
Underlying Disease ◽  
Severe Form ◽  
Pulmonary Mucormycosis ◽  
Burn Units ◽  
Contaminated Food ◽  
Direct Inoculation ◽  
Cerebral Infections ◽  
Disseminated Disease

Mucormycosis is an emerging life-threatening fungal infection caused by Mucorales. This infection occurs mainly in immunocompromised patients, especially with hematological malignancy, transplantation, or diabetes mellitus. Rhino-orbito-cerebral and pulmonary mucormycosis are the predominant forms. Interestingly, location is associated with the underlying disease as pulmonary mucormycosis is more frequent in hematological malignancy patients whereas rhino-orbito-cerebral mucormycosis is associated with diabetes. Cutaneous mucormycosis results from direct inoculation, mainly after trauma or surgery. Gastro-intestinal mucormycosis occurs after ingestion of contaminated food or with contaminated device and involves the stomach or colon. Disseminated disease is the most severe form and is associated with profound immunosuppression. Uncommon presentations with endocarditis, osteoarticluar or isolated cerebral infections are also described. Finally, health-care associated mucormycosis is a matter of concern in premature newborns and burn units. Clinical symptoms and CT scan findings are not specific, only the early reversed halo sign is associated with pulmonary mucormycosis. Circulating Mucorales DNA detection is a recent promising diagnostic tool that may lead to improving the diagnosis and prompting therapeutic initiation that should include antifungal treatment, correction of the underlying disease and surgery when feasible.

Mucormycosis

2020 ◽  
Vol 41 (01) ◽  
pp. 099-114 ◽  
Author(s):  
Gail Reid ◽  
Joseph P. Lynch ◽  
Michael C. Fishbein ◽  
Nina M. Clark
Keyword(s):  
Hematological Malignancies ◽  
Organ Transplant ◽  
Developed Countries ◽  
Underlying Disease ◽  
Diagnostic Value ◽  
Therapeutic Trials ◽  
Contaminated Food ◽  
Common Clinical Presentation ◽  
Disseminated Disease ◽  
Immunocompromised Hosts

AbstractMucormycosis is an infection caused by a group of filamentous molds within the order Mucorales. Infections may result from ingestion of contaminated food, inhalation of spores into the nares or lungs, or inoculation into disrupted skin or wounds. In developed countries, mucormycosis occurs primarily in severely immunocompromised hosts (e.g., those with hematological malignancies, organ transplantation, neutropenia, autoimmune disorders, or other impairments in immunity). Only 6 to 10% of cases occur in subjects with no underlying disease. In contrast, in developing countries, most cases of mucormycosis occur in persons with poorly controlled diabetes mellitus or in immunocompetent subjects following trauma. Mucormycosis exhibits a marked propensity to invade blood vessels, leading to thrombosis, necrosis, and infarction of tissue. Mortality associated with invasive mucormycosis is high (> 30–50%), with 90% mortality associated with disseminated disease. Mortality rates are much lower, though still significant (10–30%), among patients with localized cutaneous disease.The diagnosis of mucormycosis relies upon histopathology and culture. Blood tests are of limited diagnostic value. Even with disseminated disease, blood cultures are usually negative. Mucorales have a distinct histological appearance, with irregular, nonseptate hyphae that branch at right angles. Cultures and/or polymerase chain reaction (PCR) are important to identify the genera.Based on anatomic localization, mucormycosis can be classified as one of six forms: (1) rhino-orbital-cerebral mucormycosis (ROCM), (2) pulmonary, (3) cutaneous, (4) gastrointestinal (GI), (5) disseminated, and (6) mucormycosis of uncommon sites. Among diabetics, ROCM is the most common clinical presentation, whereas lung involvement is uncommon. In contrast, among organ transplant recipients or patients with hematological malignancies (HemeM), pulmonary and disseminated diseases are most common. Mucormycosis can progress rapidly, and delay in initiation of treatment by even a few days markedly worsens outcomes.Due to the rarity of mucormycosis, randomized controlled therapeutic trials have not been performed. Lipid formulations of amphotericin B (LFAB) are the mainstay of therapy, but the newer triazoles, posaconazole (POSA) and isavuconazole (ISAV) (the active component of the prodrug isavuconazonium sulfate), may be effective in patients refractory to or intolerant of LFAB. Early surgical debridement or excision plays an important adjunctive role. Additional studies are required to assess the optimal duration of therapy as well as the specific roles of LFAB and the triazoles in the treatment of mucormycosis.

scholarly journals Autopsy Proven Pulmonary Mucormycosis Due to Rhizopus microsporus in a Critically Ill COVID-19 Patient with Underlying Hematological Malignancy

2021 ◽  
Vol 7 (2) ◽  
pp. 88
Author(s):  
Christoph Zurl ◽  
Martin Hoenigl ◽  
Eduard Schulz ◽  
Stefan Hatzl ◽  
Gregor Gorkiewicz ◽  
...  
Keyword(s):  
Myeloid Leukemia ◽  
Distress Syndrome ◽  
Viral Infections ◽  
Hematological Malignancy ◽  
Pulmonary Infections ◽  
Rhizopus Microsporus ◽  
Pulmonary Aspergillosis ◽  
Pulmonary Mucormycosis ◽  
The Past ◽  
Secondary Acute Myeloid Leukemia

Viral infections can cause acute respiratory distress syndrome (ARDS), consequently leading to susceptibility for secondary pulmonary infections. Over the past few weeks, a number of studies have reported on secondary pulmonary aspergillosis complicating severe COVID-19. We report the case of a 53-year old male patient with secondary acute myeloid leukemia (AML) who suffered from COVID-19 ARDS and was diagnosed postmortem with mucormycosis.

scholarly journals Challenging Diagnosis in NUT Carcinoma

2021 ◽  
pp. 106689692110195
Author(s):  
Grosse Claudia ◽  
Grosse Alexandra
Keyword(s):  
Nuclear Protein ◽  
Hematological Malignancy ◽  
Undifferentiated Carcinoma ◽  
Squamous Differentiation ◽  
Poorly Differentiated Carcinoma ◽  
Poorly Differentiated ◽  
Nut Carcinoma ◽  
Disseminated Disease ◽  
Generation Sequencing

Nuclear protein in testis (NUT) carcinoma represents a highly aggressive, poorly differentiated carcinoma that is genetically defined by rearrangement of NUT gene. The histomorphological appearance ranges from entirely undifferentiated carcinoma to carcinoma with prominent squamous differentiation. NUT carcinoma can display neuroendocrine features. Although it is typically distributed along the midline axis, it may manifest in nonmidline locations. The majority of patients develop rapidly disseminated disease. We illustrate 2 cases of NUT carcinoma, one located in the lung, which closely resembled a neuroendocrine carcinoma, and the other one with assumed lung origin demonstrating metastatic dissemination with diffuse bone involvement, which was clinically first suspected to be a hematological malignancy. Due to its undifferentiated nature, NUT carcinoma may be confused with many entities. NUT immunohistochemistry is considered to be sufficient for the diagnosis. Fluorescence in-situ hybridization analysis and next-generation sequencing are currently used to confirm the diagnosis.

Contracture of the jaw joint, formed during severe angina and associated peritonsillar abscess

1930 ◽  
Vol 26 (9) ◽  
pp. 940-940
Author(s):  
B. Goland
Keyword(s):  
Underlying Disease ◽  
Severe Form ◽  
Peritonsillar Abscess ◽  
Jaw Joint

Abstracts. Otorhinolaryngology. Forschner (M. med. Woch., 1929, No. 48) describes the contracture of the jaw joint, formed during a severe form of angina and associated peritonsillar abscess. Despite the fact that all the phenomena of the underlying disease had passed and the patient felt well, the contracture of the jaw joint remained and did not respond to any ordinary treatment.

scholarly journals Cerebral venous sinuses thrombosis in both transverse sinus and torcula: Multistep endovascular treatment and stenting

2016 ◽  
Vol 23 (1) ◽  
pp. 84-89 ◽  
Author(s):  
G Cabral de Andrade ◽  
A Lesczynsky ◽  
VM Clímaco ◽  
ER Pereira ◽  
PO Marcelino ◽  
...  
Keyword(s):  
Intracerebral Hemorrhage ◽  
Endovascular Treatment ◽  
Clinical Symptoms ◽  
Sinus Thrombosis ◽  
Transverse Sinus ◽  
Cerebral Venous Sinus Thrombosis ◽  
Severe Form ◽  
Venous Sinus ◽  
Lateral Sinus ◽  
Mechanical Thrombolysis

Purpose Cerebral venous sinus thrombosis (CVST) is an unusual and potentially life-threatening condition with variable and nonspecific clinical symptoms and high morbimortality rates. Standard therapy consists of systemic anticoagulation; although there is no clear evidence about the best choice for treatment, intravenous heparin is used as the first-line treatment modality. Intravenous sinus thrombolysis can be an effective and relatively safe treatment for acutely deteriorating patients who have not responded to conventional therapy. This case report presents the possibility of endovascular treatment in multiple steps with mechanical thrombolysis with balloon, local pharmacological thrombolysis and stenting, in a patient with a severe form of CVST. Case summary A 67-year-old woman presented severe headache, agitation and confusion with diagnosis of venous sinus dural thrombosis in both lateral sinus and torcula. After 24 h there was neurological worsening evolving with seizures and numbness even after starting heparin, without sinus recanalization; CT scan showed left temporal intracerebral hemorrhage. We decided to take an endovascular approach in multiple steps. The first step was mechanical static thrombolysis with balloon; the second step was dynamic mechanical thrombolysis with a balloon partially deflated and “pulled”; the third step was local thrombolysis with Actilyse™; finally, the fourth step was angioplasty and reconstruction of the sinuses using multiple carotid stents and complete angiographic recanalization of both sinuses and torcula. After 24 h of endovascular treatment there was full clinical recovery and no tomographic complications. Conclusion This result shows that mechanical clot disruption, intrasinus thrombolysis and reconstruction of wall sinuses with stenting can be an endovascular option in the severe form of CVST with intracerebral hemorrhage and rapid worsening of neurological symptoms. Although this type of treatment can re-channel the occluded sinuses, further comparative and randomized studies are needed to clarify its efficacy versus other therapeutic modalities.

scholarly journals Presence and importance of saprophyte fungal organisms on dog skin

2007 ◽  
pp. 261-265 ◽  
Author(s):  
Igor Stojanov ◽  
Sandra Jaksic ◽  
Jasna Prodanov
Keyword(s):  
Considerable Increase ◽  
Clinical Symptoms ◽  
Systemic Mycosis ◽  
Skin Changes ◽  
Contaminated Food ◽  
Fungal Organisms ◽  
Alternaria Sp ◽  
Fusarium Sp ◽  
Aspergillus Sp ◽  
One Year

Dogs are animals that are most often kept as pets in the cities. Their health problem may be the cause of infections of humans and animals. Skin changes and etiology factors present important segment of the diseases that disturb health of the pets. The objective of this work was mycology examination of scarifications and skin swabs from dogs with clinical symptoms. The aim was to find out which fungi species can be isolated from the changed parts of the skin, and whether is possible that, besides dermatophyte, saprophyte fungi from the environment may also be the cause of the changes, and to reveal their effect on the host. During a one year period, 67 swabs and scarifications from dogs were examined to detect the presence of fungi. The samples were streaked on Sabourdaud's dextrose agar and incubated for 10-21 days at 25?C. In microscopis examination according to their shape, and color, the colonies were identified as conidia, macroconidia and conidiaophora. From 59, of total 67 samples, the following saprophyte fungi were isolated: Aspergillus sp., Penicillium sp., Alternaria sp., Mucor sp. and Fusarium sp. Occurrence of these fungi means that a considerable increase of this microbiological flora may be expected in homes of the owners. This may be the cause of systemic mycosis and allergies in animals and humans, as well as a possibility of contaminated food and incidence of mycotoxicosis.

scholarly journals Mycotoxins in Children’s Food: Problem and Halal Management

2019 ◽  
Vol 1 (1) ◽  
pp. 16-38
Author(s):  
Mosaad A. Abdel-Wahhab ◽  
Aziza A. El-Nekeety ◽  
Soher E. Aly
Keyword(s):  
Indoor Air ◽  
Clinical Symptoms ◽  
Bone Marrow Failure ◽  
Treatment Options ◽  
Pulmonary Hemorrhage ◽  
Childhood Exposure ◽  
Toxicological Effects ◽  
Food Knowledge ◽  
Contaminated Food

Mycotoxins are ubiquitous compounds found in the natural life cycle of food- producing plants. They have a range of diverse chemical and physical properties and toxicological effects on man and animal. Mycotoxins are considered the most important contaminants of the food chain due to their chronic adverse effects on health and the economy. Mycotoxins are known as the 21th century “Great Masquerader” due to its complex natural history involving different tissues and resembling different diseases at each stage in its evolution. Mycotoxins can induce a variety of clinical symptoms including epistaxis, conjunctivitis, coughing, apnea, wheezing, vomiting and nausea. Some mycotoxins induce acute pulmonary hemorrhage, bone marrow failure and pneumonia. Knowledge about these symptoms enables the clinician to ask questions for possible exposure to the main classes of mycotoxins to protect children from sources of such exposure. These sources may include food, clothes, furniture and indoor air at home. Early childhood exposure to mycotoxins may be critical determinants of later health effects. Exposure in utero and through early infancy may additionally be important. Several well-known diseases such as neural tube defects, liver and esophageal cancers are associated with the consumption of mycotoxin-contaminated food. Knowledge of previous short or long term exposure to mycotoxins may help paediatricians to more accurately diagnose and provide treatment options to children and their families. The current review discusses the problems associated with the occurrence of different common mycotoxins in children’s food and the possible halal strategies to counteract these problems.  

scholarly journals Significant Improvement of Clinical Symptoms, Bone Lesions, and Bone Turnover after Long-Term Zoledronic Acid Treatment in Patients with a Severe Form of Camurati-Engelmann Disease

2017 ◽  
Vol 8 (6) ◽  
pp. 294-302 ◽  
Author(s):  
Giampiero I. Baroncelli ◽  
Elena Ferretti ◽  
Cecilia M. Pini ◽  
Benedetta Toschi ◽  
Rita Consolini ◽  
...  
Keyword(s):  
Zoledronic Acid ◽  
Bone Turnover ◽  
Acid Treatment ◽  
Clinical Symptoms ◽  
Severe Form ◽  
Bone Lesions ◽  
Engelmann Disease

scholarly journals Mycobacterium haemophilum scleritis: two case reports and review of literature

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Punyanuch Pisitpayat ◽  
Tasanee Sirikul ◽  
Poonpilas Hongmanee ◽  
Pitak Santanirand ◽  
Kaevalin Lekhanont
Keyword(s):  
Clinical Symptoms ◽  
Case Reports ◽  
Clinical Status ◽  
Underlying Disease ◽  
Molecular Techniques ◽  
Surgical Debridement ◽  
Topical Steroids ◽  
Topical Antibiotics ◽  
Ocular Infections ◽  
Mycobacterium Haemophilum

Abstract Background Mycobacterium haemophilum is a rare and emerging nontuberculous mycobacteria (NTM). It normally causes localized or disseminated systemic diseases, particularly skin infections and arthritis in severely immunocompromised patients. There have been 5 cases of M. haemophilum ocular infections reported in the literature. Only 1 case presented with scleritis with keratitis. Here, we reported 2 cases of M. haemophilum scleritis. One of them was immunocompetent host and had keratitis with radial keratoneuritis as a presenting sign. Case presentation Case 1: A 52-year-old Thai female with rheumatoid arthritis presented with scleritis. Conjunctival scraping was carried out and the culture result was positive for M. haemophilum. Despite receiving systemic and topical antibiotics, her clinical symptoms and signs worsened. Surgical debridement was performed. After surgery, the lesion was significantly improved and finally turned to conjunctival scarring. Case 2: A 32-year old healthy Thai male without underlying disease presented with nodular scleritis and keratouveitis with multiple radial keratoneuritis. Surgical debridement of the scleral nodule was performed. Initial microbiological investigations were negative. Herpes ocular infections was suspected. Topical antibiotics, oral acyclovir, low-dose topical steroids and systemic steroids were started. The scleral inflammation subsided but later the keratitis relapsed, requiring corneal biopsy. Histopathology of the specimen revealed acid-fast bacteria and M. haemophilum was identified by polymerase chain reaction (PCR) and sequencing. The diagnosis of Mycobacterial keratitis was made. Although using the combination of systemic and topical antibiotics, his clinical status progressively deteriorated. Multiple therapeutic penetrating keratoplasties were required to eradicate the infection. No recurrence was found during the 1-year follow-up in both cases. Conclusions M. haemophilum can cause scleritis and keratitis, even in immunocompenent host. Radial keraoneuritis is first described in M. haemophilum keratitis. NTM keratitis should be considered in the differential diagnosis of patients with radial keratoneuritis. Increased awareness and early diagnosis using appropriate culture conditions and molecular techniques are important for the proper treatment of this infection. Prompt surgical intervention appears to be vital for successful management of M. haemophilum scleritis and keratitis.

scholarly journals Clinical Characteristics and Outcomes of COVID-19 in Children in Northern Iran

2021 ◽  
Vol 2021 ◽  
pp. 1-6
Author(s):  
Leila Shahbaznejad ◽  
Hamed Rouhanizadeh ◽  
Mohammad Reza Navaeifar ◽  
Fatemeh Hosseinzadeh ◽  
Faeze Sadat Movahedi ◽  
...  
Keyword(s):  
Clinical Symptoms ◽  
Age Groups ◽  
Pediatric Intensive Care ◽  
Supplemental Oxygen ◽  
Severe Form ◽  
Mazandaran Province ◽  
Northern Iran ◽  
Respiratory Problems ◽  
Duration Of Hospitalization ◽  
The Mean

Objective. Since December 2019, the coronavirus disease 2019 (COVID-19) has been spread rapidly all over the world, infecting all age groups with this novel virus. In this manuscript, we report characteristics of children with COVID-19 in Mazandaran province, northern Iran. Method. From 12 February to 28 July 2020, medical records of 100 children diagnosed with COVID-19 admitted to the hospitals of Mazandaran province were collected. Patients’ age, gender, clinical symptoms, and signs, in addition to therapeutic management and outcomes, were reported. Results. 57 (57%) boys and 43 girls with the mean age of 104.63 ± 79.14 months were evaluated. 20 patients (20%) were transferred to the PICU (pediatric intensive care unit), and 13 children experienced a severe form of the disease, pediatric inflammatory multisystem syndrome (PIMS). The mean duration of hospitalization was 5.3 ± 4.7 days. Fever (81%), respiratory (79%), gastrointestinal (47%), and neurologic complaints (29%) were experienced by the patients in addition to skin rash (14%). Sixty-two patients needed supplemental oxygen, and 6 of them underwent endotracheal intubation. Leukopenia was reported in 7, anemia in 24, and thrombocytopenia in 12 patients. 4 patients with underlying diseases including chronic renal failure, Down syndrome with cerebral palsy, and morbid obesity died. Conclusion. COVID-19 can cause symptoms in children in two stages. In the first week, upper and lower respiratory symptoms can occur which has lower severity and prevalence compared to adults. But after 2-3 weeks following infection, symptoms of MIS-C or multisystem involvement can occur and COVID-19 should be considered. The most common indication for admission is fever, rash, and respiratory problems.

Sign in / Sign up

Export Citation Format

Share Document