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The International Journal of Lower... May 2022Primary cutaneous mucormycosis is a consequence of environmental Mucorales spores inoculation at the abraded skin. In a diabetic patient, these spores germinate quickly...
Primary cutaneous mucormycosis is a consequence of environmental Mucorales spores inoculation at the abraded skin. In a diabetic patient, these spores germinate quickly and disseminate hematogenously to the surroundings. Cutaneous mucormycosis is a rare but aggressive, invasive, and life-threatening fungal infection. Its presentation is nonspecific, but it rapidly results in necrosis of underneath tissues. Diagnosis can be readily made by KOH wet mount of excise tissue. However, a prompt diagnosis with multidisciplinary management is a prerequisite for a better outcome. We present a case of fatal cutaneous mucormycosis caused by , in a diabetic patient who succumbed to death despite extensive debridement and antifungal treatment.
PubMed: 35611497
DOI: 10.1177/15347346221103387 -
Eye (London, England) Sep 2020To report the spectrum of fungal infections involving the orbit encountered in an Australian subtropical population with respect to presentation, host risk factors,...
BACKGROUND/OBJECTIVES
To report the spectrum of fungal infections involving the orbit encountered in an Australian subtropical population with respect to presentation, host risk factors, involved pathogens, treatment and outcomes.
SUBJECTS/METHODS
A retrospective chart review was performed on all adult patients with orbital mycosis treated by the senior author (TJS) from 1986 to 2017 in a tertiary setting.
RESULTS
Thirty cases of fungal infection involving the orbit were included in this case series. Of these, 26 patients had invasive disease and four patients had non-invasive disease. Causative organisms included mucormycosis (16), aspergillus (8) and other fungi (7). Common risk factors included haematological disorders or malignancy, neutropenia, corticosteroid use and diabetes mellitus. Mucormycosis in three immunocompetent patients was caused by Apophysomyces elegans. Orbital apex syndrome was observed in approximately one third of patients at initial ophthalmological assessment. Amphotericin B was used in most cases of mucormycosis, while there was a more varied spectrum of anti-fungal use in other fungal infections. Seven patients with mucormycosis proceeded to orbital exenteration with a survival rate of 43%. No patients with other orbital fungal infections were exenterated.
CONCLUSIONS
Orbital mycoses are not only opportunistic but true pathogenic infections. While initial symptoms may be varied, the development of orbital apex syndrome should raise suspicion for this condition, regardless of patient immune status or age. Survival and visual outcomes are often poor with invasive disease. Multidisciplinary team management with early orbital specialist involvement is essential.
Topics: Adult; Antifungal Agents; Australia; Eye Infections, Fungal; Humans; Mucorales; Mycoses; Orbital Diseases; Retrospective Studies
PubMed: 31822858
DOI: 10.1038/s41433-019-0733-3 -
Medical Mycology Jun 2020Apophysomyces elegans species complex is an important cause of cutaneous mucormycosis in India. However, majority of those cases are reported as case reports only. We...
Apophysomyces elegans species complex is an important cause of cutaneous mucormycosis in India. However, majority of those cases are reported as case reports only. We desired to analyze our patients with Apophysomyces infection reported over 25 years (1992-2017) to understand the epidemiology, management, and outcome of the disease. During the study period 24 cases were reported, and the majority (95.8%) of them presented with necrotizing fasciitis following accidental/surgical/iatrogenic trauma. One patient presented with continuous ambulatory peritoneal dialysis (CAPD) related peritonitis. Healthcare related Apophysomyces infection was noted in 29.2% patients. In addition to trauma, comorbidities were noted in 37.5% patients (type 2diabetes mellitus-6, chronic alcoholism-2, and chronic kidney disease-1). Of the 24 isolates, 11 isolates starting from year 2014 were identified as Apophysomyces variabilis by molecular methods. Majority (95.8%) of the patients were managed surgically with or without amphotericin B deoxycholate therapy, while one patient was treated with amphotericin B deoxycholate alone. Among 24 patients, seven (29.1%) recovered, six (25%) patients could not afford antifungal management and left the hospital against medical advice, and 11 (45.9%) patients died.The present case series highlights that necrotizing fasciitis caused by A. variabilis is prevalent in India, and the disease may be healthcare related. Although diagnosis is not difficult, awareness among surgeons is still limited about the infection, leading to a delay in sending samples to the mycology laboratory. Apophysomyces infection must be considered in the differential diagnosis in apatient with progressive necrosis of a wound who is not responding to antibacterial therapy.
Topics: Adolescent; Adult; Aged; Antifungal Agents; Comorbidity; Fasciitis, Necrotizing; Female; Humans; India; Male; Middle Aged; Mucorales; Mucormycosis; Retrospective Studies; Tertiary Care Centers; Young Adult
PubMed: 31342074
DOI: 10.1093/mmy/myz081 -
The Aging Male : the Official Journal... Dec 2020Mucor is an angioinvasive fungus that was reported mainly in immunocompromised patients. It usually presents as rhino-orbital, pulmonary, gastrointestinal, and...
Mucor is an angioinvasive fungus that was reported mainly in immunocompromised patients. It usually presents as rhino-orbital, pulmonary, gastrointestinal, and disseminated disease. Isolated renal mucormycosis is an extremely rare infection in immunocompetent patients and is associated with high fatality rate. Early diagnosis, prompt antifungal treatment, and surgery give the patient the best chance for cure and survival. We describe herein a case of renal zygomycosis caused by ) in an immunocompetent host. To the best of our knowledge, this is the first case of renal to be reported from Qatar and the Middle East.
Topics: Antifungal Agents; Humans; Male; Mucorales; Mucormycosis
PubMed: 30879364
DOI: 10.1080/13685538.2019.1586871