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Journal of Indian Prosthodontic Society Jan 2024This study aimed to systematically review the frequency and type of intraoral prosthetic rehabilitation in patients with rhino-orbital-cerebral-mucormycosis (ROCM).
AIM
This study aimed to systematically review the frequency and type of intraoral prosthetic rehabilitation in patients with rhino-orbital-cerebral-mucormycosis (ROCM).
SETTINGS AND DESIGN
Systematic review following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.
MATERIALS AND METHODS
An electronic search was conducted in databases including PubMed, Web of Science, Scopus, and Google Scholar. Case reports that documented prosthetic rehabilitation following surgery in patients with ROCM were included. This review was registered under the International Prospective Register of Systematic Reviews CRD42021262284. Assessment of the quality of the included studies was done using the Joanna Briggs Institute Critical Appraisal Checklist for Case reports, which comprised of an eight-item checklist. The recorded observations were organized and subjected to analysis.
STATISTICAL ANALYSIS USED
Qualitative analysis was used.
RESULTS
Among the 25 case reports, type IId defect was the most common. Three types of prosthetic treatments were rendered, with the obturator being the most common choice of rehabilitation, followed by implant-retained obturator overdenture and fixed implant-supported prosthesis. Patients undergoing implant-based rehabilitation exhibited a 100% survival rate for implants, with follow-up periods spanning from 6 months to 3 years. No prosthetic complications were reported in any of the included case reports.
CONCLUSIONS
The prevailing defect type identified was IId (48%), while the treatment of choice most frequently employed was an obturator (84%). However, with limited evidence available at present, further research is required to draw more definitive conclusions.
Topics: Humans; Mucormycosis; Patients; Academies and Institutes; Checklist; Databases, Factual; Eye Diseases
PubMed: 38263556
DOI: 10.4103/jips.jips_305_23 -
The Journal of Antimicrobial... Apr 2024Therapeutic drug monitoring (TDM) is a tool that supports personalized dosing, but its role for liposomal amphotericin B (L-amb) is unclear. This systematic review...
INTRODUCTION
Therapeutic drug monitoring (TDM) is a tool that supports personalized dosing, but its role for liposomal amphotericin B (L-amb) is unclear. This systematic review assessed the evidence for L-amb TDM in children.
OBJECTIVES
To evaluate the concentration-efficacy relationship, concentration-toxicity relationship and pharmacokinetic/pharmacodynamic (PK/PD) variability of L-amb in children.
METHODS
We systematically reviewed PubMed and Embase databases following PRISMA guidelines. Eligible studies included L-amb PK/PD studies in children aged 0-18 years. Review articles, case series of
RESULTS
In total, 4220 studies were screened; 6 were included, presenting data on 195 children. Invasive candidiasis and aspergillosis were the two most common infections treated with L-amb. Studies showed significant PK variability due to age (mean age ranged from 14 days to 17 years), body weight, non-linear PK and changes in the volume of distribution. Limited evidence supported a peak concentration/MIC (Cmax/MIC) of 25-50 for optimal efficacy and an AUC24 of >600 mg·h/L for nephrotoxicity. L-amb doses of 2.5-10 mg/kg/day were reported to achieve Cmax/MIC > 25 using an MIC of 1 mg/L.
CONCLUSIONS
While significant PK variability was observed in children, evidence to support routine L-amb TDM was limited. Further studies on efficacy and toxicity benefits are required before routine TDM of L-amb can be recommended.
Topics: Child; Animals; Humans; Infant, Newborn; Antifungal Agents; Drug Monitoring; Amphotericin B; Candidiasis, Invasive
PubMed: 38252921
DOI: 10.1093/jac/dkae003 -
BMC Infectious Diseases Jan 2024With the development of society, pulmonary fungal diseases, represented by pulmonary aspergillosis and pulmonary cryptococcosis, have become increasingly common....
BACKGROUND/OBJECTIVE
With the development of society, pulmonary fungal diseases, represented by pulmonary aspergillosis and pulmonary cryptococcosis, have become increasingly common. However, there is a lack of clear understanding regarding coinfection by these two types of fungi in immunocompetent individuals.
METHODS
A retrospective study from 2014 to 2022 and a systematic literature review of original articles published in English were performed. Patients with pulmonary cryptococcosis complicated with pulmonary aspergillosis including 5 in the retrospective study and 6 in the systematic literature review.
RESULT
The diagnosis of concurrent pulmonary cryptococcosis and pulmonary aspergillosis in patients was confirmed through repeated biopsies or surgical resection. Pulmonary cryptococcosis is often diagnosed initially (6/11, 55%), while the diagnosis of pulmonary aspergillosis is established when the lesions become fixed or enlarged during treatment. Transbronchial lung biopsy (3/11, 27%), thoracoscopic lung biopsy (2/11, 18%), and percutaneous aspiration biopsy of the lung (1/11, 9%) were the main methods to confirm concurrent infection. Most patients were treated with voriconazole, resulting in a cure for the coinfection (6/11, 55%).
CONCLUSION
Pulmonary cryptococcosis complicated with pulmonary Aspergillus is an easily neglected mixed fungal infection. During the treatment of lesion enlargement in clinical cryptococcus, we need to watch out for Aspergillus infection.
Topics: Humans; Coinfection; Retrospective Studies; Pulmonary Aspergillosis; Cryptococcosis; Aspergillosis
PubMed: 38229026
DOI: 10.1186/s12879-024-09014-8 -
Enfermedades Infecciosas Y... 2024The occurrence of mucormycosis has been observed in individuals with COVID-19. However, there is limited information on the epidemiological factors, presentation,... (Review)
Review
The occurrence of mucormycosis has been observed in individuals with COVID-19. However, there is limited information on the epidemiological factors, presentation, diagnostic certainty, and outcome of this infection in children. PubMed, MEDLINE, Scopus, Embase, Web of Science, LitCovid, and back-references of the identified manuscripts were systematically searched from December 2019 to March 2023. We have identified 14 cases of pediatric mucormycosis in patients with COVID-19. The median age of patients was 10.7 years. Among these cases, 10 were associated with active COVID-19. In 7 cases, the patients had pre-existing diabetes mellitus and concomitant diabetic ketoacidosis. Corticosteroids were administered to treat COVID-19 in 7 of the patients. The most common clinical presentation of the disease was rhino-orbital cerebral mucormycosis. Seven patients died (50%). Given the high mortality rate, clinicians should maintain a high level of clinical suspicion of mucormycosis in pediatric patients with COVID-19.
Topics: Humans; Mucormycosis; COVID-19; Child; Adolescent; Child, Preschool; Female; Male; Diabetic Ketoacidosis
PubMed: 38216422
DOI: 10.1016/j.eimce.2023.11.006 -
Mycoses Jan 2024In superficial fungal infections, prompt diagnosis and treatment are essential to prevent the spread of infection and minimise the impact on patients' quality of life....
BACKGROUND
In superficial fungal infections, prompt diagnosis and treatment are essential to prevent the spread of infection and minimise the impact on patients' quality of life. Traditional diagnostic methods, such as KOH smear and fungal culture, have limitations in terms of sensitivity and turnaround time. Recently, the PCR-reverse blot hybridization assay (PCR-REBA) has been developed for the direct detection of dermatophyte DNA. However, there is a lack of information assessing the diagnostic accuracy of PCR-REBA.
OBJECTIVES
This systematic review aimed to evaluate the diagnostic accuracy of PCR-REBA in superficial fungal infections compared to conventional and molecular methods.
METHODS
The comprehensive search containing Ovid MEDLINE and Embase databases was conducted on 7 August 2022. Two reviewers independently reviewed the included articles. Quality assessment was performed using the Newcastle-Ottawa Scale tool.
RESULTS
The included studies were conducted in Korea (five studies) and the Netherlands (two studies), all of which were conducted in a single institution. The quality assessment of these studies indicated low risk of bias. When compared to the potassium hydroxide (KOH) smear and fungus culture, the sensitivity of PCR-REBA ranged from 85% to 100%, and the positive predictive values ranged from 58.9% to 100%. When compared to the RT-PCR, the sensitivity of PCR-REBA ranged from 93.3% to 100%, and the positive and negative predictive values were 91.6%-99.6% and 81.0%-89.1%, respectively.
CONCLUSIONS
The PCR-REBA shows promise as a valuable diagnostic tool for dermatophytosis, offering practical and cost-effective benefits.
Topics: Humans; Quality of Life; Sensitivity and Specificity; Fungi; Dermatomycoses; Polymerase Chain Reaction
PubMed: 38214426
DOI: 10.1111/myc.13678 -
Risk factors for COVID-19-associated pulmonary aspergillosis: a systematic review and meta-analysis.The Lancet. Respiratory Medicine Mar 2024COVID-19-associated pulmonary aspergillosis (CAPA) has been reported to be an emerging and potentially fatal complication of severe COVID-19. However, risk factors for... (Meta-Analysis)
Meta-Analysis
BACKGROUND
COVID-19-associated pulmonary aspergillosis (CAPA) has been reported to be an emerging and potentially fatal complication of severe COVID-19. However, risk factors for CAPA have not been systematically addressed to date.
METHODS
In this systematic review and meta-analysis to identify factors associated with CAPA, we comprehensively searched five medical databases: Ovid MEDLINE; Ovid Embase; the Cochrane Database of Systematic Reviews; the Cochrane Central Register of Controlled Trials; and the WHO COVID-19 Database. All case-control and cohort studies in adults (aged >18 years) that described at least six cases of CAPA and evaluated any risk factors for CAPA, published from Dec 1, 2019, to July 27, 2023, were screened and assessed for inclusion. Only studies with a control population of COVID-19-positive individuals without aspergillosis were included. Two reviewers independently screened search results and extracted outcome data as summary estimates from eligible studies. The primary outcome was to identify the factors associated with CAPA. Meta-analysis was done with random-effects models, with use of the Mantel-Haenszel method to assess dichotomous outcomes as potential risk factors, or the inverse variance method to assess continuous variables for potential association with CAPA. Publication bias was assessed with funnel plots for factors associated with CAPA. The study is registered with PROSPERO, CRD42022334405.
FINDINGS
Of 3561 records identified, 27 articles were included in the meta-analysis. 6848 patients with COVID-19 were included, of whom 1324 (19·3%) were diagnosed with CAPA. Diagnosis rates of CAPA ranged from 2·5% (14 of 566 patients) to 47·2% (58 of 123). We identified eight risk factors for CAPA. These factors included pre-existing comorbidities of chronic liver disease (odds ratio [OR] 2·70 [95% CI 1·21-6·04], p=0·02; I=53%), haematological malignancies (OR 2·47 [1·27-4·83], p=0·008; I=50%), chronic obstructive pulmonary disease (OR 2·00 [1·42-2·83], p<0·0001; I=26%), and cerebrovascular disease (OR 1·31 [1·01-1·71], p=0·05; I=46%). Use of invasive mechanical ventilation (OR 2·83; 95% CI 1·88-4·24; p<0·0001; I=69%), use of renal replacement therapy (OR 2·26 [1·76-2·90], p<0·0001; I=14%), treatment of COVID-19 with interleukin-6 inhibitors (OR 2·88 [1·52-5·43], p=0·001; I=89%), and treatment of COVID-19 with corticosteroids (OR 1·88 [1·28-2·77], p=0·001; I=66%) were also associated with CAPA. Patients with CAPA were typically older than those without CAPA (mean age 66·6 years [SD 3·6] vs 63·5 years [5·3]; mean difference 2·90 [1·48-4·33], p<0·0001; I=86%). The duration of mechanical ventilation in patients with CAPA was longer than in those without CAPA (n=7 studies; mean duration 19·3 days [8·9] vs 13·5 days [6·8]; mean difference 5·53 days [1·30-9·77], p=0·01; I=88%). In post-hoc analysis, patients with CAPA had higher all-cause mortality than those without CAPA (n=20 studies; OR 2·65 [2·04-3·45], p<0·0001; I=51%).
INTERPRETATION
The identified risk factors for CAPA could eventually be addressed with targeted antifungal prophylaxis in patients with severe COVID-19.
FUNDING
None.
Topics: Adult; Humans; Aged; COVID-19; Pulmonary Aspergillosis; Aspergillosis; Continuous Renal Replacement Therapy; Databases, Factual
PubMed: 38185135
DOI: 10.1016/S2213-2600(23)00408-3 -
Brazilian Journal of Microbiology :... Mar 2024To evaluate the relationship between fungal infection in the female genital tract and infertility. (Meta-Analysis)
Meta-Analysis Review
OBJECTIVE
To evaluate the relationship between fungal infection in the female genital tract and infertility.
DATA SOURCES
A systematic review was carried out, and the search was conducted in Medline, Embase, Web of Science, Google Scholar, and Cochrane Library databases until August 2022. The search strategy used standardized keywords such as "candidiasis" and "infertility," combined with their respective synonyms. The search was limited to human studies, with no language restrictions.
STUDY ELIGIBILITY CRITERIA
Primary articles that evaluated women of reproductive age with and without infertility and related to the presence or absence of candidiasis were included.
STUDY APPRAISAL AND SYNTHESIS METHODS
For the analyses, the odds ratio association measure was used with a confidence interval of 95% using RevMan software (version 5.4).
RESULTS
Eight studies, published between 1995 and 2021 in different countries around the world, were included in this systematic review. Two studies were excluded after sensitivity analysis. A total of 909 participants were included in the group of infertile women and 2363 women in the control group. The age of the evaluated women varied between 18 and 50 years. The random effect model was used and showed no significant difference when comparing candidiasis between fertile and infertile women (odds ratio: 1.44; 95% confidence interval 0.86, 2.41 p= 0.17).
CONCLUSIONS
There was no association between candidiasis and female sterility.
Topics: Female; Humans; Adolescent; Young Adult; Adult; Middle Aged; Candidiasis, Vulvovaginal; Infertility, Female; Candidiasis
PubMed: 38153623
DOI: 10.1007/s42770-023-01225-6 -
Acta Neurochirurgica. Supplement 2023In recent years, Candida spondylodiscitis has represented an increasingly emerging disease in clinical practice. This condition requires long-term antibiotic therapy and...
OBJECTIVE
In recent years, Candida spondylodiscitis has represented an increasingly emerging disease in clinical practice. This condition requires long-term antibiotic therapy and sometimes surgical treatments. The main purpose of this study is to investigate the epidemiology, clinical and radiological aspects, treatment protocols, and outcomes of Candida-mediated vertebral osteomyelitis.
METHODS
A systematic review of the English literature was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines.The research was conducted on Medline, Cochrane library, PubMed, and Scopus using as search terms "vertebral"; "spinal"; "infection"; "spondylodiscitis"; "discitis"; "osteomyelitis"; "Candida"; and "Candidosis." A case of vertebral candidiasis that was surgically managed was also reported.
RESULTS
In total, 88 articles were included in our systematic review. Including the reported case, our analysis covered 113 cases of vertebral candidiasis. Candida albicans was isolated in 64 cases (56.1%), Candida tropicalis in 21 (18.4%), Candida glabrata in 14 (12.3%), and Candida parapsilosis in five (4.4%). The mean duration of the follow-up was 395 days. Finally, 87 (82%) patients completely recovered, ten (9.4%) died, and nine (8.5%) reported sequelae.
CONCLUSION
This systematic review summarized the state of the art on vertebral candidiasis, describing data on its clinical features, diagnostic criteria and current limitations, and treatment alternatives and their outcomes.
Topics: Humans; Candidiasis; Osteomyelitis; Spine
PubMed: 38153475
DOI: 10.1007/978-3-031-36084-8_36 -
International Dental Journal Jun 2024Mucormycosis is a rare human infection associated with Mucorales, a group of filamentous moulds found in different environmental niches. Its oral manifestations may...
AIM
Mucormycosis is a rare human infection associated with Mucorales, a group of filamentous moulds found in different environmental niches. Its oral manifestations may occur in the mandible and tongue despite being rare. We aimed to systematically review the data on clinical manifestations, risk factors, diagnostic approaches, treatment options, and outcomes of mandibular and tongue mucormycosis.
METHODS
An electronic search of articles published between January 1975 and November 2022 in PubMed, Web of Science, and EMBASE databases was performed. A total of 22 articles met the inclusion criteria and reported 27 cases of oral mucormycosis in total.
RESULTS
Fourteen patients had mandibular mucormycosis signs unrelated to COVID-19 infection, 6 had SARS-CoV-2-related mandibular mucormycosis, and 6 had manifestations in the tongue. All published case reports during the COVID-19 pandemic were from India. Patient ages ranged from 4 months old to 82 years, and most patients had important comorbidities, such as blood dyscrasias related to immune deficiency and uncontrolled type 2 diabetes mellitus. The signs and symptoms of mandibular and tongue mucormycosis varied from dental pain, loose teeth, and nonhealing sockets to dysphagia and paraesthesia of the lip. Some patients also reported trismus, draining sinus tract, and facial pain. The diagnosis of oral mucormycosis was based on a combination of clinical, radiographic, and histopathologic findings by demonstrating fungal hyphae in tissue specimens. In most cases, mucormycosis was managed with systemic amphotericin B, strict glycaemic control, and aggressive surgical debridement of infected tissue, minimising the progression of the fungal infection and thus improving the survival rate. In some cases, combined antifungal therapy, antibiotic therapy, and chlorhexidine mouthwashes were used successfully.
CONCLUSIONS
Recognition of the signs and symptoms by oral care providers is pertinent for the early diagnosis and treatment of tongue and mandibular mucormycosis, and providers should be aware of the possibility of this opportunistic fungal infection in patients with COVID-19. A multidisciplinary approach is recommended for the management of this lethal infection.
Topics: Humans; Mucormycosis; Tongue Diseases; COVID-19; Antifungal Agents; Mandibular Diseases; Aged; Middle Aged; Mandible; Risk Factors; Adult; Aged, 80 and over; Adolescent
PubMed: 38143163
DOI: 10.1016/j.identj.2023.11.011 -
BMC Oral Health Dec 2023Systemic lupus erythematosus (SLE) is a chronic autoimmune disease that can cause a range of symptoms, including oral mucosal lesions (OMLs). The prevalence of OMLs in... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Systemic lupus erythematosus (SLE) is a chronic autoimmune disease that can cause a range of symptoms, including oral mucosal lesions (OMLs). The prevalence of OMLs in SLE patients and their associated factors have been studied in various regions, but the results are inconsistent. This study aims to evaluate the prevalence of OMLs in patients with SLE.
METHODS
Observational studies of OML prevalence in SLE patients published before 2022 were retrieved from PubMed, Embase, Web of Science, Google Scholar, and the Cochrane Library without language restriction. The quality of the studies was assessed using the Newcastle-Ottawa Scale (NOS) and Agency for Healthcare Research and Quality (AHRQ).
RESULTS
Our meta-analysis included 113 studies with a total of 53,307 SLE patients. We found that the prevalence of OMLs in SLE patients was 31% (95% CI: 28%, 35%), with oral ulcers being present in 30% of SLE patients (95% CI: 26%, 33%). Subgroup analysis showed that the prevalence of OMLs varied significantly by region, disease activity, and sample size (p ≤ 0.01). However, gender and year of publication had little effect on the prevalence of OMLs (p = 0.78 and 0.30, respectively). Oral ulcers were significantly associated with age of onset (p = 0.02), geographic location (p < 0.01), and race (p < 0.01). We also found that the prevalence of oral erythema was 9%, oral candidiasis was 9%, petechiae was 8%, cheilitis was 6%, and white plaque was 3%.
CONCLUSIONS
Our analysis showed that the prevalence of OMLs varied significantly by region and disease activity, and child-onset patients of Indian, Malay, and Caucasian descent were more likely to have oral ulcers. The high prevalence of OML in SLE patients emphasizes the importance of regular oral examination and management in the comprehensive care of individuals with SLE.
Topics: Humans; Oral Ulcer; Prevalence; Candidiasis, Oral; Lupus Erythematosus, Systemic; Observational Studies as Topic
PubMed: 38129844
DOI: 10.1186/s12903-023-03783-5