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Experimental and Clinical... Apr 2024Mucormycosis, a group of opportunistic mycoses caused by Mucorales, present a significant threat to immunocompromised patients. In this report, we present the case of a...
Mucormycosis, a group of opportunistic mycoses caused by Mucorales, present a significant threat to immunocompromised patients. In this report, we present the case of a 57-year-old male patient who underwent liver transplant for secondary biliary cirrhosis following inadvertent bile duct injury. Despite initial satisfactory postoperative evolution, the patient developed fever, and imaging revealed a suspicious lesion. Preliminary culture growth suggested a filamentous fungus, leading to initiation of liposomal amphotericin B. However, the lesion progressed, and a surgical debridement was necessary. During surgery, involvement of the liver dome and diaphragm was observed, and a nonanatomical hepatectomy was performed. Despite efforts, the patient's condition deteriorated, ultimately resulting in multiple organ failure and mortality. This case emphasizes the challenging nature of mucormycosis in livertransplant recipients.
Topics: Humans; Male; Mucormycosis; Middle Aged; Liver Transplantation; Antifungal Agents; Immunocompromised Host; Fatal Outcome; Liver Cirrhosis, Biliary; Treatment Outcome; Opportunistic Infections; Debridement; Allografts; Hepatectomy; Amphotericin B; Multiple Organ Failure
PubMed: 38742324
DOI: 10.6002/ect.2023.0142 -
BMC Neurology May 2024Progressive multifocal leukoencephalopathy (PML) is a rare and fatal opportunistic viral demyelinating infectious disease of the central nervous system (CNS). There are...
Progressive multifocal leukoencephalopathy in a patient with B-cell chronic lymphocytic leukemia after COVID-19 vaccination, complicated with COVID-19 and mucormycosis: a case report.
BACKGROUND
Progressive multifocal leukoencephalopathy (PML) is a rare and fatal opportunistic viral demyelinating infectious disease of the central nervous system (CNS). There are various clinical presenting symptoms for the disease.
CASE PRESENTATION
This paper presents a clinical case of PML in a patient with B-Chronic lymphocytic leukemia (B-CLL), previously treated with Chlorambucil, later complicated later with COVID-19 and mucormycosis.
CONCLUSION
PML can develop in the setting of cellular immune dysfunction. Late diagnosis of this disease based on nonspecific symptoms is common, therefore when we face a neurological complication in a CLL or immunocompromised patient, we should consider PML infection. A remarkable feature of this case is the possible triggering effect of COVID-19 vaccination for emergence of PML as the disease can be asymptomatic or sub-clinical before diagnosis.
Topics: Humans; Leukemia, Lymphocytic, Chronic, B-Cell; Leukoencephalopathy, Progressive Multifocal; COVID-19; Mucormycosis; COVID-19 Vaccines; Male; Middle Aged; Aged; Immunocompromised Host
PubMed: 38704555
DOI: 10.1186/s12883-024-03650-y -
Indian Journal of Ophthalmology May 2024
Topics: Humans; COVID-19; Mucormycosis; Retinal Artery Occlusion; SARS-CoV-2; Eye Infections, Fungal; Orbital Diseases
PubMed: 38648440
DOI: 10.4103/IJO.IJO_2538_23 -
Oral mucormycosis associated with COVID-19 and diabetes mellitus: Case report and literature review.Biomedica : Revista Del Instituto... Mar 2024Mucormycosis is an invasive opportunistic fungal infection with high mortality, mainly detected in people with COVID-19, especially those with underlying diseases such... (Review)
Review
Mucormycosis is an invasive opportunistic fungal infection with high mortality, mainly detected in people with COVID-19, especially those with underlying diseases such as diabetes mellitus. Mucormycosis prevalence is 0.005 to 1.7 cases per million inhabitants, and it has been increasing in countries like India and Pakistan. This mycosis can affect different organs, and clinical manifestations reflect the transmission mechanism. Frequent forms are rhino-orbital-cerebral and pulmonary. This disease should be suspected in patients with necrotic injuries on mucous membranes or skin. We present a case of a patient with diabetes mellitus and diagnosed with oral mucormycosis associated with COVID-19.
Topics: Humans; Mucormycosis; COVID-19; Male; Mouth Diseases; Diabetes Complications; Middle Aged; Diabetes Mellitus, Type 2; Antifungal Agents
PubMed: 38648346
DOI: 10.7705/biomedica.6970 -
The Journal of Infection Jun 2024
Topics: Humans; Mucormycosis; Lung Diseases, Fungal; Real-Time Polymerase Chain Reaction; Male; Middle Aged; Female; Sensitivity and Specificity; Adult
PubMed: 38641138
DOI: 10.1016/j.jinf.2024.106160 -
Medical Mycology Case Reports Jun 2024Mucormycosis is a frequently lethal fungal infection that most commonly affects patients with poorly controlled diabetes or other immunosuppressed states. We report the...
Mucormycosis is a frequently lethal fungal infection that most commonly affects patients with poorly controlled diabetes or other immunosuppressed states. We report the case of a suspected disseminated infection in a patient who was pursuing naturopathic treatment including mud baths for metastatic adrenocortical carcinoma. He was empirically treated with liposomal amphotericin B but opted to stop treatment following multiorgan failure. The patient passed away on the tenth day of his hospital admission.
PubMed: 38623179
DOI: 10.1016/j.mmcr.2024.100646 -
Swiss Medical Weekly Mar 2024Invasive mould infections are life-threatening complications in patients with haematologic cancer and chemotherapy-induced neutropenia. While invasive aspergillosis...
AIMS OF THE STUDY
Invasive mould infections are life-threatening complications in patients with haematologic cancer and chemotherapy-induced neutropenia. While invasive aspergillosis represents the main cause of invasive mould infections, non-Aspergillus mould infections, such as mucormycosis, are increasingly reported. Consequently, their local epidemiology should be closely monitored. The aim of this study was to investigate the causes of an increased incidence of non-Aspergillus mould infections in the onco-haematology unit of a Swiss tertiary care hospital.
METHODS
All cases of proven and probable invasive mould infections were retrospectively identified via a local registry for the period 2007-2021 and their incidence was calculated per 10,000 patient-days per year. The relative proportion of invasive aspergillosis and non-Aspergillus mould infections was assessed. Factors that may affect invasive mould infections' incidence, such as antifungal drug consumption, environmental contamination and changes in diagnostic approaches, were investigated.
RESULTS
A significant increase of the incidence of non-Aspergillus mould infections (mainly mucormycosis) was observed from 2017 onwards (Mann and Kendall test p = 0.0053), peaking in 2020 (8.62 episodes per 10,000 patient-days). The incidence of invasive aspergillosis remained stable across the period of observation. The proportion of non-Aspergillus mould infections increased significantly from 2017 (33% vs 16.8% for the periods 2017-2021 and 2007-2016, respectively, p = 0.02). Building projects on the hospital site were identified as possible contributors of this increase in non-Aspergillus mould infections. However, novel diagnostic procedures may have improved their detection.
CONCLUSIONS
We report a significant increase in non-Aspergillus mould infections, and mainly in mucormycosis infections, since 2017. There seems to be a multifactorial origin to this increase. Epidemiological trends of invasive mould infections should be carefully monitored in onco-haematology units in order to implement potential corrective measures.
Topics: Humans; Mucormycosis; Retrospective Studies; Incidence; Antifungal Agents; Aspergillosis; Hematology
PubMed: 38579310
DOI: 10.57187/s.3730 -
Case Reports in Plastic Surgery & Hand... 2024Mucormycosis hand infection in poorly controlled diabetic presented as rapidly progressive swelling, redness, pain, and necrosis unresponsive to antibiotics. Prompt...
Mucormycosis hand infection in poorly controlled diabetic presented as rapidly progressive swelling, redness, pain, and necrosis unresponsive to antibiotics. Prompt diagnosis and aggressive surgery, antifungals, and diabetes management were critical, highlighting the need for early recognition and treatment of mucormycosis in diabetics.
PubMed: 38567104
DOI: 10.1080/23320885.2024.2333879 -
The Journal of Infection May 2024Invasive mould infections (IMIs) are a leading cause of death in patients with compromised immune systems. Proven invasive mould infection requires detection of a fungus...
INTRODUCTION
Invasive mould infections (IMIs) are a leading cause of death in patients with compromised immune systems. Proven invasive mould infection requires detection of a fungus by histopathological analysis of a biopsied specimen, sterile culture, or fungal DNA amplification by PCR in tissue. However, the clinical performance of a PCR assay on blood samples taken from patients suspected of invasive mould disease has not been fully evaluated, particularly for the differential diagnosis of invasive aspergillosis (IA) and invasive Mucormycosis (IM).
OBJECTIVES
To assess the diagnostic utility of our previously validated in-house real-time PCR in blood samples for diagnosis of invasive aspergillosis and mucormycosis in patients with suspected invasive mould infection.
METHODS
All patients with suspected invasive mould infection were prospectively enrolled from May 2021 to July 2021. Conventional fungal diagnosis was performed using tissue and respiratory samples. In-house PCR was performed on blood samples and its diagnostic performance evaluated.
RESULTS
A total of 158 cases of suspected invasive mould infection were enrolled in the study. The sensitivity and specificity of in-house PCR performed on blood samples was found to be 92.5% and 81.4% respectively for diagnosis of probable IA, and 65% and 84.62% respectively for diagnosis of proven and probable IM. It was also able to detect 3 out of 5 cases of possible IM where no other microbiological evidence of IM was obtained.
CONCLUSIONS
This assay could be helpful in minimally invasive diagnosis of IMIs for patients in whom invasive sampling is not feasible, especially as a preliminary or screening test. It can help in early diagnosis, anticipating conventional laboratory confirmation by days or weeks. Possible correlation between fungal load and mortality can help in initiating aggressive treatment for patients with high initial fungal load.
Topics: Humans; Real-Time Polymerase Chain Reaction; Female; Male; Middle Aged; Sensitivity and Specificity; Mucormycosis; Adult; Prospective Studies; Aged; Invasive Fungal Infections; DNA, Fungal; Aspergillosis; Early Diagnosis; Young Adult; Aged, 80 and over; Diagnosis, Differential
PubMed: 38555035
DOI: 10.1016/j.jinf.2024.106147 -
Journal of Gastrointestinal and Liver... Mar 2024
Topics: Humans; Mucormycosis; Stomach Ulcer; COVID-19
PubMed: 38554417
DOI: 10.15403/jgld-5149