PURPOSE: To report a case of bilateral ophthalmic artery occlusion in rhino-orbito-cerebral mucormycosis. METHODS: Reviewed clinical charts, photographs, and fluorescein angiography RESULTS: An 89-year-old man with poorly controlled diabetes developed sudden bilateral ptosis, complete ophthalmoplegia of the right eye, and superior rectus palsy of the left eye. Brain and orbit magnetic resonance imaging showed midbrain infarction and mild diffuse sinusitis. On the 2nd day of hospitalization, sudden visual loss and light reflex loss developed. There were retinal whitening, absence of retinal arterial filling, and a total lack of choroidal perfusion on fluorescein angiography of the right eye. The left eye showed a cherry red spot in the retina and the absence of retinal arterial filling and partial choroidal perfusion on fluorescein angiography. On rhinologic examination, mucormyosis was noticed. Despite treatment, visual acuity and light reflex did not recover and he died 4 days after admission. CONCLUSIONS: Bilateral ophthalmic artery occlusion can occur in rhino-orbital-cerebral mucormycosis.
Aged, 80 and over ; Arterial Occlusive Diseases/diagnosis/*etiology ; Brain Diseases/*complications/diagnosis/microbiology ; Fatal Outcome ; Functional Laterality ; Humans ; Magnetic Resonance Imaging ; Male ; Mucormycosis/*complications/diagnosis/microbiology ; Ophthalmic Artery/*pathology ; Orbital Diseases/*complications/diagnosis/microbiology ; Paranasal Sinus Diseases/*complications/diagnosis/microbiology

PURPOSE: To report a case of bilateral ophthalmic artery occlusion in rhino-orbito-cerebral mucormycosis. METHODS: Reviewed clinical charts, photographs, and fluorescein angiography RESULTS: An 89-year-old man with poorly controlled diabetes developed sudden bilateral ptosis, complete ophthalmoplegia of the right eye, and superior rectus palsy of the left eye. Brain and orbit magnetic resonance imaging showed midbrain infarction and mild diffuse sinusitis. On the 2nd day of hospitalization, sudden visual loss and light reflex loss developed. There were retinal whitening, absence of retinal arterial filling, and a total lack of choroidal perfusion on fluorescein angiography of the right eye. The left eye showed a cherry red spot in the retina and the absence of retinal arterial filling and partial choroidal perfusion on fluorescein angiography. On rhinologic examination, mucormyosis was noticed. Despite treatment, visual acuity and light reflex did not recover and he died 4 days after admission. CONCLUSIONS: Bilateral ophthalmic artery occlusion can occur in rhino-orbital-cerebral mucormycosis.
Aged, 80 and over ; Arterial Occlusive Diseases/diagnosis/*etiology ; Brain Diseases/*complications/diagnosis/microbiology ; Fatal Outcome ; Functional Laterality ; Humans ; Magnetic Resonance Imaging ; Male ; Mucormycosis/*complications/diagnosis/microbiology ; Ophthalmic Artery/*pathology ; Orbital Diseases/*complications/diagnosis/microbiology ; Paranasal Sinus Diseases/*complications/diagnosis/microbiology

A yeast-like strain was isolated from the brain abscess of a patient diagnosed with astrocytoma. Morphological and molecular analysis on D1/D2 domain in the 26S rRNA gene and internal transcript spacer region of the strain revealed that the strain belonged to the genus Pseudozyma. To the best of our knowledge, this is the first report on the isolation of a Pseudozyma strain from brain abscess.
Aged ; Astrocytoma/*complications ; Brain Abscess/complications/diagnosis/*microbiology ; Brain Diseases/*complications ; DNA, Fungal/genetics ; Humans ; Male ; Mycological Typing Techniques ; Phylogeny ; RNA, Ribosomal/genetics ; Ustilaginales/classification/genetics/*isolation &purification

Adolescent ; Aged ; Aspergillosis ; microbiology ; pathology ; Aspergillus ; isolation & purification ; Brain Diseases ; drug therapy ; microbiology ; pathology ; surgery ; Diabetes Complications ; microbiology ; Diagnosis, Differential ; Female ; Humans ; Male ; Mucorales ; isolation & purification ; Mucormycosis ; drug therapy ; pathology ; surgery ; Nose Diseases ; drug therapy ; microbiology ; pathology ; surgery

This study was aimed to investigate the clinical features and therapy of Ph(+) acute lymphoblastic leukemia (Ph(+)ALL) combined with invasive aspergillosis. A series of examination, including routine blood and bone marrow picture analysis, chest roentgenography, cranial computerized tomography and detection of cell genetics etc were carried out for a Ph(+)ALL patient combined with invasive aspergillosis. This patient received chemotherapy with DVCP, idarubicin and imatinib mesylate and was treated with sporanox and amphotericin B (Amb; including Amb-L) and cerebrotomy for drainage because the invasive aspergillosis occurred during myelosuppression. The results showed that patient gained complete remission and the invasive aspergillosis was controlled successfully. It is concluded that patient with Ph(+)ALL has poor prognosis despite intensive conventional chemotherapy, imatinib mesylate may prove to be an effective treatment for Ph(+)ALL. Because detection rate of the fungus is very low, itraconazole in combination with surgical excision of focus is the best treatment of lung and brain invasive aspergillosis.
Antifungal Agents ; therapeutic use ; Antineoplastic Combined Chemotherapy Protocols ; therapeutic use ; Aspergillosis ; diagnosis ; drug therapy ; Benzamides ; Brain Diseases ; complications ; microbiology ; Humans ; Imatinib Mesylate ; Itraconazole ; therapeutic use ; Leukemia, Myelogenous, Chronic, BCR-ABL Positive ; complications ; Lung Diseases, Fungal ; drug therapy ; etiology ; Piperazines ; administration & dosage ; Precursor Cell Lymphoblastic Leukemia-Lymphoma ; complications ; genetics ; microbiology ; Pyrimidines ; administration & dosage

INTRODUCTIONNeuropsychiatric manifestations can occur in up to two-thirds of patients with systemic lupus erythematosus (SLE). The presentations as well as the underlying immunopathogenic mechanisms can be heterogeneous and therefore have an enormous impact on therapeutic options.

CLINICAL PICTUREWe describe 2 patients who presented similarly with acute onset binocular reversible visual loss. The first patient had anti-phospholipid syndrome and optic neuritis, while the second patient suffered from posterior reversible leukoencephalopathy syndrome.

TREATMENTPatient one was treated with anti-coagulation and immunosuppression while the second patient required the withdrawal of immunosuppression and supportive therapy.

OUTCOMEBoth patients responded favourably and had complete visual recovery.

CONCLUSIONSDifferent management strategies have to be employed for similar presentations having different aetiologies, underscoring the need for constant clinical vigilance.

Adult ; Antiphospholipid Syndrome ; complications ; etiology ; Brain Diseases ; etiology ; immunology ; Epilepsy, Tonic-Clonic ; etiology ; Female ; Humans ; Lupus Erythematosus, Systemic ; complications ; microbiology ; physiopathology ; therapy ; Lupus Vasculitis, Central Nervous System ; diagnosis ; Magnetic Resonance Imaging ; Optic Neuritis ; etiology ; Salmonella Infections ; complications ; Salmonella enteritidis ; Time Factors ; Vision Disorders ; etiology ; immunology

No abstract available.
Aged ; Aneurysm/surgery ; Anti-Bacterial Agents/pharmacology ; Brain Diseases/surgery ; Craniotomy/adverse effects ; DNA, Bacterial/chemistry/genetics/metabolism ; Female ; Flavobacteriaceae Infections/etiology/microbiology ; Flavobacterium/classification/drug effects/*isolation & purification ; Humans ; Meningitis/*diagnosis/microbiology ; Microbial Sensitivity Tests ; Phylogeny ; Postoperative Complications ; Sequence Analysis, DNA