Congresses as Topic ; Humans ; Infection ; Nose Diseases ; microbiology ; Nose Neoplasms ; Rhinitis, Allergic ; Rhinitis, Allergic, Perennial

OBJECTIVETo present the clinical characteristics and combination therapy of rhino-orbito-cerebral mucormycosis.

METHODSThe clinical data of 9 patients with rhino-orbito-cerebral mucormycosis treated between January 2008 and January 2013 were analyzed retrospectively. The clinical features, diagnosis, pathological characteristics, surgical technique and combination therapy were summarized. All the patients were treated with nasal endoscopic surgery and combined drug therapy.

RESULTSNine patients were under the state of systemic immunosuppression. Two patients died of intracranial infection. One patient with the symptom of headache was first alleviated after treatment, with visual acuity recovered partially, but this patient died 4 months later due to recurrence of mucormycosis and intracranial infection. Two patients with headache recovered after treatment, the visual acuity recovered to the hand movement, endoscopic examination of surgical cavity was clean and epithelialized, with no recurrence, still alive 5 years up to now. The symptom of headache in another 4 patients disappeared after treatment, visual acuity improved significantly, endoscopic surgical cavity was clean, follow-up with no recurrence, survived more than 2 years, and were still in the treatment of primary disease.

CONCLUSIONRhino-orbito-cerebral mucormycosis is a serious chance infectious disease under the state of systemic immunosuppression, the development is rapid and the mortality rate is high, early diagnosis and combined treatment with nasal endoscopic surgery is necessary.

Adult ; Female ; Humans ; Male ; Middle Aged ; Mucormycosis ; Nose Diseases ; microbiology ; Orbital Diseases ; microbiology ; Retrospective Studies

Adult ; Cavernous Sinus Thrombosis ; microbiology ; Female ; Furunculosis ; Humans ; Nose Diseases ; microbiology

OBJECTIVE: To study the clinical diagnosis, course and combined therapy of aggressive rhinocerebral mucormycosis. METHOD: The clinical feature, diagnosis and therapy were analyzed in 5 cases with rhinocerebral mucormycosis throughout disease progress. Good treatments were found by analyzing curative effect of different treatment. RESULT: One patient died within three weeks in hospital three patients survived from 2 months to 2 years; and one patient was alive over 3 years. The mortality rate was 80% in this study. CONCLUSION Rhinocerebral mucormycosis is always secondary to patients with severe diseases and bad immunologic function. The lesion can invade the orbit and brain quickly, and the mortality rate is high. The cause of the disease can be retarded by clearing up the focus early and removing the environment of fungi thriving with combined therapy. It is effective of remodelling the necrotic tissues by nasal endoscopy.
Adult ; Brain Diseases ; diagnosis ; microbiology ; therapy ; Female ; Humans ; Male ; Middle Aged ; Mucormycosis ; diagnosis ; therapy ; Nose Diseases ; diagnosis ; microbiology ; therapy

A 70 years old male patient complained a sense of swelling on right facial, mild pain, and the obstruction of right nasal, no complain of facial numbness and toothache. Physical examination showed the slight bulging on right facial with mild tenderness, purulent nasal secretions on the right middle nasal meatus, and no significant neoplasm. CT scan showed that soft density tissue in the right maxillary sinus,and the high density tissue in some period. Postoperative diagnosis: carcinoma of maxillary sinus with fungal sinusitis.
Aged ; Carcinoma ; complications ; diagnosis ; Humans ; Male ; Maxillary Sinus ; microbiology ; pathology ; Mycoses ; complications ; Nose Neoplasms ; complications ; diagnosis ; Sinusitis ; microbiology

OBJECTIVETo study the pathologic changes in nasal and oropharyngeal mucosa caused by treponema pallidum (TP) infection.

METHODSTwenty-five cases of nasal and oropharyngeal syphilis were retrieved from the archival files of Department of Pathology of Beijing Tong Ren Hospital collected during the period from June 1996 to September 2005. The hematoxylin and eosin-stained slides were reviewed. Histochemical study using modified Warthin-Starry stain and immunohistochemical study using polyclonal antibody for TP were carried out. The diagnosis of early syphilis was confirmed by rapid plasma regain (RPR) and TP hemagglutination (TPHA) tests.

RESULTSAmong the 25 cases studied, 20 showed neutrophil infiltration, microabscess formation and plasma cell infiltration in the lamina propria. Endothelial swelling of small blood vessels and syphilitic vasculitis was also seen. Tonsillar ulcers associated with abundant plasma cells, lymphocytes and histiocytes were noted in 14 cases. One of which demonstrated florid reactive lymphoid proliferation, with transforming lymphoid cells of various stages identified. Pseudoneoplastic squamous cell proliferation was seen in one case. Spirochetes were detected by modified Warthin-Starry stain in mucosal microabscesses and squamous epithelium in 20 cases, around small blood vessels in 5 cases, and on the surface of tonsillar ulcers in 14 cases. Abundant TP were also found in smears of exudates in 6 cases. TP antigen was detected in 4 cases by immunohistochemical staining. All the 25 cases studied were RPR (1:8 to 128) and TPHA-positive.

CONCLUSIONSEarly syphilis involving nasal cavity and oropharynx has distinctive pathologic features. Detailed histologic examination, together with modified Warthin-Starry stain for demonstration of spirochetes, is important to obtain a correct diagnosis.

Adult ; Aged ; Diagnosis, Differential ; Female ; Humans ; Male ; Middle Aged ; Nasal Cavity ; microbiology ; pathology ; Nasal Mucosa ; microbiology ; pathology ; Nose Diseases ; microbiology ; pathology ; Palatine Tonsil ; microbiology ; pathology ; Pharyngeal Diseases ; microbiology ; pathology ; Syphilis ; microbiology ; pathology ; Syphilis Serodiagnosis ; Treponema pallidum ; isolation & purification ; Young Adult

Adult ; Endoscopy ; Female ; Fungi ; Humans ; Male ; Middle Aged ; Nose ; surgery ; Sinusitis ; microbiology ; surgery

The patient presented with right nasal obstruction, purulent secretion in nasal meatus and dull headache for 3 years. A dark brown mass, irregular in shape, surface roughness and purulent secretion adherent, was seen in the nose, touched as coal tar stone. CT examination showed high density in the right nasal meatus. Postoperative pathological examination proved to be rhinolith and actinomycosis.
Actinomycosis ; complications ; Calculi ; Humans ; Male ; Nose Diseases ; complications ; microbiology ; Young Adult

OBJECTIVETo investigate the genotypic diversity of Methicillin-resistant Staphylococcus aureus (MRSA) isolated from pigs and retail foods from different geographical areas in China and further to study the routes and rates of transmission of this pathogen from animals to food.

METHODSSeventy-one MRSA isolates were obtained from pigs and retail foods and then characterized by multi-locus sequencing typing (MLST), spa typing, multiple-locus variable number of tandem repeat analysis (MLVA), pulsed-field gel electrophoresis (PFGE), and antimicrobial susceptibility testing.

RESULTSAll isolated MRSA exhibited multi-drug resistance (MDR). Greater diversity was found in food-associated MRSA (7 STs, 8 spa types, and 10 MLVA patterns) compared to pig-associated MRSA (3 STs, 1 spa type, and 6 MLVA patterns). PFGE patterns were more diverse for pig-associated MRSA than those of food-associated isolates (40 vs. 11 pulse types). Among the pig-associated isolates, CC9-ST9-t899-MC2236 was the most prevalent clone (96.4%), and CC9-ST9-t437-MC621 (20.0%) was the predominant clone among the food-associated isolates. The CC9-ST9 isolates showed significantly higher antimicrobial resistance than other clones. Interestingly, CC398-ST398-t034 clone was identified from both pig- and food-associated isolates. Of note, some community- and hospital-associated MRSA strains (t030, t172, t1244, and t4549) were also identified as food-associated isolates.

CONCLUSIONCC9-ST9-t899-MC2236-MDR was the most predominant clone in pigs, but significant genetic diversity was observed in food-associated MRSA. Our results demonstrate the great need for improved surveillance of MRSA in livestock and food and effective prevention strategies to limit MDR-MRSA infections in China.

Animals ; Anti-Bacterial Agents ; pharmacology ; China ; Food Microbiology ; Humans ; Methicillin ; pharmacology ; Methicillin Resistance ; Methicillin-Resistant Staphylococcus aureus ; genetics ; isolation & purification ; Nose ; microbiology ; Swine ; microbiology

Antigens, CD ; metabolism ; Antigens, Differentiation, Myelomonocytic ; metabolism ; Face ; microbiology ; Female ; Humans ; Middle Aged ; Mycobacterium avium Complex ; isolation & purification ; Mycobacterium avium-intracellulare Infection ; metabolism ; microbiology ; pathology ; Nasal Cavity ; microbiology ; Nose Diseases ; metabolism ; microbiology ; pathology ; Vimentin ; metabolism