Humans ; Adult ; Mucormycosis ; Leukemia, Myeloid, Acute/complications* ; Acute Disease ; Antifungal Agents

OBJECTIVE: To investigate the clinical features, treatment and prognosis of patients with hematological diseases complicated with mucor infection. METHODS: The risk factors, clinical features, treatment regimen and prognosis of 18 hematological disease patients with mucor infection diagnosed by histopathology in our center from April 2014 to June 2020 were retrospectively analyzed. RESULTS: Thirteen males and five females, with an average age of 30 (13－54) years old, were diagnosed as mucor infection by histopathological examination at the site of infection, including 16 cases of mucor infection alone and 2 cases of mucor + aspergillus mixed infection. There were 12 cases with malignant hematological disease and 6 cases with severe aplastic anemia, all of whom with long-term agranulocytosis, and their clinical manifestations and imaging findings were not specific. The common sites of infection were sinuses and lungs, and some patients showed multiple systemic manifestations. The remission status of hematological diseases and recovery of immune function showed an impact on the prognosis. All the patients were treated with amphotericin B liposome combined with posaconazole, and 15 patients were treated with surgery combined with antifungal drugs, 9 of whom were effective and 6 were ineffective, while intravenous administration in 3 cases was ineffective. CONCLUSION It is difficult to diagnose hematological disease complicated with mucor infection. After early diagnosis, prognosis can be improved by amelioration of primary state and combination of drugs and surgery.
Adolescent ; Adult ; Antifungal Agents/therapeutic use* ; Female ; Hematologic Diseases/complications* ; Humans ; Male ; Middle Aged ; Mucormycosis/drug therapy* ; Prognosis ; Retrospective Studies ; Young Adult

Brain Diseases/etiology* ; Humans ; Leukemia ; Mucormycosis/complications* ; Nose Diseases

Child, Preschool ; Female ; Humans ; Male ; Mucormycosis ; drug therapy ; etiology ; Precursor Cell Lymphoblastic Leukemia-Lymphoma ; complications ; Remission Induction

No abstract available.
Aged, 80 and over ; DNA, Ribosomal/chemistry ; Diabetes Mellitus, Type 2/*complications/diagnosis ; Fatal Outcome ; Humans ; Male ; Mucormycosis/*complications/diagnosis/*microbiology ; Rhizopus/*isolation & purification ; Sequence Analysis, DNA ; Sequence Homology ; Tomography, X-Ray Computed

Peritonitis is a common problem in patients undergoing peritoneal dialysis. However, peritonitis due to Cunninghamella (C.) bertholletiae, a fungus of the class Zygomycetes, is rare. We present a case of fungal peritonitis in a patient on continuous ambulatory peritoneal dialysis due to kidney rejection. Direct examination of the patient's peritoneal fluid showed fungal hyphae, and the culture was identified as C. bertholletiae. A cumulative dose of 1,600 mg fluconazole was given to the patient intraperitoneally over a one-week period. When his condition had stabilised, oral antifungal treatment was administered for two weeks. After removal of the Tenckhoff catheter, the patient was discharged with arteriovenous fistulation for haemodialysis. Zygomycosis due to C. bertholletiae is often fatal and non-responsive to systemic antifungal therapy. This case is the first from India with a successful outcome, and highlights the importance of early detection and intervention for successful outcome of peritonitis caused by C. bertholletiae.
Antifungal Agents ; administration & dosage ; Cunninghamella ; isolation & purification ; Drug Administration Routes ; Fluconazole ; administration & dosage ; Follow-Up Studies ; Graft Rejection ; complications ; Humans ; Kidney Failure, Chronic ; complications ; therapy ; Kidney Transplantation ; Male ; Middle Aged ; Mucormycosis ; drug therapy ; etiology ; microbiology ; Peritoneal Dialysis, Continuous Ambulatory ; adverse effects ; Peritonitis ; drug therapy ; etiology ; microbiology

Adolescent ; Adult ; Aspergillosis ; complications ; microbiology ; Aspergillus ; isolation & purification ; Candida albicans ; isolation & purification ; Candidiasis ; complications ; microbiology ; Female ; Follow-Up Studies ; Granulomatosis with Polyangiitis ; complications ; microbiology ; pathology ; Humans ; Male ; Middle Aged ; Mucor ; isolation & purification ; Mucormycosis ; complications ; microbiology ; Nocardia ; isolation & purification ; Nocardia Infections ; complications ; microbiology ; Retrospective Studies ; Young Adult

PURPOSE: Mucormycosis generally occurs in patients with uncontrolled diabetes mellitus and immunocompromised conditions. It is rare, but once a patient is infected with it, it can occur as a rapidly extending, aggressive, and life-threatening rhinocerebral infection with a high mortality rate. METHODS: A 70-year-old female patient had a 40 years of history of adult onset diabetes mellitus. She presented herself with severe right hemifacial pain, swelling, and weakness for 3 days and was admitted to ENT. On a facial computed tomography(CT) scan, it was found that her infection extended from her inferior temporal scalp to her submental area and involved her submandibular, masseter, prevertebral, parapharyngeal, retropharyngeal, and pharyngeal mucosal space and pansinusitis. Through endoscopic sinus surgery, mucormycosis was confirmed via histologic examination. RESULTS: Despite empiric antibiotics and amphotericin B administration, the patient was in a septic condition and in a coma. The patient's family wanted to withdraw her life support, and the patient expired. CONCLUSION: Mucormycosis is very rare, but is one of the disastrous complications of uncontrolled diabetes mellitus. Suspicion of its occurrence, based on identified risk factors, and its rapid diagnosis can enhance the chance of its cure.
Adult ; Aged ; Amphotericin B ; Anti-Bacterial Agents ; Coma ; Diabetes Complications ; Diabetes Mellitus ; Female ; Humans ; Mucormycosis ; Risk Factors ; Scalp

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

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