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Query: UMLS:C0011849 (diabetes)
 277,896 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Rhinocerebral mucormycosis is a short-term and often rapidly lethal fungal disease. It is generally seen in uncontrolled cases of diabetes with ketoacidosis. This case exhibits many of the features of a typical fulminating rhinocerebral mucormycosis. However, the fatal complications of acute subdural hematoma and massive intracerebral hemorrhage due to rupture of aneurysm, as demonstrated by angiography, are unique clinical manifestations of patients with rhinocerebral mucormycosis.
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PMID:Acute subdural hematoma and intracerebral hemorrhage. Rare complications of rhinocerebral mucormycosis. 10 35

Mucormycosis is a very serious complication of debilitating diseases, and particularly of diabetes. Presently the treatment of choice is amphotericine B. A patient is described who, like most other renal transplant patients with mucormycosis, had cranial localization of this disease and diabetes. The clinical findings were classical and the diagnosis was confirmed histologically.
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PMID:[Cranial mucormycosis in a patient with a transplanted kidney]. 33 72

A case of mucormycosis in a 45 year-old woman with uncontrolled diabetes is reported. Following dental extractions, the patient presented with total ophthalmoplegia, chemosis and complete sensory loss of the right fifth cranial nerve. Exophthalmus was not present. Although a fungal infection was suspected, administration of Amphotericin B was avoided because of renal insufficiency. After temporary clinical improvement with high doses of antibiotics, signs of right seventh and eighth cranial nerve paralysis and of thrombosis of the right ophthalmic artery developed. The patient expired after six days. Autopsy disclosed extensive mucormycosis with involvement of the nasal cavity and paranasal sinuses, soft tissues and bones of face and orbit, cranial nerves, meninges and base of the brain, as well as mycotic thrombosis of the right cavernous sinus and the internal carotid, ophthalmic and maxillary arteries. The spread of infection is detailed, and the importance of an early diagnosis is stressed.
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PMID:[Cranial mucormycosis with thrombosis of the sinus cavernosus (author's transl)]. 42 1

The diagnosis of rhinocerebral mucormycosis is most often made at autopsy. We report a series of nine patients in whom the diagnosis was established premortem. Six of the patients had underlying diabetes mellitus and three had acute leukemia. Facial or ocular pain was the complaint found in all patients, and frequently was the initial symptom. The diagnosis was established by examination and culture of infected tissue obtained by biopsy. In seven patients, identification of hyphal elements in smears of biopsy material allowed the immediate institution of amphotericin B therapy. Four of the seven patients treated with amphotericin B survived. All surviving patients had underlying diabetes mellitus and had undergone surgical debridement. Early diagnosis leading to immediate institution of appropriate therapy is most important for survival of patients with mucormycosis.
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PMID:Rhinocerebral mucormycosis: premortem diagnosis and therapy. 44 50

Mucormycoses are rare, acute infections, most often fatal, occurring usually in a host with decreased immunity. The agents are ubiquitous fungi belonging to the Mucoraceae family, an ordinary saprophyte becoming pathogenous in patients with a severe disease (malignant hemopathy, diabetes) or treated by immunosuppressive drugs. Pulmonary localizations remained exceptional (128 cases found in the literature). The observations reported draws its originality from: -- the etiological circumstances: an aged patient with no hemopathy or diabetes, without immunosuppressive treatment but undergoing a prolonged antibiotic therapy; -- the clinical signs: discovery on X-ray of excavated infiltrates in a background of a severe infection with a very poor physical condition; -- the diagnosis criteria with the demonstration of the responsible mucor in the sputum, the endobronchial aspiration and transparietal puncture; -- the great efficiency of Amphotericin B at rather small doses. A review of the literature underlines the exceptional character of the cure.
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PMID:[Pulmonary mucormycoses (author's transl)]. 47 72

A 52-year-old man with mild diabetes and acute stem cell leukaemia developed an orbitofacial mucormycosis. Cultures showed the fungus to be Rhizopus oryzae. Vigorous treatment with amphotericin B and other bactericidal and bacteriostatic antibiotics for a concurrent sepsis failed to suppress the infections, and the patient died. On post-mortem examination characteristic haematoxylin-staining, broad, aseptate fungal hyphae were found in the right eye, orbit, and lung. A striking and unusual feature of this case is the presence of brightly birefringent crystals within the severely degenerated eye. These were found by histochemical staining and x-ray diffraction studies to be calcium salts of fatty acids, apparently liberated from necrotic adipose tissue of the orbit.
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PMID:Orbitofacial mucormycosis with unusual pathological features. 50 83

A successfully treated case of mucocutaneous mucormycosis, after dental extractions in a patient with uncontrolled diabetes, has been reported. The pathophysiology of diabetes mellitus that contributes to the development of opportunistic fungal infections and gangrenous ulcerations, in a setting of decreased host resistance, has been discussed with reference to differential diagnosis and management. The consequences of operating on a patient with uncontrolled diabetes are evident.
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PMID:Successful treatment of mucocutaneous mucormycosis after dental extractions in a patient with uncontrolled diabetes. 105 95

Rhinocerebral mucormycosis (phycomycetes), a human fungal disease with oral and perioral findings, has an extremely high morbidity and mortality. The disease is most frequently seen in patients with poorly controlled diabetes. The symptoms, findings, and treatment of rhinocerebral mucormycosis are discussed, and two case histories are presented.
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PMID:Rhinocerebral mucormycosis: diagnosis and treatment. Report of two cases. 105 38

Mucormycosis classically occurs in patients who have uncontrolled diabetes who develop rhinocerebral disease. A fatal case of rhinocerebral infection caused by Rhizopus arrhizus in a 53-year-old man who had received a renal homograft three years previously is reported. Only five similar cases have been documented, all since 1970. Although direct smears of the purulent nasal exudate revealed the presence of numerous Gram-negative bacilli, later identified as Haemophilus influenzae, the diagnosis of mucormycosis was made by demonstrating the typical broad, nonseptate branched hyphae in the necrotic tissue obtained by surgical debridement of the paranasal sinuses. Culture of this material revealed growth of mold-like fungus which, upon direct microscopic examination, showed sporangiophores bearing spherical sporangia arising directly from a cluster of root-like structures of rhizoids. Despite the immediate institution of therapy with amphotericin B postoperatively, the patient died 48 hours later. Subsequently, the Rhizopus isolated was shown to be resistant to both amphotericin B and 5-fluorocytosine. The present case and two others stress the importance of an aggressive diagnostic approach to patients suspected of having mucormycosis, because the usual microbiologic technics are frequently, inexplicably, unsuccessful, and possibly even misleading in this disease.
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PMID:Mucormycosis in a transplant recipient. 109 97

Nine cases of rhinocerebral mucormycosis are reviewed. Eight patients had diabetes and 7 had symptoms related to the orbit. Roentgen analysis of focal bone destruction and uniform mucosal thickening will frequently suggest the diagnosis. Mucormycosis should be suspected in the diabetic patient with destruction of the walls of the bony sinuses, especially when multiple sinus involvement suggests an etiology other than neoplasm.
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PMID:Rhinocerebral mucormycosis. 111 91


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