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

Of 1088 consecutive Ethiopian diabetic patients registered over 9 years 80 (7.4%) were diagnosed at or before age 15 years. There were 48 girls and 32 boys, with mean age of onset of 10.1 years. Diabetes had been present 10 years or less in 62, 11 to 20 years in 15, and more than 20 years in only 2. Twenty-two were rural, 27 had poverty certificates. Twenty-three have known diabetic relatives. The original mode of presentation could not be verified in 16, 7 presented in ketoacidosis, 5 were diagnosed by a diabetic relative, and the rest presented with the rapid onset of classical symptoms. To date, 43 have been ketoacidotic at least once. No pancreatic calcification was seen in 34 abdominal radiographs. Three of 6 newly diagnosed patients tested had islet cell surface antibodies. Three cases, initially suggestive of 'tropical malnutrition diabetes', evolved into typical type 1 diabetes. Serious complicating illnesses were tuberculosis (6), bacterial endocarditis (1) and rhinocerebral mucormycosis (1). Six patients have had metabolic cataracts. Ten patients (12%) have died, 4 of ketoacidosis and 4 of diabetic nephropathy. Childhood diabetes mellitus in Ethiopians is clinically very similar to type 1 diabetes elsewhere.
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PMID:Childhood diabetes mellitus in Ethiopians. 295 Nov 86

Mucormycosis is infrequently encountered in the pediatric population in any of its forms (nasopharyngeal, disseminated, pulmonary, or cutaneous) and generally is associated with the immunocompromised host. We present an adolescent with poorly controlled diabetes mellitus who developed a progressive skin lesion 3 weeks after a motor vehicle accident. Rhizopus species was isolated from the lesion, and the biopsy revealed a fungal vasculopathy. Control of her diabetes, aggressive surgical intervention and a 10-day course of antifungal therapy (amphotericin B) resulted in a favorable outcome. This article illustrates the importance of considering cutaneous fungal infections, especially those in the class zygomycetes, in the diabetic patient with unusual, severe or persistent skin lesions. Early recognition is essential in order to avoid morbidity and mortality from this unusual opportunistic infection.
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PMID:Post-traumatic cutaneous mucormycosis in diabetes mellitus. Short-term antifungal therapy. 305 51

Cunninghamella bertholletiae, an uncommon cause of human infection, has been reported with increasing frequency in recent years. C. bertholletiae belongs to the order Mucorales and produces infections similar to those produced by the other agents of mucormycosis. Infections with this group of organisms have typically been seen either in patients with diabetes mellitus or in those receiving chemotherapy. Recent reports of mucormycosis in dialysis patients receiving deferoxamine for iron or aluminum overload have raised the possibility that deferoxamine therapy is a risk factor for mucormycosis. A case of C. bertholletiae infection in a patient receiving deferoxamine for iron overload unrelated to hemodialysis was investigated in detail, and possible explanations for this patient's infection were assessed.
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PMID:Cunninghamella bertholletiae infection associated with deferoxamine therapy. 306 Sep 47

Pulmonary mucormycosis is an uncommon, but important, opportunistic fungal pneumonia which is often diagnosed post-mortem. This review emphasizes clinical and pathologic characteristics of pulmonary mucormycosis that differentiate this infection from other fungal pneumonias. The most common clinical presentation of pulmonary mucormycosis is a rapidly progressive pneumonia with diffuse infiltrates on chest radiographic examination of a patient with an underlying hematologic malignancy treated with immunosuppressive drugs. Other immunocompromised hosts at risk for pulmonary mucormycosis include patients with diabetes mellitus who may develop a distinctive endobronchial form of this disease. Early consideration of this diagnosis, along with aggressive diagnostic evaluation, are critical to effective therapy and patient survival. While treatment with amphotericin B is the mainstay of therapy for pulmonary mucormycosis, diabetics with endobronchial disease may benefit from early, aggressive surgical resection of the involved lung tissue.
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PMID:Clinical spectrum of pulmonary mucormycosis. 308 Dec 99

A case of diabetic keto-acidosis complicated by rhinocerebral mucormycosis is described. Early diagnosis, control of the diabetes, aggressive surgical debridement, and systemic antifungal therapy resulted in a successful outcome.
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PMID:Rhinocerebral mucormycosis in diabetic keto-acidosis. A case report. 312 Mar 24

A 25-year-old man with juvenile onset diabetes presented with rhinoorbital mucormycosis. He was treated aggressively with orbital extirpation and amphotericin B. Six months later, he presented with posterior fossa extension of the mucormycosis.
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PMID:Rhinocerebral mucormycosis with extension to the posterior fossa: case report. 320 Mar 96

Pulmonary infections can be a major complication of heart transplantation. Bacterial pneumonia has decreased markedly in the last few years among heart recipients receiving cyclosporine as immunosuppressive therapy. Fungal infections of the lung can cause serious problems in the compromised condition of these patients, with several deaths attributed to Aspergillus and Candida. To our knowledge, however, there has been no report of pulmonary mucormycosis in heart transplant recipients. We describe, therefore, a heart transplant patient with insulin-dependent diabetes mellitus who developed serious cavitary pulmonary mucormycosis. Diagnosis was made by transbronchial biopsy, and treatment required both prolonged administration of amphotericin B and surgical resection to effect a cure. The diagnostic problems and therapeutic considerations associated with pulmonary mucormycosis are discussed.
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PMID:Survival of a heart transplant recipient after pulmonary cavitary mucormycosis. 328 87

The therapy of rhinocerebral mucormycosis includes aggressive surgical debridement, administration of high-dose amphotericin B, and control of underlying predisposing conditions, especially diabetes and immunosuppression or immunodeficiency. Hyperbaric oxygen suppresses fungal growth in vitro and has theoretical value in treating mucormycosis because it reduces the tissue hypoxia and acidosis that accompany vascular invasion by the fungus. In a retrospective review of patients at Duke University Medical Center with rhinocerebral mucormycosis, six patients were treated with hyperbaric oxygen and seven cases (involving six patients) were treated without hyperbaric oxygen. All patients received surgical debridement and amphotericin B. Two of six patients receiving hyperbaric oxygen therapy died, and four of seven patients not receiving hyperbaric oxygen therapy died. Adverse effects from hyperbaric oxygen were minimal. Because mucormycosis occurs infrequently, this retrospective review involved a small number of patients. Despite this limitation, adjunctive hyperbaric oxygen appears to be a promising clinical modality for the treatment of rhinocerebral mucormycosis and warrants further investigation.
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PMID:Adjunctive hyperbaric oxygen for treatment of rhinocerebral mucormycosis. 339 82

The authors report the case of 5 1/2 year-old boy with insulin-dependent diabetes mellitus revealed during the induction therapy of an acute leukemia of the mixed type, and who presented with an unusual type of pulmonary fungal infection: mucormycosis. It had a favourable outcome with surgical excision preceded and followed by amphotericin B treatment.
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PMID:[Mucormycosis and diabetes in acute leukemia]. 340 8

Mucormycosis (or zygomycosis) is an opportunistic fungal infection which usually is seen in patients who are immunosuppressed or who have diabetes. It is uncommon in healthy persons and also is uncommon in Australia. We report a case of a 45-year-old, otherwise-healthy man with an indolent lung infection that was caused by Absidia corymbifera, who was cured by a combination of surgical and medical therapy.
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PMID:Pulmonary mucormycosis without underlying systemic disease. 341 78


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