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

A case of paranasal sinus mucormycosis in an immunocompetent patient is reported. After an extensive evaluation, no evidence of either diabetes mellitus or underlying immunologic abnormality was found. The combination of excisional surgery and amphotericin B therapy resulted in an excellent response. High-resolution axial and coronal computed tomography was useful in both planning treatment and monitoring the response to therapy.
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PMID:Paranasal sinus mucormycosis in an immunologically competent host. 408 81

We report a new case of cutaneous mucormycosis in a diabetic woman. The major favouring circumstances are found in this patient: ketoacidosis diabetes, use of bandages, local corticosteroid applications, renal insufficiency. The diagnosis, rarely made on the clinical aspect, is based on the histological and mycological data. A trial of treatment by ketoconazole has been carried out, but without success. The usual treatment by intravenous amphotericine B has been successful.
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PMID:[Cutaneous mucormycosis in a diabetic woman. Diagnostic and therapeutic problems]. 609 79

We report a case of rhinocerebral mucormycosis in a patient with poorly controlled diabetes mellitus. The pathology, clinical features, diagnosis and treatment of this disorder are discussed.
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PMID:Rhinocerebral mucormycosis complicating poorly controlled diabetes mellitus: case report. 657 26

Mucormycosis is an often-fatal opportunistic fungal infection caused by members of the class Zygomycetes (Phycomycetes), order Mucorales. Most cases are diagnosed by histologic examination, through the identification of mucormycotic hyphae in infected tissues. Chronic debilitating conditions accompanied by acidosis such as diabetes mellitus, as well as leukemia, lymphoma, and immunodeficient states, predispose to the development of this type of opportunistic infection. This report describes a hitherto undescribed finding, the presence of structures consistent with sporangia in tissue sections, in a case of pulmonary mucormycosis occurring in a nondiabetic patient with metabolic acidosis secondary to chronic salicylate poisoning.
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PMID:Pulmonary mucormycosis as a complication of chronic salicylate poisoning. 662 16

Mucormycosis is the most acutely fatal fungus infection of man. The disease causes a characteristic pattern of clinical symptoms and signs, prompt recognition of which will permit immediate institution of antifungal therapy. Personal experience with 16 cases of the rhino-orbitocerebral form of mucormycosis is the basis of this report. The first of these patients was seen in 1959, and the last in 1981. All of the patients had one or more preexisting diseases, as follows: (1) diabetes mellitus, 13; (2) acute leukemia, 3; (3) terminal carcinomatosis, 1; and (4) chronic sinusitis, 1. The most common initial symptoms and signs were sinusitis, pharyngitis, nasal discharge, and orbital/periorbital pain. Proptosis and formation of a black eschar were only seldom among the initially apparent features. Hyphas were demonstrated in tissue sections in 14 of the 16 patients in whom biopsy was done. Rhizopus species were cultured in 11 of the 13 patients from whom material for culture had been obtained clinically. Five of the 16 patients survived. All of them had been treated with surgical debridement and with intravenous amphotericin B.
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PMID:Diagnosis and management of rhino-orbitocerebral mucormycosis (phycomycosis). A report of 16 personally observed cases. 664 48

To assess the influence of diabetes mellitus in predisposing to pulmonary mucormycosis, a murine model of streptozotocin-induced diabetes was used. Intranasal inoculation of Rhizopus oryzae into diabetic mice resulted in mucormycotic infection with histopathology resembling pulmonary mucormycosis observed in humans. There was no mortality nor infection in inoculated normal mice. Diabetic mice had fatal infections caused by R. oryzae but significantly reduced mortality following inoculation with Aspergillus fumigatus. These findings reflect the specific enhanced susceptibility to mucormycosis observed in human diabetics. Normal bronchoalveolar macrophages formed part of an efficient defense against R. oryzae by inhibiting germination, the critical step in the conversion of R. oryzae to its tissue invasive phase. Bronchoalveolar macrophages inhibited spore germination in vitro and appeared to help prevent germination in vivo. In contrast, spore germination occurred in diabetic mice following intranasal inoculation. Diabetic bronchoalveolar macrophages had a decreased ability to attach to hyphae. In diabetic mice, bronchoalveolar macrophages could damage spores or hyphae of R. oryzae, but serum factors appeared to both promote spore germination and impair attachment of macrophages to spores. This murine model of diabetes mellitus provides an opportunity for evaluation of the relative importance of cell and serum-mediated host factors in the pathogenesis of mucormycosis.
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PMID:Specific susceptibility to mucormycosis in murine diabetes and bronchoalveolar macrophage defense against Rhizopus. 673 46

Three classes of important mycoses in O.R.L. field can be recognized according to the responsible fungi and to thier physiopathology: 1) mycoses due to cosmopolite, opportunistic fungi, yeast-like fungi (Candida albicans, Cryptococcus neoformans, Torulopsis glabrata) or filamentous fungi (Aspergillaceae, Mucoraceae, Penicillia, etc...) invading a compromised host by antibiotics, immunosuppressors, radiotherapy or by severe diseases (hemopathia, diabetes with acidosis). The oropharyngolaryngeal candidosis, the black tongue (a polyfungal syndrome), the sinusal aspergillosis, the otomycoses, the nasalorbital cerebral form of mucormycosis are reviewed and the allergic accompanying symptoms described. 2) deep, systemic mycoses of tropical origin with respiratory entry and oral pharyngeal laryngeal metastatic localizations (histoplasmosis, blastomycosis, paracoccidioidomycosis, coccidioimycosis); the histoplasmosis represent actually the principal imported systemic mycosis with O.R.L. localization. 3) tropical and african mycosis localized exclusively in O.R.L. area (rhino-enthomophtoromycosis and rhinosporidosis).
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PMID:[Panorama of mycoses in otorhinolaryngology]. 676 Jul 73

The defect in host defense that makes the diabetic ketoacidotic (DKA) patient susceptible to mucormycosis has not been identified. Sera from 10 DKA patients and three normal volunteers were tested for their capacity to support the in vitro growth of a common etiologic agent of mucormycosis, Rhizopus oryzae. After equilibration with room air none of the normal or DKA sera, each of which was now extremely alkaline, supported growth of R. oryzae. When the sera were placed in a CO2 atmosphere that permitted simulation of the in vivo clinical pH (normal 7.40 and DKA 7.3-6.6), four of seven DKA sera supported profuse fungal growth. No growth occurred in normal serum. The three DKA sera that did not support fungal growth at pH less than or equal to 7.3 contained less iron (x = 13 micrograms/dl) than the four sera that supported profuse fungal growth (x = 69 micrograms/dl). Increasing the iron content of iron-poor DKA serum that did not support R. oryzae growth allowed profuse growth at acidotic conditions but not at pH greater than or equal to 7.4. Simulated acidotic conditions (pH 7.3-6.6) also decreased the iron-binding capacity of normal serum stepwise from 266 micrograms/dl to 0. Our data indicate that acidosis temporarily disrupts the capacity of transferrin to bind iron and suggest that this alteration abolishes an important host defense mechanism that permits growth of R. oryzae.
Diabetes 1982 Dec
PMID:A mechanism of susceptibility to mucormycosis in diabetic ketoacidosis: transferrin and iron availability. 681 46

A case of extensive rhinocerebral mucormycosis, with associated bilateral brain abscesses, occurred in a man with diabetes. A Rhizopus sp grew from the initial nasal biopsy specimens. Successful therapy consisted of correcting metabolic acidosis, using serial computed tomographic (CT) scans to follow the progressive course of brain involvement from cerebritis to encapsulated abscesses, and performing successive biopsies to determine the adequacy of treatment. On 18-month follow-up, the patient had returned to full-time employment with minimal neurologic impairment. With CT scanning and aggressive therapy, rhinocerebral mucormycosis with bilateral brain involvement can be cured.
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PMID:Successful therapy for rhinocerebral mucormycosis with associated bilateral brain abscesses. 683 Mar 95

Two cases of rhinocerebral mucormycosis are reported to draw attention to this fulminating fungal disease. Both patients had diabetes, and presented with a rapidly progressive orbital apex syndrome.
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PMID:Rhinocerebral mucormycosis. 683 31


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