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 277,896 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Cunninghamella, a zygomycete in the order Mucorales, is an extremely rare cause of human infection. Of the five reported cases of human disease caused by this fungus, none involved rhinocerebral infection. Here, the authors document what appears to be the first case of rhinocerebral mucormycosis caused by Cunninghamella bertholletiae in an elderly man who had diabetes with sideroblastic anemia and hemochromatosis. The disease was rapidly fatal. The mycology and classification of this organism are presented, and the previous case reports in the literature are reviewed.
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PMID:Cunninghamella: a newly recognized cause of rhinocerebral mucormycosis. 685 71

Rhinocerebral mucormycosis is a virulent, rapidly progressive, potentially fatal illness which demands early diagnosis and aggressive medical and possible surgical therapy. Although most commonly reported in persons with poorly controlled diabetes, it may occur in other immunosuppressed hosts. In persons with leukemia the disease has been uniformly fatal. A well-documented case of fatal rhinocerebral mucormycosis in a leukemic patient is presented to illustrate the diagnostic and therapeutic dilemmas often faced. A review of the 233 cases thus far reported in the literature is used as a spring-board for a discussion of the pathogenesis, diagnosis, and management of this disease.
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PMID:Mucormycosis in leukemia. 695 24

Most physicians believe that diabetic individuals are predisposed to infections and that infection complicates the control of the diabetes. However, only bacteriuria can be documented to occur with increased frequency in diabetic compared with nondiabetic patients. Although most bacteriuric diabetic patients are asymptomatic, severe infections such as emphysematous pyelonephritis, papillary necrosis, perinephric abscess, and candida pyelonephritis may occur. Tuberculosis, once a proven threat to diabetic individuals, is a less serious problem now that effective screening and chemoprophylaxis programs have been initiated. Several unusual infections such as malignant external otitis, rhinocerebral mucormycosis, emphysematous pyelonephritis, and emphysematous cholecystitis occur also exclusively in diabetics. Foot infections are very important in diabetic patients; successful treatment requires accurate assessment of the extent and etiology of the infections and often involves surgery as well as broad antibiotic coverage. The important problem of infection in diabetic patients deserves careful evaluation. Questions such as do diabetic individuals have a higher incidence of infection, why are diabetic patients predisposed to infection, why is necrosis common in several of the infections, what is the course of asymptomatic bacteriuria, who do diabetic patients develop foot infections, and how should foot infections be prevented and treated should be topics of clinical investigation.
Diabetes Care
PMID:Infection and diabetes mellitus. 699 64

Mucormycosis of the temporal bone is described in a 60-year-old female with uncontrolled diabetes mellitus whose symptoms related to cranial nerve palsies and hearing loss, following spread of infection from the nasopharynx. The infection spread along the eustachian tube and tensor tympani muscle to the base of the skull, involving the internal carotid artery with mycotic thrombosis and rupture. Subsequent spread occurred from this area predominantly along nerve pathways and as mycotic emboli in blood vessels of the labyrinth and middle ear. Infection also spread from the anterior middle ear wall through the oval window into the vestibule. The temporal bone changes were those of granulomatous inflammation with necrosis and ischemic infarction.
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PMID:Mucormycosis of the temporal bone. 707 74

Five patients with mucormycosis of the heart are described. Two had leukemia,, one had multiple myeloma, one sideroblastic anemia, and one had been wounded when a body trap exploded. None had diabetes. In addition to heart involvement, each had mucormycosis of the lungs. Kidney was infected in two patients and gastrointestinal tract, spleen, liver, adrenal, brain, and skin were each involved in one patient. Three patients had cardiac symptoms. The findings in ten previously reported patients with de novo cardiac mucormycosis and in four patients with mucormycosis occurring in association with cardiovascular surgery are summarized.
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PMID:Cardiac mucormycosis. A report of five patients and review of 14 previously reported cases. 710 6

Mucormycosis is encountered in patients with diabetes mellitus, as well as other debilitating diseases. The fungus is ubiquitous, but only certain types of patients become afflicted with this disease. Early diagnosis, control of the underlying disease, drug therapy, and surgical treatment can save the lives of patients with this infection. One should not be reluctant to think of mucormycosis in a differential diagnosis. Mucormycosis is becoming more frequently diagnosed.
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PMID:Mucormycosis: case presentation and discussion. 712 57

Pulmonary mucormycosis (Phycomycetes) is an uncommon fungus infection complicating diabetes mellitus, leukemia, lymphoma, and other debilitating diseases. A review of the literature revealed that of 21 diabetic patients in whom Phycomycetes occurred without underlying malignancy, only 7 survived. These 7 underwent operation. This report concerns another patient with pulmonary mucormycosis who was successfully treated by pulmonary resection.
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PMID:Pulmonary mucormycosis (Phycomycetes) successfully treated by resection. 735 67

Rhinocerebral mucormycosis is a rare fungus infection reported mainly from the United States of America and Europe. The disease is caused by zygomycete fungi, most often by a Rhizopus species. Diagnosis is often made post-mortem and in many instances culture identification of the fungus responsible has not been performed. A case of culturally proven rhinocerebral mucormycosis is described for the first time in Sri Lanka. The patient was a 56-year-old male who had been treated for diabetes mellitus for 17 years. He had typical symptoms of numbness and loss of sensations over the temporal region, followed by loss of vision and proptosis, all on the right side of his face. The diagnosis of rhinocerebral mucormycosis was confirmed by microscopic examination and culture of material obtained from the retro-orbital space. The patient died before effective antifungal therapy could be instituted.
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PMID:Acute rhinocerebral mucormycosis caused by Rhizopus arrhizus from Sri Lanka. 756 67

Mucormycosis is a rare fungal disease commonly affecting individuals with diabetes mellitus, hematological malignancy, and immune deficiency. Isolated pulmonary mucormycosis is extremely rare. This article reports a case of isolated pulmonary mucormycosis that presented as a solitary cavity infiltrate in a patient with no underlying risk factors.
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PMID:Isolated pulmonary mucormycosis in an apparently normal host: a case report. 767 48

Patients with diabetes mellitus exhibit particular susceptibility to three severe infections of the head and neck: rhinocerebral mucormycosis, postoperative endophthalmitis, and malignant otitis externa. Rhinocerebral mucormycosis is an extensive life-threatening infection beginning in the nasal passages and sinuses and extending often into the orbit and the cerebrum. Endophthalmitis, which is infection of the vitreal contents, can occur secondary to bacteremia, trauma, or postoperatively. Invasive external otitis or malignant otitis externa is an invasive infection beginning in the adjacent soft tissue and into bone. It is usually secondary to Pseudomonas aeruginosa and occurs almost exclusively in diabetics. These will all be discussed in this article.
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PMID:Infections of the head and neck in diabetes mellitus. 776 18


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