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 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

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

Rhinocerebral mucormycosis (RCM) is a rare, fulminant fungal infection that usually occurs in diabetic or immunocompromised patients. The mortality rate has been reduced recently with the advent of amphotericin B combined with aggressive surgery. Eleven RCM patients have been treated over the past five years at Srinagarind Hospital. Eight had underlying diabetes, five had renal failure and three of them had both. In eight patients, the diagnosis was established by KOH preparation before histological confirmation. Only two cases revealed positive cultures for Rhizopus spp and Cunninghamella spp. All patients underwent surgical treatments (extensive debridement, 8 cases; sphenoidectomy, 7 cases; ethmoidectomy 8 cases; maxillectomy 5 cases and orbital exenteration, 6 cases). Amphotericin B was administered to all patients as soon as the diagnosis of RCM was made. Only three patients survived. Early diagnosis and cooperation among ophthalmologist, otolaryngologist and physician are the most important factors for the survival of patients with mucormycosis.
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PMID:Rhinocerebral mucormycosis: a report of eleven cases. 194 90

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

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

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

Rhinocerebral mucormycosis is a fulminating, devastating fungal disease, usually associated with debilitating diseases such as diabetes mellitus, leukaemia and immunosuppressive conditions. Ten patients with this rare disease have been treated over the past 14 years at the Beilinson Medical Centre. Nine patients had an underlying debilitating disease and one patient had latent diabetes mellitus which was diagnosed only after presentation of mucormycosis. Only two of the 10 patients survived. Early aggressive surgical debridement, together with amphotericin B and correction of underlying metabolic acidosis were found to be important factors associated with survival.
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PMID:Mucormycosis: experience with 10 patients. 854 76

Rhinocerebral mucormycosis is a well-described fulminant fungal infection that typically presents acutely in patients with diabetic ketoacidosis or immunosuppression. Chronic presentations of rhinocerebral mucormycosis have also been described. In the chronic infection, the disease course is indolent and slowly progressive, often occurring over weeks to months. The authors report 2 cases of chronic rhinocerebral mucormycosis (CRM) treated at their institution and review 16 other cases reported in the English-language literature. In these cases, the median time from symptom onset to diagnosis was 7 months. The most common presenting features of CRM are ophthalmologic and include ptosis, proptosis, visual loss, and ophthalmoplegia. CRM occurs predominantly in patients with diabetes and ketoacidosis. The incidence of internal carotid artery and cavernous sinus thrombosis is higher in CRM patients than in those with the acute disease, although the overall survival rate for CRM patients is 83%. CRM is clinically distinct from chronic Entomophthorales infection.
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PMID:Chronic rhinocerebral mucormycosis. 884 4

We analysed retrospectively our clinical experience with 36 cases of mucormycosis. They were seen during the last 15 years. The diagnosis suspected on clinical grounds, was confirmed in 31 cases by finding the hyphae in hematoxylin-eosin stained material obtained from aspirated or tissue biopsy or by isolation of the fungus in culture. Rhinocerebral mucormycosis was diagnosed in 22 patients. Diabetes was the underlying disorder in 20 cases, kidney failure in one and myelodysplastic syndrome in one. Nine had stable and 11 unstable diabetes (ketoacidosis in 10 and hyperosmolar coma in 1). The earliest sign was facial edema, followed by proptosis, chemosis and extraocular muscle paresis. They were treated by extensive surgical debridement, insulin and antifungal drugs with 69% of survival rate. The disseminated mucormycosis was diagnosed at the autopsy in 5 cases, acute leukemia was the underlying disease in 2 of them. Pulmonary mucormycosis was diagnosed in 2 cases, cutaneous form in 2, sinuorbital form in 4 and brain abscess in one patient. Eight of these 9 cases survived after therapy. We emphasize the importance of an early diagnosis. This can only be made in the presence of a typical clinical setting confirmed by finding the hyphae in tissue or culture. Antifungal drugs along with treatment of the underlying disorder and aggressive surgical debridement must follow.
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PMID:Rhinocerebral and systemic mucormycosis. Clinical experience with 36 cases. 898 Dec 94

Mucormycosis refers to a group of rapidly progressive infections caused by fungi belonging to the order Mucorales. Infection most often develops in individuals with immunological or metabolic compromise, although patients without underlying abnormalities have been affected. Specific clinical manifestations are associated with various predisposing factors. Rhinocerebral mucormycosis is the most common form and most frequently develops in individuals with poorly controlled diabetes mellitus. The extent of anatomical involvement and clinical course are unpredictable, depending on the intrinsic factors of the host. Over the past 20 years the prognosis for patients with rhinocerebral mucormycosis, once considered to be a uniformly fatal disease, has improved. Coordinated medical and surgical treatment, including rapid diagnosis, the advent of systemic antifungal agents, aggressive surgical debridement, and control of the underlying disease process, have been credited with its successful management. The range of survival rates recorded with the regimen of combined therapies is wide because the number of patients reported is limited and anatomical involvement is diverse. Survival with intracerebral abscess is rare. The authors describe the successful management of a patient who developed a bifrontal fungal abscess during treatment for rhinocerebral mucormycosis associated with ketoacidosis and diabetes mellitus. The patient remains without radiographic or clinical evidence of infection more than 2 years after treatment. The authors review the characteristic clinical, radiographic, and pathological features of previously reported infections and emphasize the importance of early detection and aggressive treatment in the management of this frequently fulminant and fatal disease.
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PMID:Long-term survival in rhinocerebral mucormycosis. Case report. 948 14


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