Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0011860 (type 2 diabetes)
 57,723 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Sino-orbital aspergillosis in a 61-year-old male with uncontrolled non-insulin dependent diabetes mellitus presented with three months history of left ear pain, left side headache with mucopurulent nasal discharge and one week history of progressive swelling and pain with difficulty in opening of the left eye and sudden loss of vision. In spite of surgical debridement and medical management with amphotericin B and itraconazole his visual outcome was poor and the infection was unabated at one month follow up.
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PMID:Sino-orbital aspergillosis in a diabetic patient. 1668 69

Zygomycosis is a frequently lethal invasive infection in high-risk patients such as the immunocompromised [especially haematopoietic stem cell transplant (HSCT) recipients] and patients with type 2 diabetes mellitus. However, zygomycosis has also been reported in individuals without known risk factors. The causative fungi are members of the order Mucorales and individual species within this group require a high level of laboratory skill for their identification. These organisms are resistant to voriconazole and also to the echinocandins, and although zygomycosis is less commonly documented than invasive aspergillosis in leukaemic and HSCT patients, there are recent reports suggesting that it has increased in incidence since the introduction of voriconazole. Zygomycosis can present clinically as rhinocerebral, pulmonary or disseminated disease which progresses rapidly. The management of cases is based on early diagnosis, surgical debridement when possible and aggressive antifungal therapy. Based on clinical experience, but without the benefit of comparative studies, liposomal amphotericin B has become the therapeutic agent of choice. Posaconazole is a new orally administered triazole antifungal and the first member of this class to have comparable in vitro activity to amphotericin B against most zygomycetes. Studies of salvage therapy of zygomycosis with posaconazole have yielded promising results and there are additional case reports of successful outcomes using these and other antifungal drugs as combination therapy. Adjunctive approaches that are showing promise but with limited clinical experience are iron chelation and immunotherapy.
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PMID:Treatment of zygomycosis: current and new options. 1806 3

Mucormycosis and aspergillosis are the most frequent fungal infections caused by filamentous fungi; coinfection in the same host is rare. We present a case of a 78-year-old male patient with the debut of type 2 diabetes mellitus and ketoacidosis, with swelling of the right side of the face, right facial paralysis, ptosis and a necrotic ulcer in the right palate. Facial Computed tomography showed an abscess of the right maxillary sinus. Cultured secretions revealed Aspergillus fumigatus. The pathology result of biopsies of the palate, maxillary sinus and ethmoid bone was consistent with mucormycosis. The patient was treated with voriconazole, amphotericin B deoxycholate, and surgical debridement of the maxillary sinus. The patient died despite the treatment. The coinfection of Rhinocerebral mucormycosis and aspergillosis should be suspected in immunosuppressed patients in order to establish early management that can permit an improved prognosis of the disease.
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PMID:[Coinfection of rhinocerebral mucormycosis and sinus aspergillosis]. 2673 34

Aspergillus molds are ubiquitous environmental molds that can cause devastating invasive infections in immunocompromised patients. These infections often go unrecognized in critically ill patients. This case describes a 68 year-old female resident of a long-term nursing facility with history of dementia, nonalcoholic fatty liver disease with cirrhosis, chronic kidney disease stage III and insulin-dependent type 2 diabetes who presented with vomiting, diarrhea and leg swelling. She developed hypotension and was treated for sepsis but found to have negative routine infectious workup. Chest imaging showed nodular densities and bilateral opacities. She developed acute renal failure and hypoxic respiratory failure followed by acute decompensated cirrhosis with refractory volume overload and hypotension and was eventually transitioned to comfort care measures. Autopsy ultimately showed invasive pulmonary aspergillosis. Here we review the diagnosis and management of invasive fungal infections in critically ill patients without typical risk factors or clinical findings for invasive fungal disease. Invasive fungal infections are frequently missed and carry high mortality rates, therefore warranting consideration in critically ill populations.
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PMID:Invasive pulmonary aspergillosis in a patient with cirrhosis. 3214 Apr 9

A 68-year-old man with a history of type 2 diabetes mellitus and kidney transplantation on chronic immunosuppression presented with right-sided proptosis and vision loss. He was hospitalized 4 months prior for invasive sinus aspergillosis. MRI revealed abnormal enhancement in the right orbital apex, inferior medial right orbit, anterior cranial fossa floor, and anterior aspect of the falx cerebri. The patient was successfully managed with extensive sinus surgery, bifrontal craniotomy with resection of dura, cribriform plate resection, and a right orbital apex exenteration. The globe and anterior orbital structures were preserved to cover the large surgical sinodural-orbital defect and avoid complex reconstructive surgery. Orbital perfusion was maintained by exploiting the robust anastomoses between branches of external carotid and ophthalmic artery.
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PMID:Ocular Perfusion Following Orbital Apex Exenteration. 3289 Jan 18

Diabetic patients have an increased risk of invasive aspergillosis (IA), but the mechanism is still unclear. Reactive oxygen species (ROS) produced by neutrophils play a key role in defense against Aspergillus infection. Since diabetes mellitus affects the production of ROS from neutrophils, the purpose of this study is to investigate whether this effect is related to the susceptibility of diabetic mice to IA. C57BL/6 mice were used to establish type 2 diabetes mellitus (T2DM) model, and IA was induced by airway infection with Aspergillus fumigatus. After infection, the fungal load, neutrophil count and ROS content in the lung tissues of T2DM mice were higher than those in the control mice, and the inflammation of the lung tissue was more serious. After being exposed to hyphae in vitro, compared with the control group, neutrophils in T2DM mice had higher apoptosis rate and intracellular ROS content, as well as lower viability, extracellular ROS content and fungicidal ability. In summary, after T2DM mice are infected with A. fumigatus, the reduction of extracellular ROS produced by neutrophils may lead to a decrease in fungicidal ability, while the increase of intracellular ROS is related to neutrophil and lung tissue damage.
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PMID:Different roles of intracellular and extracellular reactive oxygen species of neutrophils in type 2 diabetic mice with invasive aspergillosis. 3296 16