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Query: UMLS:C0011860 (type 2 diabetes)
 57,723 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Rhinocerebral mucormycosis was diagnosed in a 75-year-old woman with a history of type II diabetes mellitus. This rare opportunistic infection is caused by fungi belonging to the order of Mucorales. The patient had a severe osteomyelitis of the base of the skull, resulting in complaints of headache and diplopia. She was treated with intravenous colloidal amphotericin B, surgical excision, and later with liposomal amphotericin B. She died of respiratory failure. Mucormycosis is usually a rapidly fulminant infection. This patient showed a remarkably chronic course.
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PMID:[A patient with chronic mucormycosis]. 146 75

Acquired reactive perforating collagenosis (ARPC) is a rare perforating disease of the skin. It is characterized by hyperkeratotic papules with transepidermal elimination of degenerated material including collagen and elastic fibers. The disease presents clinically as umbilicated papules with a central adherent keratotic plug. Mucormycosis infection, caused by the molds of the class Zygomycetes and order Mucorales, generally occurs as an opportunistic infection. It presents most frequently in patients with diabetes mellitus, in patients with leukemia receiving chemotherapy, and in those on sustained immunosuppressive therapy. We describe a patient with type 2 diabetes mellitus and end-stage renal disease requiring hemodialysis in whom extensive cutaneous mucormycosis with secondary spread to the brain, lumbar spine, and breast developed in the setting of ARPC. To our knowledge, this is the first case report of a patient with ARPC who developed extensive cutaneous mucormycosis.
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PMID:Cutaneous mucormycosis secondary to acquired reactive perforating collagenosis. 1295 34

The object of this review is to provide the definitions and criteria for diabetic ketoacidosis (DKA) and the hyperglycemic hyperosmolar state (HHS), and convey current knowledge of the causes of permanent disability or mortality from complications of these conditions, of the risk factors for DKA and HHS, and of early indicators and contemporary treatment of suspected cerebral edema. The frequency of DKA at onset of type 1 diabetes mellitus (DM1) varies from 10-70%, depending on availability of health care and frequency of diabetes. At the onset of type 2 diabetes (DM2), DKA occurs in 5-52%. One study reported HHS in approximately 4% of new patients with DM2. Recurrent DKA rates are equally dependent on variability in medical services and socio-economic circumstances, and are estimated to be eight episodes per 100 patient years, with 20% of patients accounting for 80% of the episodes. Mortality for each episode of DKA internationally varies from 0.15-0.31%, with idiopathic cerebral edema accounting for two-thirds or more of this mortality. Other causes of death or disability include untreated DKA or HHS, hypokalemia, hypophosphatemia, hypoglycemia, other intracerebral complications, peripheral venous thrombosis, mucormycosis, rhabdomyolysis, acute pancreatitis, acute renal failure, sepsis, aspiration pneumonia, and other pulmonary complications. Population-based studies from the UK, Australia, the USA, and Canada report cerebral edema incidence in DKA of 0.5-2.0%. Published information does not support the notion that treatment factors are causal in cerebral edema. Younger age, greater severity of acidosis, degree of hypocapnia, and severity of dehydration have been suggested as risk factors in several studies. Bimodal distribution of the time of onset of cerebral edema and wide variation in brain imaging findings suggest the variability and likely multiple causation of the clinical picture. Functional brain scanning has indicated that DKA is accompanied by increased cerebral blood flow suggesting that the predominant mechanism of edema formation is a vasogenic process. A method of monitoring for diagnostic and major and minor signs of cerebral edema has been proposed and tested which indicates that intervention will be required in five individuals to provide early intervention for a single case of cerebral edema. The preferred intervention of mannitol infusion has typically been accompanied by intubation and hyperventilation, but recent evidence indicates outcome is adversely affected by aggressive hyperventilation. The prevention of DKA and HHS at the onset of diabetes mellitus requires a high degree of awareness and suspicion by primary care providers; prevention of recurrent DKA necessitates a diligent team effort.
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PMID:Hyperglycemic crises and their complications in children. 1731 23

Mucormycosis is a rare opportunistic fungal infection in renal transplant recipients which is associated with exceedingly high mortality when inadequately treated. Risk factors for this infection include diabetes, neutropaenia and immunosuppression. We report a case of pulmonary mucormycosis in a renal allograft recipient with type 2 diabetes and limited pulmonary reserve. The patient was successfully treated with lobectomy and liposomal amphotericin B with preservation of pulmonary and allograft functions. Early recognition of this infection is warranted before dissemination, which carries a poor prognosis.
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PMID:Successful treatment of pulmonary mucormycosis in a renal transplant recipient with limited pulmonary reserve by combined medical and surgical therapy. 1829 17

Rhinocerebral mucormycosis is an invasive fungal sinusitis with a high mortality rate, especially in immunocompromised patients. A 70-year-old woman, with uncontrolled type 2 diabetes mellitus, presented with a one-month history of non-specific headaches associated with progressive swelling of her left eye. Computed tomography of the brain and orbits showed the extensive involvement of bilateral intranasal sinuses, orbits, extraocular muscle and soft tissues. The diagnosis of invasive mucormycosis was confirmed from a tissue biopsy taken from the internasal septum. Despite the extensive mucormycosis invasion, she was successfully treated with intranasal and systemic amphotericin B and minimal adjunctive intranasal sphenoidotomy.
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PMID:Invasive rhinocerebral mucormycosis with orbital extension in poorly- controlled diabetes mellitus. 1935 53

Four successive cases of rhino-occulo-cerebral mucormycosis [ROCM] in patients suffering from type 2 diabetes mellitus are described. The clinical presentation is given in details. The need for high degree of suspicion, prompt diagnosis and complete surgical evacuation of inflammatory mass; and prompt initiation of antifungal therapy is discussed. The side effects associated with amphoterecin and issue regarding its total dosage is discussed.
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PMID:Rhino-occulo-cerebral mucormycosis in patients with type 2 diabetes mellitus. 1963 90

Sinonasal mucormycosis is a rare, life-threatening and insidious fungal infection. Uncontrolled diabetes mellitus and immunsupression are the most important risk factors. The infection is clinically characterized by black necrotic tissues and crusting in the nasal cavity. In acute fulminant rhinosinusitis and particularly in infections caused by mucor species, black scar tissues seen on the nasal mucosa are pathognomonic. High level of suspicion in the risk group the diagnosis is confirmed by histopathological examination. The rhinoorbital form is even rarer and the findings may range from orbital pain to ophtalmoplegia and blindness. In this report we present a 72-year-old female patient with uncontrolled type 2 diabetes mellitus who was admited with the complaints of exophtalmos in the left eye, diplopia and headache. In the physical examination there was purulent discharge in the middle meatus and left orbital abscess was detected on computed tomography. We performed an emergency endoscopic sinus surgery. While we did not observe any necrotic tissues, granulation tissues were detected and pus was drained from the orbital cavity. The result of the histopathological examination was reported as invasive mucormycosis. We presented this case to emphasize the importance of early diagnosis and treatment of rhinoorbital mucormycosis.
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PMID:[Rhino-orbital mucormycosis with orbital abscess: a case report]. 2141 75

We identified the etiological agents responsible for two fatal cases of rhinocerebral mucormycosis with the classical risk factor for uncontrolled type II diabetes mellitus. Their initial symptoms did not point immediately to the suspicion of mucormycosis. Case 1, caused by Rhizopus microsporus var. oligosporus, was a 52-year-old man who presented with a painful pimple on his nose, which evolved with swelling, erythema, and a central pustule on his right hemiface suspected to be cellulitis. After 7 days of antibiotic treatment, the patient worsened with signs of sepsis and the lesion evolved to necrosis involving all his right face. Case 2, caused by Rhizopus microsporus var. rhizopodiformis, was a 57-year-old woman placed on continuous therapy with azathioprine and corticoids after a renal transplant due to chronic arterial hypertension and uncontrolled type II diabetes mellitus. Because she was suspected to have sepsis, the patient was treated with broad-spectrum antibiotics and mechanical ventilation, yet she deteriorated. Because Candida spp. were isolated from urine and a BAL, she was treated with fluconazole for 10 days, then substituted by caspofungin. Two weeks later, she presented with exophthalmus of the left eye that was surrounded by a large inflammatory and necrotic area. Both patients were the diagnosed with mucormycosis via direct microscopy of necrotic material prior to their death.
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PMID:Mucormycosis in Mato Grosso, Brazil: a case reports, caused by Rhizopus microsporus var. oligosporus and Rhizopus microsporus var. rhizopodiformis. 2195 35

Mucormycosis is a life threatening condition caused by invasion of fungi of the order Mucorales. Gastrointestinal invasion is very rare and often lethal, particularly in disseminated mucormycosis. We present the case of a 26-year-old woman from North Africa with type 2 diabetes who, after a cholecystectomy, developed unexplained septic shock and haematemesis due to gastric necrosis. Computed tomography (CT) revealed a disseminated fungal invasion of the lungs, kidney and paranasal sinuses. A gastrectomy and subsequent amphotericin B treatment resolved her condition. The number of patients with mucormycosis is increasing. Early diagnosis of high risk patients with CT and biopsies from which fungi are directly isolated must be followed by surgery and systemic amphotericin B infusion.
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PMID:The role of surgery in a case of diffuse mucormycosis with haematemesis and gastric necrosis. 2499 11

Diabetes mellitus is the most common predisposing condition for mucormycosis, which is emerging as an important invasive fungal infection worldwide. Isolated mediastinitis is a very rare presentation of mucormycosis. A 57-year-old woman with uncontrolled type 2 diabetes mellitus and ketoacidosis presented with septic shock and was subsequently found to have mucor mediastinitis with multiple bronchial perforations. The organism was identified as Rhizopus oryzae with the help of DNA sequencing.
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PMID:Mediastinitis and Bronchial Perforations Due to Mucormycosis. 2634 93


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