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Query: UMLS:C0024141 (systemic lupus erythematosus)
 44,322 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Pulmonary mucormycosis is a rare and almost invariably fatal complication that can occur in the context of severe deficits in host defenses. Antemortem diagnosis is difficult and requires a high index of suspicion together with invasive diagnostic techniques. Mucor species exhibit a pronounced affinity to invade vessels; mucormycosis involving the pulmonary vasculature has rarely been documented antemortem, and survival in this context has been rare. In this report, we describe a patient with chronic renal failure and systemic lupus erythematosus who developed extensive invasion of the left main pulmonary artery by mucormycosis. Chest computed tomographic (CT) scans and pulmonary arteriogram demonstrated a massive pseudoaneurysm of the left pulmonary artery; these radiographic findings have not previously been described in mucormycosis. Aggressive combination therapy, employing preoperative amphotericin B (AmB) followed by surgical resection (pneumonectomy) and a full course of AmB, was curative. This favorable outcome supports the role of surgery as adjunctive therapy, and it underscores the need for early diagnosis and aggressive treatment.
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PMID:Pseudoaneurysm of pulmonary artery in mucormycosis. Radiographic characteristics and management. 848 52

The spectrum of systemic diseases that can involve the nose extends from bacterial and fungal infections to connective tissue disorders. Nasal involvement may be minor and merely an annoyance to the patient, as in systemic lupus erythematosus, or it may pose the risk of life-threatening complications, as in mucormycosis. Although the diagnosis is often readily apparent from characteristic nasal lesions or other systemic manifestations, nasal biopsy may be necessary to positively identify the cause, as in Wegener's granulomatosis. With prompt identification and treatment, nasal involvement in many disorders can be halted before further damage and destruction occur.
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PMID:Nasal manifestations of systemic disease. 647 12

The histopathological examination was performed in search of cerebral mycosis in autopsy cases at our department during the 6 years from 1976 to 1981. The cerebral mycoses were histopathologically verified in seven cases, although brain tissue was examined in only 46% of 528 autopsy cases. All cases of cerebral mycosis showed underlying diseases which were hematologic diseases (5 cases), SLE (1 case), and myocardial infarction with indwelling deep venous lines (1 case). Among these cerebral mycosis, one had double fungal infections with aspergillus and candida, while others were as follows; aspergillosis (2 cases), mucormycosis (2 cases), candidiasis (1 case) and cryptococcosis (1 case). Six cases were not diagnosed antemortem with exception of a case of cryptococcosis. Systemic fungal infections were seen in six cases, however, a case of mucormycosis was without systemic infection. Each cerebral mycosis showed its own characteristic histopathologic findings, namely, hemorrhagic and necrotic lesions in aspergillosis and mucormycosis, scattered minute abscesses or granulomatous lesions in candidiasis, and gelatinous lesions in leptomeninges in cryptococcosis. Severe lymphocytopenia (less than 500/mm3) was always present in all except a case of rhinocerebral mucormycosis. It is emphasized that cerebral mycosis should be always considered when neurological symptoms were clinically observed in patients who had severe underlying diseases and/or deep venous lines with severe lymphocytopenia.
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PMID:[A pathological study on cerebral mycosis]. 696 26

In order to clarify the present state of opportunistic fungal infections increasing in incidence in autopsy cases, all autopsy cases from 1966 to 1975 reported in the Annual of Pathological Autopsy Cases in Japan were reviewed. Of the total 233,130 autopsy cases, mycoses were present in 4,340 (1.86%). The incidence of mycoses has strikingly increased during the recent five-year period. In Japan, the mycoses most frequently occurring in autopsy cases were candidiasis (32.28%), aspergillosis (23.08%), cryptococcosis (9.63%), and mucormycosis (2.90%). These occurred more frequently in younger persons and were most commonly secondary and deep-seated infections (95.78%). Among the primary diseases associated with mycoses, aplastic anemia (14.36%), leukemia (9.89%), malignant lymphoma (5.73%), multiple myeloma (4.68%), and systemic lupus erythematosus (4.62%) were most frequent. The incidence of the primary diseases associated with mycoses is increasing extraordinarily, and this seems to be strongly related to the modern therapy of using high doses of anticancer or immunosuppressive agents.
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PMID:Present state of fungal infections in autopsy cases in Japan. 742 23

This report describes the case of a 42-yr-old woman with systemic lupus erythematosus who presented with septic shock. Initially, a source of infection could not be found and the patient was started on stress dose corticosteroids and antibiotics. A CAT scan revealed thickened colon and endoscopy revealed possible ischemic colitis. She soon developed peritonitis, and was taken to surgery where gastrointestinal mucormycosis was found. The patient died despite amphotericin therapy.
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PMID:Gastrointestinal mucormycosis mimicking ischemic colitis in a patient with systemic lupus erythematosus. 970 66

Systemic lupus erythematosus (SLE) is a multisystem, autoimmune disease with varied clinical manifestations and outcome. It may prove fatal due to disease activity or intercurrent infections. In recent years, earlier diagnosis and better treatment modalities have resulted in a change in the pattern of organ involvement and mode of death in the west. This aspect of the disease is unknown in India. Hence, in this autopsy series of SLE, the organ involvement and cause of death have been studied. Twenty five cases of clinically diagnosed SLE have been analysed retrospectively. Renal involvement was invariably present (96%) with class IV being the commonest lesion in 60% cases. Disease activity was noted in 60% cases. Pleuro pulmonary lesions were seen in 92% cases with infection being the commonest. Pulmonary infections included bacterial pneumonias (13), disseminated tuberculosis (3), pulmonary mucormycosis (1) and aspergillosis (1). Massive pulmonary haemorrhage in 5 cases and acute lupus pneumonitis in one, contributed to the demise of the patient. Vasculitis was evident in single organ in 9 cases, in two or more organs in 3 cases with systemic vasculitis significantly attributing to morbidity in 1 case. Active disease was the cause of death in 60% cases and infection in 40%.
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PMID:Fatal complications of systemic lupus erythematosus--an autopsy study from north India. 1121 78

Invasive fungal sinusitis increasingly causes significant morbidity and mortality in immunocompromised patients. It is difficult to treat. Despite standard treatment by surgical debridement and intravenous amphotericin B, morbidity and mortality remain high. Conventional amphotericin B is the standard drug but its use is limited by dose-related nephrotoxicity and infusion-related acute toxicity. Liposomal amphotericin B has proven to be as effective as conventional amphotericin B with less nephrotoxicity and infusion reaction. We report four cases of invasive fungal sinusitis who were treated with liposomal amphotericin B after having severe side effects from conventional amphotericin B. There were two cases of mucormycosis and two cases of aspergillosis. All patients had diabetes millitus. One patient had systemic lupus erythematosus and another was receiving immunosuppressive drugs after kidney transplantation. All cases needed multiple operations for sinus surgery. Two cases had acute reaction to amphotericin B infusion, one had active lupus nephritis with renal insufficiency, and one was considered treatment failure from amphotericin B. The patients received liposomal amphotericin B at the total doses of 4.55-8.85 g. Two cases of mucormycosis were considered to be successfully treated. In cases of aspergillosis, one was considered improved and another one with immunocompromised status died with active disease. From our experience, surgery is the main treatment for patients with invasive fungal sinusitis and liposomal amphotericin B is an effective alternative drug for adjuvant medical treatment. However, the degree of immunosuppression of the patients, the extension of fungal sinusitis and perhaps the species of fungus are important factors determining the clinical response.
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PMID:Treatment of invasive fungal sinusitis with liposomal amphotericin B: a report of four cases. 1146 Sep 76

A rapidly enlarging leg ulcer appeared in a 54-year-old woman with systemic lupus erythematosus receiving aggressive immunosuppressive therapy. Skin biopsy revealed proliferation of hyphae in the midst of a neutrophilic abscess. Culture yielded Rhizopus azygosporus. As no organ involvement was detected by thorough examination, the patient was diagnosed as having primary cutaneous mucormycosis. Although intravenous amphotericin B therapy seemed to be very effective, it had to be discontinued due to nephrotoxicity. She unfortunately died of subsequent disseminated fungal infection and cerebral infarction in which the primary cause could not be determined. Minimum inhibitory concentrations of several antifungal drugs to the isolate were examined and amphotericin B proved to be the only agent that may potentially reach the effective plasma concentration. This is the first case report of cutaneous mucormycosis caused by R. azygosporus.
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PMID:The first case of cutaneous mucormycosis caused by Rhizopus azygosporus. 1608 61

We describe a child with systemic lupus erythematosus and invasive gastric mucormycosis, who was successfully treated with aggressive antifungal therapy and a unique interventional radiology procedure.
Lupus 2010 Apr
PMID:Successful treatment of invasive gastric mucormycosis in a child with systemic lupus erythematosus. 1993 7

Systemic lupus erythematosus (SLE) is a multisystem connective tissue disease. Patients with SLE develop cutaneous infections due to immune dysregulation and treatment with immunosuppressive agents. Deep fungal infections are rare in SLE but are important cause of morbidity. We report a case of successfully treated rhino cerebral mucormycosis (RCM) in a female patient with SLE.
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PMID:Rhino cerebral mucormycosis in systemic lupus erythematosus. 2371 22


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