A rare case of Escherichia coli and Rhizopus sinusitis complicated with pneumocephalus, E. coli psoas abscess and sepsis

Abstract

Sinusitis is a common ailment a clinician comes across in their day-to-day practice. Simple as it may sound, it may become a very debilitating condition depending on the comorbidities of the patient and the organism involved. Rhizopus and Escherichia coli are less common organisms to affect the sinuses, but they are more common in immunocompromised patients such as patients with uncontrolled diabetes. Rhizopus can be a very debilitating infection as it erodes into the bone and blood vessels resulting in tissue necrosis. However, coinfection of both of these organisms is a very rare occurrence. Psoas abscess is also a less common infection in the immunocompetent patients but it is more common among the immunocompromised patients. It is extremely rare for both of these organisms to cause sinusitis in one patient, and for E. coli to simultaneously infect two different sites in the same patient. We report a case where a diabetic patient who had E. coli and Rhizopus coinfected sinusitis with simultaneous E. coli psoas abscess was successfully managed. The Rhizopus was treated with liposomal amphotericin B for 16 weeks while E. coli was treated with IV Meropenum. Furthermore, pneumocephalus is a condition that usually occurs following head trauma but the patient we are reporting developed pneumocephalus following Rhizopus sinusitis, which was treated with high-flow oxygen.

Fabrication of a Dual-Targeted Liposome-Coated Mesoporous Silica Core–Shell Nanoassembly for Targeted Cancer Therapy

“…Herein, we report the synthesis of MSNs loaded with Px and further coated with a liposome (L) layer, which acts as a gate keeper for drug release. The nanoassembly was further functionalized with a folate receptor-targeting folic acid (FA) and epidermal growth factor receptor (EGFR)-targeting peptide (GE11) as a dual target to create the final nanoassembly, (MSN@Px) L-GF. ,,– These receptors are popular biomarkers of cancerous cells. , Furthermore, this nanoassembly was used to study the mechanistic effects of ROS-induced lung cancer cell death with (MSN@Px) L-GF compared to that with free Px. Px was rapidly released from the nanoassembly through the degradation of the liposome layer triggered by the intracellular lipases.…”

“…Mesoporous silica nanoparticles (MSNs) have been suggested as drug-delivery vehicles due to their large surface area and porous structure, which make them ideal carriers for various pharmaceuticals and biological molecules. – MSNs have many advantages over other nanomaterials, such as their stability under biological conditions, biocompatibility, and capability to be loaded with both hydrophilic and hydrophobic drugs . MSNs can also be modified with stimuli-responsive groups to achieve controlled drug delivery .…”

“…The nanoassembly was further functionalized with a folate receptor-targeting folic acid (FA) and epidermal growth factor receptor (EGFR)-targeting peptide (GE11) as a dual target to create the final nanoassembly, (MSN@Px) L-GF. 14 , 25 , 33 – 35 These receptors are popular biomarkers of cancerous cells. 36 , 37 Furthermore, this nanoassembly was used to study the mechanistic effects of ROS-induced lung cancer cell death with (MSN@Px) L-GF compared to that with free Px.…”