Atypical presentations of mucormycosis in the head and neck

Vessely, Michelle B.; Zitsch, Robert P.; Estrem, Scott A.; Renner, Gregory J.

doi:10.1016/s0194-5998(96)70014-1

Cited by 21 publications

(19 citation statements)

References 13 publications

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“…The causative organisms are of the class Phycomycetes, the subclass Zygomycetes, and most often the order Mucorales. [1][2][3][4][5][6][7][8] Although numerous species within this order are associated with mucormycosis, the Rhizopus subsp is the most common cause. 1,3,4,6 Spores are most often disseminated through the air via inhalation, but transmission may also occur by ingestion or direct traumatic skin inoculation.…”

Section: Commentmentioning

confidence: 99%

“…2,3 Clinically, there are 5 categories of mucormycosis infection: rhinocerebral (most common), pulmonary, disseminated, gastrointestinal, and cutaneous. [1][2][3][4][5][6][7][8] Otolaryngologists are all too familiar with the rhinocerebral presentation. Cutaneous mucormycosis can be further subdivided into superficial and gangrenous subtypes.…”

Section: Commentmentioning

confidence: 99%

“…Culture of infected tissue may improve the yield, but routine blood and swab cultures are of limited use. 1,3,7,8 Therefore, early recognition of infection requires a high index of suspicion in all immunocompromised patients. Prompt diagnosis can by obtained with tissue biopsy and frozensection analysis.…”

Section: Commentmentioning

confidence: 99%

“…Prompt diagnosis can by obtained with tissue biopsy and frozensection analysis. 1,3 Frozen section often reveals areas of acute inflammation and necrosis. The fungal hyphae are usually seen as poorly staining elements, or even clear spaces.…”

Section: Commentmentioning

confidence: 99%

“…Permanent sections with hematoxylineosin and methenamine silver staining are used for confirmation. [1][2][3][4][5][6][7][8] Histopathology demonstrates broad, nonseptate hyphae with branches occurring at 45°to 90°angles.…”

Section: Commentmentioning

confidence: 99%

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Facial Cutaneous Mucormycosis in a Full-term Infant

Dave

Vivero

Roy

2008

Arch Otolaryngol Head Neck Surg

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Mucormycosis is a rare and potentially fatal fungal infection that most commonly affects the immunocompromised population. Although originally described by Paltauf in 1885 (D. G. Finn as cited by Vessely et al(1)((p573)) and A. M. Marchevsky as cited by Oh and Notrica(2)((p1607))), it was not until 1955 that Harris (as cited by Vessely et al(1)((p573))) reported the first case of a mucormycosis survivor. In recent years, the number of immunosuppressed patients has increased partly owing to the widespread implementation of organ transplantation and the increasing prevalence of human immunodeficiency virus infection. Consequently, the incidence of mucormycosis has also increased, especially in pediatric patients. In the setting of immunocompromise, a high index of suspicion is required to accurately diagnose and treat this potentially lethal infection in a timely fashion. To our knowledge, we report the first case of facial cutaneous mucormycosis in an infant, who also represents the first reported neonate or infant to survive a cutaneous mucormycosis infection of the head and neck.

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Section: Commentmentioning

confidence: 99%

Section: Commentmentioning

confidence: 99%

Section: Commentmentioning

confidence: 99%

Section: Commentmentioning

confidence: 99%

Section: Commentmentioning

confidence: 99%

See 3 more Smart Citations

Facial Cutaneous Mucormycosis in a Full-term Infant

Dave

Vivero

Roy

2008

Arch Otolaryngol Head Neck Surg

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Debates in Rhino-Orbito-Cerebral Mucormycosis: Orbital Disease Management Dilemma

Gupta

Jain²,

Singla

2022

Rhino-Orbito-Cerebral Mucormycosis

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Rhinocerebral mucormycosis: pathways of spread

Hosseini¹,

Borghei²

2005

Eur Arch Otorhinolaryngol

194

161

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Rhinocerebral mucormycosis is an invasive, opportunistic fungal infection usually seen in immunocompromised patients, and particularly in the setting of diabetes or immune deficiency. It is assumed that the port of entry is colonization of the nasal mucosa, allowing the fungus to spread via the paranasal sinuses into the orbit. Involvement of the brain and cavernous sinus occurs by way of the orbital apex; therefore, spheno-ethmoidectomy with or without maxillectomy seems to be the definitive method to eradicate this infection. We conducted a prospective study of ten patients with rhinocerebral mucormycosis from February 2000 to April 2004. Rhinocerebral mucormycosis was clinically diagnosed in 11 patients, 10 of whom were included in our study upon histopathological confirmation. Diabetes was the most common underlying disorder seen in nine out of ten patients. In this study, the patients were assessed for predisposing factors, presenting signs and symptoms, sites of extension, the number and sites of surgical debridement, as well as the outcome. Ocular, sinonasal and facial soft tissue involvement was common. Involvement of the pterygopalatine fossa at the time of debridement was evident in all patients. No invasion through the lamina papiracea or the walls of the maxillary sinus was identified. At the time of this communication, six out of ten patients were alive. For the four who died, the causes were hypokalemia, cardiac arrythmia and refractory pneumonia. Pterygopalatine fossa is considered to be the main reservoir for rhinocerebral mucormycosis, and extension into the orbit and facial soft tissues usually follows this route. After proliferation in the nasal cavity, the mucor reaches the pterygo-palatine fossa, inferior orbital fissure and finally the retroglobal space of the orbit, resulting in ocular signs. The facial soft tissues, palate and infratemporal fossa can be infected through connecting pathways from the pterygo-palatine fossa; therefore, debridement of the pterygopalatine fossa seems to be the definitive method of managing this infection.

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Atypical presentations of mucormycosis in the head and neck

Cited by 21 publications

References 13 publications

Facial Cutaneous Mucormycosis in a Full-term Infant

Facial Cutaneous Mucormycosis in a Full-term Infant

Debates in Rhino-Orbito-Cerebral Mucormycosis: Orbital Disease Management Dilemma

Rhinocerebral mucormycosis: pathways of spread

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