Diagnosis and Management of Rhino-Orbitocerebral Mucormycosis (Phycomycosis)

Ferry, Andrew P.; Abedi, Shahla

doi:10.1016/s0161-6420(83)80052-9

Cited by 184 publications

(101 citation statements)

References 6 publications

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“…These patients can survive if the underlying metabolic abnormality is corrected, systemic antifungal agents are administered, and infected tissue is excised. 36 Due to the relentless progression of sino-orbital aspergillosis in AIDS with frequent development of intracranial extension, one must consider the role of early orbital exenteration. The 2 longestsurviving patients in our study required sino-orbital exenteration after a blind, painful eye with massive orbital involvement developed, both having undergone multiple orbital debridements.…”

mentioning

confidence: 99%

Sino-orbital Aspergillosis in Acquired Immunodeficiency Syndrome

Johnson¹,

Casiano²,

Kronish

et al. 1999

Arch Ophthalmol

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To describe the clinical features, causes, imaging characteristics, treatment, and outcome of patients with the acquired immunodeficiency syndrome (AIDS) and sino-orbital aspergillosis.Design: Records of 5 patients were reviewed. Results of imaging and histopathologic examinations and clinical courses of the patients were studied.Results: There were 3 women and 2 men (mean age, 34.0 years). All had received a diagnosis of AIDS, and mean CD4 + cell count was 0.014 ϫ 10 9 /L (14 cells/mm 3 ). Computed tomographic scanning exhibited heterogeneous, enhancing sino-orbital soft tissue lesions with bony erosion, and magnetic resonance imaging disclosed soft tissue masses hypointense on T 1 -and T 2 -weighted images. The infection involved 1 or more paranasal sinuses, with extension into the right orbit in 3 patients and into the left orbit in 2. Patients were treated with aggressive surgical debridement and intravenous antifun-gal agents. In addition, local irrigation of amphotericin B was performed in 3 patients. Aspergillus fumigatus was found to be the cause in all 5 patients. Intracranial extension developed in 4 patients, and all subsequently died. The 2 longest surviving patients were the only ones being treated with protease inhibitors. Three patients had a history of frequent marijuana smoking.Conclusions: Sino-orbital aspergillosis is a progressive, relentless, and usually fatal opportunistic infection of advanced AIDS. Patients are first seen with longstanding headache and proptosis with minimal external inflammatory signs. Marijuana smoking may increase the risk for development of sino-orbital aspergillosis in these patients. Aggressive surgical and medical treatment, combined with newer combination therapies using protease inhibitors, may improve the longevity of these patients.

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confidence: 99%

Sino-orbital Aspergillosis in Acquired Immunodeficiency Syndrome

Johnson¹,

Casiano²,

Kronish

et al. 1999

Arch Ophthalmol

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“…Aspergillus must be distinguished from mucor, which form broader, non-septate hyphae and can be identified by dichotomous branching at 900 angle (12) while aspergillus shows branching at acute (450) angle (Table 1). In a study done by Ferry et al (3) in 1983 and Yohai et al (10) in 1994. They reported sinus involvement in 69%-79% of mucormycoses respectively.…”

Section: Discussionmentioning

confidence: 96%

Fungal infections involving maxillary sinus - a difficult diagnostic task

Taneja¹,

Saxena²,

Aggarwal³

et al. 2011

J Clin Exp Dent

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Fungal infections of the paranasal sinus are increasingly recognized entity both in normal and immunocompromised individuals. Aspergillosis and Mucormycoses being the commonest of all the fungal infections involving maxillary sinus manifests as two distinct entities, a non-invasive and invasive infection. It is important to distinguish the invasive disease from the non-invasive as the treatment and prognosis are different in each. These infections present a diagnostic and therapeutic challenge to the physicians. Early diagnosis is essential in order to avoid high morbidity and mortality associated with the destructive disease and to instigate treatment before irreversible condition arise. The purpose of this paper is to add a few more cases of fungal infections involving maxillary sinus to the literature in both immunocompetent and immunocompromised patients with an emphasis on the fact that early diagnosis is vital in these infections, because delay in initiation of treatment can be life threatening due to propensity of fungi to invade adjacent blood vessels and embolize to distant organs.

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“…Ferry et al [11] have described that histopathological examination is more sensitive in the diagnosis of mucor and related group of fungi compared to cultures. The present case had a favorable outcome with both anatomical and functional preservation of the involved eye.…”

Section: Discussionmentioning

confidence: 99%

Endogenous mycotic endophthalmitis in an immunocompetent patient

et al. 2008

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Acute and invasive fungal infections are usually seen in immunocompromised and debilitated patients. We report a young immunocompetent 28-year-old Indian male who presented with unilateral endogenous endophthalmitis in the left eye and was managed with pars plana vitreous surgery. The polymerase chain reaction from the vitrectomy specimen tested positive for the fungal genome while the cytology examination identified aseptate hyphae with wide-angle branching, most likely suggesting Zygomycosis. A detailed systemic evaluation failed to reveal any systemic focus or predisposing factor for fungal infection. The patient had received intravenous dextrose infusions while undergoing a surgical procedure for post-traumatic hydrocele elsewhere a week prior to this episode. The patient was successfully managed with pars plana vitreous surgery along with intravitreal Amphotericin-B and oral Voriconazole.

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Diagnosis and Management of Rhino-Orbitocerebral Mucormycosis (Phycomycosis)

Cited by 184 publications

References 6 publications

Sino-orbital Aspergillosis in Acquired Immunodeficiency Syndrome

Sino-orbital Aspergillosis in Acquired Immunodeficiency Syndrome

Fungal infections involving maxillary sinus - a difficult diagnostic task

Endogenous mycotic endophthalmitis in an immunocompetent patient

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