Mucormycosis

Rangel-Guerra, Ricardo

doi:10.1001/archneur.1985.04060060080013

Cited by 50 publications

(3 citation statements)

References 14 publications

(5 reference statements)

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“…The most frequent course of treatment involves extensive surgical debridement of all affected tissues, including exenteration of affected orbits and prolonged administration of Amphotericin B (AMB) [7][8][9][10]. This retrospective study was carried out to evaluate risk factors, including co-morbidities, clinical characteristics, diagnosis, management and outcome.…”

Section: Introductionmentioning

confidence: 99%

Clinical study of rhino-orbital-cerebral mucormycosis in COVID-19 patients in a regional institute in South India

Arunkumar,

Barki,

Dodamani

et al. 2023

Ophthalmol J

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BACKGROUND: Rhino-orbital-cerebral mucormycosis (ROCM) is usually seen in immunosuppressed conditions like uncontrolled diabetes mellitus (DM). The pandemic of severe acute respiratory syndrome coronavirus 2 (Sars-CoV-2) and its associated immunosuppression and indiscriminate use of corticosteroids emerged as a new risk factor for ROCM during its' second wave of coronavirus disease 2019 , especially in India. The lack of standardized management protocol for ROCM needs the attention of the ophthalmic community. COVID-19-associated risk factors have been linked to the pathogenesis of ROCM, which reached epidemic proportions during India's second wave of the pandemic. The aim of the present study was to document cases of ROCM and to evaluate risk factors, including co-morbidities, clinical characteristics, diagnosis, management, and outcome at tertiary care centers during the Sars-CoV-2 (2021) pandemic. MATERIAL AND METHODS: It is a retrospective study of 42 patients of biopsy-proven mucormycosis. These patients' records were reviewed from hospital data. All patients were subjected to complete ophthalmological, ortorhino-laringological examination, and imaging studies. The orbital staging was done. Each case was treated by a multidisciplinary approach with functional endoscopic sinus surgery (FESS) and intravenous (i.v.) amphotericin B (AMB). Retrobulbar liposomal AMB and exenteration were performed whenever indicated. Statistical analysis was done using the Chi square test. A p-value ≤ 0.05 was considered significant. RESULTS: Total 42 patients of ROCM were documented. The mean age was 50.48 years, with a male preponderance (82.9%). 99.8% of patients had diabetes (39 patients) and all patients were COVID-19-positive. Concurrent steroid use was seen in 83.3% where 73.1% of patients had received oxygen support during COVID-19 infection. The most common ophthalmologic presentation was orbital/facial oedema (33) and pain, diminution of vision (24), and ophthalmoplegia (26). Direct nasal endoscopy and biopsy were done to establish a diagnosis. All patients were treated with FESS and i.v. AMB. Retrobulbar AMB was given to 11 patients. Exenteration was done in (n = 4) 10.5% of cases. 41 patients recovered, and one patient died CONCLUSION: The most significant predisposing factors for developing COVID-19-associated ROCM are corticosteroids and DM. Patients with COVID-19 must be followed up even after recovery. For a favorable outcome with lower mortality in COVID-19 recovered patients, we must have a high index of clinical suspicion with awareness of red flag signs and make a timely diagnosis.

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Section: Introductionmentioning

confidence: 99%

Clinical study of rhino-orbital-cerebral mucormycosis in COVID-19 patients in a regional institute in South India

Arunkumar,

Barki,

Dodamani

et al. 2023

Ophthalmol J

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“…Type 2 diabetes (T2D) is more common than type 1 diabetes (T1D). The predisposing factors, high blood glucose, vascular insufficiency, neuropathy and, various immunological disturbances, facilitate conditions for colonization of Pathogenic fungi; including Candida, Dermatophytes, Malassezia ,Zygomycetes, Aspergillus and Fusarium species in DM patients (4)(5)(6). Nearly 56% of diabetic foot ulcers become infected and 20% of these patients with infected foot ulcers land up in some type of foot amputation.…”

Section: Introductionmentioning

confidence: 99%

Fungal infection in foot diabetic patients

Raiesi

Shabandoust

Dehghan

et al. 2018

JBRMS

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Diabetic patients are more susceptible to cutaneous fungal infections. Cutaneous lesions and Foot infections are a frequent complication of patients with diabetes mellitus, accounting for up to 20% of diabetes-related hospital admissions. Foot ulcers and other foot problems are a major cause of morbidity and mortality in people with Diabetes mellitus. The higher blood sugar levels cause increasing the cutaneous fungal infections in these patients. More than 75% of diabetes mellitus (DM) patients are at risk for diabetic ulcers. About 15% of foot ulcers in diabetic patients lead to amputations. Although every 30 seconds one leg is amputated in the world due to DM, 80% of these cases are preventable. Poor controlled had significantly higher fungal infection in diabetic foot ulcers and require careful attention and management. The findings of various studies indicate that the prevalence of fungal infections in patients with diabetic foot ulcers is increasing and there are many drug resistance issues reported in this area, therefore more attention is important in diabetic centers about this neglected issue.

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“…The predisposing factors, high blood glucose, vascular insufficiency, neuropathy and various immunological disturbances, facilitate conditions for colonization of pathogenic fungi, including Candida , Dermatophytes , Malassezia , Zygomycetes, Aspergillus , and Fusarium species in DM patients. [345] Therefore, screening and early detection of fungal infections in high-risk individuals is critical for prevention of grave complications such as foot amputation. In some diabetic patients, developing cutaneous lesions and nail infections has been documented.…”

Section: Introductionmentioning

confidence: 99%

Frequency of Cutaneous Fungal Infections and Azole Resistance of the Isolates in Patients with Diabetes Mellitus

et al. 2017

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Background:Diabetic patients are more susceptible to cutaneous fungal infections. The higher blood sugar levels cause increasing the cutaneous fungal infections in these patients. The main objective of this study was to find the frequency of fungal infections among cutaneous lesions of diabetic patients and to investigate azole antifungal agent susceptibility of the isolates.Materials and Methods:In this study, type 1diabetes (n = 78) and type 2 diabetes (n = 44) comprised 47 cases (38.5%) with diabetic foot ulcers and 75 cases (61.5%) with skin and nail lesions were studied. Fungal infection was confirmed by direct examination and culture methods. Antifungal susceptibility testing by broth microdilution method was performed according to the CLSI M27-A and M38-A references.Results:Out of 122 diabetic patients, thirty (24.5%) were affected with fungal infections. Frequency of fungal infection was 19.1% in patients with diabetic foot ulcer and 28% of patients with skin and nail lesions. Candida albicans and Aspergillus flavus were the most common species isolated from thirty patients with fungal infection, respectively. Susceptibility testing carried out on 18 representative isolates (13 C. albicans, five C. glabrata) revealed that 12 isolates (10 C. albicans and two C. glabrata isolates) (66.6%) were resistant (minimum inhibitory concentration [MIC] ≥64 mg/ml) to fluconazole (FCZ). Likewise, eight isolates (80%) of Aspergillus spp. were resistant (MIC ≥4 mg/ml), to itraconazole.Conclusion:Our finding expands current knowledge about the frequency of fungal infections in diabetic patients. We noted the high prevalence of FCZ-resistant Candida spp., particularly in diabetic foot ulcers. More attention is important in diabetic centers about this neglected issue.

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Mucormycosis

Cited by 50 publications

References 14 publications

Clinical study of rhino-orbital-cerebral mucormycosis in COVID-19 patients in a regional institute in South India

Clinical study of rhino-orbital-cerebral mucormycosis in COVID-19 patients in a regional institute in South India

Fungal infection in foot diabetic patients

Frequency of Cutaneous Fungal Infections and Azole Resistance of the Isolates in Patients with Diabetes Mellitus

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