Orbital Mucormycosis Following Periorbital Cutaneous Infection

Chahal, Harinder Singh; Abgaryan, Narine; Lakshminarayanan, Renuka; Glover, A. Tyrone

doi:10.1097/iop.0000000000000466

Cited by 7 publications

(9 citation statements)

References 11 publications

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“…The use of posaconazole in combination with AMB and LAMB has positive effects on controlling CM in diabetic patients and even in patients that experience no improvement after 3 weeks of antifungal monotherapy, the combined use of posaconazole and LAMB facilitates treatment 17,28,43,64 . Moreover, in patients with AMB‐resistant infections or after‐treatment failure with this antibiotic, which is used as the first line of CM treatment in diabetic patients, posaconazole can be a good alternative treatment 24,30,45 .…”

Section: Discussionmentioning

confidence: 99%

Epidemiology, clinical features, diagnosis and treatment of cerebral mucormycosis in diabetic patients: A systematic review of case reports and case series

Chegini

Didehdar

Khoshbayan

et al. 2020

Mycoses

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Summary Background Patients with diabetes are known as an important high‐risk group for cerebral mucormycosis (CM). Method We conducted a structured search using PubMed/MEDLINE to collect both case reports and case series case (ie including at least two patients) onto CM in diabetic patient published between 2000 and March 2020. Results Forty‐five reports of individual cases and eighteen case series articles were included. India accounted for the largest share of reports with 37.7% and 38.8% of individual cases and case series, respectively. Mortality ranged from 0% to 100% in the case series. The overall mortality in the individual cases was 46.3%, and 64.2% of deaths were reported in patients with ketoacidosis diabetes. Facial swelling (53.3%), headache (44.4%), loss of vision (35.5%) and ophthalmoplegia (35.5%) were the most frequently reported clinical symptoms. In all patients except 4 (91.1%), CM was treated surgically; however, in many cases (42%), despite the use of surgery, death occurred. Amphotericin B deoxycholate (AMB) and lipid‐based AMB (LAMB) were used as the first lines of treatment for all patients; however, posaconazole, echinocandins, hyperbaric oxygen therapy (HBOT) and deferasirox were used in combination for a number of patients. Posaconazole has been shown to have positive therapeutic effect; however, posaconazole, LAMB and HBOT are not commonly used in low‐income and health‐challenged countries. Conclusion Cerebral mucormycosis is a rapidly progressive infection in diabetic patients and carries immense morbidity despite early diagnosis and treatment. Low‐income countries have had the highest number of reports of the disease in recent years, indicating the need to control diabetes in these countries.

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Section: Discussionmentioning

confidence: 99%

Epidemiology, clinical features, diagnosis and treatment of cerebral mucormycosis in diabetic patients: A systematic review of case reports and case series

Chegini

Didehdar

Khoshbayan

et al. 2020

Mycoses

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“…have recently reported a case of orbital spread from contiguous cutaneous mucormycosis in a poorly controlled diabetic patient. [ 3 ]…”

Section: Pathogenesismentioning

confidence: 99%

“…Often, the hyphae are not well preserved and become crinkled or gnarled demonstrating a “crinkled cellophane” appearance, which should not be confused with septations. [ 3 ]…”

Section: Investigationsmentioning

confidence: 99%

Fungal infections of the orbit

Mukherjee

Raichura

Alam

2016

Indian J Ophthalmol

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Fungal infections of the orbit can lead to grave complications. Although the primary site of inoculation of the infective organism is frequently the sinuses, the patients can initially present to the ophthalmologist with ocular signs and symptoms. Due to its varied and nonspecific clinical features, especially in the early stages, patients are frequently misdiagnosed and even treated with steroids which worsen the situation leading to dire consequences. Ophthalmologists should be familiar with the clinical spectrum of disease and the variable presentation of this infection, as early diagnosis and rapid institution of appropriate therapy are crucial elements in the management of this invasive sino-orbital infection. In this review, relevant clinical, microbiological, and imaging findings are discussed along with the current consensus on local and systemic management. We review the recent literature and provide a comprehensive analysis. In the immunocompromised, as well as in healthy patients, a high index of suspicion must be maintained as delay in diagnosis of fungal pathology may lead to disfiguring morbidity or even mortality. Obtaining adequate diagnostic material for pathological and microbiological examination is critical. Newer methods of therapy, particularly oral voriconazole and topical amphotericin B, may be beneficial in selected patients.

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“…Liposomal amphotericin B used intravenously is usually effective. In severe cases, surgical removal of pathologically changed orbital tissues and pansinusectomy may be necessary [24].…”

Section: Eye Socketmentioning

confidence: 99%

Mycotic Infections of the Eye

Słowik¹,

Biernat²,

Urbaniak-Kujda³

et al. 2015

Adv Clin Exp Med

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Fungal infections of the eye are an important cause of significant visual loss and blindness in some regions of the world, especially developing countries. Ocular mycoses remain a diagnostic and therapeutic challenge to the ophthalmologist. Corneal infection is the most frequent presentation, but the orbit, eyelids, lacrimal apparatus, conjunctiva, sclera and internal structures of the eye can also be affected. Candida spp., Fusarium spp. and Aspergillus spp. are the most frequently isolated organisms in fungal keratitis and in endophthalmitis. The difficulties posed by ocular mycoses are mainly related to establishing the clinical diagnosis, isolation of the fungal pathogen and effective local treatment, particularly in infections of the cornea. The critical issue in diagnosing fungal infection of the eye is microbiological identification of the etiologic agent in clinical samples. Early diagnosis and prompt treatment allow serious complications, including blindness, to be avoided. Local, systemic and even surgical treatment is applied in the therapy.

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Orbital Mucormycosis Following Periorbital Cutaneous Infection

Cited by 7 publications

References 11 publications

Epidemiology, clinical features, diagnosis and treatment of cerebral mucormycosis in diabetic patients: A systematic review of case reports and case series

Epidemiology, clinical features, diagnosis and treatment of cerebral mucormycosis in diabetic patients: A systematic review of case reports and case series

Fungal infections of the orbit

Mycotic Infections of the Eye

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