ABSTRACT
BACKGROUND: Rhino-orbito-cerebral-mucormycosis (ROCM), a rare and potentially fatal disease was seen in increasing numbers during the COVID-19 pandemic. This study describes and compares the patient characteristics and outcomes in COVID-19 associated mucormycosis (CAM) and non-COVID-19 mucormycosis (non-CAM). METHODOLOGY: CAM patients (24 cases) were recruited from the COVID-19 period and non-CAM (24 controls) from the pre-COVID-19 period. Clinical data of the CAM group was collected retrospectively with 3 month outcomes prospectively. The non-CAM group data was collected retrospectively. Patient characteristics were compared and risk factors for mortality in ROCM were assessed. RESULTS: Orbital symptoms [altered vision, restricted eye movements, ptosis] and intracranial involvement were higher in CAM patients on presentation. Similarly, the radiological involvement of orbit (orbital apex, superior orbital fissure) and intracranial cavity (intracranial thrombosis, cavernous sinus) was also higher in CAM patients. Newly detected diabetes was found only in CAM patients (29.2%). Although univariate analysis suggested an increased mortality risk in ROCM patients with orbital involvement, the multivariate analysis showed no increased risk with any of the parameters assessed, including COVID-19 positivity. CONCLUSIONS: Compared to the non-CAM, the disease presentation was severe in CAM with higher frequency of orbital and intracranial involvement. However, with early detection and treatment, the short term survival was comparable in both groups.
Subject(s)
COVID-19 , Mucormycosis , Orbital Diseases , Humans , Mucormycosis/diagnosis , Pandemics , Retrospective Studies , NoseABSTRACT
The present report describes a case of a post-traumatic ocular leiomyosarcoma in a calf (Bos primigenius taurus) including clinical, histopathological and immunohistochemical features. Following a traumatic episode, the animal developed opacification of the lens and shrinkage of the eye. Subsequently, the ocular lesion increased in size over a period of 6 weeks and reached up to 16 cm in diameter with infiltration into the cranium. At necropsy examination, the kidneys, liver and spleen exhibited multiple firm white metastases up to 2 cm in diameter. The mass was composed of closely-packed streams and bundles of neoplastic cells, which immunohistochemically expressed vimentin and alpha smooth muscle actin. Based on the anamnestic data, morphological appearance, distribution and immunohistochemical results, a diagnosis of a post-traumatic intraocular leiomyosarcoma was made. The tumour may have originated from cells lining the pectinate ligament of the ciliary body.
Subject(s)
Cattle Diseases/etiology , Cattle Diseases/pathology , Eye Injuries/veterinary , Eye Neoplasms/veterinary , Leiomyosarcoma/veterinary , Animals , Cattle , MaleABSTRACT
OBJECTIVE: To (a) describe the technical modification of trans-caval TJLB and (b) review our series of nine cases. METHODS: We performed a retrospective review of all trans-caval TJLBs performed; we assessed indications for the procedure, technical success, complications, adequacy of specimen and histological positivity. RESULTS: The technical success rate of the procedure was 9/9 (100%); the minor complication rate was 1/9 (11%), adequate specimen was obtained in all cases and a histological diagnosis was achieved in 8/9 (89%) cases. CONCLUSION: This preliminary report suggests that trans-caval modification of TJLB is a relatively safe procedure that may be useful in cases where conventional TJLB is infeasible. ADVANCES IN KNOWLEDGE: (a) We describe the technique of trans-caval TJLBs and report our findings in the largest series of published cases. (b) Trans-caval TJLB is relatively safe and can be used to increase the success rates of conventional TJLB.
Subject(s)
Biopsy, Needle/methods , Liver Diseases/diagnosis , Liver/pathology , Adolescent , Adult , Child , Child, Preschool , Female , Humans , Jugular Veins , Liver Transplantation , Male , Middle Aged , Retrospective Studies , Young AdultABSTRACT
INTRODUCTION: Melioidosis is an infectious disease caused by a saprophytic bacterium, Burkholderia pseudomallei. It is endemic to Southeast Asia and Northern Australia. It may manifest as a pulmonary lesion, osteomyelitis, abscesses in soft tissue and various organs, or as septicaemia. CASE REPORT: We report a case of a 40-year-old, diabetic man who presented with a neck lump resulting from super-infection of a tuberculosis cavity with B pseudomallei. The patient was successfully managed by drainage along with meticulous excision of the capsule and prolonged antibiotic and anti-tubercular treatment. DISCUSSION: Melioidosis may be confused diagnostically with tuberculosis, as both diseases are endemic in the same regions. Our patient was unfortunate to suffer from both endemic diseases simultaneously, perhaps representing the first such case in the world literature. CONCLUSION: Increased awareness of melioidosis is important as, although the organism is easy to culture, it may be dismissed as a contaminant.
Subject(s)
Abscess/microbiology , Burkholderia pseudomallei/isolation & purification , Melioidosis/complications , Tuberculosis/complications , Abscess/surgery , Adult , Asia, Southeastern , Drainage/methods , Drug Therapy, Combination , Endemic Diseases , Humans , Male , Melioidosis/diagnosis , Melioidosis/therapy , Risk Factors , Treatment Outcome , Tuberculosis/diagnosis , Tuberculosis/drug therapyABSTRACT
A one-stage approach to performing crown lengthening and restorative procedures under a rubber dam is described with case reports.