RESUMO
Mucormycosis is an unusual fungal infection that usually affects immunosuppressed patients. Small outbreaks of mucormycosis have been previously reported. We present two clinical cases of fatal rhinocerebral mucormycosis with a close temporal relationship between them and a possible nosocomial transmission: case 1 was a 75-year-old male with diabetes and COPD, treated with antibiotics and systemic corticosteroids, who developed rhinocerebral mucormycosis. Case 2 was an 88-year-old woman who was treated with systemic antibiotics and corticosteroids and developed the same infection after insertion of a nasogastric tube. Both patients concurred at the same time in our hospital, and healthcare staff was common to both of them. These cases, along with previously reported cases, highlight that, although infrequent, transmission of the fungus in the hospital environment is a real possibility that should be taken into account in order to initiate contact and air isolation precautions that could avoid nosocomial transmission of this infection.
Assuntos
Infecção Hospitalar/diagnóstico , Meningite Fúngica/diagnóstico , Meningite Fúngica/patologia , Mucormicose/diagnóstico , Infecções Oportunistas/diagnóstico , Rinite/complicações , Rinite/diagnóstico , Corticosteroides/administração & dosagem , Idoso , Idoso de 80 Anos ou mais , Antibacterianos/administração & dosagem , Infecção Hospitalar/microbiologia , Infecção Hospitalar/patologia , Complicações do Diabetes , Evolução Fatal , Feminino , Humanos , Hospedeiro Imunocomprometido , Masculino , Meningite Fúngica/microbiologia , Mucormicose/microbiologia , Mucormicose/patologia , Infecções Oportunistas/microbiologia , Infecções Oportunistas/patologia , Doença Pulmonar Obstrutiva Crônica/complicações , Rinite/microbiologia , Rinite/patologia , Rhizopus/isolamento & purificaçãoAssuntos
Brônquios/diagnóstico por imagem , Meios de Contraste , Transtornos de Deglutição/complicações , Aspiração Respiratória de Conteúdos Gástricos/diagnóstico por imagem , Idoso de 80 Anos ou mais , Transtornos Cognitivos/complicações , Feminino , Idoso Fragilizado , Humanos , Infarto da Artéria Cerebral Média/complicações , Intestino Delgado/diagnóstico por imagem , Multimorbidade , Aspiração Respiratória de Conteúdos Gástricos/etiologia , Traqueia/diagnóstico por imagemRESUMO
Systemic vasculitis is a heterogeneous group of diseases of various aetiologies and manifestations. In general, the clinical results derive from ischemia caused by vascular inflammation, which depends on the organ affected. Such vasculitis cases are classified according to the classification of the Chapel Hill conference. They can present with relative frequency as ENT manifestations in both their debut and throughout their evolution. Consequently, the ENT specialist should include them in the differential diagnosis in patients with ENT manifestations that are difficult to control or of atypical presentation. Our objective was to review the most common ENT clinical signs and symptoms in each of these diseases.