Successful treatment of rhinocerebral mucormycosis by a combination of aggressive surgical debridement and the use of systemic liposomal amphotericin B and local therapy with nebulized amphotericin--a case report.

A case of mucormycosis involving the nose and paranasal sinuses in a 55-year-old man with recently diagnosed acute promyelocytic leukaemia is reported. It was successfully treated with a combination of aggressive surgical debridement and systemic amphotericin B. In addition, local nebulized amphotericin B was used as an adjunct to therapy. We believe this is only the second documented use of nebulized amphotericin in the management of sinonasal mucormycosis. The need for a high index of suspicion and early aggressive management is emphasized.

Bilateral salmonella salpingo-oophoritis.

A previously healthy nulliparous caucasian female presented with lower abdominal pain and a history of diarrhoea and vomiting for 2 weeks. Repeated stool examinations and blood culture were negative. A lump in the lower abdomen became more apparent over the next 2 weeks and a subsequent laparotomy revealed bilateral tubo-ovarian abscess formation. One ovary which was endometriotic and both the tubes were excised and the pus yielded a heavy growth of Salmonella stanley.

Ovarian tumors in Malawi -- a histopathological study.

PIP: Over the period 1976-80, 175 ovarian neoplasms from 172 Malawi African females were sent to London for histopathological diagnosis. The most common type of primary tumor was benign cystic teratoma (39%). Only 2 cases of metastatic carcinoma were seen. Overall, epithelial ovarian tumors formed 37% of the primary nonlymphomatous tumors, germ cell tumors 45% and sex cord/stromal tumors 17%. These results are consonant with data from other studies in sub-Saharan Africa; germ cell tumors and sex cord/stromal tumors are seen more frequently in Africa than in developed countries, and conversely, epithelial tumors are less common. Several reasons for this pattern are discussed. The predominance in Malawi of teratomas probably follows from the fact that 1/2 the population is aged 15 or younger. Since epithelial malignancy rates increase with age, and old women in Africa form a smaller proportion of the population, fewer epithelial tumors may be expected. Also, studies have demonstrated an inverse relationship between marital status/parity and rates of ovarian cancer; thus populations with large families as found in Africa should suffer fewer ovarian carcinomas. It appears that the relatively high ratio of malignant serous and mucinous epithelial tumors in Africa (40-70%) may be due to a genuinely different pattern of epithelial tumor pathology in the ovary, though no cause is readily evident. Further detailed study of ovary tumors with the aim of exploring particularly the differences in histogenetic patterns and their possible associations will provide valuable information on the etiology of tumors in this organ.^ieng

Granulomatous vasculitis of the penis with glomerulonephritis.

Wegener's granulomatosis is characterized by a necrotizing granulomatous vasculitis of the upper and lower respiratory tract together with glomerulonephritis. Presentation is usually with symptoms referrable to the upper respiratory tract, the glomerulonephritis manifesting itself weeks or months later. A case is reported of a man presenting with a necrotizing granulomatous vasculitis of his penis who subsequently developed glomerulonephritis 18 months later.