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1.
Medicine (Baltimore) ; 100(6): e24630, 2021 Feb 12.
Artigo em Inglês | MEDLINE | ID: mdl-33578579

RESUMO

RATIONALE: Mucormycosis is a rare fungal infection that typically occurs in immunosuppressed patients following chemotherapy or hematopoietic stem cell transplantation. PATIENT CONCERNS: An 11-year-old child with newly developed acute lymphoblastic leukemia suffered from the paroxysmal left chest pain, fever, and hemoptysis. DIAGNOSES: We made a histopathologic diagnosis aided by bronchoscopy techniques, which indicated invasive fungal hyphae that are characteristic of mucormycosis. INTERVENTIONS: The patient was treated with oral posaconazole and repeated bronchoscopy interventions for 4 months. OUTCOMES: The patient's clinical signs and symptoms and signs were no longer present. The prior lung lesions were also no longer observable using radiologic methods, and a 3-month follow-up with the patient showed no signs of mucormycosis recurrence. Finally, the patient was cured, when the cancer chemotherapy was stopped. Close follow-up for another 2 years showed no evidence of recurrence. LESSONS: Mucormycosis diagnosis is difficult as clinical and imaging findings vary. This case demonstrates that posaconazole monotherapy combined with bronchoscopy interventions may be a safe and effective treatment option for pediatric pulmonary mucormycosis.


Assuntos
Hospedeiro Imunocomprometido , Pneumopatias Fúngicas/diagnóstico , Mucormicose/diagnóstico , Leucemia-Linfoma Linfoblástico de Células Precursoras , Administração Oral , Antifúngicos/administração & dosagem , Antifúngicos/uso terapêutico , Criança , Diagnóstico Diferencial , Febre/etiologia , Humanos , Pneumopatias Fúngicas/complicações , Pneumopatias Fúngicas/tratamento farmacológico , Pneumopatias Fúngicas/patologia , Masculino , Mucormicose/complicações , Mucormicose/tratamento farmacológico , Mucormicose/patologia , Triazóis/administração & dosagem , Triazóis/uso terapêutico
2.
BMJ Case Rep ; 14(1)2021 Jan 11.
Artigo em Inglês | MEDLINE | ID: mdl-33431470

RESUMO

Mucormycosis is an aggressive and deadly fungal infection, which is invariably associated with an immunocompromised patient. Mucormycosis in the head and neck region presents as skeletal necrosis, with or without soft tissue involvement. Early identification and treatment with combination of surgical debridement and parenteral antifungal therapy is critical for a favourable outcome. This paper reports an unusual presentation of mucormycosis, mimicking a localised sino-orbital pathology involving the infraorbital subcutaneous tissue and the maxillary sinus, in a 35 years old immunocompetent man. Despite aggressive antifungal therapy and surgical management, the course of disease was fatal, reiterating the high mortality associated with mucormycosis.


Assuntos
Infecções Oculares Fúngicas/complicações , Infecções Oculares Fúngicas/diagnóstico , Mucormicose/complicações , Mucormicose/diagnóstico , Doenças Orbitárias/diagnóstico , Doenças dos Seios Paranasais/diagnóstico , Adulto , Diagnóstico Diferencial , Infecções Oculares Fúngicas/terapia , Humanos , Imagem por Ressonância Magnética , Masculino , Mucormicose/terapia
3.
BMC Infect Dis ; 20(1): 817, 2020 Nov 10.
Artigo em Inglês | MEDLINE | ID: mdl-33167878

RESUMO

BACKGROUND: Gastrointestinal (GI) mucormycosis is a rare and often deadly form of mucormycosis. Delayed diagnosis can lead to an increased risk of death. Here, we report a case of GI mucormycosis following streptococcal toxic shock syndrome in a virologically suppressed HIV-infected patient. CASE PRESENTATION: A 25-year-old Thai woman with a well-controlled HIV infection and Grave's disease was admitted to a private hospital with a high-grade fever, vomiting, abdominal pain, and multiple episodes of mucous diarrhea for 3 days. On day 3 of that admission, the patient developed multiorgan failure and multiple hemorrhagic blebs were observed on all extremities. A diagnosis of streptococcal toxic shock was made before referral to Siriraj Hospital - Thailand's largest national tertiary referral center. On day 10 of her admission at our center, she developed feeding intolerance and bloody diarrhea due to bowel ischemia and perforation. Bowel resection was performed, and histopathologic analysis of the resected bowel revealed acute suppurative transmural necrosis and vascular invasion with numerous broad irregular branching non-septate hyphae, both of which are consistent with GI mucormycosis. Peritoneal fluid fungal culture grew a grayish cottony colony of large non-septate hyphae and spherical sporangia containing ovoidal sporangiospores. A complete ITS1-5.8S-ITS2 region DNA sequence analysis revealed 100% homology with Rhizopus microsporus strains in GenBank (GenBank accession numbers KU729104 and AY803934). As a result, she was treated with liposomal amphotericin B. However and in spite of receiving appropriate treatment, our patient developed recurrent massive upper GI bleeding from Dieulafoy's lesion and succumbed to her disease on day 33 of her admission. CONCLUSION: Diagnosis of gastrointestinal mucormycosis can be delayed due to a lack of well-established predisposing factors and non-specific presenting symptoms. Further studies in risk factors for abdominal mucormycosis are needed.


Assuntos
Trato Gastrointestinal/microbiologia , Doença de Graves/complicações , Infecções por HIV/complicações , Mucormicose/complicações , Rhizopus/genética , Choque Séptico/complicações , Infecções Estreptocócicas/complicações , Streptococcus pyogenes/isolamento & purificação , Adulto , Anfotericina B/uso terapêutico , Antifúngicos/uso terapêutico , DNA Fúngico/genética , Evolução Fatal , Feminino , Infecções por HIV/virologia , Humanos , Mucormicose/diagnóstico , Mucormicose/tratamento farmacológico , Mucormicose/microbiologia , Choque Séptico/diagnóstico , Choque Séptico/microbiologia , Infecções Estreptocócicas/diagnóstico , Infecções Estreptocócicas/microbiologia , Síndrome , Tailândia
4.
BMC Infect Dis ; 20(1): 614, 2020 Aug 18.
Artigo em Inglês | MEDLINE | ID: mdl-32811466

RESUMO

BACKGROUND: The most common aetiological agents of mucormycosis are Rhizopus, Mucor, Apophysomyces and Lichtheimia. Apophysomyces is comparatively rare, as it has been reported in less than 3% of mucormycosis cases. The genus Apophysomyces includes six species, and only A. elegans, A. mexicanus, A. variabilis and A. ossiformis have been reported to cause infections in both immunocompetent and immunocompromised patients. CASE PRESENTATION: We present a case of a 46-year-old male patient with bilateral blepharoedema, corneal opacity in the left eye and poorly controlled diabetes mellitus. The patient was subjected to total maxillectomy, exenteration of the left orbit and treatment with liposomal amphotericin B. Direct mycological analysis with KOH 10% revealed hyaline, coenocytic, long and wide hyphae. Apophysomyces ossiformis was identified from maxillary biopsy using 18S-ITS1-5.8S-ITS2-28S rRNA gene amplification and sequencing. The patient requested to be transferred to another hospital to continue treatment, where he died on the ninth day after admittance. CONCLUSION: To the best of our knowledge, this is the first case of rhino-orbital mucormycosis due to A. ossiformis with a fatal outcome. This case reveals the need to identify the fungus causing mucormycosis with molecular methods to identify adequate treatment therapies for patients with this infection.


Assuntos
Complicações do Diabetes/microbiologia , Mucorales/genética , Mucormicose/complicações , Doenças Orbitárias/complicações , Rinite/complicações , Anfotericina B/uso terapêutico , Antifúngicos/uso terapêutico , Biópsia , Complicações do Diabetes/tratamento farmacológico , Complicações do Diabetes/cirurgia , Evolução Fatal , Humanos , Hospedeiro Imunocomprometido , Masculino , Maxila/microbiologia , Maxila/patologia , Maxila/cirurgia , Pessoa de Meia-Idade , Mucormicose/tratamento farmacológico , Mucormicose/microbiologia , Mucormicose/cirurgia , Doenças Orbitárias/tratamento farmacológico , Doenças Orbitárias/microbiologia , Doenças Orbitárias/cirurgia , RNA Ribossômico 28S/genética , Rinite/tratamento farmacológico , Rinite/microbiologia , Rinite/cirurgia
5.
Mycopathologia ; 185(4): 599-606, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32737747

RESUMO

Coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has been sweeping across the globe. Based on a retrospective analysis of SARS and influenza data from China and worldwide, we surmise that the fungal co-infections associated with global COVID-19 might be missed or misdiagnosed. Although there are few publications, COVID-19 patients, especially severely ill or immunocompromised, have a higher probability of suffering from invasive mycoses. Aspergillus and Candida infections in COVID-19 patients will require early detection by a comprehensive diagnostic intervention (histopathology, direct microscopic examination, culture, (1,3)-ß-D-glucan, galactomannan, and PCR-based assays) to ensure effective treatments. We suggest it is prudent to assess the risk factors, the types of invasive mycosis, the strengths and limitations of diagnostic methods, clinical settings, and the need for standard or individualized treatment in COVID-19 patients. We provide a clinical flow diagram to assist the clinicians and laboratory experts in the management of aspergillosis, candidiasis, mucormycosis, or cryptococcosis as co-morbidities in COVID-19 patients.


Assuntos
Infecções por Coronavirus/complicações , Micoses/complicações , Pneumonia Viral/complicações , Candidíase Invasiva/complicações , Candidíase Invasiva/diagnóstico , Candidíase Invasiva/terapia , China , Infecções por Coronavirus/diagnóstico , Criptococose/complicações , Criptococose/diagnóstico , Criptococose/terapia , Humanos , Aspergilose Pulmonar Invasiva/complicações , Aspergilose Pulmonar Invasiva/diagnóstico , Aspergilose Pulmonar Invasiva/terapia , Mucormicose/complicações , Mucormicose/diagnóstico , Mucormicose/terapia , Micoses/diagnóstico , Micoses/terapia , Pandemias , Pneumonia Viral/diagnóstico
6.
An Bras Dermatol ; 95(5): 623-626, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32616336

RESUMO

The authors report a rare case of primary cutaneous mucormycosis caused by Mucor irregularis and cutaneous Klebsiella pneumoniae infections in a 67-year-old Chinese woman. After the administration of liposomal amphotericin B combined with cefoperazone/sulbactam sodium, the patient recovered. Invasive fungal infection combined with cutaneous bacterial infection should receive attention.


Assuntos
Coinfecção , Mucormicose , Idoso , Antifúngicos/uso terapêutico , Coinfecção/tratamento farmacológico , Feminino , Humanos , Klebsiella pneumoniae , Mucor , Mucormicose/complicações , Mucormicose/tratamento farmacológico , Pele
9.
Rev. Hosp. Ital. B. Aires (2004) ; 40(1): 25-28, mar. 2020. ilus
Artigo em Espanhol | LILACS | ID: biblio-1102210

RESUMO

Introducción: la zigomicosis es una infección fúngica poco frecuente, con alta tasa de mortalidad y de mal pronóstico. Afecta principalmente a pacientes inmunocomprometidos. La asociación con el síndrome hemofagocítico es extremadamente inusual, más aún en pacientes inmunocompetentes, con pocos ejemplos registrados en la literatura. Caso clínico: se presenta el caso de un paciente masculino inmunocompetente de 40 años con diagnóstico de mucormicosis y síndrome hemofagocítico que evoluciona desfavorablemente, con fallo multiorgánico, a pesar de los esfuerzos médicos. Conclusión: la asociación de mucormicosis con síndrome hemofagocítico en un paciente inmunocompetente es extremadamente rara; existen pocos casos informados en Latinoamérica. Debemos tener presente esta asociación, ya que requiere un tratamiento agresivo y soporte vital avanzado. (AU)


Introduction: zygomycosis is a rare fungal infection that carries with high mortality rates. This poor prognosis, rapidly progressive infection mainly affects immunocompromised patients. The association with hemophagocytic lymphohistiocytosis is extremely unusual, even more in immunocompetent patients, with few cases reported. Case: we present the case of an immunocompetent male patient who was diagnosed with zygomycosis and hemophagocytic lymphohistiocytosis. Despite medical efforts he developed multiorganic failure. Conclusion: the association of mucormycosis with hemophagocytic lymphohistiocytosis in an immunocompetent patient is exceptional with few cases reported in Latin America. We must always suspect this association considering they require aggressive treatment and advanced life support. (AU)


Assuntos
Humanos , Masculino , Adulto , Zigomicose/diagnóstico , Linfo-Histiocitose Hemofagocítica/diagnóstico , Pancitopenia/sangue , Agitação Psicomotora , Vancomicina/uso terapêutico , Norepinefrina/administração & dosagem , Norepinefrina/uso terapêutico , Anfotericina B/uso terapêutico , Exoftalmia/diagnóstico por imagem , Hospedeiro Imunocomprometido/imunologia , Colistina/uso terapêutico , Combinação Amoxicilina e Clavulanato de Potássio/administração & dosagem , Combinação Amoxicilina e Clavulanato de Potássio/uso terapêutico , Zigomicose/etiologia , Zigomicose/mortalidade , Zigomicose/epidemiologia , Delírio , Linfo-Histiocitose Hemofagocítica/etiologia , Linfo-Histiocitose Hemofagocítica/mortalidade , Febre , Meropeném/uso terapêutico , Imunocompetência/imunologia , Icterícia , Mucormicose/complicações , Insuficiência de Múltiplos Órgãos/diagnóstico
10.
BMJ Case Rep ; 13(2)2020 Feb 20.
Artigo em Inglês | MEDLINE | ID: mdl-32086323

RESUMO

The present manuscript reports two extremely rare cases of coexisting emphysematous gastritis with gastric mucormycosis. The cases were managed successfully, considering the high mortality associated with both conditions independently. The aim of the manuscript is to elucidate the importance of prompt diagnosis, early surgical intervention for source control and concomitant application of antifungal therapy for a favourable outcome.


Assuntos
Infecções Bacterianas/complicações , Enfisema/complicações , Gastrite/complicações , Mucormicose/complicações , Estômago/patologia , Idoso , Anastomose em-Y de Roux , Antifúngicos/uso terapêutico , Infecções Bacterianas/terapia , Enfisema/terapia , Esofagostomia , Feminino , Gastrectomia , Gastrite/terapia , Humanos , Jejunostomia , Mucormicose/terapia , Doenças Raras/terapia , Resultado do Tratamento
11.
J Craniofac Surg ; 31(4): e321-e324, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-32028364

RESUMO

The authors present their experience about clinical evidences that include patients with an untreated diabetes who developed rhino-orbito-cerebral mucormycosis (ROCM). They were treated with endoscopic sinus surgery and medical treatment with intravenous, intradural therapy, and sinus washes with amphotericin B. The ROCM is a disease with a rapid evolution and an increase in mortality rate, especially if the fungus enters the cranial cavity. Therefore, it would be necessary in all diabetic patients with sinus symptoms, headaches, visual changes, suspect a mucormycosis, and perform a careful radiology assessment and a nasal endoscopy. Often, despite an early diagnosis and rapid treatment for ROCM, it is not possible to stem the disease, which ends with the patient's death.


Assuntos
Anfotericina B/uso terapêutico , Antifúngicos/uso terapêutico , Complicações do Diabetes , Mucormicose/cirurgia , Doenças Orbitárias/cirurgia , Doenças dos Seios Paranasais/cirurgia , Idoso , Diabetes Mellitus , Endoscopia , Humanos , Masculino , Pessoa de Meia-Idade , Mucormicose/complicações , Mucormicose/tratamento farmacológico , Doenças Orbitárias/complicações , Doenças Orbitárias/tratamento farmacológico , Doenças dos Seios Paranasais/complicações , Doenças dos Seios Paranasais/tratamento farmacológico
12.
J Mycol Med ; 30(1): 100923, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-31964598

RESUMO

Abortion in dairy cattle may be caused by infectious (viruses, fungi and protozoa) and non-infectious causes mostly related to bad management practices and genetic factors. Recently, the significant contribution of mycotic infection to bovine abortion has been recognized. This report describes an abortion case in a Chianina cow due to Aspergillus nidulans, Aspergillus luchuensis and Lichtheimia sp. diagnosed by histology, cytology, culture and molecular assays. A mixed infection due to more than one fungus in abortion is rarely demonstrated. To our knowledge, this is the first case of bovine abortion caused by co-infection with three different moulds.


Assuntos
Aborto Animal/microbiologia , Aspergilose/complicações , Coinfecção/complicações , Mucormicose/complicações , Aborto Espontâneo/microbiologia , Aborto Animal/diagnóstico , Animais , Aspergilose/diagnóstico , Aspergilose/veterinária , Aspergillus/classificação , Aspergillus/isolamento & purificação , Aspergillus/patogenicidade , Aspergillus nidulans/isolamento & purificação , Aspergillus nidulans/patogenicidade , Bovinos , Doenças dos Bovinos/diagnóstico , Doenças dos Bovinos/microbiologia , Coinfecção/diagnóstico , Coinfecção/microbiologia , Coinfecção/veterinária , Feminino , Mucorales/isolamento & purificação , Mucorales/patogenicidade , Mucormicose/diagnóstico , Mucormicose/veterinária , Gravidez
13.
J Postgrad Med ; 66(1): 48-50, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31929312

RESUMO

Gastrointestinal mucormycosis is a rare form of invasive mucormycosis with high fatality rate due to difficulty in establishing its diagnosis. The classic risk-factors include immunosuppression and metabolic derangement. A case of ileocecal mucormycosis following intracardiac repair of congenital heart disease in a 17-year-old boy is described here who lacked the typical risk-factors for mucormycosis. Ileocecal mucormycosis affecting an individual without the classic risk-factors is uncommon.


Assuntos
Hemorragia Gastrointestinal/etiologia , Íleo/lesões , Perfuração Intestinal , Mucormicose/diagnóstico , Adolescente , Antifúngicos/uso terapêutico , Colectomia , Enterobacter aerogenes/isolamento & purificação , Cardiopatias Congênitas/cirurgia , Humanos , Klebsiella pneumoniae/isolamento & purificação , Masculino , Mucormicose/complicações , Mucormicose/tratamento farmacológico , Peritonite/tratamento farmacológico , Peritonite/microbiologia , Complicações Pós-Operatórias
14.
Mycoses ; 63(3): 257-264, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-31762083

RESUMO

Since mould-active azole prophylaxis has become a standard approach for patients with high-risk haematologic diseases, the epidemiology of invasive fungal infections (IFIs) has shifted towards non-Aspergillus moulds. It was aimed to identify the epidemiology and characteristics of non-Aspergillus invasive mould infections (NAIMIs). Proven/probable NAIMIs developed in patients with haematologic diseases were reviewed from January 2011 to August 2018 at Catholic Hematology hospital, Seoul, Korea. There were 689 patients with proven/probable invasive mould infections; of them, 46 (47 isolates) were diagnosed with NAIMIs. Fungi of the Mucorales order (n = 27, 57.4%) were the most common causative fungi, followed by Fusarium (n = 9, 19.1%). Thirty-four patients (73.9%) had neutropenia upon diagnosis of NAIMIs, and 13 (28.3%) were allogeneic stem cell transplantation recipients. The most common site of NAIMIs was the lung (n = 27, 58.7%), followed by disseminated infections (n = 8, 17.4%). There were 23.9% (n = 11) breakthrough IFIs, and 73.9% (n = 34) had co-existing bacterial or viral infections. The overall mortality at 6 and 12 weeks was 30.4% and 39.1%, respectively. Breakthrough IFIs (adjusted hazards ratio [aHR] = 1.99, 95% CI: 1.3-4.41, P = .031) and surgical treatment (aHR = 0.09, 95% CI: 0.02-0.45, P = .003) were independently associated with 6-week overall mortality. NAIMIs were not rare and occur as a complex form of infection often accompanied by breakthrough/mixed/concurrent IFIs and bacterial or viral infections. More active diagnostic efforts for NAIMIs are needed.


Assuntos
Doenças Hematológicas/complicações , Infecções Fúngicas Invasivas/mortalidade , Adulto , Idoso , Estudos de Coortes , Comorbidade , Feminino , Doenças Hematológicas/mortalidade , Humanos , Incidência , Infecções Fúngicas Invasivas/complicações , Infecções Fúngicas Invasivas/epidemiologia , Pneumopatias Fúngicas/complicações , Pneumopatias Fúngicas/epidemiologia , Pneumopatias Fúngicas/mortalidade , Masculino , Pessoa de Meia-Idade , Mucormicose/complicações , Mucormicose/epidemiologia , Mucormicose/mortalidade , Análise Multivariada , Estudos Retrospectivos , Fatores de Risco , Adulto Jovem
15.
J Infect Chemother ; 26(2): 175-180, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31735628

RESUMO

OBJECTIVE: Although invasive fungal disease (IFD) is an important complication in allogeneic hematopoietic stem cell transplantation (HSCT), the clinical significance of surgery, including the role of surgical resection for persistent pulmonary fungal disease prior to allogeneic HSCT in the current era with a variety of available antifungal agents, is controversial. We investigated the role of surgical resection. METHODS: We retrospectively investigated six patients who underwent surgical resection of suspected pulmonary fungal disease prior to allogeneic HSCT between April 2007 and June 2016 at our medical center. RESULTS: We present six patients who underwent surgical resection of suspected pulmonary fungal disease prior to allogeneic HSCT. In our case series, three of four patients who were given a presurgical diagnosis of possible IFD were given a proven diagnosis after surgery, including two cases of invasive aspergillosis (IA) and one case of mucormycosis. All surgeries were performed by video-assisted thoracic surgery (VATS) for lobectomy without major complications. Recurrence of IFD was not observed after allogeneic HSCT in any of the six patients. CONCLUSION: Our experience indicated that surgical resection of persistent localized pulmonary lesions of IFD before allogeneic HSCT was helpful for obtaining a definitive diagnosis and might be useful for reducing recurrence after HSCT.


Assuntos
Transplante de Células-Tronco Hematopoéticas , Leucemia/cirurgia , Pneumopatias Fúngicas/cirurgia , Cirurgia Torácica Vídeoassistida/métodos , Adulto , Aspergilose/complicações , Aspergilose/cirurgia , Feminino , Humanos , Infecções Fúngicas Invasivas/complicações , Infecções Fúngicas Invasivas/cirurgia , Leucemia/complicações , Pneumopatias Fúngicas/complicações , Masculino , Pessoa de Meia-Idade , Mucormicose/complicações , Mucormicose/cirurgia , Recidiva , Estudos Retrospectivos , Transplante Homólogo , Adulto Jovem
17.
Medicine (Baltimore) ; 98(48): e18142, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31770250

RESUMO

RATIONALE: Mucormycosis is a rare opportunistic fungal infection with poor prognosis. The incidence of mucormycosis has been increasing, and it is a threat to immunocompromised hosts. We present a case of gastric mucormycosis complicated by a gastropleural fistula during immunosuppressive treatment for adult-onset Still disease (AOSD). PATIENT CONCERNS: An 82-year-old woman diagnosed with AOSD who developed gastric ulcers during the administration of an immunosuppressive therapy with corticosteroids, cyclosporine, and tocilizumab complained of melena and epigastralgia. Esophagogastroduodenoscopy showed multiple ulcers covered with grayish or greenish exudates. DIAGNOSES: The patient diagnosed with mucormycosis based on culture and biopsy of the ulcers, which showed nonseptate hyphae branching at wide angles. Mucor indicus was identified using polymerase chain reaction. INTERVENTIONS AND OUTCOMES: Although liposomal amphotericin B was administered, gastric mucormycosis was found to be complicated by a gastropleural fistula. The patient died because of pneumonia due to cytomegalovirus infection, and autopsy revealed the presence of Mucorales around the fistula connecting the stomach and diaphragm. LESSONS: Gastric mucormycosis is refractory to treatment and fatal. Surgical resection, if possible, along with antifungal drugs can result in better outcomes.


Assuntos
Fístula Gástrica/microbiologia , Mucormicose/complicações , Infecções Oportunistas/complicações , Fístula do Sistema Respiratório/microbiologia , Úlcera Gástrica/microbiologia , Idoso de 80 Anos ou mais , Feminino , Fístula Gástrica/induzido quimicamente , Humanos , Imunossupressores/efeitos adversos , Mucormicose/induzido quimicamente , Mucormicose/microbiologia , Infecções Oportunistas/induzido quimicamente , Infecções Oportunistas/microbiologia , Pleura/microbiologia , Fístula do Sistema Respiratório/induzido quimicamente , Doença de Still de Início Tardio/tratamento farmacológico , Úlcera Gástrica/induzido quimicamente
18.
Rev Esp Enferm Dig ; 111(12): 961-962, 2019 12.
Artigo em Inglês | MEDLINE | ID: mdl-31617363

RESUMO

Mucormycosis is a rare and fatal infection, largely confined to immunocompromised hosts. Duodenal involvement is extremely rare. We report a case of a 67-year-old female presented with hematemesis eventually diagnosed with duodenal mucormycosis, while radiology characteristics suggested malignancy.


Assuntos
Duodenopatias/complicações , Hemorragia Gastrointestinal/etiologia , Imunocompetência , Mucormicose/complicações , Idoso , Diagnóstico Diferencial , Duodenopatias/diagnóstico por imagem , Neoplasias Duodenais/diagnóstico por imagem , Feminino , Hemorragia Gastrointestinal/diagnóstico por imagem , Hematemese/diagnóstico por imagem , Hematemese/etiologia , Humanos , Mucormicose/diagnóstico por imagem , Tomografia Computadorizada por Raios X
19.
Rev Port Cir Cardiotorac Vasc ; 26(2): 151-153, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31476818

RESUMO

Mucormycosis is a life-threatening fungal infection that occurs mainly in immunocompromised patients. Its occurrence isolated in the lung rare and carries a high mortality risk if untreated. We report the case of a 76-year old male immunocompetent patient, under treatment for pulmonary tuberculosis, admitted to the emergency department with hemoptysis. Bronchoscopy was performed and active bleeding from the middle lobe bronchus was found. Chest CT scan identified a solitary cavitary lesion in the middle lobe. The patient was proposed for urgent open middle lobectomy. Postoperative period was uneventful. Pulmonary mucormycosis was confirmed and adjuvant therapy with Amphotericin B was performed for 30 days. Despite its rarity, mucormycosis prevalence is expected to raise together with increasing number of immunocompromised patients. A high level of suspicion is recommended as early diagnosis can be determinant.


Assuntos
Pneumopatias Fúngicas/terapia , Mucormicose/terapia , Tuberculose Pulmonar/terapia , Idoso , Anti-Infecciosos/uso terapêutico , Humanos , Imunocompetência , Pneumopatias Fúngicas/complicações , Pneumopatias Fúngicas/diagnóstico , Pneumopatias Fúngicas/imunologia , Masculino , Mucormicose/complicações , Mucormicose/diagnóstico , Mucormicose/imunologia , Pneumonectomia , Tuberculose Pulmonar/complicações , Tuberculose Pulmonar/imunologia
20.
Rev. iberoam. micol ; 36(3): 160-164, jul.-sept. 2019. tab
Artigo em Inglês | IBECS | ID: ibc-191407

RESUMO

Background: Mucormycosis is a fungal infection caused by species of the Mucorales order. These microorganisms are angioinvasive, with rapid disease progression and potentially lethal in its rhinocerebral form. Case report: We present the case of a 12-year-old female with trisomy 21, acute lymphoblastic leukemia and diabetes, with fever and neutropenia who developed rhinocerebral mucormicosis. After treatment with amphotericin B lipid complex and extensive surgery, disease progressed and posaconazole was added as salvage treatment with full remission of the infection. Four years after diagnosis the patient continues without relapse of mucormycosis or leukemia. Conclusions: This case highlights the use of posaconazole as either monotherapy or combined therapy. Although it is still debated, it can be considered an option for salvage treatment in children with non-responding mucormycosis, despite lack of standard dosage in pediatric patients


Antecedentes: La mucormicosis es una infección fúngica causada por especies del orden de los mucorales. Estos microorganismos se caracterizan por ser angioinvasivos, con progresión rápida de la enfermedad y potencialmente letales en la forma rinocerebral. Caso clínico: Presentamos el caso de una paciente de 12 años de edad con trisomía 21, leucemia linfoblástica aguda, diabetes, fiebre y neutropenia, que desarrolló una mucormicosis rinocerebral. La enfermedad progresó a pesar de recibir tratamiento con anfotericina B complejo lipídico y ser sometida a cirugía extensa. Se añadió posaconazol al tratamiento como terapia de salvamento, lo que llevó a la remisión total del proceso infeccioso. Cuatro años después la paciente continúa sin recaída de la mucormicosis o la leucemia. Conclusiones: Este caso destaca el uso del posaconazol, ya sea como monoterapia o terapia combinada en el tratamiento de la mucormicosis. Si bien aún es debatido su uso, se puede considerar como una opción en el tratamiento de niños con mucormicosis que no responden al tratamiento convencional a pesar de no contar con una dosis pediátrica establecida


Assuntos
Humanos , Feminino , Criança , Mucormicose/tratamento farmacológico , Mucorales/isolamento & purificação , Leucemia-Linfoma Linfoblástico de Células Precursoras/complicações , Antifúngicos/uso terapêutico , Triazóis/uso terapêutico , Mucormicose/complicações , Mucorales/patogenicidade , Síndrome de Down/complicações , Terapia de Salvação/métodos
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