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Predictors of mortality in rhinocerebral mycosis.
MedLine Citation:
PMID:  17921660     Owner:  NLM     Status:  MEDLINE    
INTRODUCTION: Rhinocerebral mycosis is a rapidly progressive fatal opportunistic infection, predominantly affecting people in an immunocompromised state. Aggressive surgical therapy, with repeated debridement in combination with intravenous amphotericin B can lead to a high rate of cure. AIM: To determine the predictors of mortality in rhinocerebral mycosis. MATERIALS AND METHODS: The demographic data, clinical features, radiological (MRI/CT) findings, treatment details of patients with a diagnosis of rhinocerebral mycosis confirmed on histopathology were analyzed retrospectively. The outcome was assessed as alive and dead. Univariate analysis with odds ratio (OR) was employed in data analysis. Chi-square test was used for P value. RESULTS: There were 38 patients. The age range was 7-82 (mean 48.68) years; 30 (79%) were males. Craniofacial pain was the most common initial presenting symptom, noted in 29 (76.3%). Rhino-orbital involvement was noted in 24 (63.2%) and 12 (31.6%) had associated focal neurological deficits. Immunocompromised state was noted in 24 (63.2%). Eighteen (47.4%) patients died. The predictors for mortality: odds ratio (95% CI) were 2.45 (1.01-3.89) for elderly age, 5.67 (4.13-7.21) for intracranial extension, 2.6 (1.26-3.94) for immunocompromised state, 2.62 (1.25-3.99) for infection with zygomycosis and 2.33 (1.01-3.65) for anemia. CONCLUSION: Rhinocerebral mycosis is associated with high mortality in spite of aggressive therapy. Intracranial extension with focal neurological deficits is a major predictor of mortality in rhinocerebral mycosis.
Sita S Jayalakshmi; Ramana G Reddy; Rupam Borgohain; C Subramanyam; Manas Panigrahi; C Sundaram; A K Meena; S Mohandas
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Neurology India     Volume:  55     ISSN:  0028-3886     ISO Abbreviation:  Neurol India     Publication Date:    2007 Jul-Sep
Date Detail:
Created Date:  2007-10-08     Completed Date:  2009-06-09     Revised Date:  2009-11-11    
Medline Journal Info:
Nlm Unique ID:  0042005     Medline TA:  Neurol India     Country:  India    
Other Details:
Languages:  eng     Pagination:  292-7     Citation Subset:  IM    
Department of Neurology, Nizam's Institute of Medical Sciences, Punjagutta, Hyderabad - 500 082, India.
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MeSH Terms
Brain Diseases / microbiology*,  mortality*
Confidence Intervals
Magnetic Resonance Imaging
Middle Aged
Mycoses / diagnosis,  mortality*
Odds Ratio
Predictive Value of Tests
Retrospective Studies
Tomography, X-Ray Computed / methods
Young Adult
Comment In:
Neurol India. 2007 Oct-Dec;55(4):416   [PMID:  18040125 ]

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