Document Detail


Zygomycotic necrotizing fasciitis in immunocompetent patients: a series of 18 cases.
MedLine Citation:
PMID:  16741524     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Necrotizing fasciitis is most often associated with bacterial infections. Zygomycosis is an uncommon infection causing necrotizing fasciitis. We report 18 such cases of zygomycotic necrotizing fasciitis, of these, 15 were immunocompetent. Of the eight cases cultured, five were positive for Apophysomyces elegans. A retrospective case review conducted at a tertiary referral center, from 1998 to 2004, 18 cases of fungal necrotizing fasciitis were diagnosed based on histomorphology of fungal organisms; and in few of the cases diagnosis was supported by mycologic culture reports. Of the total of 18 cases, culture report was available in eight cases, and out of which five of them grew A. elegans. Fifteen patients were immunocompetent. Clinical presentation, mycologic findings and histopathologic results were evaluated. A review of the literature pertaining to A. elegans infection was also done. Histopathologic examination showed broad, predominantly aseptate and occasional pauciseptate, thin-walled fungal hyphae with occasional angioinvasion. To the best of our knowledge, this is the first largest series of zygomycotic necrotizing fasciitis from India. Herein, we present data on 18 cases of necrotizing fasciitis assosiated with zygomycosis. Most of the cases in our series were immunocompetent. Nonsuppurative necrosis with presence of typical fungal profiles was important histologic feature. Zygomycosis must be considered in the differential diagnosis not only in immunocompromised patients but also in the absence of any underlying disorders.
Authors:
Deepali Jain; Yashwant Kumar; Rakesh K Vasishta; Logasundaram Rajesh; Sanjib K Pattari; Arunaloke Chakrabarti
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Publication Detail:
Type:  Journal Article     Date:  2006-06-02
Journal Detail:
Title:  Modern pathology : an official journal of the United States and Canadian Academy of Pathology, Inc     Volume:  19     ISSN:  0893-3952     ISO Abbreviation:  Mod. Pathol.     Publication Date:  2006 Sep 
Date Detail:
Created Date:  2006-08-23     Completed Date:  2006-10-31     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8806605     Medline TA:  Mod Pathol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1221-6     Citation Subset:  IM    
Copyright Information:
Published online 2 June 2006.
Affiliation:
Department of Histopathology, Post-Graduate Institute of Medical Education and Research, Chandigarh, India. deepalipgi@rediffmail.com
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Child, Preschool
Fasciitis, Necrotizing / immunology,  microbiology,  pathology*
Female
Humans
Immunocompetence*
Male
Middle Aged
Mucorales / cytology,  isolation & purification,  pathogenicity
Mucormycosis / complications,  immunology,  pathology*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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