Document Detail


The emergence of mucormycosis as an important opportunistic fungal infection: five cases presenting to a tertiary referral center for mycology.
MedLine Citation:
PMID:  17442077     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Mucormycosis, a rare opportunistic fungal infection, is re-emerging in importance with the increase in prevalence of immunosuppressive states, both as a result of therapy and disease. METHODS: We report five cases of mucormycosis diagnosed by the Dermatology Department and managed jointly with the Medical and Surgical Services of "Dr Manuel Gea Gonzalez" General Hospital in Mexico City, a tertiary referral center for mycology. We also review the current literature including recent advances in medical therapy. RESULTS: Four of the five cases were of the rhino-orbital-cerebral variant, commonly associated with significant mortality, and one of these patients died despite early diagnosis and aggressive management. The fifth case was primary cutaneous mucormycosis and this patient survived infection without relapse. Diabetic ketoacidosis predisposed to infection in four cases and the other was associated with advanced human immunodeficiency virus infection. Radiologic imaging was important in cases of facial involvement in order to evaluate the extent of disease and possible intracranial involvement. All cases were managed with systemic antifungals and surgical debridement, together with the treatment of predisposing factors. CONCLUSIONS: These cases illustrate the need for early clinical recognition and prompt therapy, as well as the requirement for tissue biopsy in order to demonstrate the characteristic morphologic features of this fungal agent in the absence of positive mycology culture results. This report also highlights that, although rhino-orbital-cerebral mucormycosis requires effective multidisciplinary management, the disease not uncommonly presents to dermatologists for diagnosis.
Authors:
Mahreen Ameen; Roberto Arenas; Eduwiges Martinez-Luna; Miguel Reyes; Rogelio Zacarias
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  International journal of dermatology     Volume:  46     ISSN:  0011-9059     ISO Abbreviation:  Int. J. Dermatol.     Publication Date:  2007 Apr 
Date Detail:
Created Date:  2007-04-19     Completed Date:  2007-06-19     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0243704     Medline TA:  Int J Dermatol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  380-4     Citation Subset:  IM    
Affiliation:
Department of Mycology, Hospital General "Dr Manuel Gea Gonzalez", Tlalpan, Mexico. mahreenameen@hotmail.com
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MeSH Terms
Descriptor/Qualifier:
AIDS-Related Opportunistic Infections / complications,  diagnosis*,  pathology
Adult
Aged
Dermatitis, Perioral / complications,  diagnosis*,  pathology
Diabetes Mellitus, Type 2*
Diabetic Ketoacidosis / complications,  diagnosis*,  pathology
Diagnosis, Differential
Edema / etiology
Female
Fever / etiology
Humans
Male
Mucormycosis / complications,  diagnosis*,  pathology

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


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