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Showing 3 results for Mucormycosis
Petergopalatine Fossa A Key Area In Rhinocerebral Mucormycosis Extension
Sadr-Hoseini S M, Saedi B,
Volume 61, Issue 6 (9-2003)
Abstract
Rhinocerebral mucormycosis is a rapidly progressive fungal infection that spreads from nose and sinuses to brain in short time. Cunent hypothesis about brain involvement explains that infection initiates in nose and progresses into orbit through ethmoidat sinuses via erosion of lamina papyranea. Then infection spreads from orbit apex to cavernous sinus and brain. Therefore, in addition to medical therapy surgical debridement of the sinuses plays a major role in treatment of these patients. The aim of this study is introduction of a new point of view about extension of mucor from the nose to orbit and brain. Also we discuss clinical implication of this perspective on surgery.
Materials and Methods: Since 1997-2002 nine patients with mucormycosis involving nose. Sinuses and orbit were admitted in ENT ward of Imam Khomeini general hospital. 8 patients with positive pathology entered the study. Variable such as age, underlying diseases, symptoms, site of involvement, extent of debridement and its times, and outcome were studied.
Results: After review of the history, surgical reports and pathological results, we found these findings in almost all patients: 1) facial pain, facial anesthesia, paralysis of buccal branch of facial nerve, paralysis of extrocular muscles, chemosis, periorbital edema 2) involvement of cheek subcutaneous tissue, buccal fat pad, IOF, SOF, orbital apex, infraorbital and maxillary nerves 3) involvement of pterygoid fossa with or without infratemporal fossa extension. Three patients have survived. Causes of death in other five patients were pneumonia, hypokalemia, and arrythmis during anesthesia. Mucormycosis was under control in most of these patients.
Conclusion: Pterygopalatine fossa is the main source for replication and extension of mucor. After entrance to the nose, mucor reaches this site and after involvement of IOF and SOF rapidly extends to retrobulbar portion of the orbit. Paranasal sinuses, buccal space, cheek, palate and infratemporal fossa may be secondarily involved. Exploration and debridment of this area has beneficial effect on surviving of these patients.




 


Presenting features and outcome of rhino-orbital-cerebral mucormycosis in two referral center in Mashhad
Ashraf Tavanaee Sani , Abdol Majid Fata , Mahnaz Arian ,
Volume 72, Issue 1 (4-2014)
Abstract
Background: This study was done to determine presenting features and treatment out-come of Rhino-Orbital-Cerebral Mucormycosis (ROCM). Methods: This cross sectional study was conducted during 14 years (from 1998-2012) in two educational hospitals of Mashhad University of Medical Sciences in patients with rhino-orbital-cerebral mucormycosis. Clinical symptoms, predisposing factors, demografic parameter and treatment outcome were collected by SPSS and analyzed by cox regression model. Results: A total of 123 cases were (92 proven, 1 probable, 30 possible). From 92 cases of proven rhino-orbital-cerebral mucormycosis, 52% men and 48% women were rec-orded. The most risk factor were diabet 42.4% and immune deficiency 38%. From which 32 patients have hematologic malignancy (50% ALL, 37.5% AML, 6.3% aplas-tic anemia, 6.3% other). Mean time of admission in hospital were 30.1±29.3 days (1-230 days). The sign and symptoms were fever 41.3%, nasal ulceration or necrosis of palate 54.3%, orbital sign 59.7%, Headache 55.4%, central nervous system sign 28.2% and facial sign 53.2%. Median time between first symptoms and start of amphotricin B was 8.2±8.6 days. Treatment consist of both surgery and amphotricin B was done in 70.5% of patients. Mean number of surgery were 1.8±1.5. The mean time of mortality was 60.3±83 day. Thirty seven percent of patients survived with a 6 months follow up. Conclusion: Initial symptoms of sinus invasion by mucormycosis are indistinguishable from other more common causes of sinusitis. We must consider these diseases if there is nasal ulceration or necrosis of palate with fever and orbital sign. Diabet and immune deficiency are the most risk factor for rhino-orbito-cerebral mucormycosis. There is no relationship between age, predisposing factors and adverse effect of drugs with surviv-al. Progression to central nervous system in imaging pattern are related with hospital mortality. Treatment modality and number of surgery affect to mortality P= 0.001, P= 0.033. Survival was affected with the total dose of amphotericin B (P= 0.026).
The relationship of serum iron and ferritin levels with mucormycosis infection in diabetic patients having acute COVID-19 during the year 2021 in Kermanshah University of medical sciences
Shayda Barat, Khosro Iranfar, Mahsa Ghanbari,
Volume 81, Issue 10 (1-2024)
Abstract
Background: Mucormycosis is a rare and aggressive opportunistic fungal infection that has grown significantly in recent years. This infection is rarely seen in healthy people. Mucormycosis usually appears as an acute infection with manifestations in the rhino-cerebral, pulmonary and skin areas, and sometimes its manifestations can be seen as a widespread infection. The special importance of mucormycosis is due to its high mortality rate, which leads to death in 75 to 80 percent of cases. The specific susceptibility of some patients to mucormycosis points to the importance of iron absorption in the pathogenesis of mucormycosis, therefore, we decided to investigate the relationship between serum iron and ferritin levels and mucormycosis disease in patients with underlying factors predisposing to COVID-19.
Methods: This study is a case-control type, in which patients with mucormycosis after contracting COVID-19 and also with a history of diabetes mellitus as the case group and patients with COVID-19 and a history of diabetes mellitus are considered as the control group and the serum level of iron and ferritin will be measured and compared in both groups and the outcome of the study will be determined based on the obtained results.The study took place in hospitals of the Kermanshah university of medical sciences in the Kermanshah city from March 2021 to March 2022.
Results: In this study, 38 patients were examined in two groups of patients with mucormycosis along with COVID-19 and diabetes in the case group and patients with  COVID-19 and diabetes in the control group with an average age of 63 years. In this study, there was no significant difference between the average age in the two studied groups. However, a significant difference was observed between serum iron and ferritin levels in two groups.
Conclusion: Hyperferritinemia is considered not only as an indicator of the systemic inflammatory process in the infection of COVID-19, but also indicates an increase in free iron level, which, as a result, contributes to the growth and spread of the fungus (mucormycosis).

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