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A 49-year-old woman was free of metastases for 14 years after a left radical mastectomy. Metastases were found only in the skull, also the bone marrow biopsy demonstrated metastases.

Mucormycosis is an opportunistic fungal infection that rarely occurs in immunocompetent individuals. Mucormycosis refers to a serious fungal infection caused by fungi of the order Mucorales. The common clinical presentations of mucormycosis are rhinocerebral, cutaneous, pulmonary, gastrointestinal and disseminated forms. Clinically, most patients with isolated renal mucormycosis present with fever, flank pain, tenderness, hematuria or pyuria. Histopathologic evidence of fungal invasion of the tissues is diagnostic. Early institution of amphotericin-B, combined with nephrectomy offers the best chance for cure. Isolated renal mucormycosis has been seldom reported and is even rarer in children. We present an unusual case of renal mucormycosis in a pediatric patient with no known predisposing factors.

AIM AND OBJECTIVE:To identify and compare the indications and complications of tracheostomy in pediatric and adult population. STUDY DESIGN: Prospective study. SETTING: Department of ENT, Rural based Tertiary Hospital, Nagpur, M.S., India. Duration-2 years. Material and Methods-All patients of either age and sex who required tracheostomy in our hospital were included in the study. Patients were analyzed in terms of indication of tracheostomy, early and late complications and decanulation time required and compared them between pediatric and adult age group. RESULTS: During this period, total 104 tracheostomies were performed out of which 36 were in pediatric and 68 in adult age group. Male to female ratio in pediatric group was 1.8: 1 and in adults it was 1.5: 1. Prolonged intubation for ventilation was the common indication for tracheostomy in pediatric age group (58.33%) whereas in adults it was upper airway obstruction (55.88%). Complication rate in adults (Early 51.47%, Late 13.23%) doesn't differ much from pediatric group (Early 44.4%, Late 11.11%). All patients with temporary tracheostomy in pediatric (75%) and adult group (70.66%) were decanulated successfully. Mean decanulation time was 117.19 days and 62.24 days in pediatric and adult group respectively and the difference was statistically significant (p= 0.0001). CONCLUSION: Pediatric and adult tracheostomies differ in terms of indications and decanulation time but complications are similar.

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