A case of Candida mediastinitis after dental extraction

Badiee, Parisa; Alborzi, Abdolvahab; Farhoudi, Farimah

doi:10.3855/jidc.1086

Cited by 9 publications

(6 citation statements)

References 13 publications

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“…Mediastinal extension of the abscess was noted, with cultures growing Candida parapsilosis and Candida krusei. The second case involved a 48-year old man with a seven-day history of fever and odynophagia [11]. Similar to our patient, he had no history of immunodeficiency.…”

Section: Discussionsupporting

confidence: 68%

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Ludwig’s Angina Complicated by Descending Necrotizing Mediastinitis and Superimposed Candida mediastinitis: Case Report and Literature Review

Tejura

Kapila

Dever

2018

JDMS

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Ludwig's angina is a rapidly spreading infection of the floor of the mouth and neck. A rare and dreaded complication of Ludwig's angina is extension of the infection to the mediastinum. We describe a unique case of Ludwig's angina presenting with descending necrotizing mediastinitis, with the subsequent development of Candida albicans and Candida krusei mediastinitis.A 57-year-old man presented with a three-day history of progressive neck swelling with odynophagia. Two days prior, he was treated at another facility with oral clindamycin. Upon his presentation to our Emergency Department, he was noted to have tachycardia (pulse 126/ minute), with trismus and purulent discharge from his oral cavity. He had numerous dental caries, and elevation of the floor of his mouth with visible necrotic tissue. The submental and submandibular regions were bilaterally swollen, with firm, erythematous skin extending from the neck to the upper chest wall.

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Section: Discussionsupporting

confidence: 68%

“…Two cases of Candida mediastinitis in the setting of Ludwig's angina have been reported in the literature [10,11]. One case involved a 26-year-old woman with poorly controlled type 2 diabetes mellitus, who presented with neck swelling, trismus, and dysphagia [10].…”

Section: Discussionmentioning

confidence: 99%

Ludwig’s Angina Complicated by Descending Necrotizing Mediastinitis and Superimposed Candida mediastinitis: Case Report and Literature Review

Tejura

Kapila

Dever

2018

JDMS

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“…With the development of health care, the incidence of invasive fungal infections (IFIs) in the high risk and impaired immune-function population has been increasing (1). At present, it is believed that the main risk factors for IFI include neutropenia, malignant hematopathy, bone marrow transplantation, solid organ transplantation, severe burn, glucocorticoids, long-term intensive care, chemotherapy, HIV infection, invasive medical procedures and new immunosuppression agents (2–4). The patients in ICU have the characteristics of long-term bed rest, complicated basic diseases and low immune system, which create the conditions for the breeding and implantation of fungi, leading to an increasing number of pulmonary fungal infections (5–7).…”

Section: Introductionmentioning

confidence: 99%

Clinical diagnostic value of spiral CT in invasive pulmonary fungal infection

et al. 2019

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This study explored the diagnostic value of computed tomography (CT) in pulmonary fungal infection to provide a theoretical basis for the clinical diagnosis of pulmonary fungal infections. The clinical data of 82 suspected invasive fungal infection (IFI) patients admitted to the Department of Critical Care Medicine of The Affiliated Hospital of Qingdao University from January 2016 to May 2018 were retrospectively analyzed, and 64 of them were diagnosed with IFI by pathology and sputum culture. The CT results of the 82 patients were compared with the X-ray results in order to analyze the diagnostic value of CT imaging. Taking pathological diagnosis as the gold standard, the number of true-negative, true-positive, false-negative and false-positive results in X-ray diagnosis were 13, 43, 21 and 5, respectively, while those in CT diagnosis were 11, 59, 5 and 7, respectively. The sensitivity, specificity, accuracy, positive coincidence rate, negative coincidence rate, misdiagnosis rate and missed diagnosis rate of CT in IFI were 92.18, 61.11, 85.37, 89.39, 68.75, 38.89 and 7.81%, respectively, while those of X-ray in IFI were 67.19, 72.22, 68.29, 89.58, 38.24, 27.78 and 32.81%, respectively. The sensitivity, accuracy and negative coincidence rate of CT in the diagnosis of IFI were significantly higher than those of X-ray (P<0.05), with a sensitivity of 92.18%, which indicates that CT has a higher diagnostic value in IFI. The results of CT combined with the basic condition of the patients can be used to initially diagnose pulmonary fungal infections, which is of high diagnostic value and can improve clinical treatment.

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“…Fungal corneal ulcers like other fungal infections are commonly present in immunocompromised patients but they have also been reported in healthy humans (8). This infection may occur at any age and for any sex but the most susceptible group are males engaged in agricultural or other outdoor work at the age of 31 to 40 years.…”

Section: Introductionmentioning

confidence: 99%

Mycotic Keratitis, a State-of-the-art Review

Badiee

2013

Jundishapur J Microbiol

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Microbial corneal diseases are a serious ocular infection and the major cause of ocular morbidity and blindness in the world. The outcomes of fungal keratitis are unfavorable due to the protracted course of the condition and the diversity of respective clinical presentations. Trauma, contact lens wear, foreign material, and prior corneal surgery, may make the most background for permitting invasion by exogenous fungi by injecting the fungal conidia directly in the corneal stroma. Other risk factors consist of blocked naso-lacrimal duct, and ocular surface disease. More than 105 species of fungi, such as Aspergillus spp., Fusarium spp., Candida spp., Rhizopus, Mucor, and other fungi have been identified as the etiological agents of fungal keratitis. The first step of diagnosis begins with clinical suspicion, followed by corneal scrapings or biopsy for direct smear and culture confirming the etiological agent. Slit lamp biomicroscope is used for careful examination of the infected eye and pictorial documents like the ulcer size, site, depth, extent of infiltration, abscess formation, and any perforation are evaluated. Direct smears are prepared by potassium hydroxide wet mount, or Gram's staining. To identify the isolates, a lactophenol cotton blue wet mount is prepared, and diagnosis is based on morphology of the culture media and details of microscopic examination. The results are highly specific but have suboptimal sensitivity varying in different studies. Molecular assays are valuable for the diagnosis of fungal keratitis in patients. Various advantages and limitations are reported for such methods. Overall, PCR is a sensitive and promising tool for the diagnosis of fungal keratitis but the expertise required and the lack of sophisticated facilities renders it inferior to the smear techniques in routine laboratory procedures and is not recommended accordingly. Rapid diagnosis and proper treatment are essential for fungal keratitis, and many patients require several months of therapy until the infiltrate is resolved and epithelial stroma are healed. Patients not responsive to antifungal therapy usually require corneal transplantation. Keywords: Corneal Ulcer; Keratitis; Eye InfectionsImplication for health policy/ practice/ research/ medical education: Rapid diagnosis andproper treatment are essential for fungal keratitis, and many patients require several months of therapy until the infiltrate is resolved and epithelial stroma is healed. Patients not responsive to antifungal therapy usually require corneal transplantation.

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A case of Candida mediastinitis after dental extraction

Cited by 9 publications

References 13 publications

Ludwig’s Angina Complicated by Descending Necrotizing Mediastinitis and Superimposed Candida mediastinitis: Case Report and Literature Review

Ludwig’s Angina Complicated by Descending Necrotizing Mediastinitis and Superimposed Candida mediastinitis: Case Report and Literature Review

Clinical diagnostic value of spiral CT in invasive pulmonary fungal infection

Mycotic Keratitis, a State-of-the-art Review

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