Bronchovascular mucormycosis: an urgent surgical problem

Zapatero, J.; Flandes, J.; Ruiz-Zafra, Javier; Fogué, L.; Salvatierra, Sara; Saldaña, D.G. Vázquez; Peñalver, Rafael

doi:10.1016/s1010-7940(05)80164-2

Cited by 13 publications

(4 citation statements)

References 6 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Consistent with this, the most common underlying condition was diabetes mellitus (n = 20, 65%) in EB mucormycosis. Hematologic malignancies, prolonged neutropenia, treatment with corticosteroids or deferoxamine, bronchogenic cancer, renal transplantation and acquired immunodeficiency syndrome were other reported risk factors [6,47,48,49,50,51,52,53,54,55,56,57,58,59,60,61,62,63,64,65,66,67,68,69,70,71,72,73]. Consistent with this, 7 patients (23%) were reported to be immunocompromised hosts; including diabetic patients, the number increased to 25 (81%), reflecting the opportunistic behavior of this organism.…”

Section: Discussionmentioning

confidence: 99%

“…Reviewing the English literature, we recognized that the most common agents causing EBFI are Aspergillus spp. [1,2,3,4,5,6,7,8,9,10,11,12,13,14,15,16,17,18,19,20,21,22,23,24,25,26,27,28,29,30,31,32,33,34,35,36,37,38,39,40,41,42,43,44,45], Coccidioides immitis [46] , agents of zygomycosis [6,47,48,49,50,51,52,53,54,55,56,57,58,59,60,61,62,63,64,65,66,67,68,69,70,71,72,73], Candida spp. [6, 34,74,75,76], Cryptococcus neoformans [77,78,79,80,81,82,83,84,85,86,87,88], and Histoplasma capsulatum [89,…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Endobronchial Fungal Disease: An Under-Recognized Entity

Karnak

Avery²,

Gildea

et al. 2006

Respiration

View full text Add to dashboard Cite

Most fungi enter the human body via inhalation; however, endobronchial fungal infection (EBFI) seems to be a rare manifestation compared to pulmonary or systemic disease. This presentation seems to be related to environmental factors as well as to the host status. With the increasing popularity of flexible bronchoscopy, it is being recognized with a higher frequency. Bronchoscopic findings in EBFI vary from mild mucosal inflammation to central airway obstruction. We searched English literature related to the topic and found 228 total cases of EBFI: Aspergillus species (121), Coccidioides immitis (38), Zygomycetes (31), Candida species (14) Cryptococcus neoformans (13), and Histoplasma capsulatum (11). We have also included a single case of endobronchial Pseudallescheria boydii infection in a lung transplant recipient that has not been reported previously. Most patients were immunocompromised, exhibited systemic manifestations of the primary infection, and responded to appropriate therapy. EBFI should be included in the differential diagnosis of any form of airway lesions in immunocompromised patients, especially among residents from the endemic areas.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Endobronchial Fungal Disease: An Under-Recognized Entity

Karnak

Avery²,

Gildea

et al. 2006

Respiration

View full text Add to dashboard Cite

show abstract

“…Mucormycosis usually occurs in the at-risk population alongside other common diseases, e.g., cytomegalovirus infection, bacterial infection or even other fungal diseases [202,203,[205][206][207]. Endobronchial or tracheal lesions are common [197,[208][209][210][211][212][213][214][215], and vascular involvement of great vessels may be a cause of fatal haemoptysis [216][217][218][219][220][221][222][223][224]. Symptoms may appear after near-drowning episodes [225], and the differential diagnosis of necrotising pneumonia or lung abscesses should be considered [204].…”

Section: R E S P I R a T O R Y M A N I F E S T A T I O N Smentioning

confidence: 99%

Mucormycosis: an emerging disease?

Bouza

Muñóz

Guinea

2006

Clinical Microbiology and Infection

137

127

View full text Add to dashboard Cite

A B S T R A C TMucormycosis is the third invasive mycosis in order of importance after candidiasis and aspergillosis and is caused by fungi of the class Zygomycetes. The most important species in order of frequency is Rhizopus arrhizus (oryzae). Identification of the agents responsible for mucormycosis is based on macroscopic and microscopic morphological criteria, carbohydrate assimilation and the maximum temperature compatible with its growth. The incidence of mucormycosis is approximately 1.7 cases per 1000 000 inhabitants per year, and the main risk-factors for the development of mucormycosis are ketoacidosis (diabetic or other), iatrogenic immunosuppression, use of corticosteroids or deferoxamine, disruption of mucocutaneous barriers by catheters and other devices, and exposure to bandages contaminated by these fungi. Mucorales invade deep tissues via inhalation of airborne spores, percutaneous inoculation or ingestion. They colonise a high number of patients but do not cause invasion. Mucormycosis most commonly manifests in the sinuses (39%), lungs (24%), skin (19%), brain (9%), and gastrointestinal tract (7%), in the form of disseminated disease (6%), and in other sites (6%). Clinical diagnosis of mucormycosis is difficult, and is often made at a late stage of the disease or post-mortem. Confirmation of the clinical form requires the combination of symptoms compatible with histological invasion of tissues. The probable diagnosis of mucormycosis requires the combination of various clinical data and the isolation in culture of the fungus from clinical samples. Treatment of mucormycosis requires a rapid diagnosis, correction of predisposing factors, surgical resection, debridement and appropriate antifungal therapy. Liposomal amphotericin B is the therapy of choice for this condition. Itraconazole is considered to be inappropriate and there is evidence of its failure in patients suffering from mucormycosis. Voriconazole is not active in vitro against Mucorales, and failed when used in vivo. Posaconazole and ravuconazole have good activity in vitro. The overall rate of mortality of mucormycosis is approximately 40%.

show abstract

“…Pulmonary involvement is typically expressed by rapidly progressive pneumonia with diffuse infiltrates on chest x‐ray 1. Very rarely, mucormycosis may involve the bronchi2–7 or the trachea 8, 9. Such cases are characterized by mucosal ulceration and vascular invasion, leading to profound tissue necrosis and destruction of the normal bronchial architecture.…”

mentioning

confidence: 99%