Isolated Intraventricular Chronic Mucormycosis in an Immunocompetent Infant: A Rare Case with Review of the Literature

Gupta, Shruti; Mehrotra, Anant; Attri, Gagandeep; Pal, Lily; Jaiswal, Awadhesh Kumar; Kumar, Raj

doi:10.1016/j.wneu.2019.06.190

Cited by 3 publications

(2 citation statements)

References 10 publications

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“…The literature search shows that rarely isolated cerebral mucormycosis may be seen in immunocompetent patients. Gupta et al 9 reviewed six cases of isolated cerebral mucormycosis, including two pediatric cases. Al Barbarawi et al 10 reported a case of isolated cerebral mucormycosis in an immunocompetent 4-year-old child.…”

Section: Discussionmentioning

confidence: 99%

Isolated cerebral mucormycosis masquerading as a tumor in an immunocompetent patient

et al. 2020

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Mucormycosis is an opportunistic fungal disease that commonly presents as cutaneous or rhinocerebral infections associated with immunocompromised states. It may exceptionally present as isolated involvement of the brain with a varied clinical presentation, which may be difficult to diagnose early, leading to increased mortality. Herein, we report the case of a 42-yearold immunocompetent female with left-sided limb weakness and a history of recurrent vomiting and headache for the last two years. Clinically, glioma was suspected, but histopathological examination revealed a few broad aseptate fungal hyphae. As no other organ was involved, the diagnosis of isolated cerebral mucormycosis was rendered. Reporting this case, we show an unusual presentation of a central nervous system mucormycosis masquerading a tumor in an immunocompetent patient. The case also highlights the importance of a careful histopathological examination to avoid missing the presence of occasional fungal hyphae. Ideally, recognition of fungal hyphae in the brain, during intraoperative consultation, can prompt brain tissue culture for definitive diagnosis and early empirical antifungal therapy, which may prove life-saving.

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Section: Discussionmentioning

confidence: 99%

Isolated cerebral mucormycosis masquerading as a tumor in an immunocompetent patient

et al. 2020

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“…5 Mucormycosis typically manifests in rhino-orbito-cerebral, gastrointestinal, cutaneous, pulmonary, or disseminated forms of disease. 2,[5][6][7][8][9] The symptomatic rhino-orbito-cerebral triad spreads hematogenously to the paranasal sinuses or the orbit and then intracranially through the ophthalmic artery, veins, or superior orbital fissure or directly through the cribriform plate or sinus walls. 2,[10][11][12][13][14][15] Isolated CNS disease via hematogenous spread without rhino-orbital involvement is uncommon.…”

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confidence: 99%

Immunocompetent isolated cerebral mucormycosis presenting with obstructive hydrocephalus: illustrative case

Nguyen,

Freeman,

Ung

et al. 2024

Journal of Neurosurgery: Case Lessons

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BACKGROUND Isolated cerebral mucormycosis is rare in immunocompetent adults and is only sparsely reported to be associated with obstructive hydrocephalus. OBSERVATIONS Here, the authors report a case of obstructive hydrocephalus secondary to central nervous system mucormycosis without other systems or rhino-orbital involvement and its technical surgical management. A 23-year-old, incarcerated, immunocompetent patient with history of intravenous (IV) drug use presented with syncope. Although clinical and radiographic findings failed to elucidate an infectious pathology, endoscopy revealed an obstructive mass lesion at the level of the third ventricle, which, on microbiological testing, was confirmed to be Rhizopus fungal ventriculitis. Perioperative cerebrospinal fluid diversion, endoscopic third ventriculostomy, endoscopic biopsy technique, patient outcomes, and the literature are reviewed here. The patient received intrathecal and IV amphotericin B followed by a course of oral antifungal treatment and currently remains in remission. LESSONS The patient’s unique presentation and diagnosis of isolated cerebral mucormycosis reveal this pathogen as a cause of ventriculitis and obstructive hydrocephalus in immunocompetent adult patients, even in the absence of infectious sequelae on neuroimaging.

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The underlying factors of occurrence of Mucormycosis in post-COVID-19 patients – A meta-analysis of case histories

Sen,

Tiwari,

Banerjee

et al. 2024

J Exp Bio & Ag Sci

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Mucormycosis is a life-threatening fungal infection caused by fungi of the order Mucorales. It usually affects people with weakened immune systems, such as those with uncontrolled diabetes, acquired immunodeficiency syndrome, iatrogenic immunosuppression, and hematological malignancies, as well as individuals who have had organ transplants. The type of mucormycosis a person suffers from is often determined by their underlying conditions. The most common types are rhino-cerebral mucormycosis, pulmonary mucormycosis, cutaneous mucormycosis, cerebral mucormycosis, gastrointestinal mucormycosis, and disseminated mucormycosis. The incidence of mucormycosis has been increasing over the years, with an overall mortality rate of 54%. Recent cases have shown a correlation between COVID-19 and mucormycosis. Using anti-inflammatory drugs to combat the cytokine storm associated with COVID-19 can weaken the immune system, making individuals more susceptible to opportunistic fungal infections like mucormycosis. Underlying health conditions further exacerbate the condition. This study reviewing 198 cases of mucormycosis and conducting a meta-analysis found that post-COVID-19 patients most commonly developed rhino-orbital-cerebral mucormycosis, followed by pulmonary and gastrointestinal mucormycosis. The study also identified diabetes as the most common underlying factor contributing to the development of mucormycosis in post-COVID-19 patients, followed by hypertension and obesity. The study also examined the influence of age, affected organs, and the use of certain drugs on the development of mucormycosis. Age was found to be a significant factor in the infection. This meta-analysis is one of the first to compare post-COVID mucormycosis cases with those from the pre-COVID era. The hope is that this study and analysis will help identify the determinants of mucormycosis in post-COVID patients and aid the scientific community in finding a solution to this problem.

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Isolated Intraventricular Chronic Mucormycosis in an Immunocompetent Infant: A Rare Case with Review of the Literature

Cited by 3 publications

References 10 publications

Isolated cerebral mucormycosis masquerading as a tumor in an immunocompetent patient

Isolated cerebral mucormycosis masquerading as a tumor in an immunocompetent patient

Immunocompetent isolated cerebral mucormycosis presenting with obstructive hydrocephalus: illustrative case

The underlying factors of occurrence of Mucormycosis in post-COVID-19 patients – A meta-analysis of case histories

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