Mucormycosis experience through the eyes of the laboratory

Sağıroğlu, Pınar; Koç, Ayşe; Atalay, Mustafa; Gelmez, Gülşen Altınkanat; Canöz, Özlem; Sariguzel, Fatma Mutlu

doi:10.1080/23744235.2019.1645962

Cited by 7 publications

(10 citation statements)

References 23 publications

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“…23,24 In our study, we reported three species, including a new one (A. mexicanus). 21 In our study most secondary cutaneous mucormycosis were associated with diabetes (81.4%), usually type 2; this is similar to previous studies in low-income countries like India, 1,3,10 and Iran, 25 where diabetic decompensation is frequent. The second predisposing factor was haematologic cancer, mainly acute lymphocytic leukaemia (15.4%).…”

Section: Discussionmentioning

confidence: 80%

“…5 The principal organism in our study was R. arrhizus 79/ 107 (73.8%), followed by L. corymbifera (13.9%), similar to reports from the United States, India and Iran. 1,10,25 Morphological identification is used to identify the genus of the fungus and requires the use of molecular identification. 5,24,27 Biopsy is a fundamental tool for diagnosis; the histopathological picture shows an inflammatory reaction, with oedema, necrosis, with polymorphonuclear cells, plasma cells, thrombosis and multiple tissue infarctions.…”

Section: Discussionmentioning

confidence: 99%

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Mucormycosis with cutaneous involvement. A retrospective study of 115 cases at a tertiary care hospital in Mexico

et al. 2020

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Background/Objectives: Cutaneous mucormycosis is an emerging opportunistic mycosis caused by Mucorales. It can be divided into primary caused by trauma and secondary by extension of rhino-cerebral and disseminated cases. The objective is to present a retrospective study of cases of mucormycosis with cutaneous involvement.Methods: A retrospective and descriptive study was carried out. Mucormycosis patients were included and divided into two groups: a) Primary Cutaneous and b) Secondary Cutaneous. Mycological tests were performed; the agents were identified by morphology and molecular studies (PCR and sequencing); some cases underwent histopathology. Clinical data and response to treatment were collected.Results: 115 cases were included, 18 of primary, and 97 of secondary cutaneous mucormycosis. Primary cutaneous mucormycosis was most associated with adhesive bands (44.4%) and trauma from traffic accidents (33.3%). The principal clinical form was extensive and deep necrotic ulcers. Secondary cutaneous mucormycosis cases were rhino-cerebral with uncontrolled diabetes (81.4%) The most frequent clinical presentation was necrosis of the eyelid and the nose (65.9%). In both groups, the principal agent was Rhizopus arrhizus, 38.8% and 74.2% respectively. The most effective treatment was the combination of amphotericin B with surgical debridement. The clinical and mycological cure was achieved in 31.0% of primary cases, and 44.4% for secondary cases. Conclusion:Primary cutaneous mucormycosis is caused by implantation of the Mucorales due to trauma or rupture of the cutaneous barrier-breach, and secondary cutaneous mucormycosis develops as part of the rhino-cerebral process. The response to treatment depends on the extension and depth, as well as the predisposing factors.

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Section: Discussionmentioning

confidence: 80%

Section: Discussionmentioning

confidence: 99%

Mucormycosis with cutaneous involvement. A retrospective study of 115 cases at a tertiary care hospital in Mexico

et al. 2020

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“…We obtained fast results with the use of KOH for direct microscopic examination. However, using optical brighteners for fluorescence microscopy (calcofluor white or blancophor) increase the sensitivity rate, and the detection of the fungal structures becomes easier than with KOH microscopic examination, because of the binding to chitin (polysaccharide cell wall), highlighting fungal structures, and thus highly recommended for difficult‐to‐diagnose cases 31‐33 …”

Section: Discussionmentioning

confidence: 99%

“…However, using optical brighteners for fluorescence microscopy (calcofluor white or blancophor) increase the sensitivity rate, and the detection of the fungal structures becomes easier than with KOH microscopic examination, because of the binding to chitin (polysaccharide cell wall), highlighting fungal structures, and thus highly recommended for difficult-to-diagnose cases. [31][32][33] Biopsies were performed in 105 cases (53.8%) and were import- It was possible to observe the septa in a few cases, which showed 90° (right) angles dichotomy. 4,11,25,34 In Kung et al's study, 34 R. arrhizus (formerly R. oryzae) in 64.61%.…”

Section: F I G U R E 2 Distribution Of the Mucormycosis-associated Spmentioning

confidence: 99%

Mucormycosis at a tertiary‐care center in Mexico. A 35‐year retrospective study of 214 cases

Bonifáz

Tirado‐Sánchez

Hernández-Medel

et al. 2020

Mycoses

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Background Mucormycosis is a rare, invasive disease associated with high mortality rates, produced by opportunistic pathogens related to the Mucorales order and characterised by a diverse range of clinical forms; acute rhino‐orbital‐cerebral and pulmonary symptoms are the most reported ones. Objectives To report the experience of mucormycosis observed in a tertiary‐care hospital in Mexico for 35 years. Methods This was a retrospective, descriptive and observational study on mucormycosis at a tertiary‐care hospital in Mexico from January 1985 to December 2019. Demographic and clinical data and mycological and histopathological records were selected. Results Two hundred fourteen proven cases of mucormycosis for 35 years at a tertiary‐care hospital in Mexico were included. Most of the cases were male patients with a median age of 45 years. The two most associated underlying diseases were diabetes mellitus (76.6%) and haematologic malignancy (15.4%). The three primary clinical forms were as follows: rhino‐orbito‐cerebral (75.9%), cutaneous (8.41%) and pulmonary (7.47%) mucormycosis. The most isolated agents were Rhizopus arrhizus (58.4%) and Lichtheimia corymbifera (12.3%). The overall therapeutic response was 58.5%, and the best response was observed with amphotericin B deoxycholate and surgical debridement. Conclusion Mucormycosis is an emerging disease, and its incidence has increased at our hospital over the years. In this study, the rhino‐cerebral clinical type was the most frequent in patients with uncontrolled diabetes; the main aetiological agent was R. arrhizus. Early diagnosis, control of the underlying disease and prompt management may increase the survival rate.

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“…[ 7 8 ] However, there has been a paucity of data on the surgical approaches of oral mucormycosis after the trauma. [ 9 10 ] Hence, in our study, we aim to evaluate the management of the fungal infection mucormycosis in trauma patients by the surgical approach.…”

Section: Introductionmentioning

confidence: 99%

A Surgical Approach in the Management of Mucormycosis in Trauma Patients

Singh

Jyothirmayee

Rani

et al. 2022

Journal of Pharmacy and Bioallied Sciences

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Introduction: Fungal infections are rare occurrence in the oral cavity. They are most often seen in other medical conditions such as the immunocompromised states, diabetes, on immunosuppressants, and more recently, among the COVID patients. There are various ways that are employed to manage these infections. The most usual of fungal infection in these conditions is mucormycosis, also called as zygomycosis. Hence, in our study, we aim to evaluate the management of the fungal infection mucormycosis in trauma patients by the surgical approach. Materials and Methods: We piloted a retrospective observational study among 50 subjects who were admitted to the department with oral fungal infections with mucormycosis. We analyzed various clinical and demographic parameters among the subjects. The data thus obtained were analyzed with proper statistical tools deliberating P < 0.05 as significant. Results: We observed that among the 50 subjects, the mean age was 41 ± 1.7 years. There was no significant difference between the genders and the age groups. The most common reason for the oral involvement was uncontrolled diabetes. This was followed by malignancy, specifically leukemia, AIDS, and COVID. The most common site of the involvement was the palate, followed by the mandibular region. All the subjects tested positive for the fungal hyphae of Rhizopus arrhizus which was the most common of the species. The surgical debridement along with the medical management showed satisfactory results, while one death was noted in our study. Conclusion: Although rare, oral involvement in the fungal infection with the mucormycosis is often easily managed when diagnosed early. The proper surgical debridement is the best method of treatment along with the appropriate medications. The management of the underlying medical conditions is the primary key for the success of the treatments.

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Mucormycosis experience through the eyes of the laboratory

Cited by 7 publications

References 23 publications

Mucormycosis with cutaneous involvement. A retrospective study of 115 cases at a tertiary care hospital in Mexico

Mucormycosis with cutaneous involvement. A retrospective study of 115 cases at a tertiary care hospital in Mexico

Mucormycosis at a tertiary‐care center in Mexico. A 35‐year retrospective study of 214 cases

A Surgical Approach in the Management of Mucormycosis in Trauma Patients

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