Predictors of mortality in rhinocerebral mycosis

Jayalakshmi, Sita; Reddy, Ramana G; Borgohain, Rupam; Subramanyam, Chaitra; Panigrahi, Manas; Challa, Sundaram; Meena, A K; Mohandas, Sukhada

doi:10.4103/0028-3886.35692

Cited by 16 publications

(17 citation statements)

References 35 publications

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“…3 Commonly, mucormycosis has shown an equal sex distribution, although a recent review of all published cases of pulmonary mucormycosis showed a male-to-female ratio of 3:1. 142 Mortality rate is higher than 50% with an incidence ranging from 62.5% in rhino-cerebral form 143 to 100% in disseminated form. 140 Its high morbidity and mortality rates are related to its capacity for rapidly vascular invasions, with subsequent tissue necrosis and infarction.…”

Section: Discussionmentioning

confidence: 99%

Mucormycosis in immunocompetent patients: a case-series of patients with maxillary sinus involvement and a critical review of the literature

Mignogna¹,

Fortuna²,

Leuci³

et al. 2011

International Journal of Infectious Diseases

113

134

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The literature analysis revealed that even in immunocompetent/otherwise healthy individuals mucormycosis infection has a worldwide distribution. What might be the real predisposing factors involved in its pathogenesis in such patients and the real causes of this peculiar geographic distribution still remains unknown. It is likely that, in our cases, a chronic insult of a well-defined and localized body area might have resulted in a local immunocompromission, thus fostering the development of an invasive fungal infection.

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Section: Discussionmentioning

confidence: 99%

Mucormycosis in immunocompetent patients: a case-series of patients with maxillary sinus involvement and a critical review of the literature

Mignogna¹,

Fortuna²,

Leuci³

et al. 2011

International Journal of Infectious Diseases

113

134

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“…It occurs primarily in decompensated patients with diabetes of both types, and in immunocompromised patients, particularly in those with neutropenia or in transplant recipients treated with corticosteroids. Mucorales by regulating cause lesions in pre‐disposed patients (Warnock and Richardson, 1982;Rinaldi, 1994; Eucker et al , 2001; Damante and Fleury, 1998; Jayalakshmi et al , 2007).…”

Section: Introductionmentioning

confidence: 99%

Palatal zygomycosis: experience of 21 cases

et al. 2008

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“…[18] In a study of 38 patients with rhinocerebral mycosis, 47% died; the predictors of mortality were elderly age, intracranial extension, and immunocompromised state. [15] In view of the small number of cases in our study, we could not ascertain the prognostic factors.…”

Section: Discussionmentioning

confidence: 88%

Fungal infections of the central nervous system in HIV-negative patients: Experience from a tertiary referral center of South India

Ramesha

Kate

Kesavadas

et al. 2010

Ann Indian Acad Neurol

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Objective:To describe the clinical, radiological, and cerebrovascular fluid (CSF) findings and the outcome of microbiologically or histopathologically proven fungal infections of the central nervous system (CNS) in HIV-negative patients.Methodology and Results:We identified definite cases of CNS mycosis by screening the medical records of our institute for the period 2000–2008. The clinical and imaging details and the outcome were abstracted from the medical records and entered in a structured proforma. There were 12 patients with CNS mycosis (i.e., 2.7% of all CNS infections treated in this hospital); six (50%) had cryptococcal infection, three (25%) had mucormycosis, and two had unclassified fungal infection. Four (33%) of them had diabetes as a predisposing factor. The common presentations were meningoencephalitis (58%) and polycranial neuritis (41%). Magnetic resonance imaging revealed hydrocephalus in 41% and meningeal enhancement in 25%, as well as some unusual findings such as subdural hematoma in the bulbocervical region, carpeting lesion of the base of the skull, and enhancing lesion in the cerebellopontine angle. The CSF showed pleocytosis (66%), hypoglycorrhachia (83%), and elevated protein levels (100%). The diagnosis was confirmed by meningocortical biopsy (in three cases), paranasal sinus biopsy (in four cases), CSF culture (in three cases), India ink preparation (in four cases), or by cryptococcal polysaccharide antigen test (in three cases). Out of the ten patients for whom follow-up details were available, six patients recovered with antifungal medications (amphotericin B, 1 mg/kg/day for the minimum period of 6 weeks) and/or surgical treatment. Four patients expired (only one of them had received antifungal therapy).Conclusions:Most patients with CNS mycosis recover with appropriate therapy, but the diagnosis and management of these rare infections remains a challenge to clinicians.

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Predictors of mortality in rhinocerebral mycosis

Abstract: Rhinocerebral mycosis is associated with high mortality in spite of aggressive therapy. Intracranial extension with focal neurological deficits is a major predictor of mortality in rhinocerebral mycosis.

Cited by 16 publications

References 35 publications

Mucormycosis in immunocompetent patients: a case-series of patients with maxillary sinus involvement and a critical review of the literature

Mucormycosis in immunocompetent patients: a case-series of patients with maxillary sinus involvement and a critical review of the literature

Palatal zygomycosis: experience of 21 cases

Fungal infections of the central nervous system in HIV-negative patients: Experience from a tertiary referral center of South India

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