Rhinocerebral Mucormycosis

Press, Gary A.; Weindling, Steven M.; Hesselink, John R.; Ochi, James W.; Harris, Jeffrey P.

doi:10.1097/00004728-198809010-00005

Cited by 74 publications

(27 citation statements)

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“…Cavernous sinus involvement with thrombosis frequently appears as an isointensity with enhancement on T 1 -weighted images and as an area of hyperintensity on T 2 -weighted images (Yousem et al, 1989). Areas of intracerebral inflammation are seen as hyperintense areas on T 2 -weighted images (Press et al, 1988).…”

Section: Discussionmentioning

confidence: 99%

Rhino-Orbital-Cerebral Mucormycosis With Different Cerebral Involvements: Infarct, Hemorrhage, and Ophthalmoplegia

Koç

Yerdelen

et al. 2007

International Journal of Neuroscience

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Rhino-orbital-cerebral mucormycosis is a rare but often fatal opportunistic necrotizing infection of the sinuses, orbit, and brain caused by saprophytic fungi. It usually develops in patients with diabetes or immune system deficiency. In this study, imaging features in 3 patients with rhino-orbital-cerebral mucormycosis who presented with various symptoms and different cerebral involvements are discussed. Headache, blurred vision, fever, painful ophthalmoplegia, and cranial nerve involvement were among the clinical findings. Computed tomography and magnetic resonance imaging are the best imaging methods for assessing the extent of this disease. Relatively typical but nonspecific characteristics are bone destruction, vascular invasion, and central hypointensity in the paranasal sinuses or an intracranial mass that is revealed by T(2)-weighted magnetic resonance imaging. Imaging findings include cavernous sinus involvement, cerebral infarct, and intracerebral hemorrhage. Because of the invasive and fulminant nature of rhino-orbital-cerebral mucormycosis, successful treatment seems to be based on early diagnosis and on the management of underlying immunologic problems.

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Section: Discussionmentioning

confidence: 99%

Rhino-Orbital-Cerebral Mucormycosis With Different Cerebral Involvements: Infarct, Hemorrhage, and Ophthalmoplegia

Koç

Yerdelen

et al. 2007

International Journal of Neuroscience

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“…Rhinocerebral mucormycosis refers to infections caused by fungi within the order Mucorales and usually affects individuals with poorly controlled diabetes mellitus or the immunocompromised. These organisms display a predilection for the nasal cavity and paranasal sinuses; from these sites, the organisms typically invade blood vessel walls and then spread to the cavernous sinus, internal carotid artery, and brain (403)(404)(405)(406). However, fungal hyphae and lesions have been demonstrated within the trigeminal nerve and the pons within the brain stem in the absence of leptomeningitis, suggesting that direct invasion occurred from the sinuses to the brain along the trigeminal nerve (407,408).…”

Section: Yeasts and Fungimentioning

confidence: 99%

Pathogens Penetrating the Central Nervous System: Infection Pathways and the Cellular and Molecular Mechanisms of Invasion

et al. 2014

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SUMMARY The brain is well protected against microbial invasion by cellular barriers, such as the blood-brain barrier (BBB) and the blood-cerebrospinal fluid barrier (BCSFB). In addition, cells within the central nervous system (CNS) are capable of producing an immune response against invading pathogens. Nonetheless, a range of pathogenic microbes make their way to the CNS, and the resulting infections can cause significant morbidity and mortality. Bacteria, amoebae, fungi, and viruses are capable of CNS invasion, with the latter using axonal transport as a common route of infection. In this review, we compare the mechanisms by which bacterial pathogens reach the CNS and infect the brain. In particular, we focus on recent data regarding mechanisms of bacterial translocation from the nasal mucosa to the brain, which represents a little explored pathway of bacterial invasion but has been proposed as being particularly important in explaining how infection with Burkholderia pseudomallei can result in melioidosis encephalomyelitis.

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“…Magnetic resonance imaging (MRI) and computerised tomography (CT) can help to establish an anatomical, if not pathological, diagnosis in suspected rhinocerebral fungal infections (213,252,302). Findings of diagnostic significance (in descending order of occurrence) include soft tissue opacification of sinuses with hyperdense material, nodular mucosal thickening, and an absence of fluid levels in different sinuses.…”

Section: Clinical Features Predisposing Factors and Management Of Smentioning

confidence: 99%

Current Perspectives on Ophthalmic Mycoses

2003

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Fungi may infect the cornea, orbit and other ocular structures. Species of Fusarium, Aspergillus, Candida, dematiaceous fungi, and Scedosporium predominate. Diagnosis is aided by recognition of typical clinical features and by direct microscopic detection of fungi in scrapes, biopsy specimens, and other samples. Culture confirms the diagnosis. Histopathological, immunohistochemical, or DNA-based tests may also be needed. Pathogenesis involves agent (invasiveness, toxigenicity) and host factors. Specific antifungal therapy is instituted as soon as the diagnosis is made. Amphotericin B by various routes is the mainstay of treatment for life-threatening and severe ophthalmic mycoses. Topical natamycin is usually the first choice for filamentous fungal keratitis, and topical amphotericin B is the first choice for yeast keratitis. Increasingly, the triazoles itraconazole and fluconazole are being evaluated as therapeutic options in ophthalmic mycoses. Medical therapy alone does not usually suffice for invasive fungal orbital infections, scleritis, and keratitis due to Fusarium spp., Lasiodiplodia theobromae, and Pythium insidiosum. Surgical debridement is essential in orbital infections, while various surgical procedures may be required for other infections not responding to medical therapy. Corticosteroids are contraindicated in most ophthalmic mycoses; therefore, other methods are being sought to control inflammatory tissue damage. Fungal infections following ophthalmic surgical procedures, in patients with AIDS, and due to use of various ocular biomaterials are unique subsets of ophthalmic mycoses. Future research needs to focus on the development of rapid, species-specific diagnostic aids, broad-spectrum fungicidal compounds that are active by various routes, and therapeutic modalities which curtail the harmful effects of fungus- and host tissue-derived factors

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Rhinocerebral Mucormycosis

Cited by 74 publications

References 0 publications

Rhino-Orbital-Cerebral Mucormycosis With Different Cerebral Involvements: Infarct, Hemorrhage, and Ophthalmoplegia

Rhino-Orbital-Cerebral Mucormycosis With Different Cerebral Involvements: Infarct, Hemorrhage, and Ophthalmoplegia

Pathogens Penetrating the Central Nervous System: Infection Pathways and the Cellular and Molecular Mechanisms of Invasion

Current Perspectives on Ophthalmic Mycoses

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