Tags: Mucormycosis

Fusarium, Penicillium, Paracoccidioides, & Agents of Chromomycosis

FUSARIUM INFECTION Essentials of Diagnosis Worldwide geographic distribution. Mold, septate hyphae 3-8 um in diameter. A rare infection in severely immunocompromised patients. Blood cultures often but not always positive. No serologic tests available. Cutaneous involvement is common feature. General Considerations A. Epidemiology. Fusarium spp. is an emerging fungal pathogen. Although long recognized as a cause of local infection involving nails, traumatized skin, or the cornea (eg, in contact lens wearers), deep or disseminated infection was not described until the mid 1970s. Despite its worldwide distribution and its frequent recovery from soil and vegetative material, infection is quite rare. Only ~ 100 cases involving invasive disease in immunosuppressed patients have been described …

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Chromomycosis

Essentials of Diagnosis Patients are usually immunocompetent. Found worldwide but usually in tropical or subtropical areas. Mold in culture; forms sclerotic body or muriform cell in tissue. Infection results from direct inoculation from contaminated soil or vegetative substances. Chronic indolent cutaneous verrucous lesions, most often on the feet. General Considerations Chromomycosis, also known as chromoblastomycosis, is a chronic subcutaneous infection caused by several different fungi. Although rarely seen in the United States, it is common worldwide. A. Epidemiology. Chromomycosis occurs worldwide but is most frequently encountered in tropical and subtropical regions. The most common occurrence is in barefoot individuals, particularly among agricultural workers. The organisms causing chromomycosis are found commonly in …

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Aspergillus, Pseudallescheria, & Agents of Mucormycosis

ASPERGILLUS INFECTION Essentials of Diagnosis Filamentous fungus with septate hyphae 3-6 um in diameter. Branching of hyphal elements typically at 45° angle. Specific IgG antibodies generally of no use diagnostically since most patients are immunosuppressed and will not generate antibody response. Pulmonary lesions, localized or cavitary in susceptible host. General Considerations A. Epidemiology. Aspergillus spp. are found worldwide and grow in a variety of conditions. They commonly grow in soil and moist locations and are among the most common molds encountered on spoiled food and decaying vegetation, in compost piles, and in stored hay and grain. Aspergillus spp. often grow in houseplant soil, and such soil may be a source of …

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Mucormycosis: Clinical Syndromes

1. RHINOCEREBRAL MUCORMYCOSIS Rhinocerebral mucormycosis occurs most commonly in patients with uncontrolled diabetes, especially after an episode of diabetic ketoacidosis. It may also occur in leukemic patients who have had prolonged neutropenia and therapy with broad-spectrum antibiotics and occasionally in organ transplant recipients. Clinical Findings A. Signs and Symptoms. The earliest symptoms in rhinocerebral mucormycosis are facial pain, headache, and nasal stuffiness. As the disease progresses, orbital pain and facial anesthesia may be noted. Double vision or loss of vision may develop after invasion of the orbit by the rapidly spreading infection. Mental status changes herald the penetration into the brain with ensuing cavernous sinus thrombosis, carotid artery thrombosis, and cerebral …

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Itraconazole 100 mg Capsules (Sporanox)

Itraconazole is a synthetic dioxolane triazole compound. Itraconazole: Mechanism of action Like other azoles, it interferes with the cytochrome P-450-dependent enzyme, 14a-demethylase. This leads to 14-methylsterol accumulation and ergosterol depletion in fungal cells and this results in alterations in a number of membrane-associated cell functions. Itraconazole: Spectrum of action Itraconazole has a broad spectrum of action including Aspergillus species, Blastomyces dermatitidis, Candida species, Coccidioides immitis, Cryptococcus neoformans, Histoplasma capsulatum, Paracoccidioides brasiliensis, Scedosporium apiospermum and Sporothrix schenckii. It is active in dermatophytosis and pityriasis versicolor, but appears to be ineffective in mucormycosis. Itraconazole: Acquired resistance This is rare, but ketoconazole-resistant C. albicans strains from patients with chronic mucocutaneous candidosis have been cross-resistant …

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Fluconazole 50, 100, 150, 200 mg Tablets (Diflucan)

Fluconazole Fluconazole is a synthetic bis-triazole compound. Fluconazole (Diflucan): Mechanism of action Fluconazole is a potent inhibitor of ergosterol biosynthesis, through its action on the cytochrome P-450-dependent enzyme, lanosterol 14a-demethylase. Depletion of ergosterol, the principal sterol in the membrane of susceptible fungal cells, and accumulation of methylated sterols leads to alterations in a number of membrane-associated cell functions. Fluconazole (Diflucan): Spectrum of action Fluconazole has a broad spectrum of action including Blastomyces dermatitidis, Coccidioides immitis, Cryptococcus neoformans, Histoplasma capsulatum and Paracoccidioides brasiliensis. It is active against Candida albicans, C. tropicalis and C. parapsilosis, but many strains of C. krusei and Torulopsis glabrata (now reclassified as Candida glabrata) appear to be insensitive. …

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Use and Administration of Fluconazole 50, 100, 150, 200 mg Tablets (Diflucan)

Therapeutic Use of Fluconazole 50, 100, 150, 200 mg Tablets (Diflucan) Fluconazole can be used to treat mucosal and cutaneous forms of candidosis. It is also effective in various forms of dermatophytosis and pityriasis versicolor. It is a promising drug for treatment of deep forms of candidosis in patients without neutropenia, but should not be used as first-line treatment in neutropenic patients unless there are particular reasons for favouring it against established management. Fluconazole has proved to be a useful prophylactic treatment against candidosis in neutropenic patients. However, it is ineffective in aspergillosis and mucormycosis. Fluconazole is a useful drug in acute cryptococcal meningitis, but should not be used as first-line …

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Cellulitis Periorbital & Orbital

Description of Medical Condition An acute, spreading infection of the dermis and subcutaneous tissue. Several entities are recognized. Cellulitis around the eyes is a potentially dangerous periorbital and orbital infection. System(s) affected: Skin/Exocrine, Nervous Genetics: No known genetic pattern Incidence/Prevalence in USA: Unknown Predominant age: N/A Predominant sex: Male = Female Medical Symptoms and Signs of Disease • Lid edema • Rhinorrhea • Orbital pain, tenderness • Headache • Conjunctival hyperemia • Chemosis • Ptosis • Limitation to ocular motion • Increase intraocular pressure • Disease in corneal sensation • Congestion of retinal veins • Chorioretinal stria • Gangrene and sloughing of lids What Causes Disease? • Cellulitis around the eye …

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Cellulitis

Description of Medical Condition An acute, spreading infection of the dermis and subcutaneous tissue. Several entities are recognized: • Cellulitis of the extremities — characterized by an expanding, red, swollen, tender or painful plaque with an indefinite border that may cover a wide area • Recurrent cellulitis of the leg after saphenous venectomy — patients have an acute onset of swelling, erythema of the legs arising months to years after coronary artery bypass. (Surgery using lower extremity veins for bypass grafts.) • Dissecting cellulitis of the scalp — recurrent painful, fluctuant dermal and subcutaneous nodules • Facial cellulitis in adults — a rare event. Patients usually develop pharyngitis, followed by high …

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Central Nervous System Abscess

Brain Abscess Potential Severity Often subacute in onset, but may be life-threatening if improperly managed. Early neurosurgical consultation is of critical importance. Case 4 A 19-year-old white man noted the gradual onset of severe left frontal headache. The headache was sharp and constant, interfered with sleep, and was not relieved by asparin. Two weeks after the onset of the headache, the teen was noted to have a grand mal seizure associated with urinary incontinence that lasted 15 minutes. On admission to hospital, he was afebrile and alert, but somewhat confused. He was oriented to person, but not to time or place. Examination of the head, ears, nose, and throat showed teeth …

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