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1/26. Rhinocerebral zygomycosis in childhood acute lymphoblastic leukaemia.

    The hazards associated with invasive candidiasis and aspergillosis in oncology patients are well recognised. These conditions typically present late in treatment, often after prolonged or recurrent episodes of neutropenia. We report the occurrence of absidia corymbifera infection causing rhinocerebral zygomycosis in two children with acute lymphoblastic leukaemia, early in the induction phase of treatment and within a 3-month interval, in the same oncology unit. The initial presentation of facial pain was rapidly followed by the development of cranial nerve palsies, cavernous sinus thrombosis, diabetes insipidus, seizures and death within 9 days of symptom onset, despite aggressive management with high-dose liposomal amphotericin (Ambisome), surgical debridement and local instillation of amphotericin solution. These cases highlight the need for awareness of zygomycosis as a potentially lethal fungal infection that can present even with short duration exposure to the usual risk factors. Their occurrence within a limited time period raises questions as to the relative importance of environmental exposure. The failure of medical and surgical intervention to impact on the course illustrates the need to develop appropriate preventative strategies which may have to incorporate measures to reduce the environmental exposure of susceptible patients.
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ranking = 1
keywords = zygomycosis
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2/26. Lethal rhinocerebral phycomycosis in a healthy adult: a case report and review of the literature.

    A lethal case of rhino-orbital-cerebral phycomycosis (mucormycosis) in an otherwise healthy man is presented. The clinical, radiologic, and ante mortem surgical pathology associated with microbiologic examinations failed to yield the diagnosis of fungal infection as the cause of a clinical presentation of acute sphenoid sinusitis with a fulminant cavernous sinus thrombosis. No similar case report was found in review of the literature. There is a need for a high degree of suspicion in this condition to improve the uniformly poor prognosis in this devastating infectious disease. Emphasis is placed on the necessity for early tissue or microbiologic diagnosis with appropriate histologic stains and fungal cultures. Treatment consists of extensive surgical excision of all necrotic or questionably viable tissue in conjunction with alternate-day amphotericin b therapy.
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ranking = 17.045211185895
keywords = phycomycosis
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3/26. Bilateral rhinocerebral phycomycosis.

    A 51-year-old diabetic woman developed bilateral rhinoorbitocerebral phycomycosis. Successful treatment was accomplished by correction of the ketoacidosis, surgical debridement, and amphotericin b therapy. Rhinoorbitocerebral phycomycosis is a fulminant and frequently fatal disease most often seen in debilitated hosts. This survival suggests that aggressive therapy is indicated in patients with extensive fungal involvement.
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ranking = 20.454253423075
keywords = phycomycosis
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4/26. Case report. Fatal rhinocerebral zygomycosis due to rhizopus oryzae.

    A case of rhinocerebral zygomycosis due to rhizopus oryzae, arising after trauma in a 53-year-old diabetic man, is reported. diagnosis was based on histological and mycological examination. Fragments of the colonies were observed by scanning electron microscopy. This is the first case diagnosed in Tuscany.
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ranking = 0.83333333333333
keywords = zygomycosis
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5/26. Simultaneous disseminated aspergillosis and zygomycosis in a leukemic patient.

    Although the incidence of fungal infections is increasing, infections caused by more than one fungus are rare. We have described the clinical, pathologic, and mycologic findings in a leukemic patient with simultaneous pulmonary infection and systemic dissemination caused by aspergillus fumigatus and rhizopus sp.
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ranking = 0.66666666666667
keywords = zygomycosis
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6/26. Rhinocerebral zygomycosis caused by Saksenaea vasiformis.

    A fatal rhinocerebral zygomycotic infection caused by Saksenaea vasiformis in a 71-year-old man was diagnosed based on the presence of broad, infrequently septate, branched, hyaline hyphae in tissue obtained from the right and left base of the skull, soft tissue, both maxillary sinuses and the sphenoid sinus; isolation of S. vasiformis from the tissue; and demonstration of mucoraceous antibodies by enzyme-linked immunosorbent assay. Fluorescent antibody studies carried out with a rhizopus arrhizus conjugate, stained hyphal fragments in tissue with a 2 intensity.
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ranking = 0.66666666666667
keywords = zygomycosis
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7/26. Intracranial phycomycosis: case reports.

    Cerebral phycomycosis is a rare disease. We describe two patients with unusual features of focal intracranial phycomycosis: a diabetic patient with chronic epidural abscess and a healthy individual with an isolated intracerebral abscess. biopsy established the diagnosis in both patients. Treatment was successful in the patient with intracerebral abscess.
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ranking = 20.454253423075
keywords = phycomycosis
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8/26. rhizopus arrhizus in italy as the causative agent of primary cerebral zygomycosis in a drug addict.

    A rare case of primary cerebral zygomycosis in an Italian drug addict is described. The diagnosis was based on the histologic detection of broad, aseptate, hyaline mycelium in fluid aspirated from a brain mass detected by computerized axial tomography. The zygomycete isolated from the clinical specimen was identified as rhizopus arrhizus var arrhizus. The patient had no known predisposing condition that would have suppressed his immunological defenses. Once the diagnosis was established, treatment with amphotericin b was initiated, but the patient died during the first day of treatment.
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ranking = 0.83333333333333
keywords = zygomycosis
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9/26. Ocular and orbital phycomycosis.

    Cerebro-rhino-orbital phycomycosis (CROP) occurs predominantly in individuals with diabetes mellitus in a state of metabolic acidosis. Other forms of metabolic acidosis, especially in infants, may predispose to phycomycotic infections. CROP has also been reported in patients with leukemia or lymphoma. CROP usually begins in the palate or paranasal sinuses and rapidly spreads to the orbital contents. Proptosis, loss of vision, and ophthalmoplegia occur and death from cerebral involvement commonly ensues. The fungus tends to invade arteries and cause thrombosis and tissue infarction. rhizopus is the most commonly isolated genus in CROP, accounting for almost all cases. The diagnosis can be strongly suspected by the characteristic clinical manifestations. Therapy includes treatment of the underlying disease, surgical excision of the necrotic tissue containing fungal elements and the systemic administration of amphotericin-B. The effect of treatment has improved since the disease was first described, but the condition still has a high mortality, especially if it is not diagnosed early.
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ranking = 17.045211185895
keywords = phycomycosis
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10/26. Primary phycomycosis of the brain in heroin addicts.

    Two heroin addicts had fatal primary phycomycosis of the brain. The first case is unique. A 28-year-old man displayed unusual symptoms of unilateral hydrocephalus confirmed by both computed tomography (CT) scanning of the brain and craniotomy. The nature of the fungal granuloma was verified histopathologically. The second case, a 40-year-old man, possessed bilateral basal ganglionic lesions in which the CT scanning suggested abscesses. Postmortem examination confirmed the presence of phycomycotic abscesses. There was no evidence of systemic mycoses in both cases. review of the clinical features of this fatal complication in drug abusers and narcotic addicts disclosed that hemiparesis and facial weakness are common. brain or CT scan along with brain biopsy are necessary for rapid diagnosis and prompt treatment.
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ranking = 17.045211185895
keywords = phycomycosis
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