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1/32. 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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2/32. Case report. Rhinocerebral zygomycosis.

    A case of rhinocerebral zygomycosis treated with liposomal amphotericin b is described.
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ranking = 0.83333333333333
keywords = zygomycosis
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3/32. 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 = 6.2732705646177
keywords = phycomycosis
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4/32. 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 = 7.5279246775412
keywords = phycomycosis
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5/32. Entomophthoramycosis by conidiobolus coronatus. Report of a case successfully treated with the combination of itraconazole and fluconazole.

    Rhinoentomophthoramycosis caused by conidiobolus coronatus in a 61-year old woman was unsuccessfully treated during 8 years with all the antifungals available in the Brazilian market, including potassium iodide for 1 month, sulfamethoxazole plus trimethoprim for 2 months, amphotericin b, total dose of 1130 mg, cetoconazole, 400 mg/day for 6 months, fluconazole, 200 mg/day, for at least 2 months and, itraconazole, 400 mg/day for 2 months, followed by 200 mg/day for 4 more months. Complete clinical and mycological cure was achieved using itraconazol 400 mg/day in association with fluconazol 200 mg/day during 24 months. After cure she was submitted to plastic surgery to repair her facial deformation. Today she remains clinically and mycologically cured after 59/60 months (5 years!) without any specific antifungal. We thus suggest the use of the combination of itraconazole and fluconazole as an additional option for the treatment of this mycosis.
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ranking = 5.4486235180418
keywords = entomophthoramycosis
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6/32. Successful treatment of rhinocerebral zygomycosis using liposomal nystatin.

    We describe a case of successful treatment of rhinocerebral mucormycosis in a patient with multiple myeloma. Therapeutic strategies used included liposomal amphotericin, hyperbaric oxygen, GM-CSF and liposomal nystatin.
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ranking = 0.66666666666667
keywords = zygomycosis
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7/32. Presumably entomophthoramycosis in an hiv-infected patient: the first in thailand.

    The authors reported the case of a symptomatic hiv-infected woman with a slowly progressive infiltrative lesion which invaded in and around the nasal cavity over a 6-month period. physical examination showed erythematous to violaceous plaques at the nasal and malar areas. Swelling of the inferior turbinate was noted in the right nare. skin biopsy of the involved area revealed multiple nonseptate, broad, thin-walled hyphae within giant cells and granulomata. Entomophthoramycosis was diagnosed based on clinical features and histopathology. She was treated with intravenous amphotericin b for two weeks, followed by oral itraconazole 400 mg daily. At six months there was complete resolution of all lesions.
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ranking = 21.794494072167
keywords = entomophthoramycosis
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8/32. 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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9/32. Improved outcome of zygomycosis in patients with hematological diseases?

    zygomycosis is an opportunistic fungal infection that is increasingly reported in hematological patients. We describe 2 cases of successfully treated rhino-cerebral zygomycosis and give an overview of 120 patients from the literature with underlying hematological or oncological disorders. These data document the improved survival in sinus (15/17 patients surviving) and cutaneous (6/9 patients surviving) disease. Hematological patients with pulmonary (9/30 patients surviving) or disseminated (4/38 patients surviving) zygomycosis still have a poor prognosis. The clinical course of sinus-orbital involvement (4/11 patients surviving) follows sinus-cerebral (2/3 patients surviving) or cerebral (3/6 patients surviving) disease. Besides deoxycholate amphotericin b (AmB) (24/62 patients surviving), patients seem to benefit from liposomal amphotericin B (L-AmB) (10/16 patients surviving) or sequential AmB/L-AmB treatment (6/8 patients surviving). Alternative treatment options lead only in a few patients to success.
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ranking = 1
keywords = zygomycosis
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10/32. Rhino-orbitocerebral entomophthoramycosis.

    conidiobolus coronatus is recognized as a human pathogen causing subcutaneous fungal infection of the face in immunocompetent patients. The disease process is usually benign. We report, what we believe to be the first case of intracranial extension of C. coronatus producing rhino-orbitocerebral syndrome, and subsequent dissemination of C. coronatus in an immunocompetent patient.
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ranking = 21.794494072167
keywords = entomophthoramycosis
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