Multimodal surgical and medical treatment for extensive rhinocerebral mucormycosis in an elderly diabetic patient: a case report and literature review
Paola Di Carlo,Roberto Pirrello,Giuliana Guadagnino,Pierina Richiusa,Antonio Lo Casto,Caterina Sarno,Francesco Moschella,Daniela Cabibi +7 more
TLDR
The successful, personalized medical and surgical management of extensive periorbital mucormycosis in an elderly diabetic, HIV-negative woman and the role of aesthetic plastic surgery to preserve the patient's physical appearance is reported.Abstract:
Diabetes is a well-known risk factor for invasive mucormycosis with rhinocerebral involvement. Acute necrosis of the maxilla is seldom seen and extensive facial bone involvement is rare in patients with rhino-orbital-cerebral mucormycosis. An aggressive surgical approach combined with antifungal therapy is usually necessary. In this report, we describe the successful, personalized medical and surgical management of extensive periorbital mucormycosis in an elderly diabetic, HIV-negative woman. Mono- or combination therapy with liposomal amphotericin B (L-AmB) and posaconazole (PSO) and withheld debridement is discussed. The role of aesthetic plastic surgery to preserve the patient’s physical appearance is also reported. Any diabetic patient with sinonasal disease, regardless of their degree of metabolic control, is a candidate for prompt evaluation to rule out mucormycosis. Therapeutic and surgical strategies and adjunctive treatments are essential for successful disease management. These interventions may include combination therapy. Finally, a judicious multimodal treatment approach can improve appearance and optimize outcome in elderly patients.read more
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Clinical, Immunological, and Molecular Heterogeneity of 173 Patients With the Phenotype of Immune Dysregulation, Polyendocrinopathy, Enteropathy, X-Linked (IPEX) Syndrome.
Eleonora Gambineri,Eleonora Gambineri,Sara Ciullini Mannurita,Sara Ciullini Mannurita,David Hagin,Marina Vignoli,Marina Vignoli,Stephanie Anover-Sombke,Stacey DeBoer,Gesmar Rodrigues Silva Segundo,Eric J. Allenspach,Claudio Favre,Hans D. Ochs,Troy R. Torgerson +13 more
TL;DR: A comprehensive analysis of the clinical features and molecular bases of IPEX and IPEX-like patients is provided and a simple flow-chart is proposed to effectively evaluate such patients and to focus on the most likely molecular diagnosis.
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Diabetes mellitus as the major risk factor for mucormycosis in Mexico: Epidemiology, diagnosis, and outcomes of reported cases.
TL;DR: It is proposed to establish an early diagnosis of rhino-orbital cerebral (ROC) mucormycosis based on standardized identification of warning signs and symptoms and performing an early direct microbiological exam and histopathological identification through a multidisciplinary medical and surgical team.
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A meta-analysis of survival factors in rhino-orbital-cerebral mucormycosis-has anything changed in the past 20 years?
TL;DR: An updated review of the literature is presented and whether survival outcomes have changed in the two decades since Yohai et al. published a systematic review of 145 case reports from 1970 to 1993 is assessed.
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Effect of dietary copper level on the gut microbiota and its correlation with serum inflammatory cytokines in Sprague-Dawley rats.
TL;DR: The results suggest that dietary copper level may have a direct impact on circulating inflammatory cytokines in the serum, perhaps inducing an inflammatory response by altering the microbial composition of rat feces.
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