scholarly journals Lymphocutaneous Sporotrichosis Refractory to First-Line Treatment

2021 ◽  
Vol 2021 ◽  
pp. 1-5
Author(s):  
Walter Belda ◽  
Luiz Felipe Domingues Passero ◽  
Ana Thereza Stradioto Casolato
Keyword(s):  
Amphotericin B ◽  
Potassium Iodide ◽  
Traumatic Injury ◽  
Complete Recovery ◽  
Skin Lesions ◽  
First Line ◽  
Amphotericin B Deoxycholate ◽  
The Right ◽  
Line Drug ◽  
Control Skin

Sporotrichosis is a fungal infection endemic in Latin America and has been attributed to the thermodimorphic fungus of the genus Sporothrix. Transmission to humans occurs during a traumatic injury with soil or organic material; additionally, lesions caused by infected cats play an important role in the epidemiology of the disease. The classic treatment of sporotrichosis is performed with itraconazole or potassium iodide; second-line medications, such as amphotericin B and terbinafine, can alternatively be used in cases of first-line drug failure. In the present study, a patient with lymphocutaneous sporotrichosis in the right upper limb exhibited intolerance to itraconazole and potassium iodide, additionally during the period of use; these drugs did not control skin lesions. In this patient, amphotericin B deoxycholate and its liposomal version were used in this patient; and complete recovery of the lesions was observed.

scholarly journals Giant acquired acral fibrokeratoma: A case report

2019 ◽  
Vol 11 (2) ◽  
Author(s):  
Hend M. Al-Atif
Keyword(s):  
Dorsal Surface ◽  
Surgical Excision ◽  
Skin Lesions ◽  
Skin Tumor ◽  
Central Hospital ◽  
First Line ◽  
Fibrous Tumor ◽  
The Right ◽  
Histopathology Examination ◽  
Saudi Male

Acquired acral fibrokeratoma (AAF) is a rare benign fibrous tumor. Its size is usually small (i.e., <0.5 cm). However, few cases with giant lesions (i.e., >1 cm) have been reported. A 17-year-old Saudi male presented to the Dermatology Outpatient Clinic of Aseer Central Hospital, Aseer Region, Saudi Arabia, with a painless rounded skin-colored exophytic nodule arising from the dorsal surface of the right middle toe, 1.7 cm in diameter. The tumor was surgically excised. Histopathology examination revealed a giant polyploid lesion, composed of massive hyperkeratosis, acanthosis, a core of thick collagen bundles and vertically oriented small dermal blood vessels. The diagnosis was giant AAF. There was no evidence of recurrence after surgical excision. AAF is a rare benign skin tumor which should be differentiated from other similar skin lesions. Surgical excision is the first line for treatment.

scholarly journals Desmopressin 120 mcg, 180 mcg, 240 mcg: The right treatment for the right patient

2018 ◽  
Vol 90 (2) ◽  
pp. 127 ◽  
Author(s):  
Pietro Ferrara ◽  
Ester Del Vescovo ◽  
Francesca Ianniello ◽  
Giulia Franceschini ◽  
Luciana Romaniello ◽  
...  
Keyword(s):  
Drug Therapy ◽  
Nocturnal Enuresis ◽  
Bladder Function ◽  
Efficacy And Safety ◽  
Nocturnal Polyuria ◽  
First Line ◽  
Normal Bladder ◽  
Increased Risk ◽  
The Right ◽  
Line Drug

Background: The first-line drug therapy for patients with nocturnal enuresis (NE) associated with nocturnal polyuria and normal bladder function is desmopressin (dDAVP). Objective: To evaluate if increasing dose of oral desmopressin lyophilisate (MELT) can improve response rates to dDAVP and is useful in enuretic children. Materials and methods: We enrolled a total of 260 children all diagnosed with NE. Enuretic children were treated with increasing MELT at a dose of 120, 180 and 240 mcg a day.Results. We included in our study a total of 237 children, 164 males (69.2%) and 73 females (30.8%) aged between 5 and 18 years (mean age 10.32 ± 2.52 years). Of the 237 patients enrolled in the study and treated with MELT 120 mcg, a full response was achieved in 135 (56.9%). A partial response was achieved in 21 (8.9%) patients, therefore the dose was increased up to 180 mcg, with further improving symptoms (14.3%) or full response (9.5%), and up to 240 mcg, without usefulness. Conclusions: MELT at the dose of 120 mcg resulted efficacy and safety; the increased dose up to 180 mcg resulted poorly efficacy; finally, the further increase up to 240 mcg did not improve the symptoms with the increased risk of side effects.

scholarly journals Subcutaneoous phaeohyphomycosis by Exophiala jeanselmei in a cardiac transplant recipient

2005 ◽  
Vol 47 (1) ◽  
pp. 55-57 ◽  
Author(s):  
Maria do Rosário R. Silva ◽  
Orionalda de F.L. Fernandes ◽  
Carolina R. Costa ◽  
Aiçar Chaul ◽  
Luciano F. Morgado ◽  
...  
Keyword(s):  
Mycophenolate Mofetil ◽  
Transplant Recipient ◽  
Immunosuppressive Therapy ◽  
Amphotericin B ◽  
Marked Improvement ◽  
Skin Lesions ◽  
Cardiac Transplant ◽  
Exophiala Jeanselmei ◽  
Cardiac Transplant Recipient ◽  
The Right

We report a case of phaeohyphomycosis caused by Exophiala jeanselmei in a cardiac transplant recipient maintained on immunosuppressive therapy with mycophenolate mofetil tacrolimus and prednisone. The lesion began after trauma on the right leg that evolved to multiple lesions with nodules and ulcers. Diagnosis was performed by histological examination and culture of pus from skin lesions. Treatment consisted of itraconazole (200 mg/day) for three months with no improvement and subsequently with amphotericin B (0.5 mg/Kg per day to a total of 3.8 g intravenously). After four months of treatment, the lesions showed marked improvement with reduction in the swelling and healing of sinuses and residual scaring.

Neurological deficit due to cement extravasation following a vertebral augmentation procedure

2013 ◽  
Vol 19 (1) ◽  
pp. 61-70 ◽  
Author(s):  
Gursukhman S. Sidhu ◽  
Christopher K. Kepler ◽  
Katherine E. Savage ◽  
Benjamin Eachus ◽  
Todd J. Albert ◽  
...  
Keyword(s):  
Surgical Management ◽  
Neurological Deficit ◽  
Traumatic Injury ◽  
Complete Recovery ◽  
Cement Leakage ◽  
Neurological Status ◽  
The Right ◽  
Cement Extravasation ◽  
Removal Of Cement ◽  
Biplanar Fluoroscopy

The authors endeavor to highlight the surgical management of severe neurological deficit resulting from cement leakage after percutaneous vertebroplasty and to systematically review the literature on the management of this complication. A patient presented after a vertebroplasty procedure for traumatic injury. A CT scan showed polymethylmethacrylate leakage into the right foramina at T-11 and L-1 and associated central stenosis at L-1. He underwent decompression and fusion for removal of cement and stabilization of the fracture segment. In the authors' systematic review, they searched Medline, Scopus, and Cochrane databases to determine the overall number of reported cases of neurological deficit after cement leakage, and they collected data on symptom onset, clinical presentation, surgical management, and outcome. After surgery, despite neurological recovery postoperatively, the patient developed pneumonia and died 16 days after surgery. The literature review showed 21 cases of cement extravasation with neurological deficit. Ultimately, 15 patients had resolution of the postoperative deficit, 5 had limited change in neurological status, and 2 had no improvement. Cement augmentation procedures are relatively safe, but certain precautions should be taken to avoid such complications including high-resolution biplanar fluoroscopy, considering the use of a local anesthetic, and controlling the location of cement spread in relationship to the posterior vertebral body. Immediate surgical intervention with removal of cement provides good results with complete recovery in most cases.

scholarly journals Clinical characteristics and surgical outcomes of isolated inferior rectus palsy

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Licheng Fu ◽  
Binbin Zhu ◽  
Jianhua Yan
Keyword(s):  
Surgical Outcomes ◽  
Clinical Characteristics ◽  
Traumatic Injury ◽  
Rectus Muscle ◽  
Complete Recovery ◽  
Surgical Approaches ◽  
Ocular Motility ◽  
Limited Information ◽  
Inferior Rectus ◽  
The Right

Abstract Aim As isolated inferior rectus muscle (IRM) palsy represents a rare clinical entity, very limited information is available on this condition. The aim of this report was to elucidate the etiology, clinical characteristics and surgical outcomes of isolated IRM palsy. Methods Isolated IRM palsy cases who underwent surgical treatments at the Zhongshan Ophthalmic Center, Sun Yat-sen University, China over the period from January 2008 to June 2019 were reviewed retrospectively. Data evaluated from these cases included their etiology, ocular alignment, ocular motility, surgical procedures and surgical outcomes. Results A total of 61 patients (40 males, 21 females) were included in this review. Their mean ± SD age was 27.21 ± 16.03 years (range: 2 to 73 years). In these cases, 32 (52.5%) involved traumatic injury, 28 (45.9%) congenital hypoplasia or absence of inferior rectus and 1 (1.6%) with thyroid ophthalmopathy. The right eye was affected in 33 patients (54.1%), the left in 24 patients (39.3%), and both eyes in 4 patients (6.6%). The main clinical presentations consisted of hypertropia of the affected eye, motility limitation in abduction and depression and incyclotropia. After treatment consisting of various surgical approaches, including muscle repair or resection of the affected inferior rectus, recession of ipsilateral superior rectus, elongation of contralateral superior oblique and partial transposition of the horizontal rectus, the isolated IRM palsy was rectified in 49 patients (80.4%) with one surgery, while 11 cases (18.0%) required two surgeries and 1 case (1.6%) needed three surgeries. Finally, 52 patients (85.2%) showed a complete recovery, 6 (9.9%) improved and 3 (4.9%) experienced a surgical failure. Conclusion The main etiologies of isolated IRM palsy involved traumatic injury and developmental events. Overall, surgical outcomes of the various approaches employed were quite effective.

scholarly journals Pharmacotherapy of Rhino-Orbital- Cerebral Mucormycosis

2021 ◽  
Vol 70 (2) ◽  
Author(s):  
Manisha Bisht ◽  
Sampan Singh Bist
Keyword(s):  
Amphotericin B ◽  
Early Stage ◽  
Short Review ◽  
Medical Intervention ◽  
High Dose ◽  
High Morbidity ◽  
First Line ◽  
Basic Principles ◽  
Resource Limited ◽  
Amphotericin B Deoxycholate

The aim of this study is Recently there is an alarming increase in the incidence of mucormycosis in patients diagnosed with Covid -19. In this short review, we will discuss the basic principles of mucormycosis treatment, antifungal agents used along with update on pharmacotherapeutic guidelines recommended for management of mucormycosis. Searching the Pubmed with the key words “mucormycosis and covid 19 ”, “ Treatment of mucormycosis”, “ antifungal used in Mucormycosis revealed many articles, and the relevant articles were screened. Mucormycosis is an aggressive disease which is difficult to diagnose in early stage with high morbidity and mortality. Multimodal therapeutic approach consisting of early diagnosis, urgent surgical and medical intervention and elimination of predisposing factors is key to successful management of this condition. First-line antifungal agent is high-dose liposomal amphotericin B although amphotericin B deoxycholate may be the viable option in resource limited settings.

scholarly journals SUBCUTANEOUS PHEOHYPHOMYCOSIS CAUSED BY Phoma cava: REPORT OF A CASE AND REVIEW OF THE LITERATURE

1997 ◽  
Vol 39 (1) ◽  
pp. 43-48 ◽  
Author(s):  
Clarisse ZAITZ ◽  
Elisabeth Maria HEINS-VACCARI ◽  
Roseli Santos de FREITAS ◽  
Giovana Letícia Hernández ARRIAGADA ◽  
Ligia RUIZ ◽  
...  
Keyword(s):  
Fungal Infection ◽  
Amphotericin B ◽  
Male Patient ◽  
Histopathological Examination ◽  
Corticosteroid Treatment ◽  
Skin Lesions ◽  
Pulmonary Sarcoidosis ◽  
Review Of The Literature ◽  
Right Hand ◽  
The Right

We report a case of subcutaneous pheohyphomycosis observed in a male patient presenting pulmonary sarcoidosis and submitted to corticosteroid treatment. He presented nodular erythematous-violaceous skin lesions in the dorsum of the right hand. Histopathological examination of the biopsied lesion revealed dematiaceous hyphae and yeast-like cells, with a granulomatous tissual reaction. The isolated fungus was identified as Phoma cava. A review of the literature on fungal infection caused by different Phoma species, is presented. The patient healed after therapy with amphotericin B, followed by itraconazole

Closure of Secundum Atrial Septal Defect with Autologous Right Atrial Patch: Case Report

2005 ◽  
Vol 8 (2) ◽  
pp. 96 ◽  
Author(s):  
Osman Tansel Dar�in ◽  
Alper Sami Kunt ◽  
Mehmet Halit Andac
Keyword(s):  
Atrial Septal Defect ◽  
Right Atrium ◽  
Septal Defect ◽  
Complete Recovery ◽  
Interatrial Septum ◽  
Right Atrial ◽  
Atrial Wall ◽  
Residual Shunt ◽  
Asd Closure ◽  
The Right

Background: Although various synthetic materials and pericardium have been used for atrial septal defect (ASD) closure, investigators are continuing to search for an ideal material for this procedure. We report and evaluate a case in which autologous right atrial wall tissue was used for ASD closure. Case: In this case, we closed a secundum ASD of a 22-year-old woman who also had right atrial enlargement due to the defect. After establishing standard bicaval cannulation and total cardiopulmonary bypass, we opened the right atrium with an oblique incision in a superior position to a standard incision. After examining the secundum ASD, we created a flap on the inferior rim of the atrial wall. A stay suture was stitched between the tip of the flap and the superior rim of the defect, and suturing was continued in a clockwise direction thereafter. Considering the size and shape of the defect, we incised the inferior attachment of the flap, and suturing was completed. Remnants of the flap on the inferior rim were resected, and the right atrium was closed in a similar fashion. Results: During an echocardiographic examination, neither a residual shunt nor perigraft thrombosis was seen on the interatrial septum. The patient was discharged with complete recovery. Conclusion: Autologous right atrial patch is an ideal material for ASD closure, especially in patients having a large right atrium. A complete coaptation was achieved because of the muscular nature of the right atrial tissue and its thickness, which is a closer match to the atrial septum than other materials.

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