scholarly journals Fusarium-Induced Cellulitis in an Immunocompetent Patient With Sickle Cell Disease: A Case Report

2020 ◽  
Vol 8 ◽  
pp. 232470962093430
Author(s):  
Shaher Samrah ◽  
Aroob Sweidan ◽  
Abdelwahab Aleshawi ◽  
Mahmoud Ayesh

Fungal infections due to Fusarium species are mostly present in immunocompromised and patients with poorly controlled diabetes mellitus. We report a case of lower extremity skin infection caused by Fusarium species in a 61-year-old woman diagnosed with sickle cell disease. Single skin ulceration caused by Fusarium species can result from fungal inoculation into damaged tissue, so any condition that damages the skin can be considered as a risk factor for inoculation. Long-standing sickle cell disease may develop vaso-occlusion in the skin that can produce lower extremity ulcers and myofascial syndromes. The mechanism is not completely characterized, but compromised blood flow, endothelial dysfunction, thrombosis, inflammation, and delayed healing are thought to contribute to locally compromised tissue that may eventually lead to opportunistic infection such as in our case. Other factors contribute to the pathophysiology of lower extremity ulcers such as diabetes mellitus, with the resulting peripheral vascular ischemia causing poor circulation to the lower extremity, and peripheral neuropathy, which can make patients with diabetes unaware of minor trauma leading to the development of skin infections.

Blood ◽  
2008 ◽  
Vol 112 (11) ◽  
pp. 3831-3831 ◽  
Author(s):  
John A. Heit ◽  
Michele Beckman ◽  
Althea Grant ◽  
Nigel S. Key ◽  
Marilyn J. Manco-Johnson ◽  
...  

Abstract Background: Compared to Whites, Black-Americans may have a 40% higher incidence of idiopathic VTE. However, whether other VTE characteristics vary by race is uncertain. Objective: To compare demographic and baseline characteristics among White- and Black-Americans with VTE. Methods: Using a standardized data-collection form, demographic and baseline characteristics were prospectively collected from consecutive consenting patients enrolled in seven Thrombosis and Hemostasis Centers from August 2003 to March 2008. For patients with objectively diagnosed VTE, demographic and baseline characteristics were compared among White- and Black-American VTE patients, both overall, and by age and gender. Results: Among 1960 White- and 368 Black-Americans with VTE, compared to Whites, Blacks had significantly less isolated DVT (73.9% vs. 86.5%, p<0.001) and significantly more PE ± DVT (45.1 vs. 39.6%, p=0.05). Blacks and Whites did not differ in mean age (43.4 vs. 44.3 years), but a significantly higher proportion of Black men VTE patients were in age groups 20–39 and 80+ years. Blacks and Whites differed significantly by gender, with a significantly higher proportion of Black women with VTE (69.8% vs. 59.1%, p=0.0001). Blacks had a significantly higher mean BMI (32.3 vs. 29.4 kg/m2, p<0.0001), a significantly lower proportion with recent surgery or trauma, active cancer and infection, and a significantly lower proportion with a family history of VTE or documented thrombophilia (solely due to reduced Factor V Leiden and Prothrombin G20210A prevalence). Conversely, Blacks had a significantly higher proportion with hypertension, hyperlipidemia, diabetes mellitus, chronic renal disease and dialysis, HIV and sickle cell disease. The two races did not differ significantly regarding the proportion with idiopathic VTE, CHF, CAD/MI, peripheral artery disease, stroke or other chronic neurological disease (i.e., cerebral palsy), chronic liver disease or autoimmune disease, including antiphospholipid syndrome. Compared to White women VTE patients, Black women VTE patients had a significantly lower proportion with recent surgery, trauma, infection, oral contraceptive use and possibly hormone therapy; and a significantly higher proportion with idiopathic VTE, hypertension, diabetes mellitus, chronic renal disease, HIV and sickle cell disease. Compared to White men VTE patients, Black men VTE patients did not differ significantly regarding recent surgery, trauma, cancer, infection or autoimmune disease, but Black men had a significantly higher proportion with hypertension, diabetes mellitus, HIV and sickle cell disease. Black and White men with VTE did not differ significantly regarding idiopathic VTE, CHF, CAD/MI, stroke, peripheral arterial disease and chronic renal disease. Conclusion: White- and Black-Americans with VTE differ significantly regarding demographic and baseline characteristics that may be risk factors for VTE.


1999 ◽  
Vol 26 (2) ◽  
pp. 98-104
Author(s):  
Sherry Compton-Johnson ◽  
Joyce Wilson ◽  
Jane M. Ramundo

Diabetes Care ◽  
1979 ◽  
Vol 2 (3) ◽  
pp. 327-327
Author(s):  
G. Triplett ◽  
S. Eichold

Blood ◽  
2018 ◽  
Vol 132 (Supplement 1) ◽  
pp. 4817-4817
Author(s):  
Jifang Zhou ◽  
Jin Han ◽  
Edith A. Nutescu ◽  
William Galanter ◽  
Surrey M. Walton ◽  
...  

Abstract Introduction The prevalence and incidence of type 2 diabetes mellitus (T2DM) in the United States (U.S.) is increasing with more than 100 million adults living with diabetes or pre-diabetes. Population-based evidence on the prevalence and risks for T2DM in patients with sickle cell disease (SCD) is limited. This study measured the prevalence of T2DM in patients with SCD and clinical characteristics associated with its incidence in a large commercially insured adult SCD cohort and also an academic institution-based clinical cohort. Methods We performed a population-based cohort study of commercially-insured health plan enrollees using the Truven MarketScan® Research Databases. Patients with SCD (1 inpatient or 2 outpatient claims that are at least 30 days apart) were identified and sampled each calendar year between 2009 and 2014. Prevalence in each closed cohort of continuously enrolled patients was determined per calendar year. Incidence rates of T2DM were estimated and compared with adult non-Hispanic Black respondents to the National Health and Nutrition Examination Survey (NHANES) over the same study period (2009-2014). Among SCD patients, multivariable Cox proportional hazard models were used to identify factors associated with incident T2DM, adjusting for relevant patient characteristics. Finally, prevalence of T2DM was measured in a cohort of patients with SCD aged ≥20 years at first medical encounter at the University of Illinois at Chicago (UIC) from January 2008 to December 2017. Prevalent T2DM was identified through a combination of diagnosis codes, self-reporting, anti-diabetic medications excluding insulin and glucose tests in outpatient settings. Results Among 7,070 health plan enrollees with SCD, the median age (mean) was 37.0 (38.9) years and 60.8% were female. Compared to SCD patients without T2DM, more SCD patients with T2DM had nephropathy (28.0% vs. 9.5%; p<0.001), neuropathy (17.7% vs. 5.2%; p<0.001), and history of stroke (24.1% vs. 9.2%; p<0.001). The standardized prevalence of T2DM among patients with SCD showed a modest increase from 15.7% to 16.5% from 2009 to 2014 (p trend=0.0259), and SCD patients had comparable prevalence of T2DM compared to the NHANES subjects (18.2%). [Figure A] Over 17,024 person-years, we observed a crude incidence rate for T2DM of 25.4 per 1,000 person-years. Risk of developing T2DM in patients with SCD increased with age, and incident T2DM was associated with comorbid hypertension (HR=1.45, 95%CI 1.14-1.83) and dyslipidemia (HR=1.43, 95%CI 1.04-1.96). [Figure B] Of the 672 adults in the UIC cohort of patients with SCD, 61.1% were female, the median (mean) age was 30.0 [32.9] years, and 478 (71.1%) had homozygous HbS disease (HbSS). A total of 76 (11.3%) patients had T2DM, with the highest prevalence among SCD patients ages ≥ 40 years (50/190, 26.3%). [Figure C] Abnormal glucose test results (≥200 mg/dl) were documented in 41 patients with mean (SD) of 294 (94) mg/dl. Among 31 patients with abnormal fructosamine tests (>285 µmol/L), the mean (SD) fructoasmine value was 392 (90) µmol/L. Conclusion We present evidence describing the prevalence of T2DM in patients with SCD both in a commercially-insured population and from an institution-based clinical cohort. These findings were similar to a general African American population with an increasing trend in T2DM over recent years. These trends support the routine screening for T2DM in patients with SCD, especially those of older age and with presence of comorbid hypertension and/or dyslipidemia. Disclosures No relevant conflicts of interest to declare.


Author(s):  
Prafulla Kumar Bariha ◽  
Biswaranjan Prusty ◽  
Manoj Kumar Mohapatra

Background: Type 2 diabetes mellitus (T2DM) occurs when impaired insulin effectiveness is accompanied by decreased insulin production by β cells. With 366 million people diagnosed in 2011 and a trend of increasing prevalence worldwide (Lyssenko and Laakso 2013), diabetes is one of the major threats to human health. Objectives of the study were to assess the occurrence of diabetes mellitus in sickle cell disease (SCD) patients and to study glycemic status of patients with SCD and clinical presentation.Methods: An observational study was done at department of general medicine and sickle cell clinic and molecular biology laboratory, Veer Surendra Sai institute of medical science and research, Burla between November 2014 to October 2016. All recorded data analyzed through standard statistical methods including standard diagram and groups and finding were discussed in detail to draw appropriate conclusion, through standard statistical methods including standard diagrams.Results: The study was taken on 137 cases of SCD patients admitted at VIMSAR, Burla. Sex distribution of SCD patient with male (68.81%) and female (31.38%) clinical feature of SCD patients shows VOC (vaso occlusive crisis) was the most common presentation for hospital admission followed by fever, anemia, jaundice, AVN (avascular necrosis), osteomyelitis, dactylitis. The most of SCD are having normoglycemic with most of diabetes mellitus are in control group. Glycemic status in SCD cases and controls with 6.57% cases of SCD, 13.14% of controls are hyperglycemic.Conclusions: The majority of patients in this SCD patients were between the age group 15-20 years. The occurrence of diabetes mellitus in SCD patients is low in compare to control population. Showing impairment of glucose tolerance in SCD but low presence of diabetes mellitus. presence of lower life span of RBC, hypermetabolic state and low body mass index in SCD patients.


2018 ◽  
Vol 40 (2) ◽  
pp. 118-120 ◽  
Author(s):  
Zainab Abdulmajeed Toorani ◽  
Srishma Sridhar ◽  
Wilfredo Roque

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