scholarly journals Radiological spectrum of invasive mucormycosis in COVID-19

2021 ◽  
pp. 20210111
Author(s):  
Nandini Passi ◽  
Anshu C Wadhwa ◽  
Swati Naik
Keyword(s):  
Male Patient ◽  
Fungal Infections ◽  
Sinus Thrombosis ◽  
Indian Subcontinent ◽  
Fungal Growth ◽  
Fungal Sinusitis ◽  
Left Flank ◽  
Contrast Ct ◽  
Left Flank Pain ◽  
Periorbital Swelling

Mucormycosis, commonly known as the “black fungus” is recently emerging as a deadly complication in COVID patients in the Indian subcontinent. A growing number of cases are being reported from all over the country, with a majority of the patients either undergoing treatment or having recovered from COVID. Here, we report three cases of multisystem mucormycosis in COVID positive patients showing, rhino-orbital, cerebral, pulmonary, and genitourinary involvement. The first is a case of a 41-year-old male patient who during his treatment developed left periorbital swelling with ecchymosis and headache. CT and CE-MRI of the paranasal sinuses and brain revealed features of pan fungal sinusitis and subsequent invasion into the left orbit. The second case is of a 52-year-old male patient who after complaining of a severe left-sided hemicranial headache was diagnosed with cavernous sinus thrombosis. The third is of a 57-year-old male patient who presented with left flank pain and dysuria. HRCT (High-resolution CT) chest revealed a thick-walled cavitary lesion, and NCCT KUB (Non-contrast CT of Kidneys, ureters, and bladder) revealed left-sided pyelonephritis. A cystoscopic and microbiological evaluation revealed fungal growth. In all three patients, a biopsy from the involved area revealed broad aseptate filamentous fungal hyphae suggestive of mucormycosis, which was confirmed on culture. These are all unusual cases and physicians should be aware of the possibility of secondary invasive fungal infections in patients with COVID-19 infection.

scholarly journals A case of invasive fungal sinusitis by candida species causing blindness

2021 ◽  
Vol 9 (1) ◽  
pp. 41-44
Author(s):  
Subhramanyam C ◽  
Revoori MK ◽  
Padiki S ◽  
Mohiuddin KM ◽  
Kaul S ◽  
...  
Keyword(s):  
Fungal Infections ◽  
Sinus Thrombosis ◽  
Central Retinal Artery Occlusion ◽  
Retinal Artery Occlusion ◽  
Artery Occlusion ◽  
Fungal Sinusitis ◽  
Systemic Complications ◽  
Invasive Fungal Sinusitis ◽  
Retinal Artery ◽  
The Common

Invasive fungal sinusitis (IFS) is a common manifestation in immunocompromised patients. The common offenders are Aspergillus and Mucor. These fungal infections can cause various systemic complications, both intracranial and extracranial. Ultimately it may lead to fungemia and death. Very few cases of IFS caused by candida have been reported in the literature. Candida is a yeast like fungus, present normally as a commensal in the oral cavity and skin. Invasive fungal sinusitis with central retinal artery occlusion (CRAO) with candida is extremely rare. We are reporting a case of cavernous sinus thrombosis (CST) with CRAO causing bilateral blindness in a patient with invasive candida sinusitis.

scholarly journals CD137 Signaling Is Critical in Fungal Clearance during Systemic Candida albicans Infection

2021 ◽  
Vol 7 (5) ◽  
pp. 382
Author(s):  
Vuvi G. Tran ◽  
Na N. Z. Nguyen ◽  
Byungsuk Kwon
Keyword(s):  
Candida Albicans ◽  
Defense Mechanisms ◽  
Tumor Necrosis ◽  
Fungal Infections ◽  
Fungal Growth ◽  
Wild Type ◽  
Agonistic Antibody ◽  
Innate Defense ◽  
Surface Receptor ◽  
Candida Albicans Infection

Invasive fungal infections by Candida albicans frequently cause mortality in immunocompromised patients. Neutrophils are particularly important for fungal clearance during systemic C. albican infection, yet little has been known regarding which surface receptor controls neutrophils’ antifungal activities. CD137, which is encoded by Tnfrsf9, belongs to the tumor necrosis receptor superfamily and has been shown to regulate neutrophils in Gram-positive bacterial infection. Here, we used genetic and immunological tools to probe the involvement of neutrophil CD137 signaling in innate defense mechanisms against systemic C. albicans infection. We first found that Tnfrsf9−/− mice were susceptible to C. albicans infection, whereas injection of anti-CD137 agonistic antibody protected the host from infection, suggesting that CD137 signaling is indispensable for innate immunity against C. albicans infection. Priming of isolated neutrophils with anti-CD137 antibody promoted their phagocytic and fungicidal activities through phospholipase C. In addition, injection of anti-CD137 antibody significantly augmented restriction of fungal growth in Tnfrsf9−/− mice that received wild-type (WT) neutrophils. In conclusion, our results demonstrate that CD137 signaling contributes to defense mechanisms against systemic C. albicans infection by promoting rapid fungal clearance.

scholarly journals Rapidly dissolving microneedle patch of amphotericin B for intracorneal fungal infections

2021 ◽  
Author(s):  
Alyaa A. Albadr ◽  
Ismaiel A. Tekko ◽  
Lalitkumar K. Vora ◽  
Ahlam A. Ali ◽  
Garry Laverty ◽  
...  
Keyword(s):  
Fungal Infection ◽  
Amphotericin B ◽  
Fungal Infections ◽  
Fungal Growth ◽  
Significant Inhibition ◽  
Corneal Tissue ◽  
Biodegradable Poly ◽  
Invasive Method ◽  
Poorly Soluble ◽  
Microneedle Patch

AbstractChronic fungal infection of the cornea could lead to blindness if not treated properly. Topical amphotericin B (AMP-B) is considered the first treatment of choice for ocular fungal infection. However, factors related to its poor solubility and penetration through intact cornea lead to poor bioavailability. Microneedles (MNs) are emerging as a minimally invasive method to enhance ocular drug delivery. This study aims to investigate the potential use of biodegradable poly(vinylpyrrolidone) (PVP) and hyaluronic acid (HA)–based rapidly dissolving MNs for delivery of AMP-B to treat fungal infection. The data obtained illustrates PVP/HA MN arrays’ reproducibility, good mechanical strength, and faster dissolution with 100% drug recovery. Multiphoton microscopic results revealed that MNs successfully penetrate the corneal tissue and enhance AMP-B permeation through corneal layers. Furthermore, PVP/HA MN arrays showed high solubility. Both PVP and HA successfully decreased AMP-B cytotoxicity when compared to free drug. More interestingly, the biocompatible MN formulations preserved the antifungal activity of AMP-B, as demonstrated by significant inhibition of fungal growth. Therefore, this study shows the feasibility of ocular delivery of the poorly soluble AMP-B using a fast-dissolving MN patch. Graphical abstract

scholarly journals CD137 Signaling is Critical in Fungal Clearance During Systemic Candida albicans Infection

2021 ◽  
Author(s):  
Vu Vi Giang Tran ◽  
Zen Na Nu Nguyen ◽  
Byungsuk Kwon
Keyword(s):  
Innate Immunity ◽  
Candida Albicans ◽  
Defense Mechanisms ◽  
Tumor Necrosis ◽  
Fungal Infections ◽  
Fungal Growth ◽  
Immunocompromised Patients ◽  
Agonistic Antibody ◽  
Innate Defense ◽  
Surface Receptor

Invasive fungal infections by Candida albicans frequently cause mortality in immunocompromised patients. Neutrophils are particularly important for fungal clearance at the early phase of infections, yet little has been known regarding which surface receptor controls neutrophil phagocytic activities during systemic C. albicans infection. CD137, which is encoded by Tnfrsf9, belongs to the tumor necrosis receptor superfamily and has been shown to regulate neutrophils in Gram-positive bacterial infection. Here, we used genetic and immunological tools to probe the involvement of CD137 signaling in innate defense mechanisms against systemic C. albicans infection. We first found that Tnfrsf9-/- mice were susceptible to C. albicans infection, whereas injection of anti-CD137 agonistic antibody protected the host from infection, suggesting that CD137 signaling is indispensable for innate immunity against C. albicans infection. Priming of isolated neutrophils with anti-CD137 antibody promoted their phagocytic and fungicidal activities through phospholipase C. In addition, injection of anti-CD137 antibody significantly augmented restriction of fungal growth in Tnfrsf9-/- mice that received WT neutrophils. In conclusion, our results demonstrate that CD137 signaling contributes to defense mechanisms against systemic C. albicans infection by promoting rapid fungal clearance whereby harmful immunopathology-induced tissue injuries are minimalized.

scholarly journals Denture Stomatitis: Report of a Case with Rarely Used Treatment Modality and Review of Literature

2020 ◽  
Vol 4 (5) ◽  
pp. 116-119
Author(s):  
Parul Uppal Malhotra ◽  
Neera Ohri ◽  
Yagyeshwar Malhotra ◽  
Anindita Mallik
Keyword(s):  
Candida Albicans ◽  
Candida Species ◽  
Fungal Infections ◽  
Bacterial Colonization ◽  
Oral Candidiasis ◽  
Clinical Signs ◽  
Fungal Growth ◽  
Dimorphic Fungus ◽  
Denture Stomatitis ◽  
Microbial Invasion

Candida albicans is the most common Candida species isolated from the oral cavity both in healthy and diseased. Candida albicans is a dimorphic fungus existing both in blastopore phase (yeast phase) and the hyphal or mycelial phase. Although these organisms typically colonize mucocutaneous surfaces, the latter can be portals of entry into deeper tissues when host defences are compromised. Denture stomatitis is a common form of oral candidiasis that manifests as a diffuse inflammation of the maxillary denture bearing areas & is associated with angular cheilitis. At least 70% of individuals with clinical signs of denture stomatitis exhibit fungal growth & these conditions most likely result from yeast colonization of the oral mucosa combined with Bacterial colonization. Candida species act as an endogenous infecting agent on tissue predisposed by chronic trauma to microbial invasion. At one time, oral fungal infections were rare findings in general dentist's office. They were more commonly seen in hospitalized and severely debilitated patients. However with enhanced medical and pharmaceutical technology, increasing numbers of ambulatory immunosuppressed individuals with oral fungal infections are seeking out general dentists for diagnosis and treatment of these lesions.

Utilizing CT soft-tissue markers as a screening tool for acute invasive fungal sinusitis

2021 ◽  
Author(s):  
Deepa Susan John ◽  
Karthik Shyam ◽  
Dhilip Andrew ◽  
Soumya Cicilet ◽  
Saikanth Reddy Deepalam
Keyword(s):  
Soft Tissue ◽  
Early Detection ◽  
Nasolacrimal Duct ◽  
Histopathological Diagnosis ◽  
Fungal Sinusitis ◽  
Equal Distribution ◽  
Early Therapy ◽  
Invasive Fungal Sinusitis ◽  
Poor Outcomes ◽  
Contrast Ct

Objectives: Acute invasive fungal sinusitis (AIFS) is a rapidly progressive disease, whose delayed identification results in poor outcomes, especially in immunocompromised individuals. A surge in of AIFS in the wake of the COVID-19 pandemic, has lent additional morbidity and mortality to an already precarious clinical scenario. Early detection of AIFS in individuals who are symptomatic/ at risk can allow early therapy, enabling better patient outcomes. Our study aims to determine optimal soft-tissue markers on CT for the early detection of AIFS. Methods: In this case-control study, 142 patients with equal distribution of subjects were chosen based on histopathological diagnosis of AIFS; and their non-contrast CT scans were retrospectively assessed to determine the diagnostic utility of specific soft-tissue markers that would enable diagnosis of AIFS. Results: A total of 9 markers with adequate sensitivity and specificity were identified, including pterygopalatine and sphenopalatine fossae, inferior orbital fissure and nasolacrimal duct involvement, premaxillary thickening, retro-antral and orbital stranding, and infratemporal muscle edema. It was determined that the combined occurrence of any 3 out of 9 markers was 91.5% sensitive and 95.9% specific for diagnosis of AIFS (p < 0.005). Conclusion: Early, accurate detection of AIFS in predisposed individuals is possible with identification of soft-tissue markers on NECT, enabling early intervention. Advances in knowledge: Being the aggressive disease that it is, AIFS may be managed early if the index of suspicion is held high via CT imaging; which our diagnostic checklist aims at enabling.

Impacted vesicouretric stone a quagmire settled with holmium laser

2021 ◽  
Vol 2 (5) ◽  
Author(s):  
Manjeet Kumar ◽  
◽  
Sanjeev Chauhan ◽  
Keyword(s):  
Medical Treatment ◽  
Ct Scan ◽  
Flank Pain ◽  
Nausea And Vomiting ◽  
Holmium Laser ◽  
Operation Theatre ◽  
Left Flank ◽  
Noncontrast Ct ◽  
Left Flank Pain

A 38 years female presented with left flank pain, nausea, and vomiting. Ultrasound and Noncontrast CT scan were suggestive of left hydronephrosis with left Vesicoureteral stone (Figure 1). Conservative medical treatment previously was not successful. Blood investigations were Hb 11.5 gm%, TLC 11500/mm3 , urea 22, creatinine 0.6, urine was full of RBCs. She was taken to the operation theatre for emergency double j stenting. Cystoscopy showed impacted left vesicoureteral stone (Figure 2,3).

Analysis of Fungi on Coix (Coix lacryma-jobi) Seed and the Effect of Its Aqueous Extract on the Growth of Aspergillus flavus

2019 ◽  
Vol 82 (10) ◽  
pp. 1775-1782 ◽  
Author(s):  
XUEMEI LUO ◽  
HONGXIA LI ◽  
DAN JIANG ◽  
JIEQIN MENG ◽  
FAN ZHANG ◽  
...  
Keyword(s):  
Dna Barcoding ◽  
Aspergillus Flavus ◽  
Aqueous Extract ◽  
High Throughput Sequencing ◽  
Rhizopus Oryzae ◽  
Fungal Infections ◽  
Fungal Growth ◽  
Promoting Effect ◽  
Illumina Hiseq ◽  
Coix Seed

ABSTRACT Coix (Coix lacryma-jobi) seeds are susceptible to fungal infections, making their surface fungi complex and diverse. Some fungi can produce mycotoxins under suitable conditions, and fungal growth is closely related to the production of mycotoxins. In this study, the surface fungi of coix seed were identified by Illumina HiSeq high-throughput sequencing. Simultaneously, the fungi cultured by the plate method were identified by microscopy and DNA barcoding; finally, the species of fungi were identified accurately and reliably by combining three methods. The aqueous extract of coix seed was cocultured with Aspergillus flavus spores, and the relationship between the aqueous extract and the growth of A. flavus was studied with the dry weight of mycelium as an indicator. The results showed that there were 89 genera and 96 species of fungi on coix seed, which were mainly distributed in Ascomycota (81.48%) and Basidiomycota (4.08%), and Xeromyces (8.50%), Gibberella (7.25%), and Aspergillus (4.74%) were the predominant genera. Four fungi were isolated from coix seed by plate culture and identified as Aspergillus fumigatus, A. flavus, Aspergillus oryzae, and Rhizopus oryzae by microscopy and DNA barcoding. The aqueous extract of coix seed at low concentrations has a promoting effect on the growth of A. flavus. When the concentration is 3.125%, the promotion effect is the most pronounced, and the promotion rate is 29.17%. These results reveal the diversity of fungi on the coix seed, which can provide a reference for the prevention and control of harmful fungi on coix seed.

scholarly journals Elderly woman with left flank pain

2019 ◽  
Vol 16 ◽  
pp. 100533
Author(s):  
Caroline Trippel ◽  
Anthony Furiato
Keyword(s):  
Elderly Woman ◽  
Flank Pain ◽  
Left Flank ◽  
Left Flank Pain

scholarly journals Different Imaging Modalities for Evaluating Emphysematous Pyelonephritis (EPN); a Life Threatening Urological Emergency – A case report

2018 ◽  
Vol 20 (1) ◽  
pp. 63
Author(s):  
Rawnak Afrin ◽  
ABM Golam Mostofa ◽  
Shankar Kumar Biswas ◽  
Sadia Hossain ◽  
Sanowar Hossain
Keyword(s):  
Left Kidney ◽  
Lower Abdominal Pain ◽  
Tertiary Hospital ◽  
Renal Parenchyma ◽  
Ct Number ◽  
Emphysematous Pyelonephritis ◽  
Left Flank ◽  
Life Threatening ◽  
Urological Emergency ◽  
Contrast Ct

<p>Emphysematous pyelonephritis (EPN) is a severe necrotizing infection of the renal parenchyma; it causes gas formation within the collecting system, renal parenchyma, and/or perirenal tissues. In this reported case, a female patient of 40 years was admitted in a tertiary hospital with history of severe left flank pain, lower abdominal pain, fever, vomiting and scanty micturition for three days. Ultrasonogram showed-normal right kidney but left renal bed reveals extensive air obscuring visualization of left kidney with probe tenderness in left flank. Contrast CT scan of KUB shows larger left kidney with extensive air (CT number = -1000 HU) within the renal parenchyma, collecting systems and perinephric space. This case was diagnosed as EPN. After conservative treatment patient was improved significantly.</p><p>Bangladesh J. Nuclear Med. 20(1): 63-66, January 2017</p>

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