scholarly journals A case series on post-covid deadly fungal infection: mucormycosis

2021 ◽  
Vol 7 (9) ◽  
pp. 1503
Author(s):  
Kalpana G. ◽  
Amol A. Patil ◽  
Manohar Shaan ◽  
Mitusha Verma ◽  
Gayatri Harshe
Keyword(s):  
Fungal Infection ◽  
Opportunistic Infection ◽  
Surgical Intervention ◽  
Case Series ◽  
Medical Intervention ◽  
Morbidity And Mortality ◽  
Diabetic Patients ◽  
High Morbidity ◽  
Per Se

<p class="abstract">The prevailing pandemic situation by SARS-CoV-2 infection is not only worrisome by the disease per se but also for the accompanying opportunistic infection are in the rise especially in diabetic patients. We presented a case series of post-covid rhino orbital cerebral mucormycosis infection in diabetic patients resulting in high morbidity. The need to present this was to emphasis on the timely surgical and medical intervention needed to reduce morbidity and mortality by the infection. The study highlighted the importance of surgical intervention in the deadly infection.</p>

scholarly journals The importance of mucormycosis infections on example of Rhino Orbital Cerebral Mucormycosis

2021 ◽  
Vol 75 ◽  
pp. 211-216
Author(s):  
Łukasz Pałka ◽  
Vivek Gaur
Keyword(s):  
Fungal Infection ◽  
General Health ◽  
Clinical Manifestations ◽  
Medical Intervention ◽  
Health Condition ◽  
Morbidity And Mortality ◽  
High Morbidity ◽  
Proper Treatment ◽  
General Health Condition ◽  
Immunocompetent Patients

Mucormycosis is an angioinvasive fungal infection, characterized by high morbidity and mortality and is strongly dependent on the patient’s general health condition, initial site of infection, and the time from diagnosis to treatment commencement. It has been reported that the occurrence of mucormycosis has increased rapidly, also among immunocompetent patients. Moreover, the rise in number is expected to continue. Among all clinical manifestations of mucormycosis, the rhino-orbital-cerebral type (ROCM) is the most common. The aim of this article is to increase the awareness of mucoral infections, especially ROCM, and to describe its first symptoms, as proper treatment requires immediate surgical and medical intervention.

scholarly journals Heterotopic caval valve implantation for the management of severe tricuspid regurgitation: a case series

2020 ◽  
Author(s):  
Aidan Sharkey ◽  
Ronny Munoz Acuna ◽  
Kiran Belani ◽  
Ravi K Sharma ◽  
Omar Chaudhary ◽  
...  
Keyword(s):  
Medical Therapy ◽  
Tricuspid Regurgitation ◽  
Surgical Intervention ◽  
Symptom Relief ◽  
Vena Cava ◽  
Case Series ◽  
High Morbidity ◽  
Severe Tricuspid Regurgitation ◽  
Maximal Medical Therapy ◽  
Valve Implantation

Abstract Background Severe tricuspid regurgitation (TR) is a complex condition that can be difficult to treat medically, and often surgical intervention is prohibited due to the high morbidity and mortality associated with this intervention. In patients who have failed maximal medical therapy and have progressive symptoms related to their severe TR, heterotopic caval valve implantation (CAVI) offers potential for symptom relief for these patients. Case summary We present two cases of patients with severe TR with symptoms of heart failure that were refractory to medical therapy. Due to extensive comorbidities in these patient’s surgical intervention was deemed unsuitable and the decision was made to proceed with heterotopic CAVI in order to try and control their symptoms. Both patients successfully underwent the procedure and had an Edwards SAPIEN 3 valve (Edwards Lifesciences, Irvine, CA, USA) implanted in the inferior vena cava/right atrium junction. In both patients, there was improvement in the postoperative haemodynamics as measured by invasive and non-invasive methods. Successful discharge was achieved in both patients with improvement in their symptoms. Discussion Selective use of heterotopic CAVI to treat symptomatic severe TR that is refractory to medical therapy may be a viable option to improve symptoms in those patients that are unsuitable for surgical intervention.

Acute stroke management and late referrals-Clinician and community unawareness, A one month case series from Tumbi regional referral hospital Pwani, Tanzania

2021 ◽  
Vol 2 (2) ◽  
Author(s):  
Adam M Gembe ◽  
◽  
Erhad Bilaro ◽  
Keyword(s):  
Emergency Department ◽  
Acute Stroke ◽  
Developing World ◽  
Case Series ◽  
Referral Hospital ◽  
Morbidity And Mortality ◽  
High Morbidity ◽  
Stroke Management ◽  
Regional Referral Hospital ◽  
The Common

Stroke is among the common emergency department presentations in Tanzania at large. In the developing world, still there are challenges in diagnosis, management and monitoring of these cases hence high morbidity and mortality. A one month case series is presented here, from Pwani region Tanzania, to demonstrate the encountered challenges. Keywords: Acute stroke management clinician; Community unawareness.

scholarly journals Gastrointestinal Mucormycosis: A Rare but Lethal Mimicker of Necrotising Enterocolitis

2016 ◽  
Vol 36 (2) ◽  
pp. 198-200 ◽  
Author(s):  
Veerbhadra Radhakrishna ◽  
Krishna Kumar Govindarajan ◽  
Bharathi Balachandar ◽  
Nishad Plakkal ◽  
Sree Rekha Jinkala
Keyword(s):  
Fungal Infection ◽  
Necrotizing Enterocolitis ◽  
Necrotising Enterocolitis ◽  
Morbidity And Mortality ◽  
High Morbidity

Neonatal Gastrointestinal mucormycosis is a rare fungal infection carrying high morbidity and mortality. Clinically, it is not easily distinguishable from the more common necrotizing enterocolitis. Diagnosis is made by histopathology of the involved bowel. We report a neonate with gastrointestinal mucormycosis, bringing to notice the fatality of this infection.J Nepal Paediatr Soc 2016;36(2):198-200.

scholarly journals Surgical outcomes of diabetic hand infections in Lagos, Nigeria

2019 ◽  
Vol 31 (3) ◽  
pp. 198-201
Author(s):  
Bolaji O Mofikoya
Keyword(s):  
Type 2 Diabetes ◽  
Surgical Intervention ◽  
Morbidity Rate ◽  
Diabetic Patients ◽  
High Morbidity ◽  
Skin Grafts ◽  
Tertiary Institutions ◽  
Modes Of Presentation ◽  
High Morbidity Rate

Background Hand infections in diabetics can be a major cause of functional impairment .In patients with Tropical Diabetic hand syndrome prompt surgical intervention may salvage the hand, but return to premorbid function remain a challenge.Objectives A retrospective study of consecutive diabetic patients with hand infections was done in 2 tertiary institutions in Lagos,Nigeria to identify the epidemiology, modes of presentation, types of surgical intervention and outcomes oftreatment.Results Twenty one patients were studied over a 5 year period. ten males, eleven females .All were type 2 Diabetes. 52.4%(11) were diagnosed less than a year prior to presentation. 61.9%(13) had digit/hand gangrene on presentation. All operated patients (20) had wound debridements. 52.5% (11) digit/hand amputations and this was the commonest surgical procedures done. Other surgeries done include skin grafts and `flap reconstructions. There was a 19% mortality rate. Less than a fifth were able return to their premorbid occupation after 3 months. But all had reduced range of motion in the interphalangeal joints in the adjacent digits.ConclusionsThere is a high morbidity rate for hand infections in the diabetic, even though majority of the hands were salvaged, most patients were unable to return to their premorbid occupation at 3 months.

scholarly journals Clinicopathological study of diabetic foot in Bundelkhand area with special reference to fungal infection in asymptomatic feet of diabetic patients

2017 ◽  
Vol 4 (11) ◽  
pp. 3690
Author(s):  
Mayank Mishra ◽  
Dinesh Pratap
Keyword(s):  
Fungal Infection ◽  
Diabetic Patient ◽  
Diabetic Foot ◽  
Morbidity And Mortality ◽  
Control Group ◽  
Diabetic Patients ◽  
Foot Care ◽  
Clinicopathological Study ◽  
Foot Lesions ◽  
Foot Disease

Background: As with substantial increasing in incidence of diabetes mellitus in present century and with huge prevalence in population; the incidence of one of the dreadful complication of diabetes i.e. diabetic foot also increases, leading to increase morbidity and mortality. Fungal infection in foot is one of the underweighted cause of foot ulceration. These microulceration in conjunction with diabetes may leads to fulminant infection. The study comprised of 66 cases out of which 16 served as control. Aim and objectives of our study is to study the incidence of fungal infection in asymptomatic feet of diabetic patients, identification of the type of fungus, comparison with nondiabetics and clinicopathological study of the patients.Methods: The present study was carried at Department of Surgery, MLB. Medical College, Jhansi, the study group was classified into two groups. Control group; this group comprised of non-diabetic patients with foot lesions. Disease group; diabetic patients with foot lesions. Webs scrapings were inoculated in Sabouraud’s media slopes. Cultured media were examined after 3 days for the growth. Identification depends on colonial appearance and the morphology of the spores and by Gram, s and AFB Staining.Results: By this study we conclude that fungal infection in asymptomatic foot of diabetes patient are significantly more than non-diabetic patients which is accentuated by duration, type, glycaemic control and practice of bare foot walking which makes diabetic patient more prone for diabetic foot. So, the foot care of patients of diabetes should include the prophylactic steps to prevent fungal growth.Conclusions: By above study, we reasonably conclude that fungal infection in diabetic patients plays a pivotal role in formation of diabetic foot disease, so by eradication of fungal infection in asymptomatic foot of diabetic patient by general preventive methods and/or pharmacological methods may be beneficial in reducing morbidity and mortality in diabetic foot patients.

scholarly journals DIABETIC FOOT SYNDROME AS A POSSIBLE CARDIOVASCULAR MARKER IN TYPE 2 DIABETIC PATIENTS

2021 ◽  
Author(s):  
Mohd Riyaz Beg ◽  
Vidhi Gupta
Keyword(s):  
Type 2 Diabetes ◽  
Cardiovascular Risk ◽  
Diabetic Foot ◽  
Plasma Levels ◽  
Vascular Complications ◽  
Morbidity And Mortality ◽  
Foot Ulcers ◽  
Diabetic Patients ◽  
High Morbidity

Diabetic foot ulcerations have been extensively reported as vascular complications of diabetes mellitus associated with a high degree of morbidity and mortality; in fact, some studies showed a higher prevalence of major, previous and new-onset, cardiovascular, and cerebrovascular events in diabetic patients with foot ulcers than in those without these complications. This is consistent with the fact that in diabetes there is a complex interplay of several variables with inflammatory metabolic disorders and their effect on the cardiovascular system that could explain previous reports of high morbidity and mortality rates in diabetic patients with amputations. Involvement of inflammatory markers such as IL-6 plasma levels in diabetic subjects confirmed the pathogenetic issue of the “adipovascular” axis that may contribute to cardiovascular risk in patients with type 2 diabetes. In patients with diabetic foot, this “adipovascular axis” expression in lower plasma levels of adiponectin and higher plasma levels of IL-6 could be linked to foot ulcers pathogenesis by microvascular and inflammatory mechanisms. The purpose of this review is to focus on the immune inflammatory features of DFS and its possible role as a marker of cardiovascular risk in type 2 diabetes patients.

scholarly journals Low-dose etomidate for the management of severe hypercortisolaemia in different clinical scenarios: a case series and review of the literature

2019 ◽  
Vol 10 ◽  
pp. 204201881982554
Author(s):  
Agnieszka Łebek-Szatańska ◽  
Karolina M. Nowak ◽  
Wojciech Zgliczyński ◽  
Elżbieta Baum ◽  
Agnieszka Żyłka ◽  
...  
Keyword(s):  
Cushing’S Syndrome ◽  
Surgical Intervention ◽  
Therapeutic Option ◽  
Case Series ◽  
Cushing's Syndrome ◽  
Medical Intervention ◽  
Infectious Complications ◽  
Mortality And Morbidity ◽  
Clinical Scenarios ◽  
Lowering Drug

Background: Severe Cushing’s syndrome (SCS) is associated with acute cardiovascular, metabolic and infectious complications. It is considered an emergency, requiring an immediate diagnosis, together with a broad spectrum of supportive and hypocortisolaemic treatments. Surgical intervention, aimed at removing the source of cortisol or adrenocorticotropic hormone (ACTH), is the optimal treatment in most cases of Cushing’s syndrome. However, in hypercortisolaemic states, surgical intervention has high rates of perioperative mortality and morbidity. Oral adrenal steroidogenesis inhibitors, even if more effective in combination, are not always efficient enough or well tolerated. Despite their common use, a more potent, parental, immediate, and thus life-saving, therapy is necessary. Methods: The authors present three different clinical scenarios of etomidate treatment in patients hospitalized in the third reference endocrinological centre in Poland between 2016 and 2017. Results: Patients with Cushing’s disease, ectopic Cushing’s syndrome and adrenocortical carcinoma presented with severe hypercortisolaemia and exacerbated cortisol-dependent comorbidities. In these three cases, etomidate acted as an accurate, well tolerated and effective cortisol-lowering drug for several days or even months. Patients were monitored in a general ward setting, and no side effects of the therapy were observed. Conclusions: In doses far lower than those used for anaesthesia, etomidate works as a useful cortisol-lowering therapy in patients intolerant to or unable to take oral medications. Additionally, if urgent, the most potent and effective medical intervention is necessary, and clinicians should be aware of such a therapeutic option.

scholarly journals Survey On Methanol Poisoning Epidemic in Rafsanjan City in Year 2013

2017 ◽  
Vol 2 (3) ◽  
pp. 84
Author(s):  
Vahid Mirzaee ◽  
Zahra Riahi ◽  
Zahra Sharifzadeh ◽  
Moein Kardoust Parizi ◽  
Amir Adinehpour
Keyword(s):  
Metabolic Acidosis ◽  
Gastrointestinal Symptoms ◽  
Case Series ◽  
Morbidity And Mortality ◽  
Diagnosis And Treatment ◽  
High Morbidity ◽  
Methanol Poisoning ◽  
Arterial Blood ◽  
Number Of Patients ◽  
Case Series Study

Background: Examination and early detection of the methanol toxicity epidemic are very important, so identification and initiation of appropriate therapy can significantly reduce morbidity and mortality. Therefore, this study was aimed to investigation methanol poisoning epidemic in  Rafsanjan city.Methods: This case series study was conducted in 252 patients with methanol poisoning in 2013 in the Ali-ibn-Abi-Talib hospital of Rafsanjan. Data were through interviews and records that were collected at hospital admission. Due to the large number of patients and the possible lack of ability of rapid measurement of serum levels of methanol and need of rapid intervention, treatment to reduce any further complications, early diagnosis and treatment were carried out by clinical history and interpretation of arterial blood gas test results. Data record on provided checklists and then analyzed using SPSS version 19.Results: The mean pH was 0.13±7.27. The most frequent clinical features were visual disturbances (39.7%), dyspnea (1.2%), and gastrointestinal symptoms (7.1%). There was a trend towards decreasing PCO2 with decreasing pH amongst the patients surviving. The opposite trend was demonstrated in the dying; the difference was highly significant by linear regression analyses (P< 0.001).Conclusions: Methanol poisoning still has a high morbidity and mortality, mainly because of late diagnosis and treatment. Respiratory arrest, coma and severe metabolic acidosis upon admission were strong predictors of poor outcome. Early admission and ability of respiratory compensation of metabolic acidosis were associated with survival.

PS02.148: ENDOSCOPIC MANAGEMENT OF GASTRO-BRONCHIAL FISTULA FOLLOWING 2-STAGE OESOPHAGECTOMY USING OVER-THE-SCOPE-CLIP (OTSC): CASE SERIES

2018 ◽  
Vol 31 (Supplement_1) ◽  
pp. 162-163
Author(s):  
Chih Ying Tan ◽  
Htet Arkar Kyaw ◽  
Bruno Lorenzi ◽  
Alex Charalampopoulos ◽  
Naga Venkatesh Jayanthi ◽  
...  
Keyword(s):  
Conflicts Of Interest ◽  
Treatment Algorithm ◽  
Case Series ◽  
Complete Healing ◽  
Morbidity And Mortality ◽  
Heavy Smoker ◽  
Endoscopic Management ◽  
High Morbidity ◽  
Bronchial Fistula ◽  
Over The Scope Clip

Abstract Background Post-oesophagectomy gastro-bronchial fistula (GBF) has significant morbidity and mortality. Management of GBF remains non-standardized due its rarity and limited available evidence. Re-operation and surgical repair has been the main approach. More recently, multimodal endoscopic treatment is gaining popularity as primary treatment option due to its relatively non-invasiveness, increasing evidence of success rate and reduced morbidity. We present a case series of GBF managed endoscopically using over-the-scope-clip (OTSC). Methods A dedicated, prospective and contemporaneous regional Upper GI cancer database was searched to identify GBF from January 2015 to December 2017. Clinical notes and investigation images of identified cases were analysed. Results Three patients developed post-oesophagectomy GBF during study period. Mean age of patients was 53. Mean time of GBF diagnosis was 233 days (range: 20–608). Two patients had endoscopic stent placement prior to OTSC application. Primary technical success was achieved in all patients. No adverse events were reported. Two patients had complete healing of GBF and mean healing time was 15 days (range: 6–24). One patient who had significant co-morbidities (peripheral arterial disease, diabetes, hepatitis C, rheumatoid arthritis and heavy smoker) developed persistent leak of GBF and died from cardiac event. Conclusion GBF and its surgical treatment are associated with a high morbidity and mortality. We present this case series where two out of three patients with GBF were successfully treated with this modality. Endoscopic therapy incorporating OTSC placement is a feasible option in management of post-oesophagectomy GBF. Further studies are required to understand and establish its role in treatment algorithm of post-oesophagectomy GBF. Disclosure All authors have declared no conflicts of interest.

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