scholarly journals New insights on mucormycosis and its association with the COVID-19 pandemic

2021 ◽  
Author(s):  
Mona G Alshahawey ◽  
Ghadir S El-Housseiny ◽  
Noha S Elsayed ◽  
Mohammad Y Alshahrani ◽  
Lamia M EL Wakeel ◽  
...  
Keyword(s):  
Risk Factors ◽  
Immune Response ◽  
Fungal Infection ◽  
Clinical Presentation ◽  
Host Immune Response ◽  
Immune Dysregulation ◽  
Historical Record ◽  
Diagnosis And Treatment ◽  
Secondary Infections ◽  
Definite Correlation

COVID-19 continues to cause significant fatality worldwide. Glucocorticoids prove to play essential roles in COVID-19 management; however, the extensive use of steroids together with the virus immune dysregulation may increase the danger of secondary infections with mucormycosis, an angioinvasive fungal infection. Unfortunately, a definite correlation between COVID-19 and elevated mucormycosis infection cases is now clear worldwide. In this review, we discuss the historical record and epidemiology of mucormycosis as well as pathogenesis and associated host immune response, risk factors, clinical presentation, diagnosis and treatment. Special emphasis is given to its association with the current COVID-19 pandemic, including latest updates on COVID-19-associated mucormycosis cases globally, with recommendations for efficacious management.

scholarly journals Covid-19-Associated Pulmonary Aspergillosis: The Other Side of the Coin

Vaccines ◽  
2020 ◽  
Vol 8 (4) ◽  
pp. 713
Author(s):  
Claudio Costantini ◽  
Frank L. van de Veerdonk ◽  
Luigina Romani
Keyword(s):  
Immune Response ◽  
Clinical Presentation ◽  
Fungal Infections ◽  
Critical Factor ◽  
The Other ◽  
Current View ◽  
Immune Homeostasis ◽  
Pulmonary Aspergillosis ◽  
Secondary Infections ◽  
The Individual

The immune response to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a critical factor in the clinical presentation of COVID-19, which may range from asymptomatic to a fatal, multi-organ disease. A dysregulated immune response not only compromises the ability of the host to resolve the viral infection, but may also predispose the individual to secondary bacterial and fungal infections, a risk to which the current therapeutic immunomodulatory approaches significantly contribute. Among the secondary infections that may occur in COVID-19 patients, coronavirus-associated pulmonary aspergillosis (CAPA) is emerging as a potential cause of morbidity and mortality, although many aspects of the disease still remain unresolved. With this opinion, we present the current view of CAPA and discuss how the same mechanisms that underlie the dysregulated immune response in COVID-19 increase susceptibility to Aspergillus infection. Likewise, resorting to endogenous pathways of immunomodulation may not only restore immune homeostasis in COVID-19 patients, but also reduce the risk for aspergillosis. Therefore, CAPA represents the other side of the coin in COVID-19 and our advances in the understanding and treatment of the immune response in COVID-19 should represent the framework for the study of CAPA.

scholarly journals Interplay Among the Oral Microbiome, Oral Cavity Conditions, the Host Immune Response, Diabetes Mellitus, and Its Associated-Risk Factors—An Overview

2021 ◽  
Vol 2 ◽  
Author(s):  
Thais de Cássia Negrini ◽  
Iracilda Zeppone Carlos ◽  
Cristiane Duque ◽  
Karina Sampaio Caiaffa ◽  
Rodrigo Alex Arthur
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Immune Response ◽  
Oral Health ◽  
Inflammatory Response ◽  
Oral Cavity ◽  
Periodontal Disease ◽  
Host Immune Response ◽  
Oral Microbiome ◽  
Associated Risk Factors

This comprehensive review of the literature aimed to investigate the interplay between the oral microbiome, oral cavity conditions, and host immune response in Diabetes mellitus (DM). Moreover, this review also aimed to investigate how DM related risk factors, such as advanced age, hyperglycemia, hyperlipidemia, obesity, hypertension and polycystic ovary syndrome (PCOS), act in promoting or modifying specific mechanisms that could potentially perpetuate both altered systemic and oral conditions. We found that poorly controlled glycemic index may exert a negative effect on the immune system of affected individuals, leading to a deficient immune response or to an exacerbation of the inflammatory response exacerbating DM-related complications. Hyperglycemia induces alterations in the oral microbiome since poor glycemic control is associated with increased levels and frequencies of periodontal pathogens in the subgingival biofilm of individuals with DM. A bidirectional relationship between periodontal diseases and DM has been suggested: DM patients may have an exaggerated inflammatory response, poor repair and bone resorption that aggravates periodontal disease whereas the increased levels of systemic pro-inflammatory mediators found in individuals affected with periodontal disease exacerbates insulin resistance. SARS-CoV-2 infection may represent an aggravating factor for individuals with DM. Individuals with DM tend to have low salivary flow and a high prevalence of xerostomia, but the association between prevalence/experience of dental caries and DM is still unclear. DM has also been associated to the development of lesions in the oral mucosa, especially potentially malignant ones and those associated with fungal infections. Obesity plays an important role in the induction and progression of DM. Co-affected obese and DM individuals tend to present worse oral health conditions. A decrease in HDL and, an increase in triglycerides bloodstream levels seem to be associated with an increase on the load of periodontopathogens on oral cavity. Moreover, DM may increase the likelihood of halitosis. Prevalence of impaired taste perception and impaired smell recognition tend to be greater in DM patients. An important interplay among oral cavity microbiome, DM, obesity and hypertension has been proposed as the reduction of nitrate into nitrite, in addition to contribute to lowering of blood pressure, reduces oxidative stress and increases insulin secretion, being these effects desirable for the control of obesity and DM. Women with PCOS tend to present a distinct oral microbial composition and an elevated systemic response to selective members of this microbial community, but the association between oral microbiome, PCOS are DM is still unknown. The results of the studies presented in this review suggest the interplay among the oral microbiome, oral cavity conditions, host immune response and DM and some of the DM associated risk factors exist. DM individuals need to be encouraged and motivated for an adequate oral health care. In addition, these results show the importance of adopting multidisciplinary management of DM and of strengthening physicians-dentists relationship focusing on both systemic and on oral cavity conditions of DM patients.

Diabetic Ketoacidosis in a Child with Acute Surgical Abdomen

2018 ◽  
Author(s):  
Rahul Baijal ◽  
Carlos J. Campos
Keyword(s):  
Risk Factors ◽  
At Risk ◽  
Diabetic Ketoacidosis ◽  
Cerebral Edema ◽  
Clinical Presentation ◽  
Treatment Plan ◽  
Diagnosis And Treatment ◽  
Surgical Patient ◽  
Children At Risk ◽  
Acid Base

Management of the pediatric surgical patient in diabetic ketoacidosis (DKA) is particularly challenging given the electrolyte and acid-base abnormalities, compounded with the risk of cerebral edema. This chapter highlights the risk factors, diagnosis, and treatment plan, for the pediatric surgical patient who presents in DKA. This chapter will help the reader identify children at risk for DKA, understand the clinical presentation and pathophysiology of DKA, identify children at risk for cerebral edema, manage cerebral edema in children with DKA, manage DKA in children, and understand the anesthetic implications in children with DKA.

COVID-19: Inflammatory Profile

2021 ◽  
Vol 73 (1) ◽  
Author(s):  
Yuhang Wang ◽  
Stanley Perlman
Keyword(s):  
Immune Response ◽  
Distress Syndrome ◽  
Multiorgan Failure ◽  
Critical Role ◽  
Host Immune Response ◽  
Immune Dysregulation ◽  
Annual Review ◽  
Publication Date ◽  
Inflammatory Profile

Infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the cause of coronavirus disease 2019 (COVID-19), has resulted in a pandemic that has had widespread effects on human activities. The clinical presentation of severe COVID-19 includes a broad spectrum of clinical disease, most notably acute respiratory distress syndrome, cytokine release syndrome (CRS), multiorgan failure, and death. Direct viral damage and uncontrolled inflammation have been suggested as contributory factors in COVID-19 disease severity. The COVID-19 pandemic has emphasized the critical role of an effective host immune response in controlling a virus infection and demonstrated the devastating effect of immune dysregulation. Understanding the nature of the immune response to SARS-CoV-2 pathogenesis is key to developing effective treatments for COVID-19. Here, we describe the nature of the dysregulated host immune response in COVID-19, identify potential mechanisms involved in CRS, and discuss potential strategies that can be used to manage immune dysregulation in COVID-19. Expected final online publication date for the Annual Review of Medicine, Volume 73 is January 2022. Please see http://www.annualreviews.org/page/journal/pubdates for revised estimates.

scholarly journals A Case of Hemophagocytic Syndrome due to Tuberculosis: Uncommon Manifestation of a Common Disease

2014 ◽  
Vol 2014 ◽  
pp. 1-3 ◽  
Author(s):  
Arijit Singha ◽  
Adreesh Mukherjee ◽  
Riddhi Dasgupta ◽  
Tapas Das
Keyword(s):  
Immune Response ◽  
Early Detection ◽  
Early Diagnosis ◽  
Clinical Condition ◽  
Hemophagocytic Lymphohistiocytosis ◽  
Hemophagocytic Syndrome ◽  
Immune Dysregulation ◽  
Diagnosis And Treatment ◽  
Common Disease ◽  
Immunocompromised Patients

Hemophagocytic syndrome, also known as hemophagocytic lymphohistiocytosis (HLH), is the manifestation of immune dysregulation. It is associated with ineffective but exaggerated immune response and infiltration of active lymphocytes and histiocytes in various organs. This devastating clinical condition has myriad of clinical and biochemical manifestations such as fever, splenomegaly, pancytopenia, hypertrygliceridemia, and hyperferritinemia. It can be either primary or secondary. Primary HLH usually presents in childhood. Secondary HLH occurs due to infection mostly viruses but other aetiologies are also important as early detection and treatment may improve survival. Hemophagocytosis due to tuberculosis is uncommon. Only handful of cases have been reported mostly in immunocompromised patients. We report a case of hemophagocytic syndrome associated with disseminated tuberculosis in an immunocompetent women highlighting early diagnosis and treatment is a demanding need in this devastating disease.

scholarly journals Immunopathogenesis of Human Sporotrichosis: What We Already Know

2018 ◽  
Vol 4 (3) ◽  
pp. 89 ◽  
Author(s):  
Fatima Conceição-Silva ◽  
Fernanda Morgado
Keyword(s):  
Immune Response ◽  
Clinical Presentation ◽  
Severe Disease ◽  
Host Immune Response ◽  
Domestic Animals ◽  
Dimorphic Fungus ◽  
Geographic Dispersion ◽  
Multiple Factors ◽  
Clinical Evolution ◽  
Host Interaction

Sporotrichosis is a subacute/chronic mycosis caused by dimorphic fungus of the genus Sporothrix. This mycosis may affect both human and domestic animals and in the last few years, the geographic dispersion and increase of sporotrichosis worldwide has been observed. The occurrence of cases related to scratching/bites of domestic felines have increased, characterizing the disease as predominantly a zoonosis. In humans, sporotrichosis mainly involves the cutaneous tegument of infected patients, but other tissues may also present the infection. The main forms of clinical presentation are lymphocutanous sporotrichosis (LC) and fixed sporotrichosis (F). Although less common, mucosal, cutaneous disseminated, and extracutaneous forms have also been described. Multiple factors from the fungus and host can play a role in driving the clinical evolution of sporotrichosis to benign or severe disease. In this review, we discuss the immunopathological aspects involved in human sporotrichosis. Putting together the two branches of knowledge—host immune response and fungal evading mechanisms—we may perceive new possibilities in understanding the fungus–host interaction in order to be in a position to go further in the control of sporotrichosis.

scholarly journals Orbital mucormycosis in immunocompetent children; review of risk factors, diagnosis, and treatment approach

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Ali Amanati ◽  
Hamide Barzegar ◽  
Gholamreza Pouladfar ◽  
Anahita Sanaei Dashti ◽  
Mohamad Bagher Abtahi ◽  
...  
Keyword(s):  
Risk Factors ◽  
Fungal Infection ◽  
Clinical Presentation ◽  
Treatment Approach ◽  
Healthy Children ◽  
Surgical Drainage ◽  
Healthy Individuals ◽  
Successful Management ◽  
Case Presentation ◽  
Life Threatening

Abstract Background Orbital mucormycosis is a rare but potentially severe and troublesome invasive fungal infection that could be occurred even in healthy individuals. The initial clinical presentation is similar to bacterial pre-septal or septal cellulitis, especially in early stages. Case presentation Herein, we describe the successful management of a series of five cases presenting with orbital mucormycosis in previously healthy children. Conclusions Orbital mucormycosis is extremely rare in healthy children and maybe life-threatening when diagnosis delayed given a similar clinical presentation with bacterial septal cellulitis. Intravenous antifungal therapy with amphotericin B and timely surgical drainage is live-saving.

On the Variable Clinical Presentation of Molar-Incisor Hypomineralization

2019 ◽  
Vol 53 (4) ◽  
pp. 482-488 ◽  
Author(s):  
Alexandre Rezende Vieira ◽  
David J. Manton
Keyword(s):  
Risk Factors ◽  
Immune Response ◽  
Genetic Variation ◽  
Clinical Presentation ◽  
Dental Enamel ◽  
Genetic Component ◽  
Enamel Formation ◽  
Molar Incisor Hypomineralization ◽  
Complex Inheritance ◽  
Variable Clinical Presentation

Molar-incisor hypomineralization (MIH) is a condition that is defined based on its peculiar clinical presentation. Original reports on the etiology of the condition and possible risk factors were inconclusive, and we refuted the original suggestion that MIH is an idiopathic condition and suggested that MIH has complex inheritance and is due to the interaction of more than one gene and the environment. Our group was the first to suggest MIH has a genetic component that involves genetic variation in genes expressed during dental enamel formation. Later we expanded this work to include genes related to the immune response. In this report, we provide a rationale to explain the variation seen in the clinical presentation of MIH, which can affect just one molar out of the four or just a portion of a particular molar.

A comprehensive review on gout: the epidemiological trends, pathophysiology, clinical presentation, diagnosis and treatment

2020 ◽  
pp. 1-12
Author(s):  
Kanwal Ashiq ◽  
Mayyda Asif Bajwa ◽  
Samreen Tanveer ◽  
Mehwish Qayyum ◽  
Sana Ashiq ◽  
...  
Keyword(s):  
Risk Factors ◽  
Developing Countries ◽  
English Language ◽  
Clinical Presentation ◽  
Developed Countries ◽  
The Other ◽  
Diagnosis And Treatment ◽  
Comprehensive Review ◽  
The Developed Countries ◽  
Epidemiological Trends

Abstract This review is aimed at provision of an updated knowledge about the gout and highlights the various areas which need to be focused for better healthcare. Relevant published articles in English Language were reviewed by utilizing various available databases including: Google Scholar, Springer Link, Science Direct and MEDLINE. The data reveal a precipitating number of gout cases from the developed countries, while the developing countries on the other hand are faced with an even higher threat. The risk factors and pathophysiology of gout are immaculate and clearly established. Hence, appropriate measures can be explored and worked on to pinpoint diagnosis, effective and economical treatment. Continuous...

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