scholarly journals MR Imaging Spectrum of Neuro Rhino Sino Orbital Fungal Infections in patients treated for COVID

2021 ◽  
Vol 18 (4) ◽  
pp. 19-25
Author(s):  
Sushil Ghanshyam Kachewar ◽  
Smita Kachewar
Keyword(s):  
Fungal Infection ◽  
Standard Treatment ◽  
Fungal Infections ◽  
Signs And Symptoms ◽  
Staging System ◽  
Imaging Findings ◽  
Recent Past ◽  
Mri Findings ◽  
Facial Soft Tissue ◽  
Soft Tissue Inflammation

Objectives: To analyse the spectrum of imaging findings of fungal infection as seen in MRI images of priorly treated for COVID. Materials and methods: The different patterns of findings of Neuro Rhino Sino Orbital Fungal Infections as seen in MRI images in 100 patients who received standard treatment for COVID in recent past and presented with suggestive signs and symptoms.   Results: No positive MRI findings to suggest any neural tissue, orbital or Sino nasal involvement was seen in 35 % of cases. Only sino nasal involvement noted in 23 % cases. Sino-nasal as well as orbital involvement seen in 21 % cases. Neuro Sino Naso Orbital lesions were seen in 11% cases. Non fungal orbito-facial soft tissue inflammation was seen in 10 % cases. Conclusion: In patients who have received standard treatment for Covid and who later developed signs and symptoms of neural, orbital or Sino nasal involvement; positive imaging findings were noted in 65% cases. Fungal infections were seen more in middle aged population [40-60 years of age]. About 75 % of affected patients were known diabetics. Neural involvement was least common. This study proposes a new staging system [Stage 0, X, I, II, III, IV] for describing the affected region by fungal infection.

scholarly journals Misdiagnosis of Systemic Metastatic Melanoma for fungal infection: A case report

2021 ◽  
Author(s):  
Juan Sun ◽  
Yun-Zhu Zhu ◽  
Pan-Pan Shao ◽  
Jing Ke ◽  
Wei Wang ◽  
...  
Keyword(s):  
Fungal Infection ◽  
Lung Biopsy ◽  
Clinical Symptoms ◽  
Fungal Infections ◽  
Chest Imaging ◽  
Imaging Findings ◽  
Imaging Diagnosis ◽  
Puncture Wound ◽  
Chest Computed Tomography ◽  
Multiple Nodules

Abstract BackgroundMost of malignant melanomas originate from skin and often metastasize to the lungs, rarely metastasizes to the liver and bone. However, imageology characters of lung metastasis tumor are commonly similar to those of fungal infections. Case presentationA patient was admitted with unhealed plantar puncture wound for 3 years, and cough and expectoration for 2 years. The chest computed tomography (CT) revealed multiple nodules with cavities, and the patient was diagnosed of pulmonary fungal infection in another hospital and received antifungal therapy for more than 8 months, but the clinical symptoms and chest imaging findings continue to progress. After admission, the pathological results of both lung biopsy and biopsy of the plantar wound 3 years ago indicated malignant melanoma. ConclusionsThe diagnosis of lung lesions cannot rely solely on imaging diagnosis, lung biopsy should be performed if necessary.

Disseminated Fungal Infections in Very Low-Birth-Weight Infants: Clinical Manifestations and Epidemiology

PEDIATRICS ◽  
1984 ◽  
Vol 73 (2) ◽  
pp. 144-152
Author(s):  
Jill E. Baley ◽  
Robert M. Kliegman ◽  
Avroy A. Fanaroff
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Fungal Infection ◽  
Very Low Birth Weight ◽  
Fungal Infections ◽  
Clinical Manifestations ◽  
Signs And Symptoms ◽  
Abdominal Distension ◽  
Acute Onset ◽  
Low Birth Weight Infants

In 1979 and 1980, an apparent increase in the occurrence of disseminated fungal infections was observed. The clinical features of such infections in very low-birth weight infants are poorly described, and diagnosis is often delayed. Over a 24-month period, a discrete group of ten clinically diagnosed and four autopsy-diagnosed cases of systemic fungal infections in very low-birth-weight infants was observed. Prior to developing systemic fungal illness, these infants required prolonged total parenteral nutrition, central arterial or venous catheters, and multiple courses of broad-spectrum antibiotics for documented or suspected bacterial sepsis. The clinically diagnosed disseminated fungal infection (ten infants) was noted at a mean age of 33 days with one or more of the following: respiratory deterioration, abdominal distension, guaiac positive stools, carbohydrate intolerance, candiduria, endophthalmitis, meningitis, abscesses, erythematous rash, temperature instability, and hypotension. These signs and symptoms were seen as chronic or were intermittent in clinical course. In contrast, the autopsy-diagnosed disseminated fungal infection (four infants) was present at an earlier age with fewer recognizable predisposing factors and a more acute onset of infection. Nevertheless, in both groups the diagnosis of systemic candidal infection was delayed, due to an inability to consistently recover the organism from blood, CSF, or urine. The neonatologist caring for the very low-birth-weight infant needs to become more aware of these clinical entities. A high index of suspicion and ancillary diagnostic evaluation, such as retinoscopy or tissue biopsy, may be indicated in the critically ill, culture-negative patient.

scholarly journals The Prediction and Prognosis of Fungal Infection in Lung Transplant Recipients—A Retrospective Cohort Study in South Korea

2021 ◽  
Vol 7 (8) ◽  
pp. 639
Author(s):  
Yae-Jee Baek ◽  
Yun-Suk Cho ◽  
Moo-Hyun Kim ◽  
Jong-Hoon Hyun ◽  
Yu-Jin Sohn ◽  
...  
Keyword(s):  
Cohort Study ◽  
South Korea ◽  
Fungal Infection ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Lung Transplant ◽  
Fungal Infections ◽  
Transplant Recipients ◽  
Tertiary Center ◽  
Lung Transplant Recipients

(1) Background: Lung transplant recipients (LTRs) are at substantial risk of invasive fungal disease (IFD), although no consensus has been reached on the use of antifungal agents (AFAs) after lung transplantation (LTx). This study aimed to assess the risk factors and prognosis of fungal infection after LTx in a single tertiary center in South Korea. (2) Methods: The study population included all patients who underwent LTx between January 2012 and July 2019 at a tertiary hospital. It was a retrospective cohort study. Culture, bronchoscopy, and laboratory findings were reviewed during episodes of infection. (3) Results: Fungus-positive respiratory samples were predominant in the first 90 days and the overall cumulative incidence of Candida spp. was approximately three times higher than that of Aspergillus spp. In the setting of itraconazole administration for 6 months post-LTx, C. glabrata accounted for 36.5% of all Candida-positive respiratory samples. Underlying connective tissue disease-associated interstitial lung disease, use of AFAs before LTx, a longer length of hospital stay after LTx, and old age were associated with developing a fungal infection after LTx. IFD and fungal infection treatment failure significantly increased overall mortality. Host factors, antifungal drug resistance, and misdiagnosis of non-Aspergillus molds could attribute to the breakthrough fungal infections. (4) Conclusions: Careful bronchoscopy, prompt fungus culture, and appropriate use of antifungal therapies are recommended during the first year after LTx.

scholarly journals Estimated Burden of Fungal Infections in Oman

2020 ◽  
Vol 7 (1) ◽  
pp. 5
Author(s):  
Abdullah M. S. Al-Hatmi ◽  
Mohammed A. Al-Shuhoumi ◽  
David W. Denning
Keyword(s):  
Fungal Infection ◽  
Fungal Infections ◽  
Epidemiological Studies ◽  
Vaginal Candidiasis ◽  
Skin Infections ◽  
Opportunistic Pathogens ◽  
Fungal Rhinosinusitis ◽  
Populations At Risk ◽  
Different Populations ◽  
Underlying Pathology

For many years, fungi have emerged as significant and frequent opportunistic pathogens and nosocomial infections in many different populations at risk. Fungal infections include disease that varies from superficial to disseminated infections which are often fatal. No fungal disease is reportable in Oman. Many cases are admitted with underlying pathology, and fungal infection is often not documented. The burden of fungal infections in Oman is still unknown. Using disease frequencies from heterogeneous and robust data sources, we provide an estimation of the incidence and prevalence of Oman’s fungal diseases. An estimated 79,520 people in Oman are affected by a serious fungal infection each year, 1.7% of the population, not including fungal skin infections, chronic fungal rhinosinusitis or otitis externa. These figures are dominated by vaginal candidiasis, followed by allergic respiratory disease (fungal asthma). An estimated 244 patients develop invasive aspergillosis and at least 230 candidemia annually (5.4 and 5.0 per 100,000). Only culture and microscopy are currently available for diagnosis, so case detection is suboptimal. Uncertainty surrounds these figures that trigger the need for urgent local epidemiological studies with more sensitive diagnostics.

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

Transperineal Ultrasonographic and Magnetic Resonance Imaging Findings of Vaginal Adenosis

2021 ◽  
Vol 17 ◽  
Author(s):  
Sebnem Karasu ◽  
Atilla Hikmet Cilengir ◽  
Irfan Ocal ◽  
Serpil Aydogmus
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Chronic Pelvic Pain ◽  
English Literature ◽  
Vaginal Wall ◽  
Imaging Findings ◽  
Resonance Imaging ◽  
Mri Findings ◽  
Proven Case ◽  
Magnetic Resonance Imaging Mri

Background: Vaginal adenosis is a rare clinicopathological entity which refers to the presence of glandular endometrial tissue in the vaginal wall. Case report: A gravida 46-year-old woman was presented to the gynecology department with symptoms of chronic pelvic pain. Maternal Diethylstilbestrol (DES) usage has been proven effective in the development of vaginal adenosis. It can also be idiopathic. Its sonographic or magnetic resonance imaging (MRI) findings have not been described in English literature previously. Conclusion: Here, we report the clinical, transperineal ultrasonographic (US) and MRI findings of a pathologically proven case of vaginal adenosis.

Fungal infection after endothelial keratoplasty: association with hypothermic corneal storage

2018 ◽  
Vol 103 (10) ◽  
pp. 1487-1490 ◽  
Author(s):  
Nicola Lau ◽  
Aida Hajjar Sesé ◽  
Victor A Augustin ◽  
Geert Kuit ◽  
Mark R Wilkins ◽  
...  
Keyword(s):  
Organ Culture ◽  
Fungal Infection ◽  
Fungal Infections ◽  
Case Definition ◽  
Endothelial Keratoplasty ◽  
Donor Tissue ◽  
Purpureocillium Lilacinum ◽  
Eye Banks ◽  
The Usa ◽  
Host Cornea

PurposeTo compare the incidence of fungal infection after endothelial keratoplasty (EK) when donor tissue had been stored in hypothermic medium or organ culture.MethodsWe describe the clinical features of 10 cases of fungal infection (keratitis or endophthalmitis) following EK identified at three European centres. Case definition was the culture of fungus or a positive PCR from the host cornea or anterior chamber after EK. A survey of the incidence of infection after EK was conducted by the European Eye Bank Association. The main outcome measure was the number of cases in which donor tissue had been stored in hypothermic medium compared with organ culture.ResultsThe 10 cases occurred between 2014 and 2017. All donor corneas had been stored in hypothermic medium sourced from three US eye banks. Three pairs of mate corneas caused infections in six recipients. Candida spp were identified from nine cases, with one isolate of Purpureocillium lilacinum. Data on 16 862 corneas supplied for EK were available from 16 European eye banks for the 5-year period from 2012. There were 17 reported cases of infection, of which 15 (88%) were fungal infections and 14 (82%) were Candida spp. Fungal infection was reported from 3 of 14 476 (0.02%) corneas supplied in organ culture compared with 12 of 2386 (0.50%) corneas supplied in hypothermic medium (p<0.0001). The incidence of infection after hypothermic storage was similar for material sourced from Europe (0.52%) or the USA (0.61%).ConclusionsInfection after EK is strongly associated with Candida spp. The possible explanations for the higher incidence of infection when tissue is stored in hypothermic medium are discussed.

scholarly journals Effect of Prophylactic Antifungal Protocols on the Prognosis of Liver Transplantation: A Propensity Score Matching and Multistate Model Approach

2016 ◽  
Vol 2016 ◽  
pp. 1-7 ◽  
Author(s):  
Yi-Chan Chen ◽  
Ting-Shuo Huang ◽  
Yu-Chao Wang ◽  
Chih-Hsien Cheng ◽  
Chen-Fang Lee ◽  
...  
Keyword(s):  
Liver Transplantation ◽  
Propensity Score ◽  
Fungal Infection ◽  
Propensity Score Matching ◽  
Fungal Infections ◽  
Transition Probability ◽  
Antifungal Prophylaxis ◽  
Chang Gung Memorial Hospital ◽  
Multistate Model ◽  
End Stage

Background. Whether routine antifungal prophylaxis decreases posttransplantation fungal infections in patients receiving orthotopic liver transplantation (OLT) remains unclear. This study aimed to determine the effectiveness of antifungal prophylaxis for patients receiving OLT.Patients and Methods. This is a retrospective analysis of a database at Chang Gung Memorial Hospital. We have been administering routine antibiotic and prophylactic antifungal regimens to recipients with high model for end-stage liver disease scores (>20) since 2009. After propensity score matching, 402 patients were enrolled. We conducted a multistate model to analyze the cumulative hazards, probability of fungal infections, and risk factors.Results. The cumulative hazards and transition probability of “transplantation to fungal infection” were lower in the prophylaxis group. The incidence rate of fungal infection after OLT decreased from 18.9% to 11.4% (p=0.052); overall mortality improved from 40.8% to 23.4% (p<0.001). In the “transplantation to fungal infection” transition, prophylaxis was significantly associated with reduced hazards for fungal infection (hazard ratio: 0.57, 95% confidence interval: 0.34–0.96,p=0.033). Massive ascites, cadaver transplantation, and older age were significantly associated with higher risks for mortality.Conclusion. Prophylactic antifungal regimens in high-risk recipients might decrease the incidence of posttransplant fungal infections.

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