scholarly journals Coronavirus Disease (COVID-19) Associated Rhinocerebral Mucormycosis and Complications: A Case Report

2021 ◽  
Vol 2 (1) ◽  
pp. 93-99
Author(s):  
Soad Al Osta ◽  
Gibran Atwi ◽  
Nourhan El Ahmar ◽  
Noha Bejjani ◽  
Fayez Abillama ◽  
...  
Keyword(s):  
Case Report ◽  
Fungal Infections ◽  
Sinus Thrombosis ◽  
Subsequent Development ◽  
Rhinocerebral Mucormycosis ◽  
Cranial Nerve Palsies ◽  
Increased Risk ◽  
Disease Case ◽  
Wide Range ◽  
Facial Swelling

Background: Mucormycosis is a rare fatal infection caused by a ubiquitous fungus from the order of Mucorales, which can have varying clinical presentations. Immunocompromised patients are particularly susceptible to mucormycosis and can suffer fatal consequences if not treated adequately. COVID-19 infection with its immunomodulatory properties has been associated with a wide range of secondary bacterial and fungal infections. We present a case of rapidly progressive rhinocerebral mucormycosis post-COVID-19 infection with the subsequent development of several complications associated with the disease. Case Report: A 62-year-old male patient with a history of hypertension and diabetes mellitus type II, presented 14 days post-COVID-19 recovery with right facial swelling, erythema, and right eye proptosis. Throughout his disease, the patient developed blindness and cranial nerve palsies. He was also found to have palatal necrotic lesions, consistent with the diagnosis of mucormycosis. The patient’s disease was complicated by Garcin syndrome, meningitis, orbital apex syndrome, cavernous sinus thrombosis, brain infarction, and hemorrhage. Despite all measures and interventions, the patient died. Conclusion: COVID-19 infection and its treatments are associated with an increased risk of secondary fungal infections like mucormycosis. As such, a high index of suspicion is needed amongst healthcare workers for the early diagnosis and treatment of such opportunistic infections since prompt treatment is associated with a marked improvement in outcome. Furthermore, optimal glucose control and judicious use of corticosteroids in COVID-19 patients decreases the risk of developping such life threatening superinfections.

scholarly journals Deep Venous Thrombosis and Bilateral Pulmonary Embolism Revealing Silent Celiac Disease: Case Report and Review of the Literature

2017 ◽  
Vol 2017 ◽  
pp. 1-8 ◽  
Author(s):  
Igor Dumic ◽  
Scott Martin ◽  
Nadim Salfiti ◽  
Robert Watson ◽  
Tamara Alempijevic
Keyword(s):  
Celiac Disease ◽  
Case Report ◽  
Venous Thrombosis ◽  
Deep Venous Thrombosis ◽  
Deficiency Anemia ◽  
Increased Risk ◽  
Disease Case ◽  
Wide Range ◽  
Life Threatening ◽  
Work Up

Celiac disease (CD) is a systemic, chronic autoimmune disease that occurs in genetically predisposed individuals following dietary gluten exposure. CD can present with a wide range of gastrointestinal and extraintestinal manifestations and requires lifelong adherence to a gluten-free diet [GFD]. Venous thromboembolism (VTE) as a presentation of celiac disease is unusual and rarely reported. We present a case of a 46-year-old man who was admitted for shortness of breath and pleuritic chest pain and was found to have iron deficiency anemia, deep venous thrombosis, and bilateral pulmonary emboli (PE). After work-up for his anemia, the patient was diagnosed with CD. Comprehensive investigation for inherited or acquired prothrombotic disorders was negative. It is becoming increasingly recognized that CD is associated with an increased risk for VTE. PE, however, as a presentation of CD is exceedingly rare and to the best of our knowledge this is the third case report of such an occurrence and the only case report of a patient from North America. It is important to recognize that the first symptoms or signs of celiac disease might be extraintestinal. Furthermore, VTE as a presentation of CD is rare but life-threatening.

scholarly journals Proven pulmonary aspergillosis in a COVID-19 patient: A case report

2021 ◽  
Author(s):  
Sadegh Khodavaisy ◽  
Nasim Khajavirad ◽  
Seyed Jamal Hashemi ◽  
Alireza Izadi ◽  
Seyed Ali Dehghan Manshadi ◽  
...  
Keyword(s):  
Case Report ◽  
Fungal Infections ◽  
Left Lung ◽  
Aspergillus Species ◽  
Pulmonary Aspergillosis ◽  
Biopsy Material ◽  
Cavitary Lesion ◽  
Healthcare Settings ◽  
Increased Risk ◽  
History Of

Background and Purpose: Coronavirus disease 2019 (COVID-19) has become a significant clinical challenge in healthcare settings all over the world. Critically ill COVID-19 patients with acute respiratory distress syndrome may be at increased risk of co-infection with pulmonary aspergillosis. This study aimed to describe a clinical case of proven pulmonary aspergillosis caused by Aspergillus tubingensis in a 59-year-old man with a history of hospitalization due to COVID-19 infection. Case report: The Covid-19 infection was confirmed by positive nasopharyngeal polymerase chain reaction. He had a cavitary lesion measured 20 mm in diameter with intracavitary soft tissue density in the left lung in the first chest computerized tomography scan. After 25 days, he showed two cavitary lesions in both lungs which raised suspicion of fungal infection; hence, the patient underwent a trans-thoracic biopsy of the cavitary lesion. The direct examination and culture of the biopsy material revealed Aspergillus species. To confirm the Aspergillus species identification, the beta-tubulin region was sequenced. The patient was treated with oral voriconazole. Conclusion: This report underlined the importance of early diagnosis and management of invasive fungal infections in severe COVID-19 patients

scholarly journals Simultaneous involvement of optic and abducens nerves by Lyme disease: Case report with review of the literature

2019 ◽  
Vol 11 (3) ◽  
Author(s):  
Iman Dabiri ◽  
Ahmet Z. Burakgazi
Keyword(s):  
Case Report ◽  
Lyme Disease ◽  
False Negative ◽  
Diagnostic Process ◽  
Review Of The Literature ◽  
Ocular Manifestations ◽  
First Case ◽  
Clinical Presentations ◽  
Disease Case ◽  
Wide Range

Ocular manifestations of Lyme disease (LD) remain a rare feature of the disease, but it may present a wide range of clinical presentations with different combinations. LD related optic neuritis or cranial nerve (CN) six palsy have been reported in the literature. However, this is the first case report of simultaneous involvement of CN 2 and CN 6 in a patient with LD. The diagnosis of LD can be challenging and initial laboratory tests can be a false negative. It is paramount important to repeat the diagnostic test if clinical suspicious is ongoing. With this case, we aim to increase awareness of clinicians for possible ocular manifestations of LD and its complex diagnostic process.

scholarly journals Cerebral venous thrombosis secondary to an occult maxillary sinusitis in a young male from sub-Saharan Africa

2019 ◽  
pp. 08-12
Author(s):  
Mazou N Temgoua ◽  
Mickael Essouma ◽  
Larry N Tangie ◽  
Cedric Tsinda ◽  
Drusille Feze Foko ◽  
...  
Keyword(s):  
Venous Thrombosis ◽  
Acute Stroke ◽  
Cerebral Venous Thrombosis ◽  
Fungal Infections ◽  
Sinus Thrombosis ◽  
Maxillary Sinusitis ◽  
Case Reports ◽  
Sub Saharan Africa ◽  
First Case ◽  
Increased Risk

Cerebral venous thrombosis (CVT) also termed cerebral venous sinus thrombosis (CVST), is a special type of cerebrovascular disease characterized by cerebral venous infarction [1]. As from 1825 when the first case was described by Ribes[2], epidemiological descriptions are still restricted to case reports and small retrospective cross-sectional studies yielding low butincreasing incidence: <10 cases per million per year in 1995 to about 13.2 cases per million per year in 2012.CVT mainly occurs in women of child bearing age, probably owing to the use of oral contraceptive pills, and mostly has an acute or subacute course [1]. It can be categorized as primary/idiopathicand secondary. Secondary CVT can further be classified into infective (mainly due to bacterial or fungal infections) and non-infective CVT; the latterbeing due tocoagulation disorders, neoplasms, procoagulant hemodynamic states, vascularitis,homocystinuria, or head trauma [3].With the advent of antibiotics, the epidemiology of CVT has shifted from predominant infective CVT to predominant non-infective CVT, leading to increased risk of misdiagnosis and delayed treatment [3]. We report occult purulent maxillary sinusitis-related CVT in a male Cameroonian patient who presented with headaches, seizures and acute stroke syndrome. The aim of this paper is to reiterate CVT as the main cause of acute stroke syndrome in young adults irrespective of ethnic origin and sex, and suggest systematic screening of infections in those patients, especially in regions with high rates of infections likesub-Saharan Africa.We describe this case with regard to CARE guidelines.

scholarly journals Post-COVID rhinocerebral mucormycosis: an otolaryngologists nightmare

2021 ◽  
Vol 7 (7) ◽  
pp. 1144
Author(s):  
Samir V. Joshi ◽  
Nimita Dubey ◽  
Rajesh R. Havaldar ◽  
Amish Wakhlu
Keyword(s):  
Vision Loss ◽  
Fungal Infections ◽  
Tertiary Care ◽  
Positive Outcome ◽  
Rhinocerebral Mucormycosis ◽  
Facial Swelling ◽  
Life Threatening ◽  
History Of ◽  
High Index Of Suspicion

<p class="abstract"><strong>Background: </strong>Rhinocerebral mucormycosis which was considered to be a rare occurrence in the pre-COVID era is currently emerging as a life-threatening disease with seemingly poor prognosis in post COVID recovered patients. Prompt diagnosis with urgent surgical and medical management is vital to a positive outcome.</p><p class="abstract"><strong>Methods: </strong>A retrospective observational study and analysis was done among patients of biopsy proven mucormycosis with preceding history of COVID 19 disease between March 2021 to April 2021 in a tertiary care state run hospital at Pune coinciding with the sudden surge and second COVID 19 wave.</p><p class="abstract"><strong>Results:</strong> 20 0ut of 23 patients were having a history of type 2 diabetes mellitus for a mean duration of 4±3.5 years. The most common presenting complaint was unilateral facial swelling, periorbital pain, swelling and oedema in 18 out of 23 patients. All patients had COVID infection within the last one month of presentation with mean duration of 18±8.4 days. Out of 23 patients 16 survived while 19 patients had permanent vision loss and ophthalmoplegia.</p><p class="abstract"><strong>Conclusions:</strong> Establishing the possibility of invasive secondary fungal infections in patients with history of COVID-19 infection especially in patients with pre-existing risk factors should raise high index of suspicion. Prompt early diagnosis and treatment should be started to reduce morbidity and mortality.</p>

scholarly journals Fungus in a Viral Land-Orbital Mucormycosis in Patients With COVID-19 Infection.

2021 ◽  
Author(s):  
Sufia Imam ◽  
Dattatreya Mukherjee ◽  
Suriya Narayan Harikrishnan ◽  
Aayushi Raj Sinha
Keyword(s):  
Rhizopus Oryzae ◽  
Fungal Infections ◽  
Cardiac Injury ◽  
Organ Transplant ◽  
Signs And Symptoms ◽  
Invasive Fungal Infections ◽  
Intracranial Extension ◽  
Nasal Discharge ◽  
Increased Risk ◽  
Wide Range

The coronavirus disease 2019(COVID-19) infection caused by the novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) may be associated with a wide range of disease patterns, ranging from mild to life-threatening pneumonia[1].During the current pandemic of COVID-19, a myriad of manifestations and complications has emerged and are being reported frequently. We are discovering patients with COVID-19 are at increased risk of acute cardiac injury, arrythmias, thromboembolic complications (pulmonary embolism and acute stroke), and secondary infections[2]. Recently, we have noticed that there is an increase in the incidence of invasive fungal infections in COVID-19 disease manifesting as orbital compartment syndrome,orbital cellulitis and rhino-orbital-cerberal mucormycosis. Several such cases have been reported during the course of COVID-19 disease or as a sequelae. In general mucormycosis infections are rare and opportunistic and are associated with high mortality ranging from 25-62%[3].Mucormycosis is an invasive fungal infection caused by mold fungi of the genus Mucor Rhizopus, Rhizomucor and Absidia, which are in the Mucorales order of the Zygomycetes class [4]. The most common type is Rhizopus Oryzae and approximately 60% of mucormycosis cases in humans; it is responsible for 90% of the rhino-orbital-cerebral form [5]. The pathogenesis of mucormycosis include killing of mucorales by mononuclear and polymorphonuclear phagocytes of normal hosts through generation of oxidative metabolites and defensins, hence neutropenic patients and those with dysfunctional phagocytes are susceptible to develop invasive mucormycosis[6,7]. A hallmark of mucormycosis infection is the presence of extensive angioinvasion with resultant vessel thrombosis, infarction and tissue necrosis[8].In COVID-19 there is endothelial barrier disruption, dysfunctional alveolar-capillary oxygen transmission and impaired oxygen diffusion capacity[9]. Profound lymphopenia with reduced numbers of T lymphocytes, CD4+T, and CD8+T cells, may alter the immune response of COVID-19 patients enhancing the risk of invasive fungal infections[10].We conducted a literature search online and read several published papers on ‘mucormycosis post COVID-19 infection. Here we present to you the risk factors, clinical profile, investigations, treatment and prevention of this rare disease which is causing havoc during the COVID-19 pandemic.Risk Factors: Preexisting morbidities like uncontrolled diabetes mellitus and lung disease, ventilator-associated pneumonia, neutropenia, elevated free iron levels, deferoxamine, hematological malignancies, stem cell transplants, and organ transplant patients on immunosuppressants, use of corticosteroids and tocilizumab, iatrogenic immunosuppressions, COVID-19 infection &amp; its treatment causing immunosuppression.Clinical Profile: fever, pain, redness, and periocular swelling, acute and progressive, drooping of eyelids, limitation of ocular movements, and painful loss of vision. The progression is usually rapid, an average of two days from the onset. Eyelid and periocular edema, complete ptosis, total ophthalmoplegia, proptosis and relative afferent pupillary defect, unilateral facial or orbital pain, headache, periocular swelling, double vision or diminution of vision,congestion with conjunctival edema and signs of exposure keratitis, chemosis, sinusitis, nasal discharge and neurological signs and symptoms if intracranial extension is present. The patients may exhibit one or more of the above mentioned signs and symptoms depending on the severity of disease.

scholarly journals Bilateral Cranial Nerve VI Palsies in Cryptococcal Meningitis, HIV, and Syphilis: A Case Report

2021 ◽  
Vol 5 (4) ◽  
pp. 515-518
Author(s):  
Germaine Rival ◽  
Onyi Okorji ◽  
Rachael Kern ◽  
Preya Patel ◽  
Kate Fradeneck ◽  
...  
Keyword(s):  
Case Report ◽  
Cryptococcal Meningitis ◽  
Cranial Nerve ◽  
Altered Mental Status ◽  
Cranial Nerve Palsies ◽  
Wide Range ◽  
Life Threatening ◽  
Acquired Immunodeficiency ◽  
New Diagnosis ◽  
Immunodeficiency Syndrome

Introduction: Cranial nerve (CN) VI palsy is a common complaint seen in the emergency department (ED) and has a wide range of causes. Bilateral CN VI palsies are uncommon and appear to be associated with more severe complications. Case Report: A 29-year-old male presented to the ED from an ophthalmology office for diplopia, headache, and strabismus. He was found to have bilateral CN VI palsies and new-onset seizure in the ED. A lumbar puncture revealed cryptococcal meningitis. Additional tests revealed a new diagnosis of human immunodeficiency virus (HIV), acquired immunodeficiency syndrome (AIDS), and syphilis. Conclusion: Cryptococcal meningitis remains a life-threatening complication of HIV/AIDS. Coinfections with HIV, particularly syphilis, further complicate a patient’s prognosis as both can lead to devastating neurological sequelae. In cryptococcal meningitis, elevated intracranial pressure is a complication that can manifest as seizures, altered mental status, and cranial nerve palsies.

scholarly journals The importance of microbiological tests of vaginal secretion during reproductive period

2004 ◽  
Vol 132 (1-2) ◽  
pp. 44-49 ◽  
Author(s):  
Valentina Arsic-Arsenijevic ◽  
Ivana Radonjic ◽  
Vera Mijac ◽  
Ivana Cirkovic
Keyword(s):  
Bacterial Vaginosis ◽  
Fungal Infections ◽  
Diabetes Mellitus Type 1 ◽  
Reproductive Period ◽  
Vaginal Secretion ◽  
Vaginal Infections ◽  
Microbiological Test ◽  
Birth Canal ◽  
Increased Risk ◽  
Wide Range

Vaginal infections, during reproductive period are frequent and although not life treating, they can affect their normal functions. They can also affect wommen's fertility as well as the course of pregnancy. The outcome of pregnancy can be endangered due to the possibility of infection of newborn while passing trough birth canal of the infected mother. As statistically shown, bacterial vaginosis is considerably more often found with the patients having precancerous changes on cervix, or diagnosed cancer of cervix, comparing with women with healthy cervix. It can also cause the apperance of postoperative pelvic cellulitis after hysterectomy. On the other side, the presence of S. agalactiae in vaginal secretion may cause very serious and lethal infections of the newborn such as meningitis, pneumonia and sepsis. As for protozoa T. vaginalis it has been shown that it could cause reduced fertility ability and that during pregnancy it could demage fetal membranes and bring to its premature rupture and premature birth. There is also increased risk of cervix cancer. During reproductive period of women especially if risk factors are existing such as hormone therapy, diabetes mellitus type 1 and applications of wide range antibiotics, vaginal fungal infections caused by Candida can frequently appear. These infection apart from the discomfort like itch and affluent secretion they can also mean diagnostic and therapeutical problem. Regular microbiological test of women are highly recommended during reproductive period as standard for bacterial vaginosis, fungal and trichomonas infections. If those results appear negative, further microbiological tests are necessary. Such tests which are more elaborate, more timely and more expensive are referring to tests on chlamidia, micoplasma and some viruses that can also be the cause of vaginal secretion disbalance in women during reproductive period.

Sign in / Sign up

Export Citation Format

Share Document