scholarly journals Invasive fungal rhinosinusitis in patients with diabetes

2018 ◽  
Vol 12 (09) ◽  
pp. 787-793
Author(s):  
Nishant Raizada ◽  
Viveka P Jyotsna ◽  
Devasenathipathy Kandasamy ◽  
Immaculata Xess ◽  
Alok Thakar ◽  
...  
Keyword(s):  
Hospital Stay ◽  
Care Center ◽  
Tertiary Care ◽  
North India ◽  
Treatment Modalities ◽  
Fungal Sinusitis ◽  
Invasive Fungal Sinusitis ◽  
Fungal Rhinosinusitis ◽  
Patients With Diabetes ◽  
Invasive Fungal Rhinosinusitis

Introduction: We report the clinical and radiological features as well as outcomes of invasive fungal rhinosinusitis in patients with diabetes from a tertiary care center in North India. Methodology: All patients admitted with a diagnosis of invasive fungal rhinosinusitis with pre-existing or newly diagnosed diabetes from 1st January 2008 to 31st December 2015 were included. Hospital records were used to identify clinical features, biochemical investigations and treatment modalities used. The imaging findings were reported at baseline, 30, 60,90 and 120 days of admission and progression of disease was reported as static, worse or improved. The outcomes were sight loss and survival at end of hospital stay. Results: 22 patients of invasive fungal sinusitis and diabetes were identified. At presentation, 5 had ketoacidosis, all of whom died at the end of hospital stay. Loss of vision in one eye was seen in 70% cases. The survival at end of hospital stay was 72.7% and at six months after end of study period was 57.8%. No patients had radiological improvement at day 30 imaging (including those who subsequently improved). Conclusion: Radiological improvement is not apparent before two months of therapy. Ketoacidosis is a predictor of mortality in invasive fungal sinusitis with diabetes.

scholarly journals Chronic Invasive Fungal Rhinosinusitis in Immunocompetent Patients: A Retrospective Chart Review

2020 ◽  
Vol 7 ◽  
Author(s):  
Naif H. Alotaibi ◽  
Omar Abu Omar ◽  
Mays Altahan ◽  
Haifa Alsheikh ◽  
Fawziah Al Mana ◽  
...  
Keyword(s):  
Chart Review ◽  
Tertiary Care ◽  
Retrospective Chart Review ◽  
Csf Leak ◽  
Fungal Sinusitis ◽  
Invasive Fungal Sinusitis ◽  
Fungal Rhinosinusitis ◽  
Invasive Fungal Rhinosinusitis ◽  
Chronic Invasive ◽  
Immunocompetent Patients

Objective: We report cases of Chronic Invasive Fungal Sinusitis (CIFS) in patients considered as immunocompetent at tertiary care center (King Faisal Specialist Hospital), to analyze their clinical, biological, radiological features, and management.Material and methods: A retrospective chart review of CIFS in immunocompetent patients. The inclusion criteria as the following: immunocompetent patients of any age with histopathological findings of CIFS. Immunocompromised patients, acute Invasive Fungal Sinusitis (IFS), non-invasive fungal rhinosinusitis, and no positive histological findings were excluded.Results: Seventeen (17) patients were included. The species isolated included: Aspergillus (most frequent) & Mucor. Surgical treatment approaches were described. Complications reported include CSF leak, blindness, recurrence, and death.Conclusions: Early diagnosis and management of CIFS improve clinical outcomes.

scholarly journals Invasive Fungal Rhinosinusitis: Our Experience

2009 ◽  
Vol 2 (3) ◽  
pp. 21-26
Author(s):  
Kapil Dua ◽  
H Chopra ◽  
Neha Chopra ◽  
Sanjeev Puri ◽  
Vikrant Mittal
Keyword(s):  
Facial Pain ◽  
Antifungal Agents ◽  
Fungal Infections ◽  
Immunocompromised Patient ◽  
Fungal Sinusitis ◽  
Adequate Treatment ◽  
Invasive Fungal Sinusitis ◽  
Fungal Rhinosinusitis ◽  
Endemic Mycoses ◽  
Invasive Fungal Rhinosinusitis

Abstract Opportunistic fungal infections in immunocompromised patients are associated with a high mortality rate. Endemic mycoses are often asymptomatic, but in appropriate hosts, fungi can cause severe and even fatal infection. Facial pain in an immunocompromised patient may signify invasive fungal sinusitis. Treatment with antifungal agents needs to be individualized according to factors such as the type of fungus, presence of renal failure, or pregnancy. Combining antifungal agents or addition of other approaches, such as surgical debridement or steps to control intracranial pressure, may be needed for adequate treatment of certain types of fungal infections.

TO DETERMINE THE VARIOUS CLINICAL PRESENTATIONS, UNDERLYING IMMUNOCOMPROMISED CONDITION, COMPLICATION OF ACUTE INVASIVE FUNGAL RHINOSINUSITIS (AIFRS): AN OBSERVATIONAL STUDY.

2020 ◽  
Vol 4 (6) ◽  
Author(s):  
Abhiniti . ◽  
Pawan Kumar Lal
Keyword(s):  
Diabetes Mellitus ◽  
Observational Study ◽  
Sinus Thrombosis ◽  
Fungal Sinusitis ◽  
Cavernous Sinus Thrombosis ◽  
Invasive Fungal Sinusitis ◽  
Fungal Rhinosinusitis ◽  
Acute Invasive Fungal Rhinosinusitis ◽  
Clinical Presentations ◽  
Invasive Fungal Rhinosinusitis

Aim: to determine the various clinical presentations, underlying immune-compromised condition, complication of acute invasive fungal rhinosinusitis (AIFRS). Materials and Methods: The present prospective observational study was conducted in the Department of ENT, Sri Krishna Medical College and Hospital, Muzaffarpur, Bihar, India. Among 40 patients of acute invasive fungal sinusitis that underwent treatment as inpatient basis. Nasal swabs from the middle meatus were subjected to potassium hydroxide mount and if fungal elements were identified, then fungal culture was done. Post-operatively, tissue removed from the sinuses was sent for histopathological examinations. Results: majority of the patients were male 57.5% and rest 42.5% were female. Patients having Diabetes Mellitus were found to be more susceptible to acute and invasive fungal sinusitis. The common presenting symptoms were nasal obstruction followed by rhinorrhea, epistaxis, headache, fever, facial swelling. Most common complication reported in this study was Cavernous sinus thrombosis 11 (27.5%). Conclusion: acute invasive fungal sinusitis is most common in immunocompromised patients, with the highest incidence in patients with uncontrolled diabetes mellitus. The most consistent finding of acute invasive fungal sinusitis was mucosal necrosis and black crust/debris. Keywords: acute invasive fungal sinusitis, diabetes mellitus, cavernous sinus thrombosis

scholarly journals A rare case of invasive fungal sinusitis by co-infection of two fungi in a post COVID-19 patient: a case report

2021 ◽  
Vol 7 (8) ◽  
pp. 1361
Author(s):  
Timna Chungath ◽  
Deepak Dileep Kumar ◽  
Shalu Susan Mathew ◽  
Jijo Paul
Keyword(s):  
Case Report ◽  
Nasal Cavity ◽  
Liposomal Amphotericin ◽  
Rare Case ◽  
Patient Survival ◽  
Severe Headache ◽  
Fungal Sinusitis ◽  
Invasive Fungal Sinusitis ◽  
Fungal Rhinosinusitis ◽  
Invasive Fungal Rhinosinusitis

<p>Invasive fungal rhinosinusitis is a disease of the paranasal sinuses and nasal cavity that typically affects immunocompromised patients in acute fulminant form. Early symptoms can often mimic rhino sinusitis while late symptoms can cause significant morbidity and mortality. With early diagnosis and treatment can increase the patient survival. This case report is of 73 years old diabetic post COVID-19 patients. The patient presented to us was having severe headache and facial pain confined to left side cheek area with loosening of teeth. The patient underwent nasal cavity and biopsy from the maxillary sinus (left side) under local anaesthesia, which confirmed the diagnosis of invasive fungal sinusitis suggestive of co-infection by 2 fungi, aspergillus flavus and mucor. Further, the patient underwent surgical debridement and started on liposomal amphotericin B and patient improved significantly.</p>

scholarly journals MICROBIOLOGICAL ASPECT OF FUNGAL RHINOSINUSITIS: STUDY CONDUCTED IN TERTIARY CARE HOSPITAL OF NORTH INDIA.

2020 ◽  
Vol 4 (2) ◽  
Author(s):  
Shubhdeep Kaur
Keyword(s):  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
North India ◽  
Treatment Modalities ◽  
Fungal Culture ◽  
Care Hospital ◽  
Direct Microscopy ◽  
Fungal Rhinosinusitis ◽  
Microbiological Aspect ◽  
Isolated Species

Introduction: Fungal rhinosinusitis is the emerging disease of current era, so isolation of fungus is important aspect to plan the treatment modalities accordingly. Methods: 50 samples of suspected patients of fungal rhinosinusitis were studied. Various samples like nasal secretion, nasal lavage and tissue were examined on direct microscopy using KOH and processed by standard protocols for fungal culture. Result: Out of 50 suspected cases fungal rhinosinusitis was seen in 23 (46%) cases. The 40% of cases were positive by direct microscopy using 20%KOH and 46% were positive by fungal culture. The most common fungal  isolates was Aspergillus flavus (65.5%) followed by  Aspergillus niger (13%). Conclusion: Aspergillus spp. was the most common isolated species among all the cases of fungal rhinosinusitis. Keywords: Aspergillus spp., Fungal, Rhinosinusitis.

Prevalence, Correlates and Management of Hyperglycemia in Diabetic Non-critically Ill Patients at a Tertiary Care Center in Lebanon

2019 ◽  
Vol 15 (2) ◽  
pp. 133-140 ◽  
Author(s):  
Ghada El Khoury ◽  
Hanine Mansour ◽  
Wissam K. Kabbara ◽  
Nibal Chamoun ◽  
Nadim Atallah ◽  
...  
Keyword(s):  
Hospital Stay ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Care Center ◽  
Descriptive Analysis ◽  
Tertiary Care ◽  
Multivariable Analysis ◽  
Length Of Hospital Stay ◽  
Retrospective Chart Review ◽  
Diabetic Patients

Background: Diabetes Mellitus is a chronic metabolic disease that affects 387 million people around the world. Episodes of hyperglycemia in hospitalized diabetic patients are associated with poor clinical outcomes and increased morbidity and mortality. Therefore, prevention of hyperglycemia is critical to decrease the length of hospital stay and to reduce complications and readmissions. Objective: The study aims to examine the prevalence of hyperglycemia and assess the correlates and management of hyperglycemia in diabetic non-critically ill patients. Methods: The study was conducted on the medical wards of a tertiary care teaching hospital in Lebanon. A retrospective chart review was conducted from January 2014 until September 2015. Diabetic patients admitted to Internal Medicine floors were identified. Descriptive analysis was first carried out, followed by a multivariable analysis to study the correlates of hyperglycemia occurrence. Results: A total of 235 medical charts were reviewed. Seventy percent of participants suffered from hyperglycemia during their hospital stay. The identified significant positive correlates for inpatient hyperglycemia, were the use of insulin sliding scale alone (OR=16.438 ± 6.765-39.941, p=0.001) and the low frequency of glucose monitoring. Measuring glucose every 8 hours (OR= 3.583 ± 1.506-8.524, p=0.004) and/or every 12 hours (OR=7.647 ± 0.704-79.231, p=0.0095) was associated with hyperglycemia. The major factor perceived by nurses as a barrier to successful hyperglycemia management was the lack of knowledge about appropriate insulin use (87.5%). Conclusion: Considerable mismanagement of hyperglycemia in diabetic non-critically ill patients exists; indicating a compelling need for the development and implementation of protocol-driven insulin order forms a comprehensive education plan on the appropriate use of insulin.

Evaluation of Various Diagnostic Techniques for the Diagnosis of Pulmonary and Extra Pulmonary Tuberculosis at a Tertiary Care Center in North India

2020 ◽  
Vol 20 (4) ◽  
pp. 433-439
Author(s):  
Monika Rajani ◽  
Molay Banerjee
Keyword(s):  
Care Center ◽  
Tertiary Care ◽  
Diagnostic System ◽  
Diagnostic Techniques ◽  
Automated System ◽  
North India ◽  
Mortality And Morbidity ◽  
Indicator Tube ◽  
Extra Pulmonary ◽  
Uv Lamp

Introduction: Tuberculosis (TB) is a one of the main causes of mortality and morbidity worldwide. Bactec MGIT (Mycobacteria Growth Indicator Tube) system is a rapid, reliable automated system for early diagnosis of pulmonary and extra pulmonary TB in setups where purchase of expensive instruments is not possible. The present study was thus carried out to evaluate AFB microscopy, culture on Lowenstein Jensen media and micro MGIT system for early and accurate diagnosis of Tuberculosis. Methods: A total of 280 samples were processed for direct AFB smear examination, and culture on micro MGIT and LJ media. The identification of Mycobacterium tuberculosis complex in positive cultures was done by MPT64 Ag card test (BD MGIT TBC Identification Test). Results: Out of the processed samples, (47.1%) 132/280 were positive for Mycobacterium spp by Micro MGIT, (35%) 98/280 on LJ medium and (25.7%) 72/280 by AFB smear. A total of (48.5%) 136 samples were positive by a combination of Micro MGIT and LJ medium. Among the total positive samples (136/280), Micro MGIT was found to be positive in 97% (132/136) of samples, LJ was positive in 72% (98/136), while 52.9% (72/136) were positive by AFB smear. Conclusion: Manual MGIT System is a simple and efficient, safe to use the diagnostic system. It does not require any expensive/special instrumentation other than the UV lamp for the detection of fluorescence. In areas with limited resources where the purchase of expensive instruments such as the MGIT 960 is out of scope, the use of manual MGIT for rapid susceptibility testing for MDR-TB could be an option. We would recommend testing MGIT 960 using first and secondline drugs to determine DST.

Outcomes of radiocephalic fistula created by nephrologists

2019 ◽  
Vol 20 (6) ◽  
pp. 615-620
Author(s):  
Narayan Prasad ◽  
Venkatesh Thammishetti ◽  
DS Bhadauria ◽  
Anupama Kaul ◽  
RK Sharma ◽  
...  
Keyword(s):  
Arteriovenous Fistula ◽  
Care Center ◽  
Tertiary Care ◽  
Primary Patency ◽  
North India ◽  
Maintenance Hemodialysis ◽  
Secondary Patency ◽  
Arteriovenous Fistulas ◽  
Secondary Failure ◽  
Stage Renal Disease

Introduction: Arteriovenous fistula is considered as gold standard access for maintenance hemodialysis. Due to increasing burden of end-stage renal disease requiring dialysis, it is important for nephrologists to complement creation of arteriovenous fistula to meet the demand. Methods: This retrospective study was designed to assess the outcomes of arteriovenous fistula made by nephrologists at a tertiary care center from North India. The study included all radiocephalic arteriovenous fistula performed by nephrologists between November 2015 and January 2017. All arteriovenous fistulas were performed in patients whose duplex ultrasonography revealed both arterial and venous diameter of at least 2 mm. Data were collected with regard to age, gender, dialysis status, basic diseases, co-morbidities, and mineral bone disease parameters. The predictors of the primary and secondary patency rates were analyzed. Results: Five hundred patients (age 39.3 ± 14.4 years; 82.4% males; 21.6% diabetics) were included. In total, 83 (16.6%) patients had primary failure and 31 (7%) patients had secondary failure. Diabetes was associated with poor primary and secondary patency rates. Mean survival among the patients without primary failure was 11 months. The primary patency rates at 3, 6, 12, 18, and 21 months were 82%, 78%, 73%, 70%, and 70%, respectively. Conclusion: To conclude, the outcomes of radiocephalic arteriovenous fistulas created by nephrologists are at par with historic outcomes.

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