scholarly journals Mucormycosis with extensive cranial nerve involvement as the first presentation of diabetes mellitus: A case report

2021 ◽  
Vol 2021 (3) ◽  
Author(s):  
Mouna Al Saad ◽  
Ahmad Rimawi ◽  
Ahmad Saadeh ◽  
Amin Shehadeh
Keyword(s):  
Diabetes Mellitus ◽  
Hemoglobin A1c ◽  
Facial Nerve Palsy ◽  
Early Recognition ◽  
Nasal Congestion ◽  
Severe Disease ◽  
Cranial Nerves ◽  
Cranial Nerve Involvement ◽  
Acute Bacterial Sinusitis ◽  
Frozen Orbit

Mucormycosis, a rare fungal infection, mainly affects individuals with diabetes mellitus and those who were immunocompromised and has a high mortality rate. Its most common presentation is similar to that of acute bacterial sinusitis with symptoms of nasal congestion, headache, and fever. The involvement of multiple cranial nerves in mucormycosis was rarely reported in the literature and indicates severe disease. Herein, we report the case of a 56-year-old man who was referred to the ophthalmology outpatient clinic for facial nerve palsy. He was treated with systemic steroids for 10 days with no improvement. On examination, he had a loss of vision and a frozen orbit due to involvement of cranial nerves II, III, IV, V, VI, and VII. An extensive workup revealed a hemoglobin A1C of 10%. However, he was never diagnosed with diabetes mellitus previously and denied any of the classical symptoms of diabetes mellitus. He underwent ethmoidectomy, maxillectomy, and drainage of an intraorbital abscess after appropriate imaging studies. Histopathology confirmed the diagnosis of mucormycosis, and the patient was started on systemic amphotericin B. This case emphasizes the importance of screening for diabetes mellitus. Early recognition of underlying diabetes mellitus in this patient may have prevented the development of mucormycosis along with its devastating complications.

scholarly journals Cephalic tetanus manifesting as isolated facial nerve palsy- a case report from rural Armenia

2021 ◽  
Vol 15 (11) ◽  
pp. 1770-1773
Author(s):  
Armen Kishmiryan ◽  
Jeevan Gautam ◽  
Deeksha Acharya ◽  
Bishnu Mohan Singh ◽  
Armen Ohanyan ◽  
...  
Keyword(s):  
Case Report ◽  
Facial Nerve ◽  
Nerve Palsy ◽  
Facial Nerve Palsy ◽  
Early Recognition ◽  
Cranial Nerves ◽  
Tetanus Antitoxin ◽  
The Face ◽  
Cephalic Tetanus ◽  
Initiation Of Therapy

Cephalic tetanus is a rare clinical form of tetanus, clinically characterized by trismus and cranial nerve palsy involving one or more cranial nerves, facial nerve being the most common. We report a case of cephalic tetanus with left-sided lower motor facial nerve palsy in a 66-year-old non-immunized patient after an untreated laceration injury. The patient had dysphagia, spasm of the muscles of mastication, asymmetry of the left side of the face, cough, shortness of breath, and stiffness of neck muscles. The presentation was unique given that the facial nerve palsy appeared prior to the occurrence of trismus, which misled the initial diagnosis towards Bell's palsy. He was successfully treated with tetanus antitoxin without any adverse events. Although widespread use of tetanus vaccine has led to a dramatic decline in this fatal disease, sporadic disease occurrence is still possible, particularly in individuals without up-to-date vaccinations. In this case report we illustrate the importance of early recognition of cephalic tetanus prior to the development of the full clinical picture. The early initiation of therapy is the key to recovery from this deadly disease. Physicians are encouraged to include cephalic tetanus as a cause of facial nerve palsy in their differential. In particular, paying attention to cases manifesting early after head or neck injury.

scholarly journals Changes of Blink Reflex in Type 2 Diabetes Mellitus

2021 ◽  
Vol 2021 ◽  
pp. 1-7
Author(s):  
Li Xiao ◽  
Kang Zou ◽  
Duoyan Zhou ◽  
Guilan Ouyang ◽  
Shuixiang Liu ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Body Mass Index ◽  
Type 2 Diabetes Mellitus ◽  
Body Mass ◽  
Hemoglobin A1c ◽  
Objective Assessment ◽  
Cranial Nerves ◽  
Blink Reflex

Blink reflex provides an objective assessment of the cranial and central nervous systems. However, the relationships between body mass index, dizziness, and BR have not been explored in patients with type 2 diabetes mellitus (T2DM). Moreover, R2 duration, one of the parameters of the blink reflex, has not been studied to date. In the present study, we aimed to investigate the characteristics and influencing factors of blink reflex in patients with T2DM. We included 45 healthy subjects and 105 hospitalized patients with T2DM. The relationships between these parameters and sex, age, body mass index, duration of T2DM, hemoglobin A1c, distal symmetrical polyneuropathy (DSPN), and dizziness symptoms were analyzed. The results showed that blink reflex latencies (including R1, ipsilateral R2, and contralateral R2 latency) were negatively associated with body mass index but were positively correlated with the duration of T2DM. There were no correlations between blink reflex parameters and sex, age, and hemoglobin A1c. Patients with DSPN had longer blink reflex latencies and shorter R2 durations than those without DSPN. Patients with dizziness had longer latencies (including R1, ipsilateral R2, and contralateral R2 latencies) and shorter R2 durations (including ipsilateral R2 and contralateral R2 durations) than those without dizziness. R2 duration was also a predictive factor for blink reflex abnormality. R2 latency was the most sensitive factor and the optimal predictor of dizziness. These results demonstrate that patients with T2DM with low body mass index, longer duration of T2DM, DSPN, and dizziness-related symptoms had more abnormal blink reflex parameters, indicating more serious injuries to the cranial nerves or the central nervous system.

scholarly journals The role of comorbidities and clinical predictors of severe disease in COVID-19: a systematic review and meta-analysis

2020 ◽  
Author(s):  
Reza Tabrizi ◽  
Kamran B Lankarani ◽  
Peyman Nowrouzi-sohrabi ◽  
Mojtaba Shabani-Borujeni ◽  
Shahla Rezaei ◽  
...  
Keyword(s):  
Random Effects ◽  
Early Recognition ◽  
Nasal Congestion ◽  
Meta Analysis ◽  
Severe Disease ◽  
Random Effects Model ◽  
Clinical Predictors ◽  
Severe Group ◽  
Meta Analyses ◽  
Specific Symptoms

AbstractBackgroundCOVID_19 is unpredictable due to non-specific symptoms and clinical course diversity in different individuals. We analyzed studies regarding the factors associated with severe status of the disease to identify unique findings in severely affected patients.MethodsWe systematically searched the electronic databases, including PubMed, Scopus, EMBASE, Web of Science, and Google Scholar from inception to 12th of March 2020. Cochrane’s Q and I-square statistics were used to assess the existence of heterogeneity between the included studies. We used the random-effects model to pool the odds ratios (ORs) at 95% confidence intervals (CIs).ResultsSeventeen articles out of 3009 citations were included. These contained 3189 patients, of whom 732 were severely affected (severe group) and 3189 were in non-severe group. Using the random-effects model, our meta-analyses showed that the odds of comorbidities, including COPD, DM, HTN, CVD, CKD, and symptoms, including dyspnea, dizziness, anorexia, and cough, were significantly higher among the severe group compared with the non-severe group. There were no significant changes in odds of CVA, liver disease, immunodeficiency/immunosuppression, fever, fatigue, myalgia, headache, diarrhea, sore throat, nasal congestion, sputum, nausea, vomiting, chest pain between the two groups.ConclusionsEarly recognition and intervention can be critical in management, and might stop progression to severe disease. Predictive symptoms and comorbidities can be used as a predictor in patients who are at risk of severe disease.

1287-P: Psychosocial and Racial Predictors of Hemoglobin A1c in Teenagers with Type 1 Diabetes Mellitus

Diabetes ◽  
2020 ◽  
Vol 69 (Supplement 1) ◽  
pp. 1287-P
Author(s):  
ALISSA GUARNERI ◽  
SUNIL K. SINHA ◽  
K. MING HONG ◽  
ROBERT P. HOFFMAN
Keyword(s):  
Diabetes Mellitus ◽  
Type 1 Diabetes ◽  
Type 1 Diabetes Mellitus ◽  
Hemoglobin A1c

Use of hemoglobin A1c as an early predictor of gestational diabetes mellitus

2014 ◽  
Vol 211 (6) ◽  
pp. 641.e1-641.e7 ◽  
Author(s):  
Alex Fong ◽  
Allison E. Serra ◽  
Lauryn Gabby ◽  
Deborah A. Wing ◽  
Kathleen M. Berkowitz
Keyword(s):  
Diabetes Mellitus ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Hemoglobin A1c ◽  
Early Predictor

scholarly journals A Rare Case of Persistent Lactic Acidosis in the ICU: Glycogenic Hepatopathy and Mauriac Syndrome

2016 ◽  
Vol 2016 ◽  
pp. 1-4 ◽  
Author(s):  
Kirsten S. Deemer ◽  
George F. Alvarez
Keyword(s):  
Diabetes Mellitus ◽  
Lactic Acidosis ◽  
Rare Case ◽  
Hemoglobin A1c ◽  
Blood Glucose Control ◽  
Primary Treatment ◽  
High Dose ◽  
Single Feature ◽  
Mauriac Syndrome

Mauriac syndrome is a rare disorder that can present with the single feature of glycogenic hepatopathy in children and adults with poorly controlled diabetes mellitus. An often underrecognized finding of glycogenic hepatopathy is lactic acidosis and hyperlactatemia. Primary treatment of glycogenic hepatopathy is improved long-term blood glucose control. Resolution of symptoms and hepatomegaly will occur with improvement in hemoglobin A1C. We present here a case of a young adult female presenting to the intensive care unit with Mauriac syndrome. This case demonstratesexacerbationof lactic acidosis in a patient with glycogenic hepatopathy treated for diabetic ketoacidosis with high dose insulin and dextrose.

scholarly journals Hemoglobin A1c as screening for gestational diabetes mellitus in Nordic Caucasian women

2016 ◽  
Vol 8 (1) ◽  
Author(s):  
Ingrid Hov Odsæter ◽  
Arne Åsberg ◽  
Eszter Vanky ◽  
Siv Mørkved ◽  
Signe Nilssen Stafne ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Hemoglobin A1c ◽  
Caucasian Women
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