amphotericin-b and Exophthalmos

Topics: Amphotericin B; Antifungal Agents; Blindness; Brain Diseases; Debridement; Exophthalmos; Eye Diseases; Fatal Outcome; Female; Humans; Magnetic Resonance Imaging; Maxillary Sinusitis; Middle Aged; Mucormycosis; Optic Neuritis

Mucormycosis is an invasive fungal infection usually observed in immunocompromised patients. Mucormycosis is rapidly fatal without an early diagnosis and treatment. We report five patients of rhino-orbital-cerebral mucormycosis and a literature review.. The medical records of five patients presenting with rhino-orbital-cerebral mucormycosis, admitted between January 1995 and December 2007, were analyzed. All patients underwent tissue biopsy. The histologic sections revealed the presence of non-septate hyphae of the order Mucorales.. The five patients, three men and two women, between 27 and 61 years of age, were all diabetic. The main symptoms were exophthalmia (five patients), facial swelling (four patients), periorbital cellulitis (four patients), and cranial nerve palsy (four patients). Anterior rhinoscopy revealed palatine or nasal necrotic lesions in four patients. All presented with diabetic ketoacidosis and CT scan revealed rhino-orbital-cerebral involvement in every patient. All patients were given intravenous amphotericin B. Four patients underwent surgical debridement of necrotic tissue. Two patients survived.. Mucormycosis is usually a fatal infection in diabetic patients. Early diagnosis should be based on imaging data and histology. Amphotericin B must be rapidly initiated and associated with aggressive surgical debridement to reduce mortality.

Topics: Acute Kidney Injury; Adult; Aged; Amphotericin B; Antifungal Agents; Biopsy; Cavernous Sinus Thrombosis; Combined Modality Therapy; Cranial Nerve Diseases; Debridement; Diabetes Complications; Diabetic Ketoacidosis; Disease Susceptibility; Drug Substitution; Encephalitis; Exophthalmos; Female; Humans; Ketoconazole; Male; Middle Aged; Mucorales; Mucormycosis; Orbital Cellulitis; Retrospective Studies; Rhinitis; Sinusitis; Tomography, X-Ray Computed

Fungal orbital infections are rare among children, especially in immunocompetent infants. Two infants presented to us with unilateral proptosis and swelling of the eyelids and periorbital area. Imaging showed an intraorbital mass causing proptosis and bony orbital expansion. There was no sinus, nasal, or intracranial involvement. Systemic evaluation did not reveal any evidence of a compromised immune system. A biopsy from the mass showed the presence of fungal infection. Both infants responded well to medical therapy with intravenous amphotericin B.

Topics: Amphotericin B; Antifungal Agents; Aspergillosis; Edema; Exophthalmos; Eye Infections, Fungal; Eyelid Diseases; Humans; Immunocompetence; Infant; Infusions, Intravenous; Magnetic Resonance Imaging; Male; Mucormycosis; Orbital Diseases; Tomography, X-Ray Computed

Scytalidium dimidiatum is mainly responsible for human skin and nail infections but the mould has also been reported for invasive infections in immunocompromised individuals. We report a young immunocompetent individual diagnosed with invasive non-traumatic Scytalidium dimidiatum infection involving the left orbital cavity and maxillary sinus.

Topics: Amphotericin B; Antifungal Agents; Ascomycota; Diagnosis, Differential; Exophthalmos; Humans; Immunocompetence; Magnetic Resonance Imaging; Male; Mycoses; Sinusitis; Tomography, X-Ray Computed; Young Adult

There has been an increase in the number of primary and secondary fungal infections of the paranasal sinuses in recent years. Aspergillosis and mucormycosis are the most common fungal infections involving the paranasal sinuses. In the past, fungal infections usually occurred in patients with uncontrolled metabolic diseases or compromised defense mechanisms as an acute, rapidly progressing process, often leading to the patient's demise. Primary fungal infections may also be aggressive in otherwise healthy individuals. Physicians should be aware of these microorganisms in order to establish an early diagnosis by biopsy and to institute prompt surgical debridement and medical therapy.

Topics: Adult; Aged; Amphotericin B; Debridement; Exophthalmos; Female; Humans; Male; Middle Aged; Mycoses; Paranasal Sinus Diseases; Paranasal Sinuses; Radiography

In connection with a case report, the mycological diagnosis and treatment of orbital aspergillosis are reviewed. In a 59-year-old male patient an exophthalmus on the right side could be diagnosed as aspergillosis spreading from the corresponding sinus maxillaris into retro- and peri-orbicular regions, after other causes had been excluded by differential diagnosis. In a biopsy specimen from the retrobulbar tumor, a fungal granuloma was found which, histologically and by isolation of the fungus, could be identified as an infection by A. fumigatus. Because of the good visus of the right eye, no exenteratio orbitae but an enoral revision of the sinus maxillaris, ethmoidal bone, and bottom of orbita was performed.--By infusions of amphotericin B and local washings with pimaricin (natamycin) in the sinus maxillaris and the region of the operation, a complete healing of the mycotic process was achieved.--Since 1 1/2 years, the patient has not had a relaps. This success of therapy was possible by exemplary cooperation of otorhinolaryngologists, ophthalmologists, pathologists and microbiologists.--In view of the prophylaxis of such infections, recent contributions to the epidemiology of aspergillosis are discussed.

Topics: Amphotericin B; Aspergillosis; Aspergillus fumigatus; Exophthalmos; Humans; Male; Maxillary Diseases; Middle Aged; Natamycin; Orbit

Topics: Abscess; Amphotericin B; Black or African American; Blastomyces; Blastomycosis; Drainage; Exophthalmos; Eye Diseases; Humans; Louisiana; Lung Diseases, Fungal; Male; Middle Aged; North America; Orbit

Topics: Adrenal Cortex Hormones; Amphotericin B; Biopsy; Blepharoptosis; Blindness; Brain Diseases; Child; Child, Preschool; Conjunctiva; Edema; Exophthalmos; Eye Diseases; Humans; Inflammation; Male; Mucormycosis; Paranasal Sinuses; Penicillins; Sinusitis