amphotericin-b and Facial-Dermatoses

Mucormycosis and aspergillosis are two opportunistic fungal infections, which can evolve into life-threatening complications. They generally affect patients with relevant risk factors such as immunocompromisation or long-term use of antibiotics or corticosteroids. Treatment usually combines medical and surgical approaches, often including extended necrosectomies, although the prognosis of generalized fungal infections is very poor. In this paper, we present the case of a 17-year-old girl affected by combined aspergillosis and mucormycosis, following treatment of a recurrent glioma. The patient was hospitalized for a suspected cellulitis of the right hemi-face, involving frontal maxillary area and the upper airways and was immediately put on intravenous antibiotic therapies; after performing nasal septum and maxillary biopsies, concomitant mucormycosis and aspergillosis were diagnosed and antimycotic therapy with liposomal B-amphotericin was administered. After evaluation by the oral surgeon and otolaryngologist, surgical cranio-facial necrosectomy was suggested, but refused by the parents of the patient. The girl died only few days later, due to a respiratory arrest. Awareness of this pathology with prompt diagnosis and early treatment may improve the outcome of these infections and reduce the mortality.

Topics: Adolescent; Amphotericin B; Antifungal Agents; Aspergillosis; Brain; Coinfection; Facial Dermatoses; Fatal Outcome; Female; Glioma; Histocytochemistry; Humans; Magnetic Resonance Imaging; Maxilla; Microscopy; Mucormycosis; Recurrence; Stomatitis; Tomography, X-Ray Computed

Topics: Acute Disease; Amphotericin B; Antifungal Agents; Diagnosis, Differential; Facial Dermatoses; Female; Hepatomegaly; Humans; Itraconazole; Lung Diseases, Fungal; Molluscum Contagiosum; Paracoccidioides; Paracoccidioidomycosis; Paraguay; Pleural Effusion; Spores, Fungal; Young Adult

The term mucormycosis encompasses a distinctive group of infections caused by fungi belonging to genera within the taxonomic order Mucorales, usually Rhizopus, Absidia, Mortierella, and Mucor. These fungi are widespread in nature, subsisting on decaying vegetation and diverse organic materials. Although the fungi and spores of Mucorales show minimal intrinsic pathogenicity toward normal persons, they can initiate aggressive and fulminant infections under certain clinical conditions. Ketoacidotic diabetics are predisposed to rhinocerebral mucormycosis, whereas patients with leukemia or lymphoma are susceptible to pulmonary or disseminated infections. These infections, which often result in devastating long-term sequelae for surviving patients, pose difficult diagnostic and therapeutic challenges.

Topics: Amphotericin B; Dermatomycoses; Diabetic Ketoacidosis; Facial Dermatoses; Female; Gastrointestinal Diseases; Humans; Leukemia; Lung Diseases, Fungal; Lymphoma; Male; Mucorales; Mucormycosis

Cutaneous leishmaniasis (CL), a common condition in many parts of the world, is being increasingly encountered in non-endemic countries secondary to immigration. The clinical manifestations and course can vary substantially, with appropriate management ranging from observation for self-healing lesions to urgent treatment to prevent damaging anatomical and cosmetic sequelae. While there are now several effective medications, optimal therapy is not well defined, and decision-making can be challenged by the location of lesions and various drug issues, including availability, mode of delivery and adverse effects. A 7-year-old Afghani boy who presented shortly after arriving in the United States with a rapidly progressing crusting and ulcerative facial rash caused by Leishmania tropica is described. The various drugs currently available for CL and experience of using liposomal amphotericin B specifically are reviewed.

Topics: Amphotericin B; Antiprotozoal Agents; Child; Facial Dermatoses; Humans; Leishmania tropica; Leishmaniasis, Cutaneous; Male; Treatment Outcome; United States

Topics: Amphotericin B; Antifungal Agents; Cavernous Sinus Thrombosis; Cheek; Cranial Nerve Diseases; Dermatomycoses; Facial Dermatoses; Fatal Outcome; Humans; Male; Middle Aged; Mucormycosis

Cryptococcosis is a potentially severe infection that usually occurs in a setting of immunosuppression. Its occurrence outside of this context is rare. We report a case of disseminated cryptococcosis revealed by a spectacular skin disease in an immunocompetent patient.. A 40-year-old male patient had been presenting multiple nodules and tumors on his face for one month in a context of asthenia and intermittent fever. Histological examination of a skin biopsy revealed encapsulated yeasts strongly suggestive of Cryptococcus neoformans. Mycological examination of the skin biopsy and cerebrospinal fluid isolated Cryptococcus gattii. The blood cultures were positive. Brain MRI demonstrated cryptococcal parenchymal involvement. Screening for primary or secondary immunodeficiency was negative. The patient received amphotericin B 1mg/kg/day and fluconazole 600mg/day but died 2months after diagnosis.. Cryptococcosis is a potentially severe infection caused by C. neoformans. This rare condition occurs most commonly in patients with profound deficiency in terms of cellular immunity. Although rare, the occurrence of cryptococcosis in immunocompetent patients is possible, and in this event the signs are highly polymorphic, which usually makes it very difficult to diagnose. The diagnosis of cryptococcosis is based on the identification by direct examination and after staining with India ink of encapsulated yeasts of the Cryptococcus genus. Culture on Sabouraud medium is essential for identification of the species. Treatment for disseminated cryptococcosis involves amphotericin B, often associated with flucytosine IV. In the event of meningitis infection in non-HIV patients, mortality continues to be around 15%, despite adequate medical treatment.. Although rare, cryptococcosis can occur in immunocompetent subjects. The prognosis is severe even after treatment.

Topics: Adult; Amphotericin B; Antifungal Agents; Cryptococcosis; Cryptococcus gattii; Facial Dermatoses; Fatal Outcome; Fluconazole; Fungemia; Humans; Immunocompetence; Male; Meningitis, Cryptococcal

Limited data are available regarding topical and systemic therapies for Leishmania tropica in children.. We sought to characterize the clinical presentation and evaluate the efficacy and safety of topical and systemic treatments in pediatric patients infected with L tropica.. A retrospective study was performed on 47 children with L tropica cutaneous leishmaniasis. Treatments included topical or systemic therapy with liposomal amphotericin B or pentavalent antimony.. Seventy patients with L tropica cutaneous leishmaniasis were treated at our center between 2008 and 2012, of which 47 (67%) were children. The average age of the pediatric population was 8.8 years, and the face was the most common site of involvement (76%). The average number of lesions was 2.6. 24 children (51%) required systemic therapy. The patients were treated with 3 to 5 mg/kg/d of intravenous liposomal amphotericin B, and a response was observed in 83% of the patients within 3 months.. This was a retrospective study.. The disease burden of L tropica in children is high, and because of facial involvement and a low response to topical therapies, systemic therapy is often required. In our experience, liposomal amphotericin B treatment in children is safe and effective and is required for a considerably shorter duration than treatment with pentavalent antimony.

Topics: Administration, Cutaneous; Administration, Intravenous; Adolescent; Amphotericin B; Antimony Sodium Gluconate; Child; Child, Preschool; Cryotherapy; Facial Dermatoses; Female; Humans; Infant; Injections, Intralesional; Leishmania tropica; Leishmaniasis, Cutaneous; Male; Paromomycin; Retrospective Studies; Trypanocidal Agents

Zygomycosis is an invasive disease that affects both immunocompetent and immunocompromised, depending on the type of strain. This disease diagnosis is clinical and histopathological, and its treatment is based on antifungal therapy and surgical cleaning. This paper reports a case of a boy with invasive zygomycosis rinofacial who final treatment was successful after underwent antifungal and surgical therapies.

Topics: Amphotericin B; Antifungal Agents; Child; Dermatomycoses; Facial Dermatoses; Humans; Immunocompetence; Male; Paranasal Sinus Diseases; Tomography, X-Ray Computed; Treatment Outcome; Zygomycosis

American cutaneous leishmaniasis is an important endemic zoonotic disease in the New World that comprises a spectrum of clinical manifestations. Diffuse cutaneous leishmaniasis (DCL) is a rare form of the disease characterized by antigen-specific immunodeficiency that often presents with multiple disfiguring non-ulcerated confluent nodules or plaques that involve large areas of the skin, resembling lepromatous leprosy. Relapse is invariable in advanced stages, despite aggressive chemotherapy, and a plethora of drugs has been tested with unchanging results. We report on a severe an exceptional case that resolved after treatment with amphotericin B, a drug considered only mildly effective, and discuss the therapeutic approach to this disease.

Topics: Adolescent; Amphotericin B; Antiprotozoal Agents; Facial Dermatoses; Humans; Leishmaniasis, Diffuse Cutaneous; Male

Topics: Amphotericin B; Cheek; Cryptococcosis; Cryptococcus neoformans; Facial Dermatoses; Flucytosine; Humans; Kidney Transplantation; Male; Middle Aged; Postoperative Complications

American tegumentary leishmaniasis (ATL) can occur in different forms, classically categorised as cutaneous leishmaniasis, mucosal leishmaniasis, diffuse cutaneous leishmaniasis and disseminated leishmaniasis. We analysed the presence of atypical manifestations (vegetative, verrucous, crusted and lupoid) among a cohort of patients presenting to the Health Post of Corte de Pedra, Bahia, Brazil. Among 1396 patients diagnosed with ATL in 2005-2006, 35 patients (2.5%) presented with atypical manifestations of the disease. Of these patients, 14 were pregnant women, 2 were co-infected with HIV and 19 had no co-morbidity or other apparent risk factors for the development of atypical ATL. The latter 19 patients were the focus of this study. They were predominantly adult males, frequently presenting with facial lesions [P<0.001; odds ratio (OR)=17.5, 95% CI 6.1-52.4] and had higher rates of treatment failure with antimonial therapy (P<0.001; OR=327, 95% CI 45-6668) compared with patients with classic ATL attending in the same period. Thirteen cases healed with amphotericin B, introduced after failure of three or more courses of antimony, suggesting that amphotericin B should be considered as the drug of choice for all patients diagnosed with atypical ATL.

Topics: Adolescent; Adult; Amphotericin B; Animals; Antiprotozoal Agents; Brazil; Facial Dermatoses; Female; Humans; Leishmania braziliensis; Leishmaniasis, Cutaneous; Male; Meglumine; Meglumine Antimoniate; Middle Aged; Organometallic Compounds; Pregnancy; Pregnancy Complications, Parasitic; Prognosis; Risk Assessment; Risk Factors; Treatment Outcome; Young Adult

Topics: Adult; Agricultural Workers' Diseases; Amphotericin B; Antifungal Agents; Blastomyces; Blastomycosis; Brain; Cognition Disorders; Contrast Media; Deoxycholic Acid; Disasters; Drug Combinations; Encephalitis; Facial Dermatoses; Gadolinium; Humans; Itraconazole; Louisiana; Lung Diseases, Fungal; Magnetic Resonance Imaging; Male; Phosphatidylcholines; Phosphatidylglycerols; Skin Ulcer

Topics: Adult; AIDS-Related Opportunistic Infections; Amphotericin B; Antifungal Agents; Cryptococcosis; Diagnosis, Differential; Drug Therapy, Combination; Facial Dermatoses; Female; Flucytosine; HIV Infections; Humans; Pruritus; Radiography

Topics: Adult; Amphotericin B; Antifungal Agents; Brain; Child; Dermatomycoses; Diagnosis, Differential; Facial Dermatoses; Fatal Outcome; Humans; Itraconazole; Magnetic Resonance Imaging; Male; Paranasal Sinuses; Skin; Zygomycosis

We report the case of a patient suffering from subcutaneous phaeohyphomycosis caused by Cladophialophora bantiana. The face of the upper site was involved with small, stellate, pyogranulomatous foci and low inflammation. The patient was treated by topical and systemic corticosteriod and amphotericin B. After 3 months of treatment, the patient showed good response.

Topics: Amphotericin B; Anti-Inflammatory Agents; Antifungal Agents; Cladosporium; Dermatomycoses; Drug Therapy, Combination; Face; Facial Dermatoses; Female; Humans; Middle Aged

A wide spectrum of oral lesions has been associated with human immunodeficiency viral infection (HIV), or AIDS. This report describes the case of an HIV-infected patient who developed a case of disseminated sporotrichosis whose first clinical sign was the presence of orofacial lesions. A histopathological study of this patient's biopsy specimens taken from the oropharyngeal lesions revealed a number of rounded and/or oval free-spore forms of Sporothrix schenkii, the identification of which was corroborated by culturing skin lesion exudate on Sabouraud's glucose agar. To the best of our knowledge to date, this is the first time a case of the oral manifestation of sporotrichosis in association with HIV infection has been described in the dental literature.

Topics: Acquired Immunodeficiency Syndrome; Adult; AIDS-Related Opportunistic Infections; Amphotericin B; Antifungal Agents; Biopsy; Facial Dermatoses; Gingival Hyperplasia; HIV Infections; Humans; Male; Mouth Diseases; Oropharynx; Periodontal Diseases; Pharyngeal Diseases; Sporothrix; Sporotrichosis

Topics: Adult; AIDS-Related Opportunistic Infections; Amphotericin B; Antifungal Agents; Dermatomycoses; Diagnosis, Differential; Facial Dermatoses; Histoplasma; Histoplasmosis; Humans; Itraconazole; Male

We report a case of persistent annular erythema of infancy in a 4-month-old boy. Physical and laboratory parameters showed no sign of internal disease or specific infection except a massive Candida albicans colonization (> 103 organisms/mm3) of the lower gastrointestinal tract. Oral treatment with amphotericin B for 2 weeks resulted in a complete remission of the skin lesions indicating Candida colonization as a trigger.

Topics: Amphotericin B; Anti-Bacterial Agents; Candidiasis; Erythema; Facial Dermatoses; Humans; Infant; Intestinal Diseases; Intestine, Large; Male; Treatment Outcome

Topics: Adult; Amphotericin B; Dermatomycoses; Diabetes Complications; Facial Dermatoses; Female; Humans; Mouth Diseases; Mucormycosis; Nose Diseases; Orbital Diseases; Oroantral Fistula; Osteonecrosis; Paranasal Sinus Diseases

Diagnosis and successful therapy for primary cutaneous zygomycosis (mucormycosis) that complicated the securing of an endotracheal tube with cloth tape. Primary cutaneous mucormycosis is a rare fungal infection noted most often in immunosuppressed individuals. Cloth tape, of the type commonly used to secure endotracheal tubes, often is contaminated with fungal spores. In the case reported here, cloth tape securing the endotracheal tube was the probable vector for transmission of zygomycosis to a moderately imunocompromised host. Rapid diagnosis and combined medical and surgical therapy resulted in a favorable outcome.

Topics: Adult; Amphotericin B; Antifungal Agents; Dermatomycoses; Disease Reservoirs; Equipment Contamination; Facial Dermatoses; Female; Follow-Up Studies; Humans; Immunocompromised Host; Intubation, Intratracheal; Lupus Erythematosus, Systemic; Mucormycosis; Pneumonia, Pneumococcal; Rhizopus; Spores

The skin is frequently a site of extrapulmonary dissemination in patients with coccidioidomycosis. Clinical experience in an endemic area suggests an association between facial cutaneous coccidioidomycosis and meningitis. Awareness of this association is important because coccidioidal meningitis is the most ominous site of spread in coccidioidomycosis. In this study, we assess whether cutaneous dissemination involving the face is associated with meningitis to a greater degree than that limited to the body. We retrospectively reviewed the medical records of 201 patients from 1987 to 1996 with disseminated coccidioidomycosis and found 30 patients with cutaneous involvement. Their mean age was 29.5 +/- 11.6 years; 20 patients were male; 14 were African American, 12 were Hispanic, 3 were white, and 1 was Asian. Nineteen patients had facial involvement, and 11 had isolated body involvement. Meningitis developed in 11 patients, 10 with facial involvement and 1 with only body involvement. Patients with facial lesions were more likely to have meningitis (odds ratio, 11.1; 95% confidence interval, 1.1 to 529, P = .023). The identification of a subgroup of patients at significant risk of developing meningitis may allow earlier detection and perhaps improved management of patients with meningeal disease.

Topics: Adult; Amphotericin B; Antifungal Agents; Coccidioidomycosis; Confidence Intervals; Dermatomycoses; Facial Dermatoses; Female; Fluconazole; Humans; Male; Meningitis, Fungal; Odds Ratio; Retrospective Studies

A 12-year-old girl had been presenting a woody infiltration and erythema in the frontal region and on the entire left half of the face, leading to deformity of the nose and buccal fissure, and adenomegaly in a posterior cervical chain, for the last 18 months. Sinusitis was diagnosed and treated with antibiotics, and submitted to ethmoid sinusotomy, with no improvement. Several laboratory tests were made to find the correct diagnosis. An intradermal test for delayed hypersensitivity showed a positive reaction (5 mm) with necrosis for metabolic antigens for Conidiobolus. An oral mucosa biopsy showed a dense lymphohistiocytic infiltrate and focal points of necrosis. Gomori staining for fungi revealed countless wide, nonseptate hyphae. Amphotericin B was prescribed during 35 days, with no improvement. Terbinafine given orally was started in association with amphotericin B. Reduction of the lesions was observed 2 months later. No side effects were seen during 4 months of treatment.

Topics: Amphotericin B; Antifungal Agents; Antigens, Fungal; Child; Dermatomycoses; Drug Combinations; Entomophthora; Erythema; Ethmoid Sinusitis; Facial Dermatoses; Female; Humans; Lymphatic Diseases; Mouth Diseases; Naphthalenes; Nose Diseases; Terbinafine

The diagnosis of acute lymphatic non-T-non-B leukaemia of common ALL type was confirmed in a 22-year-old woman. Cytostatic treatment brought full remission for 21/2 years. Renewed cytostatic treatment for recurrence brought about a mucormycosis in the mid-face region during a period of protracted agranulocytosis, despite antibiotic prophylaxis with ketoconazole and cotrimoxazole. The causative mucor organism was demonstrated in smears and biopsy material. The infection was successfully treated with i.v. amphotericin B and débridement of the affected tissue. There remained large tissue defects in the region of gum, nose, upper lip and right oral cavity. Previously the mortality rate of mucormycosis in the course of leukaemia was 100%.

Topics: Adult; Agranulocytosis; Amphotericin B; Antineoplastic Combined Chemotherapy Protocols; Debridement; Facial Dermatoses; Female; Gingival Diseases; Humans; Leukemia, Lymphoid; Mouth Diseases; Mucormycosis; Nose Diseases; Palate; Paranasal Sinus Diseases

Topics: Adolescent; Amphotericin B; Blastomycosis; Facial Dermatoses; Fistula; Humans; Male; Maxillary Sinus; Osteomyelitis

A case of mucormycosis in a 82-year old woman is reported. In spite of an early diagnosis, a surgical intervention and the antimycotic treatment with Miconazol-Sodium (Daktar [R]) and Amphothericin B "Squibb" (R) could only prolonge the bad prognosis of this infection. The pathogenesis, the typical, in most cases letal fungal infection and its therapy is discussed.

Topics: Aged; Amphotericin B; Facial Dermatoses; Female; Humans; Imidazoles; Maxillary Sinus; Miconazole; Mucormycosis; Ophthalmoplegia; Radiography

Two clinical cases of paracoccidioidomycosis were described in two children in São Paulo, Brazil. Some clinical peculiarities were pointed out with regard to this mycosis in infancy, i.e., its rarity in children, and the absence of lesions in mucous membranes and lungs, which are so frequent in adults.

Topics: Adolescent; Amphotericin B; Drug Therapy, Combination; Facial Dermatoses; Female; Humans; Paracoccidioidomycosis; Recurrence; Sulfadimethoxine

A verrucose dermatitis of the face, accompanied by onychomycosis was observed in a 30 years old male living in Algeria. He was born there and 15 years previously he had been treated successfully for "Dermatophytic disease" due to Trichophyton verrucosum. A deficiency in his cellular immune mechanism was noted at that time. On this occasion Hendersonula toruloidea was isolated from facial lesions and affected nails. The infection of the face, but not the nails, responded to treatment with amphotericin B. In the facial lesions, the fungus was present as single cell units sometimes with a false bud or a short hyphal extension. Cross walls were occasionally present but the cell walls were not pigmented. Intratesticular inoculation of the isolates to guinea pigs resulted in an infection in which the morphology of the fungus conformed to that found in the facial lesions. In cultures, the isolates of H. toruloidea conformed to the descriptions in literature, although pycnidia were not formed.

Topics: Adult; Amphotericin B; Dermatomycoses; Facial Dermatoses; Humans; Male; Mitosporic Fungi; Onychomycosis

Topics: Adult; Amphotericin B; Biopsy; Cheek; Coccidioidomycosis; Dermatomycoses; Facial Dermatoses; Female; Granuloma; Humans; Nose Diseases; Pregnancy; Pregnancy Complications, Infectious

Topics: Adult; Amphotericin B; Candida; Candida albicans; Candidiasis; Dermatitis; Facial Dermatoses; Female; Fluocinolone Acetonide; Humans; Nystatin

Topics: Amphotericin B; Blastomyces; Blastomycosis; Cytosine; Erythema; Facial Dermatoses; Flour; Humans; Leg Dermatoses; Male; Microscopy, Electron; Middle Aged; Spain; Spores, Fungal

Topics: Amphotericin B; Candidiasis; Child, Preschool; Dermatomycoses; Facial Dermatoses; Female; Humans; Male; Scalp Dermatoses; Stomatitis

Topics: Adult; Amphotericin B; Coccidioidomycosis; Facial Dermatoses; Humans; Male

Topics: Adult; Amphotericin B; Facial Dermatoses; Female; Humans; Male; Middle Aged; Potassium Iodide; Sporotrichosis

Topics: Amphotericin B; Aspergillosis; Aspergillus; Drug Therapy; Facial Dermatoses; Humans

Topics: Adrenal Cortex Hormones; Amphotericin B; Anti-Bacterial Agents; Dermatitis; Facial Dermatoses; Humans; Nasolabial Fold; Skin Diseases; Tetracycline