amphotericin-b and Oral-Ulcer

Topics: Acquired Immunodeficiency Syndrome; Adult; Amphotericin B; Antifungal Agents; Antiretroviral Therapy, Highly Active; Cryptococcosis; Humans; Male; Oral Ulcer; Palate; Scalp; Skin Diseases, Infectious

Mucormycosis represents a group of life-threatening infections caused by fungi of the order mucorales of subphylum mucormycotina (formely known as the class zygomycetes). It is highly invasive and progressive disease resulting in higher rates of morbidity and mortality. Newer therapies have declined the rates of mortality. Early initiation of therapy often before confirmation of the diagnosis is necessary to optimize outcomes. Here, we report a case of mucormycosis with palatal ulcer in a 63-year male patient, which is a rare anatomic site for the occurrence of mucormycosis or is a rare clinical presentation. The patient was successfully treated with surgical debridement and amphotericin B.

Topics: Amphotericin B; Antifungal Agents; Debridement; Humans; Male; Middle Aged; Mucormycosis; Oral Ulcer; Palate; Treatment Outcome

Leishmaniasis affects both the visceral and cutaneous tissues in body. Oral Mucosal involvement in leishmaniasis is rare and is often overlooked. We present a case 17 year old boy from the north east region of Bihar who has a history of visceral leishmaniasis one year back, came to the department of oral surgery for treatment of persistent oral ulcers. Oral examination did not give any diagnostic information while systemic examination revealed enlarged spleen and low grade fever. Patient was screened for leishmaniasis by rK39 based immunochromatographic strip test which came to be positive. Biopsy of the ulcer as well as splenic and bone marrow aspirate confirmed the presence of leishmaniasis. Patient was administered Amphotericin B for 20 days following which significant clinical and haematological improvement followed.

Topics: Adolescent; Amphotericin B; Antiprotozoal Agents; Bone Marrow; Chromatography, Affinity; Fever; Humans; Leishmania donovani; Leishmaniasis, Visceral; Male; Mouth Mucosa; Oral Ulcer; Spleen; Treatment Outcome

The term leishmaniasis comprises a group of diseases caused by different protozoan species of the genus Leishmania. There are three main clinical forms of leishmaniasis: visceral, cutaneous and mucocutaneous. Exclusive involvement of the mucosa is very rare.. To present a case of mucocutaneous leishmaniasis in an elderly patient, discuss the clinical presentation, diagnostic process and treatment emphasizing the distinctions from other granulomatous lesions.. A 71-year-old male presenting with a symptomatic lesion on the hard and soft palate, which had developed over a period of 6 months was evaluated. The oral exam revealed a lesion with multiple ulcerated nodules on the hard and soft palate extending to the oropharynx. The diagnostic hypothesis was chronic infectious disease (paracoccidioidomycose, tuberculosis and leishmaniasis) or squamous cell carcinoma. Histopathological, histochemical and immunohistochemical analysis were performed. A chest x-ray revealed a normal pulmonary pattern. The Montenegro skin test was positive. The definitive diagnosis was leishmaniasis with exclusive oral manifestation and the patient was treated with liposomal amphotericin.. Localized oral mucosa leishmaniasis is an uncommon event in an immunocompetent patient. Dentists play an important role in the diagnosis of oral leishmaniasis, which has systemic repercussions.

Topics: Aged; Amphotericin B; Antiprotozoal Agents; Carcinoma, Squamous Cell; Diagnosis, Differential; Follow-Up Studies; Humans; Immunohistochemistry; Leishmaniasis; Male; Mouth Diseases; Mouth Neoplasms; Oral Ulcer; Palate, Hard; Palate, Soft; Paracoccidioidomycosis; Tuberculosis, Oral

To present a clinical report of palatal zygomycosis, its epidemiological, mycological features, and our treatment experience.. Retrospective report.. This is a 25-year long retrospective trial of clinically and mycologically proven cases of zygomycosis. Some patients underwent a biopsy of the palatal lesion and autopsy. This study reports the treatment experience with amphotericin B alone and in combination with itraconazole and fluconazole.. Twenty-one cases (18.75%) of zygomycosis with palatal involvement were included in the study, from a total of 112 cases screened. Mean age was 36.5 years, with 18 adults and three children. The associated pre-disposing factors were: ketoacidotic diabetes (five type-1 and 15 type-2), and acute leukaemia in one patient. The clinical varieties were as follows: 19 cases of rhinocerebral (RC) involvement and two disseminated cases. Palatal ulcers occurred in 3/21 early cases (14.3%) and in 16/21 cases after the nasal involvement. All patients received amphotericin B; in four patients, it was combined with itraconazole and four with fluconazole. Clinical and mycological cure was achieved in 4/21 patients (19.04%).. Zygomycosis with palatal involvement occurs in around 18% of cases, usually associated with RC modalities; it has an acute and generally lethal course.

Topics: Absidia; Adolescent; Adult; Aged; Amphotericin B; Antifungal Agents; Brain Diseases; Child; Diabetic Ketoacidosis; Drug Combinations; Female; Fluconazole; Humans; Itraconazole; Male; Mouth Diseases; Mucormycosis; Nose Diseases; Opportunistic Infections; Oral Ulcer; Palate; Precursor T-Cell Lymphoblastic Leukemia-Lymphoma; Retrospective Studies; Rhizopus; Treatment Outcome; Zygomycosis

Mucormycosis is caused by fungi of the order Mucorales and is one of the most rapidly fatal fungal infections known to man. Rhinocerebral mucormycosis is the most common type and its extension to the orbit and brain is quite usual. Location of mucormycosis on the palate is a rare and late occurrence. A case of deep hard palate ulcer due to sinonasal mucormycosis in a 79-year-old man is reported. He was successfully treated with a combination of surgical debridement and systemic liposomal amphotericin B administration for six weeks. By presenting this case report we would like to point out that mucormycosis should be included in the differential diagnosis of hard palate ulcers.

Topics: Aged; Amphotericin B; Antifungal Agents; Drug Combinations; Fatal Outcome; Humans; Male; Mucormycosis; Oral Ulcer; Palate, Hard; Phosphatidylcholines; Phosphatidylglycerols