amphotericin-b and Oroantral-Fistula

Topics: Adolescent; Adult; Amphotericin B; Antifungal Agents; Brain Diseases; Central Nervous System Fungal Infections; Combined Modality Therapy; Debridement; Diabetes Complications; Early Diagnosis; Endoscopy; Fatal Outcome; Female; Humans; Male; Maxillary Sinus; Middle Aged; Mucormycosis; Nose Diseases; Opportunistic Infections; Oroantral Fistula; Paranasal Sinus Diseases; Precursor Cell Lymphoblastic Leukemia-Lymphoma; Pregnancy; Pregnancy Complications, Infectious; Sinusitis; Zygomycosis

Mucormycosis is an opportunistic, fulminating fungal infection of the sino-nasal region. It tends to affect people with immune suppression. The hard palate is a rare site of the disease and few cases have been reported in the literature. This report discusses the nature of hard palate mucormycosis, with the aim of outlining possible explanations and reviewing associated characteristics.. This was a prospective analysis of four cases of hard palate mucormycosis. The patients were referred from the medical department, with uncontrolled diabetes mellitus. An aggressive treatment protocol was used, i.e. an intensive course of antifungal drugs and frequent debridement of dead tissue.. A painful, dusky red swelling was noticed at the early stages of the hemi-palate lesion. It was eventually followed by deep ulceration and even big perforation. Orbit and intracranial extension was the preceding sign in all instances. The progression of the perforation was not controlled by a full course of treatment. There were two deaths during the treatment course.. Mucormycosis of the hard palate is an ominous sign. Although rare, the lesion is progressive in nature and barely controlled by treatment. Clinicians should maintain a high degree of clinical suspicion in the management of patients with palatal ulcer and debilitating illness.

Topics: Adult; Aged; Amphotericin B; Antifungal Agents; Biopsy; Brain Diseases; Debridement; Diabetes Complications; Fatal Outcome; Female; Humans; Male; Middle Aged; Mucorales; Mucormycosis; Orbital Diseases; Oroantral Fistula; Palate, Hard; Paranasal Sinus Diseases; Prospective Studies; Tomography, X-Ray Computed; 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

Opportunistic mycotic infections, such as aspergillosis, can produce morbid consequences with or without aggressive therapy in an immunocompromised patient. Treatment including amphotericin B and resection of the infected tissue must be considered early in the overall management of the patient. We describe two patients with acute myelogenous leukemia who underwent intense cytoreductive therapy with bone marrow transplantation and an associated fungal infection treated with an investigational form of amphotericin B.

Topics: Adult; Amphotericin B; Antineoplastic Combined Chemotherapy Protocols; Aspergillosis; Bone Marrow Transplantation; Female; Humans; Immunocompromised Host; Leukemia, Myeloid, Acute; Male; Oroantral Fistula; Sinusitis; Stomatitis; Tomography, X-Ray Computed