exudates and Necrosis

Mucormycosis is a rare fungal infection and high mortality that commonly affects patients with the weakened immune system. We present an unusual case of tongue necrosis probably due to the healthcare-associated mucormycosis (HCM) in a diabetic patient. Although cannot be proved with certainty, we surmise that intubation as a risk factor in our case. The diagnosis was confirmed by histopathological examination (HPE) of the necrotic tissue specimen. The patient was responded well to lipid complex amphotericin B (250mg) regime after surgery. Subsequent follow up revealed that no signs of recurrence. Early, recognition, diagnosis, prompt treatment and awareness among clinician are representing the most effective way of managing the disease.

Topics: Amphotericin B; Antifungal Agents; Debridement; Diabetes Complications; Diabetic Ketoacidosis; Female; Humans; Immunocompromised Host; Intubation; Malaysia; Middle Aged; Mucormycosis; Necrosis; Risk Factors; Tongue; Treatment Outcome

Lucio's phenomenon is a rare and aggressive necrotising variant of erythema nodosum leprosum that classically occur in patients with undiagnosed, diffuse non-nodular lepromatous leprosy. It is a potentially fatal leprosy reaction characterised by extensive, bizarrely-shaped, painful purpuric skin lesions and ulcerations. Lucio's phenomenon is very rarely reported outside of Mexico and Costa Rica.. We describe 3 cases seen in Johor, Malaysia.. The first two cases responded to the prompt simultaneous institution of daily rifampicin, dapsone, clofazimine and prednisolone. Case 3 continued to have new lesions and extension of existing lesions while on dapsone and clofazimine. The subsequent addition of rifampicin and prednisolone prevented new lesion formation but patient succumbed to the extensive cutaneous infarcts and consequent sepsis.. Early diagnosis and prompt institution of multi-drug therapy together with prednisolone may improve the prognosis and outcome of Lucio's phenomenon.

Topics: Adult; Erythema Nodosum; Female; Humans; Leprosy, Lepromatous; Malaysia; Male; Middle Aged; Necrosis; Young Adult

An outbreak of food poisoning resulting in 13 deaths in children occurred in Malaysia during the Chinese Festival of the Nine-Emperor Gods in 1988. The offending food was a Chinese noodle called 'Loh See Fun' (LSF). The source was traced to a factory where a banned food preservative was added to make the LSF. The food poisoning was attributable to aflatoxins and boric acid. The clinical features included vomiting, pyrexia, diarrhoea, abdominal pain, anorexia, giddiness, seizures, and eventual coma. Initially, many presented with a Reye-like syndrome. Eleven post-mortem examinations were performed. The pathological findings included extensive coagulative necrosis of the liver with proliferative 'ductal/ductular metaplasia of the hepatocytes'. Giant cell formation, central vein sclerosis, bile stasis, and steatosis were also noted. There was presence of acute tubular necrosis, superficial upper gastrointestinal erosions, and ensuing encephalopathy. The eventual cause of death is acute hepatic and renal failure.

Topics: Aflatoxins; Boric Acids; Child; Child, Preschool; Diagnosis, Differential; Disease Outbreaks; Female; Humans; Kidney; Liver; Malaysia; Male; Metaplasia; Middle Aged; Mycotoxicosis; Necrosis; Reye Syndrome

To report a case of enteritis necroticans acquired in Australia, and to review the history, epidemiology, pathogenesis, clinical features, management and prevention of this disease.. A 44-year-old diabetic and alcoholic restaurateur of Chinese-Malay origin, who had been living in Australia for over 20 years, was admitted to hospital with bloody diarrhoea which progressed to fulminant toxaemia and circulatory collapse, and ultimately required laparotomy. Typical pathological features and the isolation of Clostridium perfringens type C from faeces confirmed the diagnosis of enteritis necroticans.. He was treated initially with ampicillin, gentamicin, metronidazole and chloramphenicol, and later with penicillin and metronidazole, and he required large volumes of intravenously administered fluid and blood for his toxaemic, hypotensive state. Laparotomy was performed as a life-saving procedure. Despite a lengthy convalescence, the patient recovered.. Enteritis necroticans is a rare disease in developed countries, however it is likely to be underdiagnosed. Clinicians are encouraged to be on the alert for signs of severity that may indicate the need for laparotomy in a predisposed individual with features of this condition.

Topics: Adult; Anti-Bacterial Agents; Australia; China; Clostridium Infections; Clostridium perfringens; Drug Therapy, Combination; Enteritis; Feces; Humans; Intestinal Mucosa; Intestine, Small; Malaysia; Male; Necrosis

Topics: Cross-Cultural Comparison; Erythema Nodosum; Humans; Leprosy; Malaysia; Mexico; Necrosis; New Guinea

Topics: Adult; Biopsy; Fungi; Humans; Malaysia; Male; Mycoses; Necrosis; Stomach Diseases