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Article
Rhinocerebral Mucormycosis: A Review of 32 Cases In Mosul

Authors: Abdul Muhsen Younis Saleem --- Ajib Ali Moho --- Muna Muneer --- Emad Khalil
Journal: Medical Journal of Babylon مجلة بابل الطبية ISSN: 1812156X 23126760 Year: 2016 Volume: 13 Issue: 2 Pages: 366 -369
Publisher: Babylon University جامعة بابل

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Abstract

The aim of the present study is to evaluate the effectiveness of oral systemic antifungal (fluconazol) with nasal antifungal wash and aggressive surgical debridement in treatment of rhinocerebral mucormycosis. In a prospective hospital based study, we reviewed the management of 32 patients with rhinocerebral mucormycosis in Mosul general hospital and Al-Rahma Hospital (Mosul_Iraq), over a period of 7 years (Jan 1995 - Dec 2001). Diabetes mellitus was the main underlying cause in our patients and the main causative agent was mucor sp..The mortality rate was 56.2%. In Conclusion management of patients with rhinocerebral mucormycosis by oral antifungal (fluconazol) with nasal antifungal wash by mixture of clotrimazol and 20% sodium bicarbonate solution and aggressive surgical debridement after the control of the underlying disease, seems to be effective.


Article
RHINO-ORBITO-CEREBRAL MUCORMYCOSIS IN BASRAH - IRAQ

Authors: Ahmed M Al-Abbasi --- Ali Abdil-Wahab --- Abdil Razak Al-Jezani --- Sabri Hashim --- et al.
Journal: Basrah Journal of Surgery مجلة البصرة الجراحية ISSN: 16833589 / ONLINE 2409501X Year: 2017 Volume: 23 Issue: 2 Pages: 9-14
Publisher: Basrah University جامعة البصرة

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Abstract

RHINO-ORBITO-CEREBRAL MUCORMYCOSIS IN BASRAH - IRAQAhmed M Al-Abbasi@, Ali Abdil-Wahab#, Abdil Razak Al-Jezani$, Haider Sabri Hashim* & Duraid Ahmed Al-Temimi&.@FICMS, FRCS, Professor of Otolaryngology, Basrah College of Medicine. #CABS, Otolaryngologist, Basrah General Hospital. $FICMS, Neurosurgeon, AlSadir Teaching Hospital. *FICMS, Otolaryngologist, Basrah General Hospital. &CABS, Otolaryngologist, Al Sadir Teaching Hospital, Basrah, IRAQ.Abstract This study was designed to through some light on mucormycosis infection, its stages, risk factors, presenting clinical features and to suggest early diagnostic techniques. A prospective explanatory study was carried out in the period between March 2011 to March 2016 for patients proved to be affected by this disease in Basrah General Hospital and different departments from all teaching hospitals in Basrah. The total studied patients were 32 with male to females ratio 2.2:1. The mostly affected age group was those between 51-60 years (16 patients, 50%). Seventeen patients (53.1%) belonged to stage I, nine (28.1%) to stage II, the remaining 6 patients(18.7%) to stage III. Majority of affected patients were immuno-compromised 27(84.3%). Diabetes mellitus was the main single risk factor (12 patients, 44.4%). The commonest recorded symptom was facial pain and numbness in 27 patients (84.3%), and the most common sign was nasal crustations and eschar in 28 patients(87.5) . This study concluded that surgeons should have an index of suspicion to be aware about this condition among the community, this can help in taking early preventive measures

Keywords

RHINO --- ORBITO --- CEREBRAL --- MUCORMYCOSIS


Article
Facial Nerve Palsy as Frequent Presentation in Patient with Rhinocerebral Mucormycosis

Author: Suha N. Aloosi
Journal: Journal of Oral and Dental Research مجلة طب الفم والاسنان ISSN: 23106417 Year: 2018 Volume: 5 Issue: 1 Pages: 55-69
Publisher: Iraqi Association for Oral Research الجمعية العراقية لبحوث طب الفم

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Abstract

Background Early recognition of rhinocerebral mucormycosis is critical for initiation of treatment. The clinical presentation of the disease shares the same clinical picture with many other diseases, which might lead to misdiagnosis. Features of neural involvement, such as facial nerve palsy, headache and mental state alteration, are important in presentation of mucormycosis; however, they are commonly overlooked.Objectives This study was done to highlight facial nerve palsy as an early feature of Rhinocerebral mucormycosis, which may improve the quality of the clinical recognition and encourage further related investigation and managements steps.Materials and Methods Thirteen patients with variable signs and symptoms of Rhinocerebral Mucormycosis were diagnosed and treated in The Maxillofacial Unit in Sulaimani Teaching Hospital, Kurdistan / Iraq. Their clinical and laboratory data were retrospectively analyzed. Results Neurological features of facial nerve palsy were reported in a signifcant percent of the included patients (61.5%) p=0.001. It was signifcantly associated with misdiagnosis as Cerebro-Vascular Accident (CVA) (P=0.047) and with bad prognosis of the disease (p=0.042). Conclusion Facial nerve weakness is a signifcant sign in presentation of mucormycosis. A signifcant proportion of such patients could be misdiagnosed as CVA patients, with subsequent delay in treatment. Increasing the suspicion index for mucormycosis in diabetic patients presenting withfacial palsy helps in reaching an accurate and early diagnosis.


Article
Rhinocerebral Mucormycosis

Author: Karim Q.AL.Naffi
Journal: Karbala Journal of Medicine مجلة كربلاء الطبية ISSN: 19905483 Year: 2006 Volume: 1 no. 1 Pages: 8-16
Publisher: Kerbala University جامعة كربلاء

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Abstract

Rhinocereberal mucormycosis is a relatively rare opportunistic fungal infection, usuallyaffect patient with DM, renal failure, organ transplant, desferal user&rarely in healthyperson5, 7, 8,9,18. We try to look how frequent this disease is prevalent in the cases admittedto our hospital & what is the outcome of our treatment.MethodA prospective study done in Al-Hussein General Hospital-Karbala/Iraq in the period June2001-Augest 2005, to examine all patients with DM, CRF who have unexplained headache,facial edema, ophthalamoplgia or disturbed conscious for rhinocerebralmucormycosis.Diagnosis based on clinical suspicion , The presence of necrotic tissues innasal cavity, radiological exam including CT- scan whenever available &fungal detectionon of nasal swab &scraping..ResultWe diagnosed ten patients. Eight treated surgically &with amphotricin B (0.5mg/kg/d for sixweeks). Two were treated with amphotricin B&local cleaning only. Seven of those treatedpatients were cured; three died, those who died were presented late with ophthalamoplegiawith or without disturbed conscious.ConclusionRhinocereberal mucormycosis which is relatively rare disease actually is present in ourpatients especially those who have DM with or without renal failure or patient with CRF ondialysis3.13.16. It is a killing disease yet if we carry high index of suspicion in those caseswho is presented with headache, dirty nasal discharge, fever &facial edema. We can diagnosethem earlier &start treatment to control of the underlying condition, with aggressive surgicalinterventions combined with amphotricin B, we may safe many patients life.

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