• Title/Summary/Keyword: Antifungal therapy

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An Atypical Case of Chronic Invasive Fungal Sinusitis with Concurrent Fungal Ball (진균구를 동반한 비정형적 만성 침습형 진균성 부비동염 1예)

  • Jung, Young Do;Kim, Bo Mun;Kang, Byung Jun;Shin, Seung Heon
    • Journal of Clinical Otolaryngology Head and Neck Surgery
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    • v.29 no.2
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    • pp.264-268
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    • 2018
  • Chronic invasive fungal sinusitis (CIFS) is a relatively rare disease which occurs in immunocompetent or immunocompromised patients. We report a case of CIFS in ethmoid sinus with concurrent fungal ball in maxillary sinus. After surgical debridement and antifungal therapy, CIFS recurred with submucosal invasion in nasopharynx and osteomyelitis of clivus. Although CIFS encompasses a slowly progressing invasive fungal disease but potentially aggressive. It should be noted that CIFS could progress and extend through submucosal route without evidence of mucosal lesion.

A Case of Isolated Pulmonary Mucormycosis in an Immunocompetent Host

  • Lee, Jung Su;Kim, Ho Cheol;Park, Sang Woo;So, Hoon Sub;Woo, Chang Yun;Choi, Jong Han;Kim, Sang Hyung;Kim, Se Jin;Oh, Yeon-Mok
    • Tuberculosis and Respiratory Diseases
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    • v.74 no.6
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    • pp.269-273
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    • 2013
  • Mucormycosis is a rare fungal disease that holds a fatal opportunistic fungal infection in diabetes mellitus, hematological malignancy, and immunocompromised host. Isolated pulmonary mucormycosis is extremely rare. Optimal therapy is a combined medical-surgical approach and a management of the patient's underlying disease. Herein, we report a case-study of isolated pulmonary mucormycosis which was being presented as multiple lung nodules in a patient with no underlying risk factors. Considering that the patient had poor pulmonary functions, we treated him with only antifungal agent rather than a combined medical-surgical approach. After treatment with antifungal agent for six months, the nodules of pulmonary mucormycosis were improved with the prominent reductions of size on the computed tomography.

SUGICAL TREATMENT OF MUCOSITIS AND FUNGAL INFECTION IN THE ACUTE LEUKEMIC PATIENTS (급성 백혈병 환자에서 점막 질환과 진균감염의 외과적 처치)

  • Ha, Won-Suk;Ye, Young-Geun;Park, Jae-Hong;Pyo, Sung-Un;Yun, Hyun-Jung;Lee, Sang-Hwa
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.28 no.2
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    • pp.172-177
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    • 2006
  • It is generally known that mucositis which often occur on hematopoietic disease patients, shows local necrosis of oral mucosa when the CBC is below the normal range. But sometimes, the lesions are occasionally infiltrate into adjacent tissue. When the pathologic destructive expansion is occurred, differential diagnosis with fungal infection, one of opportunistic infections, is needed. This means treatment and prognosis can be changed according to the diagnosis. So the diagnostic process is more important in this hematopoietic disease patients. In case of fungal infection, the range of tissue damage can expand broadly, and also proper antifungal agent and surgical extirpation should be done. After operation, continuous antifungal therapy and observations are needed. We made a comparative study of following 2 cases of fungal infection appeared on the acute lymphatic leukemia patients to discuss what the proper surgical treatment and medications are, and when the proper surgical intervention time is.

Review on Studies of Korean Medicine about Tinea Pedis (족부백선의 한의학 논문에 대한 고찰)

  • Park, Sun-Yeong;Seo, Hyung-Sik
    • The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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    • v.29 no.3
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    • pp.42-49
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    • 2016
  • Objectives : The purpose of this study is to analyze research trends on tinea pedis in studies of Korean medicine.Methods : We searched papers using NDSL, KISS, RISS and KTKP(Korean Traditional Knowledge Portal). The first search used the keyword "Tinea pedis" in NDSL, KISS, RISS and KTKP. Used searching duration was not specified.Results : Studies found in NDSL, KISS and RISS were 122 and 118 studies were excluded. Studies found in KTKP were five papers and four studies of them were excluded. Finally five studies were selected and analyzed. Two studies of five selected ones were experimental researches and three studies were clinical researches. Among 2 researches of experimental researches, one of them was about antifungal efficacy of herbal medicines and ethahol extract of the mixture of Sophorae Subprostratae Radix, Aconiti Radix and Hibisci Syriaci Cortex and hot water extract of Phellodendri Cortex were effective. The other was about antifungal effect of the medicinal herb extraction method and vinegar extract was effective. Among 3 researches of clinical researches, there were one clinical study and two case studies. Functional soap containing herbal medicines and bee venom therapy were effective.Conclusions : As we looked for five researches, which were two experimental studies, one clinical study and two case studies. It is possible to treat tinea pedis with korean medical approach by conclusions of 5 researches. We expect that further researches will be proceeded and following results can be actively used as clinical treatments.

Case of seropositive allergic bronchopulmonary aspergillosis in a 10-year-old girl without previously documented asthma

  • Shin, Jeong Eun;Shim, Jae Won;Kim, Deok Soo;Jung, Hae Lim;Park, Moon Soo;Shim, Jung Yeon
    • Clinical and Experimental Pediatrics
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    • v.58 no.5
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    • pp.190-193
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    • 2015
  • Allergic bronchopulmonary aspergillosis (ABPA) is a hypersensitivity lung disease due to bronchial colonization of Aspergillus fumigatus that occurs in susceptible patients with asthma or cystic fibrosis. A 10-year-old girl was referred to the Department of Pediatric Pulmonology for persistent consolidations on chest radiography. Pulmonary consolidations were observed in the right upper and left lower lobes and were not resolved with a 4-week prescription of broad-spectrum antibiotics. The patient had a history of atopic dermatitis and allergic rhinitis but no history of asthma. She had no fever but produced thick and greenish sputum. Her breathing sounds were clear. On laboratory testing, her total blood eosinophil count was $1,412/mm^3$ and total serum IgE level was 2,200 kU/L. Aspergillus was isolated in the sputum culture. The A. fumigatus-specific IgE level was 15.4 kU/L, and the Aspergillus antibody test was also positive. A chest computed tomography scan demonstrated bronchial wall thickening and consolidation without bronchiectasis. An antifungal agent was added but resulted in no improvement of pulmonary consolidations after 3 weeks. Pulmonary function test was normal. Methacholine provocation test was performed, revealing bronchial hyperreactivity ($PC_{20}=5.31mg/mL$). Although the patient had no history of asthma or bronchiectasis, ABPA-seropositivity was suspected. Oral prednisolone (1 mg/kg/day) combined with antifungal therapy was started. Pulmonary consolidations began decreasing after 1 week of treatment and completely resolved after 1 month. This is the first observed and treated case of seropositive ABPA in Korean children without previously documented asthma.

Successful Treatment of Invasive Gastric Mucormycosis in a Kidney Transplant Recipient

  • Kim, Hyung Nam;Han, Sun Ae;Park, Ha Yeol;Kim, Hyun Woo;Hong, Ran;Choi, Nam Gyu;Shin, Min Ho;Yoon, Na Ra;Kim, Hyun Lee;Chung, Jong Hoon;Shin, Byung Chul
    • Korean Journal of Transplantation
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    • v.32 no.4
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    • pp.104-107
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    • 2018
  • Mucormycosis is an extremely rare but potentially life-threatening fungal infection. Gastrointestinal (GI) mucormycosis is very rare and occurs primarily in highly malnourished patients, especially in infants and children. A 55-year-old man with end-stage renal disease due to diabetic nephropathy, who had undergone deceased donor kidney transplantation 2 years prior, complained of abdominal pain and distension with a 3-day duration. Computed tomography revealed diffuse gastric wall thickening, and a huge amount of grey colored necrotic debris surrounded by erythematous erosive mucosa was observed at the antrum to upper body by GI endoscopy. The microscopic examination obtained from a GI endoscopic specimen demonstrated peptic detritus with numerous non-septate mucor hyphae in the mucosa and submucosa. Mucormycosis was diagnosed based on the clinical findings and morphological features. A total gastrectomy was performed and an antifungal agent was administered. A microscopic examination of the surgical specimen demonstrated invasive mucormycosis with numerous fungal hyphae with invasion into the mucosa to subserosa. The patient and graft were treated successfully by total gastrectomy and antifungal therapy.

The Effects of Fluconazole on Chronic Oral Candidiasis Refractory to Nystatin: Case Report (Nystatin에 반응하지 않는 만성 구강 캔디다증 증례에서 Fluconazole의 효과에 관한 보고)

  • Lee, Eun-Jin;Park, Won-Kyu;Kho, Hong-Seop
    • Journal of Oral Medicine and Pain
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    • v.33 no.1
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    • pp.27-33
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    • 2008
  • Candidiasis, an opportunistic infectious condition caused by the genus Candida, is the most common oral fungal infection in humans. The diagnosis of oral candidiasis can often be made based on recognition of its clinical pattern, but at times there is difficulty in making a clinical diagnosis because of its various manifestations. Several antifungal medications have been developed for managing fungal infections. Despite the availability of several effective antimycotics for the treatment of oral candidiasis, failure of therapy is not uncommon due to the unique environment of the oral cavity, where the flushing effect of saliva and the cleaning action of the oral musculature tend to reduce the drug concentration to sub-therapeutic levels. In this case report, we present two patients diagnosed with chronic hyperplastic candidiasis and median rhomboid glossitis, which are known as rare forms of candidiasis. In both cases, there was a significant reduction of clinical signs and symptoms when fluconazole was prescribed after the failure of initial nystatin therapy.

Dyspnea Due to Candidal Septic Pulmonary Embolism Originated from Odontogenic Infection (치성감염에서 유래한 칸디다성 폐색전증으로 인한 호흡곤란)

  • Jeong, Ki-Hyun;Cho, Hyun-Jae;Jang, Kun-Soo;Jeon, Jae-Yun;Shim, Kwang-Sup;Hwang, Kyung-Gyun;Park, Chang-Joo
    • Journal of The Korean Dental Society of Anesthesiology
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    • v.14 no.2
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    • pp.115-117
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    • 2014
  • Septic pulmonary embolism is a rare disease entity that consists of pulmonary infection and embolism predominantly arising from endocarditis and thrombophlebitis. We report a rare case of candidal septic pulmonary embolism secondary to odontogenic infection in a previously healthy and immunocompetent man, who had a submandibular abscess with dyspnea and fever. The patient was not responsive to prolonged broad spectrum antibiotics and surgical drainage, however, antifungal therapy was successful after Candida albicans was confirmed by his blood culture. Since proper identification and the resolution of the septic origin is as important as the diagnosis of septic pulmonary embolism, in a patient with odontogenic infection, who shows definite respiratory complications despite antimicrobial therapy with surgical drainage, various culture examinations should be adopted.

Mucormycosis Management in COVID-19 Era: Is Immediate Surgical Debridement and Reconstruction the Answer?

  • Gupta, Samarth;Goil, Pradeep;Mohammad, Arbab;Escandon, Joseph M.
    • Archives of Plastic Surgery
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    • v.49 no.3
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    • pp.397-404
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    • 2022
  • Background Excessive use of corticosteroids therapy along with gross immunocompromised conditions in the novel coronavirus disease 2019 (COVID-19) pandemic has raised the risks of contracting opportunistic fungal infections. Here, we describe our experience with the implementation of a surgical protocol to treat and reconstruct rhino-orbital-cerebral mucormycosis. Methods A retrospective review of our prospectively maintained database was conducted on consecutive patients diagnosed with mucormycosis undergoing immediate reconstruction utilizing our "Mucormycosis Management Protocol." All patients included in this study underwent reconstruction after recovering from COVID-19. Wide local excision was performed in all cases removing all suspected and edematous tissue. Reconstruction was done primarily after clear margins were achieved on clinical assessment under a cover of injectable liposomal amphotericin B. Results Fourteen patients were included. The average age was 43.6 years and follow-up was 24.3 days. Thirteen patients had been admitted for inpatient care of COVID-19. Steroid therapy was implemented for 2 weeks in 11 patients and for 3 weeks in 3 patients. Eight patients (57.1%) had a maxillectomy and mucosal lining resection with/without skin excision, and six patients (42.8%) underwent maxillectomy and wide tissue excision (maxillectomy and partial zygomatic resection, orbital exenteration, orbital floor resection, nose debridement, or skull base debridement). Anterolateral thigh (ALT) flaps were used to cover defects in all patients. All flaps survived. No major or minor complications occurred. No recurrence of mucormycosis was noted. Conclusion The approach presented in this study indicates that immediate reconstruction is safe and reliable in cases when appropriate tissue resection is accomplished. Further studies are required to verify the external validity of these findings.

TWO CASES REPORT OF MAXILLARY SINUS ASPERGILLOSIS (상악동에 발생한 국균증의 치험2례)

  • Kim, Soo-Min;Yeo, Hwan-Ho;Kim, Young-Kyun;Kim, Su-Gwan;Cho, Jeo-O
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.18 no.4
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    • pp.726-733
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    • 1996
  • Aspergillosis of the maxillary sinus was rare disease, but it was increasing tendency with overuse antibiotics, streoid hormones, and anticanncerous agents. The clinical features and X-ray findings are similar to chronic suppurative paranasal sinusitis. Aspergillosis of the maxillary siuses may occur as a chronic diseae in an otherwise healthy person. This infection is usually confined to a single paranasal sinus, the maxillary antrum, though it can involve the orbit and may initiate with findings of proptosis and decreased vision. The disease is characterized by a wide range of initial symptoms, and should be considered as a possible diagnosis in sinusitis refractory to antibiotics and antral lavage. The choice of treatment of this disease is radical surgery and adjunctive systemic antifungal therapy. We experienced a case of right maxillary sinus aspergillosis in a 34 years old male who has dull pain on Rt. zygoma area, and a case of left maxillary sinus aspergillosis in a 30 years old male who had been suffered from nasal stiffness and frontal headache for 3-4 years. We reported two cases with review of literature.

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