[Mucormycosis in the diabetic patient].
BACKGROUND
Mucormycosis is a rare, devastating, fungal infection, which disproportionately affects non-controlled diabetic patients, notably during ketoacidosis. It can be manifested in rhinocerebral, but also pulmonary and disseminated forms.


METHODS
Four consecutive diabetic patients who were admitted to the Farhat Hached Hospital, Sousse, Tunisia, between January 2001 and November 2002, are presented. Three patients exhibited ketoacidosis and one renal failure with hyperosmolarity. Infection was limited to the sinuses in two cases, to lower respiratory tract in one case, and was probably disseminated in one case. Diagnosis was confirmed by mycological and histological findings in all cases. Systemic Amphotericin B was associated with surgical debridement of the lesions in patients with rhinocerebral involvement.


CONCLUSIONS
Despite aggressive therapy, mortality was high (3 out of 4 patients). Mucormycosis remains a severe, frequently fatal disease in diabetic patients.
Chadli-Chaieb
M
M
Service d'endocrinologie et des maladies metaboliques, Centre hospitalo-universitaire Farhat Hached de Sousse, 4000 Sousse, Tunisia. l.chaieb@rns.tn
Bchir
A
A
Fathallah-Mili
A
A
Ach
K
K
Maaroufi
A
A
Garrouche
A
A
Chaieb
L
L
D000293:Adolescent; D000328:Adult; D000368:Aged; D000666:Amphotericin B / Q000627:therapeutic use; D000935:Antifungal Agents / Q000627:therapeutic use; D003646:Debridement; D003922:Diabetes Mellitus, Type 1 / Q000150:complications*; D003924:Diabetes Mellitus, Type 2 / Q000150:complications*; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D009091:Mucormycosis / Q000209:etiology* / Q000473:pathology*
D000935:Antifungal Agents; D000666:Amphotericin B