Cerebral zygomycosis.
Fifty-six patients with cerebral zygomycosis (mucormycosis) were seen during the period 1971-2001 in two tertiary care hospitals located in south India with tropical climate and catering to neurological diseases. Forty-four patients had rhinocerebral and twelve patients had isolated central nervous system (CNS) zygomycosis. Of these, ten were culture proven (Rhizopus oryzae in eight and Mucor in two); 30 were diagnosed as probable and 16 were diagnosed possible; mixed infections were seen in three patients. Diabetes mellitus was the predisposing condition in a majority (31/44) of patients with the rhinocerebral form of zygomycosis. The tissue obtained at biopsy/autopsy in either form showed necrotic/infarcted tissue with neutrophilic infiltration with broad non-septate hyphae showing irregular branching. The outcome was poor despite surgical excision and antifungal therapy. The high concentration of spores in a mouldy environment, the bird population and improper disposal of hospital waste may facilitate healthy hosts presenting with primary CNS disease.
Sundaram
C
C
Department of Pathology, Nizam's Institute of Medical Sciences, Punjagutta, Hyderabad, India. challa_sundaram@yahoo.com
Mahadevan
A
A
Laxmi
V
V
Yasha
T C
TC
Santosh
V
V
Murthy
J M K
JM
Purohit
A K
AK
Mohandas
S
S
Shankar
S K
SK
D000293:Adolescent; D000328:Adult; D000368:Aged; D001706:Biopsy; D020314:Central Nervous System Fungal Infections / Q000188:drug therapy / Q000382:microbiology* / Q000473:pathology / Q000601:surgery; D002648:Child; D048909:Diabetes Complications; D005260:Female; D006761:Hospitals; D006801:Humans; D007194:India; D007297:Inpatients; D008297:Male; D008875:Middle Aged; D009089:Mucor / Q000302:isolation & purification; D009091:Mucormycosis / Q000188:drug therapy / Q000473:pathology / Q000601:surgery; D012233:Rhizopus / Q000302:isolation & purification; D016896:Treatment Outcome; D014329:Tropical Climate; D020096:Zygomycosis / Q000188:drug therapy / Q000473:pathology / Q000601:surgery