Harun Gür1, Onur İsmi2, Yusuf Vayısoğlu2, Kemal Görür2, Rabia Bozdoğan Arpacı3, Elif Şahin Horasan4, Cengiz Özcan2. 1. Department of Otorhinolaryngology, University of Mersin School of Medicine, Çiftlikköy Kampüsü, Çiftlikköy/Yenişehir, Mersin, Turkey. hrngur@hotmail.com. 2. Department of Otorhinolaryngology, University of Mersin School of Medicine, Çiftlikköy Kampüsü, Çiftlikköy/Yenişehir, Mersin, Turkey. 3. Department of Pathology, University of Mersin School of Medicine, Mersin, Turkey. 4. Department of Clinical Microbiology and Infectious Diseases, University of Mersin School of Medicine, Mersin, Turkey.
Abstract
PURPOSE: To investigate the factors affecting disease specific mortality (DSM) in patients with mucormycosis. METHODS: This retrospective study included 24 patients diagnosed with mucormycosis and who had undergone surgical and medical treatment between 2010 and 2020. There were 14 male and 10 female patients whose mean age was 53.70 ± 16.87 years, range 18-83. We reviewed the factors affecting DSM, including the extent of disease (paranasal sinus, palatal, orbital or intracranial involvement) and blood parameters (BP) that are serum glucose level (SGL), white blood cell, neutrophil, lymphocyte counts, C-reactive protein and hemoglobulin levels. Also, the effect of SGL in diabetes mellitus and BP in hematological malignancies on DSM was additionally evaluated. RESULTS: Orbital (p = 0.001) and intracranial (p < 0.01) involvement had statistically significant effect on DSM but not the palatal involvement. When Cox regression analysis was employed to analyze the effect of multiple independent factors on DSM, only the extent of disease (p = 0.023) had statistically significant effect. Receiver operating characteristic analysis of SGL for diabetic patients demonstrated that the area under the curve was 0.917 (p = 0.016). A cut-off SGL of 360 mg/dl revealed an 83.3% sensitivity and 83.3% specificity for mortality outcome for diabetic patients having mucormycosis. CONCLUSION: Orbital or cerebral involvement is related to a poor prognosis, so early endoscopic nasal examination, diagnosis and treatment are of vital importance for DSM in mucormycosis. Serum glucose level over 360 mg/dl in uncontrolled diabetic patients with fever, ophthalmological findings and facial hypoesthesia should necessitate a consultation to an otolaryngologist and an endoscopic careful nasal examination.
PURPOSE: To investigate the factors affecting disease specific mortality (DSM) in patients with mucormycosis. METHODS: This retrospective study included 24 patients diagnosed with mucormycosis and who had undergone surgical and medical treatment between 2010 and 2020. There were 14 male and 10 female patients whose mean age was 53.70 ± 16.87 years, range 18-83. We reviewed the factors affecting DSM, including the extent of disease (paranasal sinus, palatal, orbital or intracranial involvement) and blood parameters (BP) that are serum glucose level (SGL), white blood cell, neutrophil, lymphocyte counts, C-reactive protein and hemoglobulin levels. Also, the effect of SGL in diabetes mellitus and BP in hematological malignancies on DSM was additionally evaluated. RESULTS: Orbital (p = 0.001) and intracranial (p < 0.01) involvement had statistically significant effect on DSM but not the palatal involvement. When Cox regression analysis was employed to analyze the effect of multiple independent factors on DSM, only the extent of disease (p = 0.023) had statistically significant effect. Receiver operating characteristic analysis of SGL for diabetic patients demonstrated that the area under the curve was 0.917 (p = 0.016). A cut-off SGL of 360 mg/dl revealed an 83.3% sensitivity and 83.3% specificity for mortality outcome for diabetic patients having mucormycosis. CONCLUSION: Orbital or cerebral involvement is related to a poor prognosis, so early endoscopic nasal examination, diagnosis and treatment are of vital importance for DSM in mucormycosis. Serum glucose level over 360 mg/dl in uncontrolled diabetic patients with fever, ophthalmological findings and facial hypoesthesia should necessitate a consultation to an otolaryngologist and an endoscopic careful nasal examination.
Authors: Maureen M Roden; Theoklis E Zaoutis; Wendy L Buchanan; Tena A Knudsen; Tatyana A Sarkisova; Robert L Schaufele; Michael Sein; Tin Sein; Christine C Chiou; Jaclyn H Chu; Dimitrios P Kontoyiannis; Thomas J Walsh Journal: Clin Infect Dis Date: 2005-07-29 Impact factor: 9.079
Authors: Oliver A Cornely; Ana Alastruey-Izquierdo; Dorothee Arenz; Sharon C A Chen; Eric Dannaoui; Bruno Hochhegger; Martin Hoenigl; Henrik E Jensen; Katrien Lagrou; Russell E Lewis; Sibylle C Mellinghoff; Mervyn Mer; Zoi D Pana; Danila Seidel; Donald C Sheppard; Roger Wahba; Murat Akova; Alexandre Alanio; Abdullah M S Al-Hatmi; Sevtap Arikan-Akdagli; Hamid Badali; Ronen Ben-Ami; Alexandro Bonifaz; Stéphane Bretagne; Elio Castagnola; Methee Chayakulkeeree; Arnaldo L Colombo; Dora E Corzo-León; Lubos Drgona; Andreas H Groll; Jesus Guinea; Claus-Peter Heussel; Ashraf S Ibrahim; Souha S Kanj; Nikolay Klimko; Michaela Lackner; Frederic Lamoth; Fanny Lanternier; Cornelia Lass-Floerl; Dong-Gun Lee; Thomas Lehrnbecher; Badre E Lmimouni; Mihai Mares; Georg Maschmeyer; Jacques F Meis; Joseph Meletiadis; C Orla Morrissey; Marcio Nucci; Rita Oladele; Livio Pagano; Alessandro Pasqualotto; Atul Patel; Zdenek Racil; Malcolm Richardson; Emmanuel Roilides; Markus Ruhnke; Seyedmojtaba Seyedmousavi; Neeraj Sidharthan; Nina Singh; János Sinko; Anna Skiada; Monica Slavin; Rajeev Soman; Brad Spellberg; William Steinbach; Ban Hock Tan; Andrew J Ullmann; Jörg J Vehreschild; Maria J G T Vehreschild; Thomas J Walsh; P Lewis White; Nathan P Wiederhold; Theoklis Zaoutis; Arunaloke Chakrabarti Journal: Lancet Infect Dis Date: 2019-11-05 Impact factor: 25.071