Isolated Cerebral Mucormycosis Caused by <i>Lichtheimia</i> Species in a Polytrauma Patient
Isolated post-traumatic cerebral mucormycosis represents an extremely rare and severe disease. A case of isolated cerebral mucormycosis infection caused by <i>Lichtheimia</i> spp. in a 21-year-old multi-trauma patient is presented. The patient was hospitalized in the intensive care unit...
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MDPI AG
2022-01-01
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| Series: | Diagnostics |
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| Online Access: | https://www.mdpi.com/2075-4418/12/2/358 |
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| author | Vasiliki Mamali Christos Koutserimpas Olympia Zarkotou Georgia Vrioni George Samonis |
| author_facet | Vasiliki Mamali Christos Koutserimpas Olympia Zarkotou Georgia Vrioni George Samonis |
| author_sort | Vasiliki Mamali |
| collection | DOAJ |
| description | Isolated post-traumatic cerebral mucormycosis represents an extremely rare and severe disease. A case of isolated cerebral mucormycosis infection caused by <i>Lichtheimia</i> spp. in a 21-year-old multi-trauma patient is presented. The patient was hospitalized in the intensive care unit and underwent craniotomy due to brain injuries. Two weeks following the initial procedure, pus drained from the surgical wound was microscopically examined and cultured, yielding <i>Lichtheimia</i> spp. Imaging showed parietal, temporal and frontal abscesses at the right side. The patient was commenced on amphotericin B and underwent surgical debridement, while histopathological examination of the affected tissue demonstrated broad, aseptate hyphae, findings typical for mucormycetes. The patient passed away due to heavy traumatic injuries after 2 months. It is speculated that direct inoculation was the portal of entry for infection, and that high steroid use for 2 weeks following inoculation contributed to the severity of infection that developed. Isolated cerebral mucormycosis in immunocompetent hosts is an extremely rare, but severe disease. Diagnosis is established through direct microscopy, histopathology and/or cultures. PCR-based techniques are useful either to detect mucormycetes in tissues, especially when cultures are negative, or to accurately identify the fungi grown in cultures at the species level. A high suspicion index, especially in the necrotic lesions of traumas, is of the utmost importance for early diagnosis. Appropriate surgical debridement, as well as antifungal therapy, including amphotericin B, represents the treatment of choice. |
| first_indexed | 2024-03-09T22:11:27Z |
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| institution | Directory Open Access Journal |
| issn | 2075-4418 |
| language | English |
| last_indexed | 2024-03-09T22:11:27Z |
| publishDate | 2022-01-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Diagnostics |
| spelling | doaj.art-8239c11617e44cc78367bc6a602dcec12023-11-23T19:30:43ZengMDPI AGDiagnostics2075-44182022-01-0112235810.3390/diagnostics12020358Isolated Cerebral Mucormycosis Caused by <i>Lichtheimia</i> Species in a Polytrauma PatientVasiliki Mamali0Christos Koutserimpas1Olympia Zarkotou2Georgia Vrioni3George Samonis4Department of Clinical Microbiology, Tzaneio General Hospital of Piraeus, 185 36 Pireas, GreeceDepartment of Orthopaedics and Traumatology, 251 Hellenic Air Force General Hospital of Athens, 115 25 Athens, GreeceDepartment of Clinical Microbiology, Tzaneio General Hospital of Piraeus, 185 36 Pireas, GreeceDepartment of Microbiology, Medical School, National and Kapodistrian University of Athens, 157 72 Athens, GreeceDepartment of Internal Medicine, University Hospital of Heraklion, 715 00 Heraklion, GreeceIsolated post-traumatic cerebral mucormycosis represents an extremely rare and severe disease. A case of isolated cerebral mucormycosis infection caused by <i>Lichtheimia</i> spp. in a 21-year-old multi-trauma patient is presented. The patient was hospitalized in the intensive care unit and underwent craniotomy due to brain injuries. Two weeks following the initial procedure, pus drained from the surgical wound was microscopically examined and cultured, yielding <i>Lichtheimia</i> spp. Imaging showed parietal, temporal and frontal abscesses at the right side. The patient was commenced on amphotericin B and underwent surgical debridement, while histopathological examination of the affected tissue demonstrated broad, aseptate hyphae, findings typical for mucormycetes. The patient passed away due to heavy traumatic injuries after 2 months. It is speculated that direct inoculation was the portal of entry for infection, and that high steroid use for 2 weeks following inoculation contributed to the severity of infection that developed. Isolated cerebral mucormycosis in immunocompetent hosts is an extremely rare, but severe disease. Diagnosis is established through direct microscopy, histopathology and/or cultures. PCR-based techniques are useful either to detect mucormycetes in tissues, especially when cultures are negative, or to accurately identify the fungi grown in cultures at the species level. A high suspicion index, especially in the necrotic lesions of traumas, is of the utmost importance for early diagnosis. Appropriate surgical debridement, as well as antifungal therapy, including amphotericin B, represents the treatment of choice.https://www.mdpi.com/2075-4418/12/2/358fungal cerebral infectionfungal traumamucormycosisfungal infection<i>Mucorales</i>zygomycosis |
| spellingShingle | Vasiliki Mamali Christos Koutserimpas Olympia Zarkotou Georgia Vrioni George Samonis Isolated Cerebral Mucormycosis Caused by <i>Lichtheimia</i> Species in a Polytrauma Patient Diagnostics fungal cerebral infection fungal trauma mucormycosis fungal infection <i>Mucorales</i> zygomycosis |
| title | Isolated Cerebral Mucormycosis Caused by <i>Lichtheimia</i> Species in a Polytrauma Patient |
| title_full | Isolated Cerebral Mucormycosis Caused by <i>Lichtheimia</i> Species in a Polytrauma Patient |
| title_fullStr | Isolated Cerebral Mucormycosis Caused by <i>Lichtheimia</i> Species in a Polytrauma Patient |
| title_full_unstemmed | Isolated Cerebral Mucormycosis Caused by <i>Lichtheimia</i> Species in a Polytrauma Patient |
| title_short | Isolated Cerebral Mucormycosis Caused by <i>Lichtheimia</i> Species in a Polytrauma Patient |
| title_sort | isolated cerebral mucormycosis caused by i lichtheimia i species in a polytrauma patient |
| topic | fungal cerebral infection fungal trauma mucormycosis fungal infection <i>Mucorales</i> zygomycosis |
| url | https://www.mdpi.com/2075-4418/12/2/358 |
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