Cultures from the BAL revealed a rapidly growing fungi with broad hyphae 5 to 15 micron diameter that are irregularly branched, and have rare septations. In patients with pneumonia, often lobectomy is needed for cure 5. The most common sites of infection are rhino-orbital-cerebral and pulmonary and typically occur in immunocompromised hosts and diabetics 2.
If infection spreads from the sphenoid sinuses to the adjacent cavernous sinus, it can result in cranial nerve palsies, thrombosis of the sinus, and involvement of the carotid artery 4.
The infection can spread to contiguous structures, such as the mediastinum and heart, or disseminate hematogenously to other organs such as the GI tract, kidney, and brain 5. Rhizopus will have root like rhizoids and are typically located near the sporangiophores.
Typically, the spores are transported by the muco-cilliary escalader to the pharynx, are swallowed, and then are broken down by the GI tract. Survival factors in rhino-orbital-cerebral mucormycosis.
Unlike traditional case studies that are based solely on the medical model with patient history followed by questions leading to the diagnosisthese cases not only correlate results with disease states, but serve as problem-solving and critical-thinking exercises based on real scenarios that occur in typical clinical laboratories.
Mucormycosis of the nose and paranasal sinuses. Infections are treated with a combination of antifungal drugs such as Amphotericin B, and aggressive surgical debridement. Pathophysiology, etiology and epidemiology are naturally reviewed as a case unfolds, and students deal firsthand with interpreting data from two, three or four disciplines, challenging them to integrate laboratory data from different departments and to think critically about what they mean.
Pediatric pulmonology elected not to restart the Bactrim but changed his antibiotic to Augmentin. These features, paired with the morphology of the sporangia are diagnostic for a Zycomycete; further identification was attempted however, rhizoids characteristic of Rhizopus, and branching characteristic of Mucor were not identified in this culture.
Annals of Thoracic Surgery. In immunocompromised patients, the spores can settle in the nasal turbinates and alveoli causing disease 1. Scotch tape prep showing broad hyphae with rare septation and round sporangia.
He has had low grade fevers for the past several days but denies chills, sweats, or hemoptysis. This unique collection of 55 multidisciplinary case studies enables students to better integrate material from all the major clinical laboratory disciplines-Blood Bank, Chemistry, Hematology, Immunology, Microbiology, Urinalysis-by giving them the opportunity to "experience" how departments work together to help the physician make a diagnosis and determine the best course of treatment for the patient.
The Zygomycetes are also known to invade blood vessels making tissue infarction and necrosis one of the hallmarks of the disease 3. When the spores are inhaled into the lung, pneumonia with infarction and necrosis results.
Infection can spread from the ethmoid sinus to the frontal lobe and result in obtundation. Because of this rapid growth, infection with Zygomycetes typically progress quickly and cause periorbital edema, proptosis, and blindness. Current Infectious Disease Reports. Author Lablogatory Posted on.
The patient continued to have chest pain and coughing, so the decision was made to proceed with bronchoscopy Laboratory Identification Image 1. The genera most commonly found in human infections are Rhizopus, Mucor, and Rhizomucor. Current Opinions in Infectious Diseases.
Discussion Zygomycetes Mucormycetes are widely distributed in the environment in soil and vegetation and infection is through inhalation of spores.
Mucor is more likely to have branching and is often identified when all other species are ruled out; they do not produce a rhizoid. Rhizopus organisms have an enzyme called ketone reductase, which allows them to thrive in high glucose, acidic conditions, such as in individuals with diabetic ketoacidosis.
He is using his albuterol nebulizer every 3 hours, and feels as though his asthma may be contributing to his symptoms but is not the main cause as he has not had a wet cough and chest heaviness and pain with previous asthma attacks. In some situations removal of the palate, nasal cartilage, and orbit are necessary for cure.
Facial numbness can occur if there is infarction of sensory branches of the fifth cranial nerve. Otolaryngology Clinics of North America.CASE STUDIES FOR THE LABORATORY PROFESSIONAL Clinical Laboratory Science.
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Case Studies in Clinical Laboratory Science has 7 ratings and 0 reviews. This unique collection of 55 multidisciplinary case studies is designed to help /5(7). Oct 11, · Case Studies in Clinical Laboratory Science Unique in its approach and comprehensive in subject matter, Case Studies in Clinical Laboratory Science is the only text to present case studies from the broad spectrum of disciplines within the clinical laboratory science field/5(7).
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Unlike traditional case studies that are based solely on the medical model (with patient history followed by questions leading to the diagnosis), these cases not only correlate results with disease states, but serve as problem-solving and critical-thinking exercises based on real scenarios that occur in typical clinical laboratories.
Case Studies in Clinical Laboratory Science Unique in its approach and comprehensive in subject matter, Case Studies in Clinical Laboratory Science is the only text to present case studies from the broad spectrum of disciplines within the /5(9).Download